Firefighter Fatalities Research Articles

Emergency medical service personnel injury and fatality in the United States

Introduction: Emergency Medical Services (EMS) personnel comprise an intricate part of the public safety net in the US. The purpose of this study was to synthesize data sources to understand the major workplace dangers facing EMS providers. Methods: This study examined four data sources: The BLS Census of Fatal Occupational Injuries (CFOI), BLS Survey of Occupational Injuries and Illnesses (SOII), Firefighter Fatalities and Statistics from USFA, and the EMS Voluntary Event Notification Tool (E.V.E.N.T.). Characteristics of the most common causes of injury and fatalities were described and compared. Results: SOII reports covered 13 years and 64,780 nonfatal reported cases. COFI covered 12 years and 149 fatalities. 111 fatalities from the USFA dataset who had been identified as EMS in some manner in their rank between 2003-2016 were inspected. 21 cases where a firefighter died in the course of providing EMS/patient care were also identified and discussed. All events submitted to E.V.E.N.T. were read and categorized. 214 events were identified as near-miss EMS provider injuries and included in the study. Conclusions: The biggest mortal threat to private EMS personnel is vehicular incidents. Among firefighters/EMTs Heart Attacks was the most common nature of death. The biggest nonfatal concerns are violence, slips, trips, and falls, and overexertion in addition to vehicular incidents. Most violent events were the result of a patient with a Temporarily Altered Mental Status. There is clearly a need for further research to develop evidence-based methods and policies to reduce injury and death in EMS personnel from an agency level.

22 Firefighter Fatalities: Crude Mortality Rates and Risk Factors for Line of Duty Injury and Death

22 Firefighter Fatalities: Crude Mortality Rates and Risk Factors for Line of Duty Injury and Death

Wildland firefighter deaths in the United States: A comparison of existing surveillance systems

ABSTRACTWildland fire fighting is a high-risk occupation requiring considerable physical and psychological demands. Multiple agencies publish fatality summaries for wildland firefighters; however, the reported number and types vary. At least five different surveillance systems capture deaths, each with varying case definitions and case inclusion/exclusion criteria. Four are population-level systems and one is case-based. System differences create challenges to accurately characterize fatalities.Data within each of the five surveillance systems were examined to better understand the types of wildland firefighter data collected, to assess each system's utility in characterizing wildland firefighter fatalities, and to determine each system's potential to inform prevention strategies. To describe similarities and differences in how data were recorded and characterized, wildland fire deaths for three of the population-based systems were matched and individual fatalities across systems were compared.Between 2001 and 2012, 247 unique deaths were captured among the systems; 73% of these were captured in all three systems. Most common causes of death in all systems were associated with aviation, vehicles, medical events, and entrapments/burnovers. The data show that, although the three systems often report similar annual summary statistics, events captured in each system vary each year depending on the types of events that the system is designed to track, such as inclusion/exclusion of fatalities associated with the Hometown Heroes Survivor Benefits Act of 2003.The overarching and central goal of each system is to collect accurate and timely information to improve wildland firefighter safety and health. Each system is unique and has varying inclusion and exclusion criteria for capturing and tracking different subsets of wildland firefighter tasks and duties. Use of a common case definition and better descriptions and interpretations of the data and the results would help to more accurately characterize wildland firefighter traumatic injuries and illnesses, lessen the likelihood for misinterpretation of wildland firefighter fatality data, and assist with defining the true occupational injury burden within this high-risk population.

The benefits of data linkage for firefighter injury surveillance

BackgroundWhile survey data are available for national estimates of fire events and firefighter fatalities, data on firefighter injury at the national and local levels remain incomplete and unreliable. Data linkage...

"It Happened in Seconds" Firefighter Burn Prevention Program: Evaluation of a "Train the Trainer" Course.

