Three Simple Ideas to a Healthier Fire Service

  The U.S. Fire Administration (USFA) recently published its yearly analysis, Firefighter Fatalities in the United States in 2009 (http://www.usfa.dhs.gov/downloads/pdf/publications/ff_fat09.pdf). There is a section on firefighter line-of-duty...


  The U.S. Fire Administration (USFA) recently published its yearly analysis, Firefighter Fatalities in the United States in 2009 ( http://www.usfa.dhs.gov/downloads/pdf/publications/ff_fat09.pdf ). There is a section on firefighter line-of-duty deaths due to stress and overexertion. The...


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The U.S. Fire Administration (USFA) recently published its yearly analysis, Firefighter Fatalities in the United States in 2009 (http://www.usfa.dhs.gov/downloads/pdf/publications/ff_fat09.pdf). There is a section on firefighter line-of-duty deaths due to stress and overexertion. The year 2009 was particularly bad in terms of lost firefighters, with 56% of all fatalities coming under the category of stress and overexertion.

Here is what the report said: "Firefighting is extremely strenuous physical work and is likely one of the most physically demanding activities that the human body performs. Stress or overexertion is a general category that includes all firefighter deaths that are cardiac or cerebrovascular in nature such as heart attacks, strokes and other events such as extreme climatic thermal exposure. Classification of a firefighter fatality in this cause of fatal injury category does not necessarily indicate that a firefighter was in poor physical condition."

Fifty firefighters died in 2009 as a result of stress/overexertion:

  • Thirty-nine firefighters died due to a heart attack
  • Eight firefighters died due to strokes
  • One firefighter died of heat exhaustion
  • One firefighter died from a pulmonary embolism
  • One firefighter died from damage to a heart valve, an acute event caused by the extreme physical exertion (see page 110).

We believe that there are three essential principles that must be embraced in order to raise the bar for firefighter health and wellness. We use the word principles because we recognize that it is the responsibility of our leadership to move all of us forward. They are entrusted to better the health and wellness of all firefighters. There is no more important task than saving the life of a firefighter who may be injured or fall victim to a preventable illness:

Principle 1. Firefighters with a history of coronary artery bypass grafting or percutaneous coronary artery angioplasty, or cardiac stents, should not be classified as interior-qualified Class A firefighters.

Principle 2. Firefighters with morbid obesity should not be classified as interior-qualified Class A firefighters if their body mass index is more than 40.

Principle 3. Firefighters should wear their self-contained breathing apparatus (SCBA) during overhaul because of an extreme risk of inhaling ultra-fine particles that can cause cancer, respiratory illness and heart disease.

This month's column focuses on the first principle (the second and third principles will be addressed in upcoming columns). We have learned a lot when we look at the rate of heart attacks in the fire service over the past 20 years. When we look at individual cases and review National Institute for Occupational Safety and Health (NIOSH) firefighter fatality reports, we clearly see a pattern.

Research has shown that approximately half of the cardiovascular deaths are heart attacks in firefighters who have had coronary artery bypass graft surgery or percutaneous coronary artery angioplasty, or cardiac stents. Bypass surgery is a complicated procedure that involves opening the chest and re-establishing blood flow across blocked arteries of the heart using arteries and veins from other parts of the body. Angioplasty is a procedure in which a catheter or wire is placed in an artery of the heart in order to open a critical blockage and re-establish blood flow. Cardiac stents are small sleeves inserted into the artery as part of the angioplasty procedure to keep open the blood vessel.

On Dec. 15, 2003, President George W. Bush signed into law the Hometown Heroes Survivors Benefit Act of 2003. The law presumes that a heart attack or stroke is in the line of duty if the firefighter was engaged in non-routine stressful or strenuous physical activity while on duty and the firefighter becomes ill on duty or within 24 hours after engaging in such activity.

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