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 F2011-11, 2011 Sep; :1-13
On October 23, 2010, a 37-year-old male career fire fighter (FF) was working a 24-hour shift as the driver/operator of the tanker. During the shift he responded to two emergency calls. At the first call, a dwelling fire, the FF participated in interior structural fire fighting. At the second fire, a mutual aid call, the FF provided water supply. During the remainder of the shift, the FF performed about 2 hours of physical fitness training. That evening, he was having trouble falling asleep and remained in the day room where he sent a text message to a friend at midnight. The next morning crew members found the FF deceased and notified the coroner. The death certificate listed "sudden cardiac death probably exasperated (sic) or induced by overexertion fighting two structure fires while on duty" as the cause of death. The autopsy listed "cardiac arrhythmia secondary to dilated hypertrophic cardiomyopathy and severe arteriosclerotic cardiovascular disease" as the cause of death. Given the FF's underlying dilated hypertrophic cardiomyopathy, NIOSH investigators concluded that the physical stress of fire suppression activities and physical fitness training triggered a fatal heart arrhythmia. NIOSH investigators offer the following recommendations to address general safety and health issues. It is unclear, however, whether these recommendations could have prevented the FF's death. NIOSH investigators offer the following recommendations to address general safety and health issues. It is unlikely, however, that any of these recommendations would have prevented the Trainee's death. 1. Provide preplacement and annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Ensure that fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of NFPA 1582. 3. Phase in a mandatory comprehensive wellness and fitness program for fire fighters. 4. Perform a candidate and an annual physical performance (physical ability) evaluation for all members. 5. Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the Fire Department's medical evaluation program.