Each year, there are approximately 100 firefighter fatalities and tens of thousands of injuries in the United States. 'It Happened in Seconds' is a firefighter burn injury awareness program offered to firefighters nationwide. The course focuses on situational awareness, personal protective equipment, and burn injury prevention. In order to create more instructors, a 'Train the Trainer' instructor course was developed to prepare experienced firefighters and healthcare providers from around the United States to teach firefighters in their respective communities. This study evaluates trainees' perception of the instructor course. Three instructor courses were held in a period between November 2013 and January 2015. Trainees were asked to complete both precourse/postcourse assessments and provide demographics. In both surveys, trainees rated their confidence to instruct firefighters about burn prevention and their awareness about firefighter-specific burn issues using a 5-point Likert Scale (1 = none and 5 = high). The postassessment asked if trainees thought the course should be mandatory for all firefighters. Pretest and post-test scores were compared using a Wilcoxon's signed-rank test. A total of 140 experienced firefighters and healthcare professionals completed the Train the Trainer course. The average age was 40 ± 9 years, and 41 were women and 99 men. The average trainee had 13.6 ± 9 years experience in his or her respective job and 11 ± 9 years experience in burn care. Trainees reported a significant increase in their confidence to instruct firefighters about burn prevention (2.9/5 precourse vs. 4.5/5 postcourse, P < .0001) and in their current awareness of firefighter-specific burn issues (3.2 precourse vs. 4.4 postcourse, P < .0001). In the postcourse assessment, 139 of 140 respondents agreed that the 'It Happened in Seconds' course should be mandatory for all firefighters. This study showed that experienced firefighters and healthcare professionals thought that the course significantly improved their awareness level of issues specific to firefighter burn injury as well as their confidence in teaching these concepts to firefighters. Based on this positive evaluation, additional instructors will be trained to provide the course to all firefighters nationwide. Additional research must be conducted to evaluate whether the 'It Happened in Seconds' course results in a decreased rate of firefighter burn injuries.

소방대원 개인보호용 전자장비 패키징 기술개발

While the conventional personal protective equipments (PPEs) covers a variety of devices and garments such as respirators, turnout gear, gloves, blankets and gas masks, several electronic devices such as personal alert safety system (PASS) and heads-up displays in the facepiece have become a part of firefighters personal protective equipments through past several years. Furthermore, more advanced electronic sensors including location traking sensor, thermal imaging caerma, toxic gas detectors, and even physiological monitoring sensors are being integrated into ensemble elements for better protection of firefighters from fire sites. Despite any electronic equipment placed on the firefighter must withstand environmental extremes and continue to properly function under any thermal conditions that firefighters routinely face, there are no specific criteria for these electronics to define functionability of these devices under given thermal conditions. Although manufacturers provide the specifications and performance guidelines for their products, their operation guidelines hardly match the real thermal conditions. Present study overviews firefighter's fatalities and thermal conditions that firefighters and their equipments face. Lastly, thermal packaging methods that we have developed and tested are introduced.

Aviation-Related Wildland Firefighter Fatalities--United States, 2000-2013.

Airplanes and helicopters are integral to the management and suppression of wildfires, often operating in high-risk, low-altitude environments. To update data on aviation-related wildland firefighting fatalities, identify risk factors, and make recommendations for improved safety, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed reports from multiple data sources for the period 2000-2013. Among 298 wildland firefighter fatalities identified during 2000-2013, 78 (26.2%) were aviation-related occupational fatalities that occurred during 41 separate events involving 42 aircraft. Aircraft crashes accounted for 38 events. Pilots, copilots, and flight engineers represented 53 (68%) of the aviation-related fatalities. The leading causes of fatal aircraft crashes were engine, structure, or component failure (24%); pilot loss of control (24%); failure to maintain clearance from terrain, water, or objects (20%); and hazardous weather (15%). To reduce fatalities from aviation-related wildland firefighting activities, stringent safety guidelines need to be followed during all phases of firefighting, including training exercises. Crew resource management techniques, which use all available resources, information, equipment, and personnel to achieve safe and efficient flight operations, can be applied to firefighting operations.

Cardiac Fatalities in Firefighters: An Analysis of the U.S. Fire Administration Database.

