The recent death of an apprentice firefighter in Baltimore, Maryland (Linskey, 2007b) during live fire training has many people asking questions. The preliminary investigation conducted by the Baltimore City Fire Department determined that this training exercise was not conducted in compliance with 1403 Standard on Live Fire Training in Structures (National Fire Protection Association, 2002). But does this answer the question of how this happened or why this young mother died? I would contend that lack of compliance with existing standards provides only a partial answer.
It is unknown exactly when fire service agencies began the practice of live fire training to develop and maintain skill in interior firefighting operations. However, it is likely that firefighter fatalities have occurred during this type of training activity since its inception.
At first glance, the only difference between these two incidents is the month and day of occurrence. However, a major difference between these two tragic events is that the first occurred in 1982 while the second occurred 20 years later in 2002.
This comparison provides a dramatic example of the limited impact that existing live fire training policy has had on the safety of individuals participating in this hazardous, but essential training activity. This observation is not to minimize the important guidance provided by NFPA 1403 (2002), but to point to several limitations in the scope of this standard and examining this critical type of training activity simply from a reactive, rules based approach.
Structure fires present significant hazards to firefighters. These hazards include rapid fire development, toxic products of combustion, potential for structural collapse, and the physiological stress of firefighting itself. The fire service has worked diligently to reduce the risks of firefighting operations through procedural and technological means. However, firefighters and fire officers continue to be significantly at risk of injury or death. This is illustrated by the upward trend in the number of firefighter fatalities during two related activities:
- Firefighting operations inside structures (Fahy, 2002).
- Fire training activities (United States Fire Administration, 2003).
Mitigating these hazards and reducing the risk to firefighters during structural firefighting is a complex undertaking due to the interactive complexity and tight coupling of the structure fire environment and firefighting operations. Any policy change intended to address these two problems involves the question of acceptable risk. Perow (1984) observes that "sensible living with risky systems means keeping the controversies alive, listening to the public, and recognizing the essentially political nature of risk assessment' (P. 306).
A fire in a structure presents complex and dynamic challenges. Firefighters are faced with the need to protect the lives of the building occupants as well as their own while controlling the fire and protecting the uninvolved areas of the structure and its contents. Structure fires develop quickly requiring decision-making and action under extreme time pressure. These conditions require a high level of situational awareness and decision-making skill that is dependent on recognition of complex patterns of information presented by the fire environment (Klein, 1999; Klein, Orasanu, Calderwood, & Zsambok, 1995).
Firefighters learn their craft through a mix of classroom and hands-on training. A majority of skills training is performed out of context (i.e. no smoke or fire) or in a simulated fire environment (i.e. using non-toxic smoke). However, this alone does not prepare firefighters to operate in the heat and smoke encountered in an actual structure fire or develop critical decision-making skills. Developing this type of expertise requires live fire training!
Live fire training presents the same types of hazards encountered during emergency response operations. However, as a planned activity, training requires a higher standard of care to ensure the safety of participants. This is consistent with standard risk management practices in firefighting operations outlined by Chief Alan Brunacini (2002).
- We will risk our lives a lot, in a calculated manner to save savable lives.
- We will risk our lives a little, in a calculated manner to save savable property.
- We will not risk our lives at all for lives or property that are already lost.
This perspective on risk management is commonly accepted throughout the fire service in the United States. Live fire training parallels the second element of the risk management profile: We will risk our lives a little in a calculated manner to develop competence in structural firefighting operations.
Regulations and Standards
Requirements for conducting live fire training vary from state to state. Some states define specific requirements within the context of occupational safety and health regulations that carry the weight of law.
Section 5 of the Occupational Safety and Health Act of 1970 defines the duties of employers and employees with regards to occupational safety and health. This "general duty clause" provides the basis for enforcement action in the absence of specific regulations and places a greater burden on employers to maintain a safe workplace.
Meeting section 5(a)(1) of this clause on the fireground is not feasible in that there are inherent hazards in the fire environment. However, fire departments address the intent of this clause through effective risk management (i.e. guidelines and procedures, personal protective equipment, training). In some OSHA Plan States (where state occupational safety and health agencies promulgate equivalent regulations and have enforcement authority rather than federal OSHA), this clause has been applied specifically to live fire training.
