Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, FACE F2010-26, 2010 Oct; :1-12
On January 26, 2010, a 52-year-old male volunteer lieutenant (LT) responded to a residential fire. At the scene, the LT, wearing street clothes, assisted in stretching two 1¾-inch hose lines, carried a positive pressure ventilation (PPV) fan to the porch, and started the fan. After replenishing the fan's fuel supply, the LT collapsed. Cardiopulmonary resuscitation (CPR) was begun. The ambulance, already en route to the structure fire, arrived 6 minutes later, and advanced life support was begun. Despite CPR and advanced life support on scene, during transport, and in the hospital's emergency department (ED), the LT died. The death certificate and the autopsy listed "arteriosclerotic cardiovascular disease" as the cause of death. Given the LT's severe underlying heart disease, NIOSH investigators concluded that the physical exertion involved in responding to the call, stretching the fire hoses, and carrying and starting the PPV fan triggered his sudden cardiac death. NIOSH investigators offer the following recommendations to address general safety and health issues. These recommended programs would have restricted the LT from participating in physically demanding emergency response activities. 1. Provide preplacement and annual medical evaluations to all fire fighters. 2. Ensure fire fighters are cleared for emergency response activities by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of National Fire Protection Association (NFPA) 1582. 3. Phase in a comprehensive wellness and fitness program for fire fighters. 4. Perform a preplacement and an annual physical performance (physical ability) evaluation. 5. Provide fire fighters with medical clearance to wear self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program. 6. Conduct annual respirator fit testing.