Cardiac fatalities are the leading cause of death among all firefighters. Increasing age has been linked to increased cardiac fatalities in firefighters; however, circumstances surrounding in-line-of-duty cardiac firefighter deaths can also increase the risk of a cardiac death. The authors hypothesize that cardiac fatalities among firefighters will be related to the type of duty and level of physical exertion. The authors analyzed the Firefighter Fatalities and Statistics data collected by the U.S. Fire Administration (http://apps.usfa.fema.gov/firefighter-fatalities/fatalityData/statistics) from January 2002 to December 2012. Data were analyzed for associations between age, firefighter classification, duty-type, and cause of fatal cardiac event. A total of 1153 firefighter fatalities occurred during the 10-year period reviewed. Of these, 47% were cardiac fatalities. Mean age was significantly higher in firefighters who suffered a cardiac fatality (52.0 ± 11.4 ± 40.8 ± 14.7 years; P < .05). Volunteer firefighters suffered significantly higher proportion of cardiac fatalities (62%; P < .05) followed by career firefighters (32%). Additionally, cardiac fatalities were the leading cause of death for volunteer firefighters (54%; P < .05). The highest proportion of cardiac fatalities occurred on-the-scene (29%; P < .05) followed by after-duty fatalities (25%). Stress and overexertion accounted for 98% of the cause of cardiac fatalities. Adjusting for rank and firefighter classification, age (odds ratio, 1.06; 95% confidence interval, 1.05-1.08) and stress or overexertion (odds ratio, 11.9; 95% confidence interval, 1.7-83.4) were independent predictors of a firefighter cardiac fatality. Both career and volunteer firefighters are at significantly higher risk of a fatal cardiac event as they age. These fatalities occur in a significant proportion on-the-scene. National efforts should be aimed at these high-risk populations to improve cardiovascular health.

Line of duty firefighter fatalities: an evolving trend over time.

Between 1990 and 2012, 2775 firefighters were killed in the line of duty. Myocardial infarction (MI) was responsible for approximately 40% of these mortalities, followed by mechanical trauma, asphyxiation, and burns. Protective gear, safety awareness, medical care, and the age of the workforce have evolved since 1990, possibly affecting the nature of mortality during this 22-year time period. The purpose of this study is to determine whether the causes of firefighter mortality have changed over time to allow a targeted focus in prevention efforts. The U.S. Fire Administration fatality database was queried for all-cause on-duty mortality between 1990 to 2000 and 2002 to 2012. The year 2001 was excluded due to inability to eliminate the 347 deaths that occurred on September 11. Data collected included age range at the time of fatality (exact age not included in report), type of duty (on-scene fire, responding, training, and returning), incident type (structure fire, motor vehicle crash, etc), and nature of fatality (MI, trauma, asphyxiation, cerebrovascular accident [CVA], and burns). Data were compared between the two time periods with a χ test. Between 1990 and 2000, 1140 firefighters sustained a fatal injury while on duty, and 1174 were killed during 2002 to 2012. MI has increased from 43% to 46.5% of deaths (P = .012) between the 2 decades. CVA has increased from 1.6% to 3.7% of deaths (P = .002). Asphyxiation has decreased from 12.1% to 7.9% (P = .003) and burns have decreased from 7.7% to 3.9% (P = .0004). Electrocution is down from 1.8% to 0.5% (P = .004). Death from trauma was unchanged (27.8 to 29.6%, P = .12). The percentage of fatalities of firefighters over age 40 years has increased from 52% to 65% (P = .0001). Fatality by sex was constant at 3% female. Fatalities during training have increased from 7.3% to 11.2% of deaths (P = .00001). The nature of firefighter mortality has evolved over time. In the current decade, line-of-duty mortality is more likely to occur during training. Mortality from burns, asphyxiation, and electrocution has decreased; but death from MI and CVA has increased, particularly in older firefighters. Outreach and education should be targeted toward vehicle safety, welfare during training, and cardiovascular disease prevention in the firefighter population.

