On Jan. 17, 2010, a 51-year-old male volunteer major responded to a reported residential fire at 1:30 P.M. The major, on call for the weekend, responded from his home to the scene. Units arrived on the scene at 1:37 and determined the “smoke” was actually steam from a shower. Units were released from the scene at 1:40. Three hours after returning home, the major went to exercise at a local fitness facility with his trainer. After walking on a treadmill for approximately 25 minutes, the major had a short cool-down period when he suddenly collapsed. Cardiopulmonary resuscitation (CPR) and advanced life support were begun as an ambulance was requested. Despite CPR and advanced life support by the fitness center staff, fire department (FD) emergency medical technicians, ambulance paramedics, and hospital’s emergency department (ED) staff, the major died. The death certificate, completed by the attending physician, listed “ischemic heart disease with cardiac arrest” due to “coronary artery disease” as the cause of death. The autopsy, completed by the county coroner, listed “ischemic heart disease” as the cause of death. Given the major’s severe underlying coronary artery disease, NIOSH investigators concluded that the physical exertion involved in performing physical fitness training triggered his sudden cardiac death.
The major was 6-foot-2 and weighed 253 pounds, giving him a body mass index (BMI) of 32.5. A BMI greater than 30 is considered obese. The major’s risk factors for coronary artery disease included hypercholesterolemia (high blood cholesterol) and obesity/lack of exercise. He had not been prescribed any lipid-lowering medications and had begun a self-initiated exercise program in January 2010.
NIOSH investigators offer the following recommendations to address general safety and health issues. It is unclear whether these recommendations would have prevented the major’s death:
- Perform an annual physical performance (physical ability) evaluation
- Phase in a comprehensive wellness and fitness program for firefighters
For the complete report, see http://www.cdc.gov/niosh/fire/reports/face201008.html.