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...


To access the remainder of this piece of premium content, you must be registered with Firehouse. Already have an account? Login

Register in seconds by connecting with your preferred Social Network.

OR

Complete the registration form.

Required
Required
Required
Required
Required
Required
Required
Required
Required
Required

We should consider eliminating the interior-qualified duty status of any firefighter with a history of coronary artery bypass graft surgery or percutaneous coronary artery angioplasty. There is a significant opportunity going forward to reduce these line-of-duty deaths if we all adopt this policy. We should not be so shortsighted as to overlook the medical history of firefighters who are at the highest risk of dying from heart attacks.

This is based upon the statistical fact that these individuals are the predominant victims of cardiovascular line-of-duty deaths. Interestingly, it is not the firefighters with a history of myocardial infarction or heart attack who are at the highest risk. It may be that they are already excluded from being interior-qualified firefighters either because they themselves realize that their history of heart attack warrants changing their duty status or that the medical screening process has determined they should be excluded.

This principle would not dramatically change the process of medically qualifying firefighters for duty. It would be a uniform policy that undergoing cardiac procedures precludes one from returning to interior-qualified duty status. We should not leave this to individual discretion where one's personal physician advocates for a return to interior firefighting. Most physicians do not understand the incredible physical burden imposed upon a firefighter.

In our columns, we say emphatically that every firefighter performing interior firefighting duties should receive a comprehensive medical examination by a qualified physician every year. This examination should include lab work; if the firefighter is a male over the age of 40, it should also include a PSA. Just adding blood work to the screening process every year is a tremendous value-added benefit.

Although National Fire Protection (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, mandates medical examination for the fire service, there is a wide disparity of implementation throughout the country. Furthermore, when we review the 2009 fatalities, we see a spike in the number of heart attacks and strokes involving firefighters ages 41 to 45. This should make us aware of the need to do focused medical examinations that quantify the number of cardiac risk factors of firefighters who are still in their 30s.

DR. RAYMOND BASRI, MD, FACP, is in the private practices of internal medicine and diagnostic cardiology in Middletown, NY. Dr. Basri is a Diplomate of the American Board of Internal Medicine and president of the Mid-Hudson Section. He received the 2008 Laureate Award of the American College of Physicians, of which he is a Fellow. Dr. Basri also is clinical assistant professor of medicine at New York Medical College, attending physician in the Department of Internal Medicine at Orange Regional Medical Center and on the consulting staff in cardiology at The Valley Hospital in Ridgewood, NJ. He is a member of the Excelsior Hook and Ladder Company in Middletown and a deputy fire coordinator for Orange County. Dr. Basri is the senior physician of the Disaster Medical Assistance Team (DMAT NY-4). He is a senior aviation medical examiner for the Federal Aviation Administration (FAA) and chief physician for Health & Safety Specialists in Medicine, which does onsite medical examinations for the fire service and consultant to FirePhysicals.com.

ERIC BERGMAN, PA-C, is a physician assistant practicing internal medicine at Hartford Hospital in Hartford, CT. He earned a bachelor of science degree in allied health from the University of Connecticut and a master's degree from Albany Medical College. He is a member of the Killingworth, CT, Volunteer Fire Company; a past company officer and life member of the Avon, CT, Volunteer Fire Department; and a past member of the Shaker Road-Loudonville Fire Department in Colonie, NY.

CAUSES OF FIREFIGHTER FATALITIES, 2009

Stress/overextertion

50

Source: U.S. Fire Adimistration

Vehicle collision

16

Fall

6

Caught/trapped

3

Struck by

3

Collapse

2

Lost

2

Contact with

1

Other

7