Simulation and thermal imaging of the 2006 Esperanza Wildfire in southern California: application of a coupled weather–wildland fire model

The 2006 Esperanza Fire in Riverside County, California, was simulated with the Coupled Atmosphere–Wildland Fire Environment (CAWFE) model to examine how dynamic interactions of the atmosphere with large-scale fire spread and energy release may affect observed patterns of fire behaviour as mapped using the FireMapper thermal-imaging radiometer. CAWFE simulated the meteorological flow in and near the fire, the fire’s growth as influenced by gusty Santa Ana winds and interactions between the fire and weather through fire-induced winds during the first day of burning. The airflow was characterised by thermally stratified, two-layer flow channelled between the San Bernardino and San Jacinto mountain ranges with transient flow accelerations driving the fire in Cabazon Peak’s lee. The simulation reproduced distinguishing features of the fire including its overall direction and width, rapid spread west-south-westward across canyons, spread up canyons crossing its southern flank, splitting into two heading regions and feathering of the fire line. The simulation correctly depicted the fire’s location at the time of an early-morning incident involving firefighter fatalities. It also depicted periods of deep plume growth, but anomalously described downhill spread of the head of the fire under weak winds that was less rapid than observed. Although capturing the meteorological flow was essential to reproducing the fire’s evolution, fuel factors including fuel load appeared to play a secondary role.

Developing an Aviation Exposure Index to Inform Risk-Based Fire Management Decisions

Wildland firefighting is an inherently dangerous activity, and aviation-related accidents in particular comprise a large share of firefighter fatalities. Due to limited understanding of operational factors that lead to aviation accidents, it is unclear how local decisionmakers, responsible for requesting aviation support, can mitigate the risk of an aviation accident once resources are requested. This research expands the knowledge base regarding the quantification and analysis of aerial firefighting exposure by developing methods to evaluate expected aviation accident rates at the incident level using a metric called the aviation exposure index (AEI). Our analysis is based on coupling historical aviation accident rates (10-year average) with observed aviation resource use. As an example of the applicability of the approach, we present results according to aircraft type, unique incident, and incident jurisdiction for large wildfires that occurred during the 2012 US fire season. Ideally, the AEI could be automatically calculated and incorporated into incident decision support systems to help guide fire managers as they balance the complicated tradeoffs between attaining wildfire management objectives and reducing the exposure of individuals engaged in aerial firefighting activities.

Environmental circumstances surrounding bushfire fatalities in Australia 1901–2011

Abstract This paper describes the development and analysis of a dataset covering bushfire related life loss in Australia over the past 110 years (1901–2011). Over this time period 260 bushfires have been associated with a total of 825 known civilian and firefighter fatalities. This database was developed to provide an evidence base from which an Australian national fire danger rating system can be developed and has benefits in formalising our understanding of community exposure to bushfire. The database includes detail of the spatial, temporal and localised context in which the fatalities occurred. This paper presents the analysis of 674 civilian fatalities. The analysis has focused on characterising the relationship between fatal exposure location, weather conditions (wind speed, temperature, relative humidity and drought indices), proximity to fuel, activities and decision making leading up to the death. The analysis demonstrates that civilian fatalities were dominated by several iconic bushfires that have occurred under very severe weather conditions. The fatalities from Australia's 10 worst bushfire days accounted for 64% of all civilian fatalities. Over 50% of all fatalities occurred on days where the McArthur Forest Fire Danger Index (FFDI) exceeded 100 (the current threshold for declaring a day as ‘catastrophic’) proximal to the fatality. The dominant location category was open air representing 58% of all fatalities followed by 28% in structures, and 8% in vehicles (6% are unknown). For bushfires occurring under weather conditions exceeding an FFDI value of 100, fatalities within structures represented over 60% of all fatalities. These were associated with people dying while attempting to shelter mainly in their place of residence. Of the fatalities that occurred inside a structure in a location that was specifically known, 41% occurred in rooms with reduced visibility to the outside conditions. Over 78% of all fatalities occurred within 30 m of the forest.

