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 F2012-22, 2013 Jan; :1-13
On June 27, 2011, a 47-year-old male career fire chief ("the Chief") responded to two medical calls. The first occurred approximately 1 hour prior to his shift, while the other occurred at 0833 hours. He assisted at both calls, but neither patient was transported to the hospital. During the remainder of his shift, the Chief performed apparatus inspection and maintenance and station duty. At 1900 hours, the Chief and the emergency medical service (EMS) officer went to the high school gym to lift weights for about an hour. The Chief returned to his home, and at 2208 hours he commented that he did not feel well and then collapsed. Arriving ambulance personnel described the Chief as having seizure-like movements. As they carried him to the ambulance, the seizure stopped, as did the Chief's pulse and breathing. Cardiopulmonary resuscitation (CPR) and advanced life support were begun as the Chief was transported to the local hospital's emergency department (ED) at 2225 hours, arriving 11 minutes later. Inside the ED, cardiac resuscitation efforts continued for more than 45 minutes, but at 2321 hours the Chief was pronounced dead and resuscitation efforts were stopped. The death certificate, completed by the county chief deputy coroner, and the autopsy report, completed by the pathologist, listed "cardiac dysrhythmia due to atherosclerotic coronary artery disease and myocardial bridging of anterior descending coronary artery" as the cause of death. Given the Chief's underlying coronary heart disease, NIOSH investigators concluded that the physical stress of performing physical fitness training may have triggered a cardiac arrhythmia and a possible heart attack resulting in his sudden cardiac death. NIOSH investigators offer the following recommendations to address safety and health issues and prevent similar incidents in the future. 1. Provide preplacement and annual medical evaluations to all fire fighters consistent with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments. 2. Ensure that fire fighters are cleared for 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 physical performance (physical ability) evaluation for all candidates and an annual physical ability evaluation for members.