In many cases, these regulations are based on NFPA 1403. In other states there are no specific regulatory requirements for live fire training. In other cases, NFPA 1403 simply defines recommended practice.
The Live Fire Training Standard
Originally developed in 1986, NFPA 1403 established a common framework for acceptable practice for live fire training. This standard has evolved since its inception undergoing four revisions (National Fire Protection Association, 1986, 1992, 1996, 2002, 2007). While compliance with these requirements has undoubtedly prevented or limited the effect of some accidents during live fire training (Colletti & Davis, 2004), the number of injuries and fatalities has continued to increase since its development (United States Fire Administration, 2003).
Detailed review of the latest revision of NFPA 1403 (National Fire Protection Association, 2007) shows little substantive change in areas that potentially impact the most substantive threats to firefighter safety. The 2007 edition of this standard prohibits location of fires in designated exit paths (a reasonable idea) and increases emphasis on the responsibility of the instructor-in-charge, stating: "It shall be the responsibility of the instructor-in-charge to coordinate overall acquired structure (or training structure) fireground activities to ensure correct levels of safety." While this too is a reasonable idea, what exactly is the "correct level of safety" and how is the instructor-in-charge to coordinate this effort?
NFPA 1403 (National Fire Protection Association, 2007) places specific emphasis on addressing unsafe acts and conditions directly connected to accidents that have occurred during live fire training (e.g., removal of low density fiberboard, prohibiting the use of flammable liquids except under specific conditions, prohibiting fires in exit paths and use of live victims). However, it does not explicitly address the primary causal factor influencing traumatic fatalities during live fire training. Most firefighters who die from traumatic injuries during live fire training die as a result of human error, often on the part of the individuals charged with ensuring their safety, the instructors. Reducing the risk of error requires both technical proficiency and competence in leadership, communication, and teamwork (i.e., crew resource management).
Fire service agencies responsible for conducting live fire training establish or clarify policy through development of standard operating guidelines and procedures. Generally these policies are in alignment with the requisite occupational safety and health regulations and national consensus standards. However, agencies are not precluded from establishing additional or more useful requirements.
In addition to the three primary elements of live fire training policy (regulations, standards, and guidelines or procedures), the courts have also weighed in on the responsibility of instructors to ensure the safety of students during this type of training activity. A fire department training officer in Lairdsville, NY was found guilty of criminally negligent homicide due to a fatality during live fire training in an acquired structure (Little, 2002). While this criminal proceeding did not directly establish detailed live fire training policy, this landmark case established precedent for holding instructors criminally accountable for fatalities occurring during live fire training. In addition, this incident generated sufficient political interest that the New York state legislature passed regulations governing live fire training procedure and NFPA 1403 (National Fire Protection Association, 1996) was modified in 2002 to proscribe the use of humans as simulated victims during live fire training
The Missing Link
Some will propose that the solution is to prohibit live fire training or to limit live fire training to purpose built structures. In fact, section A.4.2.1 of NFPA 1403 (Annex A includes non mandatory explanatory material) states "where live fire training structures are available, they should be used instead of acquired structures". Following the death of a Baltimore City apprentice firefighter during live fire training, the national news quoted several fire officers from metropolitan fire departments as stating that they do not conduct live fire training in acquired structures due to the high level of risk involved (Linskey, 2007a). I contend that this perspective ignores the real problem. The hazards presented by structural firefighting (in both an emergency and training context) are given. The degree of risk on the other hand is not. The missing link is the human element. In each live fire training fatality I would ask the same series of questions:
- If the instructors, officers, and firefighters involved knew what was going to happen, would they have taken the same course of action?
- Did anyone recognize the risks involved or developing fire conditions that placed participants' lives at risk? If they did, why didn't they intervene?
The safety of the participants (instructors and learners) is dependent on the competence of the instructor staff and the organizational culture in which the training takes place.