Sudden Cardiac Death Among Firefighters ≤45 Years of Age in the United States

Sudden cardiac death (SCD) is the leading cause of death in firefighters. Although on-duty SCD usually occurs in older victims almost exclusively because of coronary heart disease, no studies have examined causation across the career span. In the present retrospective case-control study, cases of SCD in young (aged ≤45 years) firefighters from the National Institute for Occupational Safety and Health fatality investigations (n = 87) were compared with 2 age- and gender-matched control groups: occupationally active firefighters (n = 915) and noncardiac traumatic firefighter fatalities (n = 56). Of the SCD cases, 63% were obese and 67% had a coronary heart disease-related cause of death. The SCD victims had much heavier hearts (522 ± 102 g) than noncardiac fatality controls (400 ± 91 g, p <0.001). Cardiomegaly (heart weight >450 g) was found in 66% of the SCD victims and conveyed a fivefold increase (95% confidence interval [CI] 1.93 to 12.4) in SCD risk. Furthermore, hypertension, including cases with left ventricular hypertrophy, increased SCD risk by 12-fold (95% CI 6.23 to 22.3) after multivariate adjustment. A history of cardiovascular disease and smoking were also independently associated with elevated SCD risk (odds ratio 6.89, 95% CI 2.87 to 16.5; and odds ratio 3.53, 95% CI 1.87 to 6.65, respectively). In conclusion, SCD in young firefighters is primarily related to preventable lifestyle factors. Obesity entry standards, smoking bans, and improved screening and/or wellness program are potential strategies to reduce SCD in younger firefighters.

Surveillance of Traumatic Firefighter Fatalities: An Assessment of Four Systems

Firefighters regularly respond to hazardous situations that put them at risk for fatal occupational injuries. Traumatic occupational fatality surveillance is a foundation for understanding the problem and developing prevention strategies. We assessed four surveillance systems for their utility in characterizing firefighter fatalities and informing prevention measures. We examined three population-based systems (the Bureau of Labor Statistics' Census of Fatal Occupational Injuries and systems maintained by the United States Fire Administration and the National Fire Protection Association) and one case-based system (data collected through the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program). From each system, we selected traumatic fatalities among firefighters for 2003-2006. Then we compared case definitions, methods for case ascertainment, variables collected, and rate calculation methods. Overall magnitude of fatalities differed among systems. The population-based systems were effective in characterizing the circumstances of traumatic firefighter fatalities. The case-based surveillance system was effective in formulating detailed prevention recommendations, which could not be made based on the population-based data alone. Methods for estimating risk were disparate and limited fatality rate comparisons between firefighters and other workers. The systems included in this study contribute toward a greater understanding of firefighter fatalities. Areas of improvement for these systems should continue to be identified as they are used to direct research and prevention efforts.

Acute effects of firefighting on arterial stiffness and blood flow

Sudden cardiac events are responsible for 40-50% of line-of-duty firefighter fatalities, yet the exact cause of these events is unknown. Likely, combinations of thermal, physical, and mental factors impair cardiovascular function and trigger such events. Therefore, the purpose of this study was to examine the impact of firefighting activities on vascular function. Sixty-nine young (28 ± 1 years) male firefighters underwent 3 hours of firefighting activities. Carotid, aortic, and brachial blood pressures (BP), heart rate (HR), augmentation index (AIx), wave reflection timing (TR), aortic pulse wave velocity (PWV), forearm blood flow (FBF), and forearm reactive hyperemia (RH) were measured before and after firefighting activities. Paired samples t-tests revealed significant (p < 0.05) increases in aortic diastolic BP, HR, AIx, PWV, RH, and FBF, and significant decreases in brachial and aortic pulse pressure and TR following firefighting activities. In conclusion, these results suggest that 3 hours of firefighting activities increase both arterial stiffness and vasodilation.

