Abstract
Sudden cardiac death accounts for approximately 45% of duty-related fatalities among United States firefighters. Strenuous physical exertion is recognized as a trigger of sudden cardiac events. This study describes the duration of strenuous physical exertion on-scene preceding a fatal cardiac event by situation encountered during firefighting duties. Data provided by the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program for duty-related firefighter fatalities over a 9-year period were analyzed. Among the 235 fatalities investigated, 45% had a cause of death that was cardiac in origin. Time (mean ± SD) spent on-scene in strenuous work was 30 ± 26 min, 14 ± 15 min, and 47 ± 52 min for fire, non-fire emergency, and training situations, respectively. Across all emergency operations and training, 31% of fatalities occurred among firefighters who performed ≤10 min of strenuous work, whereas 13% of fatalities occurred among those who performed >60 min. Study findings indicate that there is considerable variability in the duration of strenuous work preceding fatal cardiac events during firefighting duties. Notably, a high percentage of fatal cardiac events occurred after a relatively brief period of strenuous work, suggesting that the performance of any strenuous work, even that of short duration, may be sufficient to provoke a cardiac event in a firefighter with underlying cardiac disease.
Highlights
Since the National Fire Protection Association (NFPA) began tracking on-duty firefighter fatalities more than 30 years ago, sudden cardiac death (SCD) has consistently accounted for the largest share of duty-related firefighter deaths annually, averaging 43% over the last decade [1]
There was no significant association between the nature of fatality or the origin of medical-related death and the decision to investigate by National Institute for Occupational Safety and Health (NIOSH)
This study provides the most complete characterization to date of the work performed by firefighters prior to the onset of a duty-related fatal cardiac event over a 9-year period (January 2008 to February 2017) using data from the NIOSH FFFIPP
Summary
Since the National Fire Protection Association (NFPA) began tracking on-duty firefighter fatalities more than 30 years ago, sudden cardiac death (SCD) has consistently accounted for the largest share of duty-related firefighter deaths annually, averaging 43% over the last decade [1]. This statistic is conspicuously high compared with values of 7% and 11% for duty-related deaths attributable to similar causes for police officers [2] and emergency medical services workers [3], respectively. Research clearly shows that specific firefighting duties, namely fire suppression, alarm response, and training, are associated with an increased risk of death due to cardiac-related causes [9,10,11,12]. The greatest risk of cardiac death occurs during or shortly after fire suppression, when the odds are
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