NFPA 1403 (National Fire Protection Association, 2007) addresses qualification of instructors in general terms, specifying that instructors must "be qualified by the authority having jurisdiction to deliver fire fighter training, who has the training and experience to supervise students during live fire training evolutions" (p. 4). More specific competencies are inferred, but not addressed specifically. For example, Sections 4.3.7, 5.3.5, and 6.3.8 of NFPA 1403 require that "The instructor-in-charge shall assess the selected fire room environment for factors that can affect the growth, development, and spread of fire (p. 7, p. 10, p. 13). Appendix A of NFPA 1403 expands on this responsibility pointing to the importance of heat release characteristics of materials used as primary fuels, preheating of combustibles, combustibility of wall and ceiling materials, and room geometry in fire development. However, the section of NFPA 1403 dealing with instructors does not address the competency of instructors in fire behavior and fire dynamics (beyond the minimum required of participants).
Instructors have substantive responsibility for the safety and health of all participants in live fire training activities. Many injuries or fatalities resulting from rapid changes in fire conditions or interior environment result from instructors' inability to anticipate fire development and the impact of tactical operations. In other cases heat stress injuries occur as a result of instructors' lack of understanding of the physiological demands of live fire training (despite the requirements for rehab and information on heat stress provided in NFPA 1403 (National Fire Protection Association, 2007)). In some cases this lack of technical skill is compounded by inappropriate individual or organizational attitudes towards risk and injury. This is exemplified by one fire chief who observed "if a fireman is on the department and doesn't get burned, he isn't doing his job. . . If they don't get burned, I don't want them [on] our department. If they are afraid to get burned, they're on the wrong job" (Walsh, 2006).
By not providing guidance and clarity in the requisite knowledge and experience, NFPA 1403 places the burden of determining instructor qualification on the "agency having jurisdiction". What qualifications should individuals conducting live fire training have? Given the substantive responsibility placed on live fire training instructors they should be highly skilled in crew resource management, fire dynamics, firefighting operations, and the delivery of instruction.
Some states have taken positive steps in this direction, requiring certification of live fire training instructors. It is essential that these programs not simply focus on ensuring that instructors know and have the ability to follow the rules, but that they have a sound knowledge of fire dynamics, physiological demands of live fire training, and are skilled in the essential elements of crew resource management. (leadership, communications, and teamwork).
Fire Service Manual Volume 4, Guidance and Compliance Framework for Compartment Fire Behavior Training (CFBT Steering Group, 2002) addresses the competency requirements for compartment fire behavior training (live fire) instructors in considerable detail. The following general recommendations are based on this document and have been adapted from 3D Firefighting: Training, Techniques, and Tactics (Grimwood, Hartin, McDonough, & Raffel, 2005) should be considered as a framework for instructor qualification.
- Demonstrated commitment to personal safety and the safety of others.
- High level of skill in crew resource management (communications, situational awareness, problem solving, decision making, and teamwork).
- High level of technical skills such as the use of self-contained breathing apparatus (SCBA), hose and appliances, fire apparatus pumps, etc.
- High level of knowledge and expertise in fire behavior, tactical ventilation, and fire control tactics
- Substantial operational experience in structural firefighting
- Qualification as a fire and emergency services instructor
- Experienced in delivery of classroom and/or skills training (depending on the instructional assignment)
- Specific training and qualification in the delivery of live fire training
Training programs leading to certification as a firefighter or fire officer address some of these competencies. However, current standards to not address crew resource management skills and fire dynamics on a substantive basis. Further, instructor training often focuses on developing classroom instructional skills, with little emphasis on hands on instruction, particularly in high hazard topics.
A Call to Action
Neither improved technology nor more restrictive work rules will eliminate firefighter fatalities during live fire training. The common denominator in most, if not all traumatic fatalities during live fire training is human error. The missing link is improved technical and crew resource management competence on the part of all participants, but most of all the instructors, that have responsibility for providing a positive and safe learning environment.
The general requirements outlined in the preceding section provide a basic framework for establishing qualifications for live fire training instructors. Organizations contemplating implementation of or conducting a live fire training program should expand on this basic framework, and define the specific requirements based on the scope and nature of the training to be conducted.
IIt will be important to ensure that subsequent editions of NFPA 1403 include guidance on the qualification of live fire instructors. However, the fire service should not wait, but take immediate steps to mitigate the risks presented by live fire training and provide a realistic and effective context for developing expertise in structural firefighting.
- Develop a comprehensive standard operating guideline (SOG) to ensure compliance with NFPA 1403 and other applicable (state specific) regulations dealing with live fire training.