Fatalities Among Volunteer and Career Firefighters—United States, 1994-2004

Approximately 800,000 firefighters in the United States are volunteer firefighters and 300,000 are career firefighters. Volunteer firefighters primarily serve communities with fewer than 25,000 inhabitants, whereas most career firefighters serve communities of more than 25,000 persons. To characterize fatalities among volunteer and career firefighters, CDC analyzed data from the U.S. Fire Administration (USFA). This report summarizes the results of that analysis and, to illustrate the most common types of volunteer and career firefighter fatalities, describes two cases investigated by the National Institute for Occupational Safety and Health (NIOSH) Firefighter Fatality Investigation and Prevention Program. Fifty-three percent (610 of 1,141) of U.S. firefighters who died while on duty during 1994-2004 were volunteers, and 32% (368) were career firefighters. The remaining 15% (163) of deaths were among other firefighters (e.g., wildland, paid on-call, and part-time paid firefighters). Among volunteer firefighters, sudden cardiac death (e.g., from myocardial infarction or arrhythmia) and motor vehicle (MV) crashes during emergency response were the leading causes of fatality. Among career firefighters, sudden cardiac death and asphyxiation were leading causes of death. Adoption and enforcement of existing fire-service recommendations regarding fitness standards, mandatory medical evaluations with appropriate work restrictions, and emergency vehicle response protocols are needed to prevent these fatalities among firefighters.

Fire fighter fatalities 1998–2001: overview with an emphasis on structure related traumatic fatalities

Objective: To review the causes of all fire fighter line-of-duty-deaths from 1998 through 2001, and present recommendations for preventing fatalities within the specific subgroup of structure related events. Methods: Fire...

Fire truck crashes with apparatus driver fatalities: Fatality Analysis Report System (FARS): 1991-2000

This analysis reports crashes in which firefighters were killed on fire apparatus. The National Highway Traffic Safety Administration’s (NHTSA) Fatality Analysis Reporting System (FARS) from 1991 through 2000 included 33 incidents with 38 firefighter fatalities, including 23 apparatus drivers. Crashes increased steadily from two in 1991 to six in 2000. The average age of the victims was 37.7 years and the average of the drivers was 38.3. Alcohol was a possible factor in two incidents. The most commonly cited driver-related factors are “failure to keep in proper lane or running off road” and “driving too fast for conditions or in excess of posted speed limit.” Of 33 total incidents, 25 involved rollover. In 19 crashes involving rollover in which the apparatus drivers were killed, 12 drivers were either totally or partially ejected from the vehicle. Eleven were not wearing restraints. Twelve of the drivers were killed while using lights and sirens. Most fatalities took place on dry roads, in fair weather, during daylight hours. Twenty-one of 23 incidents occurred on rural roads. In 11 of the incidents, the driver was the sole vehicle occupant. Drivers should wear seat belts and adjust for vehicle limitations and hazardous conditions. Semiannual refresher driver training is recommended.

The application of interactive multimedia CD-ROM technology to wildland fire safety training

Interactive multimedia technology has been utilized in the development of a CD-ROM based wildland fire safety training course, Wildland Fire – Safety on the Fireline. Interactive multimedia technology allows delivery of training to a large number of students on a consistent basis. In addition, cost savings can be achieved through reduced learning time, reduced travel, minimal use of instructors, and most of all, through retention of knowledge as a result of using multimedia. The course, Wildland Fire – Safety on the Fireline, was developed and reviewed by a national team of specialists in wildland fire behavior and wildland fire safety with the intent of reducing and/or eliminating injuries and fatalities associated with the suppression of wildland fires. Wildland Fire – Safety on the Fireline focuses on due diligence, situational awareness, entrapment survival, health, equipment, and hazards encountered when working on the fireline. Each of the four sections comprising the course is followed by a board game test in preparation for a final test that is tracked by the computer. Key words: Canada, computer applications, fire behavior, fire entrapment avoidance, firefighter fatalities, firefighter physiology, fire suppression, fire survival, personal protective equipment, risk management, safe work practices, situational awareness, wildfire case studies, wildland firefighting, wildland-urban interface.