- Develop a SOG on live fire instructor qualification that addresses training, experience, and demonstration of competency in critical skills.
- Ensure that live fire training that your organization conducts is safe, effective, and conducted in compliance with applicable regulations, standards, and SOGs.
- Expand your training in crew resource management and fire dynamics throughout your department.
- Participate in the NFPA standards development process to ensure that professional qualifications standards (e.g., Firefighter, Fire Officer, and Instructor) and the live fire training standard address key competencies for safe operation on both the fireground and in training.
For a copy of Gresham Fire and Emergency Services Compartment Fire Behavior Training Instructor Qualifications system, please contact the author at email@example.com.
- Brunacini, A. (2002). Fire command (2nd ed.). Quincy, MA: National Fire Protection Association.
- CFBT Steering Group. (2002). Fire service manual volume 4, fire service training, guidance and compliance framework for compartment fire behavior training. Norwich, UK: The stationary office.
- Colletti, D., & Davis, L. (2004). Calculated risk. Fire Chief, 48(4), 48-54.
- Demers Associates. (1982, August). Two die in smoke training drill. Fire Service Today.
- Fahy, R. (2002). U.S. fire service fatalities in structure fires, 1977-2000. Quincy, MA: National Fire Protection Association.
- Grimwood, P., Hartin, E., McDonough, J., & Raffel, S. (2005). 3D firefighting: Training, techniques, and tactics. Stillwater, OK: Fire Protection Publications.
- Klein, G. A. (1999). Sources of power. Cambridge, MA: MIT Press.
- Klein, G. A., Orasanu, J., Calderwood, R., & Zsambok, C., E. (Eds.). (1995). Decision making in action: Models and methods. Norwood, NJ: Ablex.
- Linskey, A. (2007a, February 13). City halts training exercise. Baltimore Sun.
- Linskey, A. (2007b, February 13). Recruit firefighter dies. Baltimore Sun.
- Little, K. (2002). One year later: Lessons learned from Lairdsville. Retrieved June 1, 2004, from http://www.firehouse.com/training/news/2002/0925_Pyear.html
- National Fire Protection Association. (1986). Standard on live fire training. Quincy, MA: Author.
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- National Fire Protection Association. (1996). Standard on live fire training. Quincy, MA: Author.
- National Fire Protection Association. (2002). Standard on live fire training. Quincy, MA: Author.
- National Fire Protection Association. (2007). Standard on live fire training. Quincy, MA: Author.
- National Institute for Occupational Safety and Health. (2003). Death in the line of duty (Report Number F2002-34). Retrieved July 2003, 2003, from http://www.cdc.gov/niosh/pdfs/face200234.pdf
- Occupational safety and health act, 29 USC ?? 654(5) (1970).
- Perrow, C. (1984). Normal accidents: Living with high-risk technologies. New York: Basic Books.
- United States Fire Administration. (2003). Trends and hazards in firefighting training: Special report. Retrieved November 6, 2003, from http://www.usfa.fema.gov/downloads/pdf/publications/tr-100.pdf
- Walsh, B. (2006, February 3). Rookie firefighters burned at training. Gannet County Chronicle Tribune.
Ed Hartin, M.S., EFO, MIFireE, CFO is a Battalion Chief with Gresham Fire and Emergency Services in Gresham, Oregon. Ed has a longstanding interest in fire behavior and has traveled internationally, studying fire behavior and firefighting best practices in Sweden, the UK, and Australia. Along with Paul Grimwood (UK), Shan Raffel and John McDonough (Australia), Ed co-authored 3D Firefighting: Techniques, Tips, and Tactics a text on compartment fire behavior and firefighting operations published by Fire Protection Publications. Ed has delivered compartment fire behavior training (CFBT) and tactical ventilation training in the US, Australia, and Malaysia. Ed has also authored articles in a number of fire service publications in the US and UK, and presented at the British Fire Service College's annual research conference in 2006. The International Association of Fire Chiefs (IAFC) at its 2006 Annual Conference recognized Gresham Fire and Emergency Services compartment fire behavior training (CFBT) program as a finalist for an Award of Excellence. At the same conference, the Commission on Fire Accreditation International awarded Ed Chief Fire Officer (CFO) designation.