Firefighter Fatalities

July 1, 1996
J. Gordon Routley, Reade Bush and Jeffrey Stern recommend measures that help prevent line-of-duty deaths.
Over the past two decades, we have made tremendous progress in improving firefighter safety which has resulted in a downward trend in the number of firefighter line-of-duty deaths. The total number of deaths has been reduced from about 150 annually in the 1970s to around 120 in the 1980s to around 100 in the 1990s. This clearly shows that the efforts that have been directed toward safety have been successful, up to a point. We have almost eliminated falls from fire apparatus as a cause of death, by adopting fully enclosed apparatus and learning how to fasten our seatbelts. Where do we go from here to further reduce the loss of lives?
Photo by James M. Kubus/Pittsburgh Tribune-Review More than 10,000 firefighters were in attendance at joint funeral services for three Pittsburgh, PA, firefighters who were killed in the line of duty last year. The Pittsburgh firefighters died when they ran out of air at a house fire.

Almost half of the total deaths are caused by heart attacks, many of which are triggered by stress and overexertion at emergency incidents. We could reduce a significant number of those deaths by simply improving the physical fitness of firefighters. We could also ensure that regular medical examinations and fitness evaluations are provided to identify members with high cardiac risk factors and those who need to improve their conditioning. As much as he or she may love the fire service, it doesn't make a lot of sense to have an overweight, out-of-shape individual with a history of heart problems dragging hoses and raising ladders.

The most challenging problem is how to reduce the fireground deaths that are caused by the inherent risks we normally associate with fighting fires, such as being caught or trapped inside burning buildings, running out of air, falling through roofs or floors and having parts of buildings fall on us. The best place to start is by looking at the circumstances that lead to these unwelcome occurrences.

Structural Operations

The U.S. Fire Administration conducts an annual survey of line-of-duty deaths to compile information on their causal factors and circumstances. The survey found that during 1995, only 15 firefighters died from traumatic injuries that occurred during structural firefighting operations. The death toll included 14 career firefighters and one volunteer who were involved in nine separate incidents. That is about half as many operational deaths as we experienced each year in the 1970s, when breathing apparatus was still reserved for special occasions and before the role of safety officers was invented.

Four of the incidents in 1995 involved firefighters trapped inside buildings by rapidly changing fire conditions; each claimed the life of one firefighter in New York, NY; Stoughton, MA; Hobart, IN; and New Kensington, PA. Three floor collapse incidents claimed the lives of six firefighters; four in a single incident in Seattle, WA, and one each in Mission, KS, and New York City. All six fell into fires that were burning below them.

Three Pittsburgh, PA, firefighters died when they ran out of air at a house fire. A San Francisco, CA, lieutenant died when in the garage of a large single-family home, the overhead door closed unexpectedly and trapped his engine company inside.

If we could have prevented the things that went wrong at just those nine incidents, we could have eliminated fireground accidents as a cause of firefighter deaths, at least for 1995. Was there something special about those nine incidents that could have been recognized? Are there critical factors that would have warned everyone to be particularly careful? It is for just these reasons that we need to thoroughly investigate every line of duty death not to figure out whether someone can be blamed for a tragedy but to learn about the causes and how to avoid them in the future.

Unfortunately, when we look at those specific incidents and many others, we do not find any common, easily recognizable factors that might have provided such a warning. In fact, the most notable similarity in fatal incidents is that most of them appeared to be fairly routine situations, where nothing unusual was recognized until something went wrong. The investigation usually reveals several causal factors, showing that there was not one single "thing" that went wrong but a whole series of little things!

Preventive Actions

Some fatal incidents involve circumstances that would have been very difficult to anticipate or prevent but even in these cases the analysis often points out safety and operational procedures that were overlooked or are commonly neglected. Some of those procedures are intended to keep us out of trouble and some are designed to get us out of trouble when things go wrong but none of them work when they are ignored.

Many factors have been identified in several line-of-duty death investigations over a number of years that should be emphasized. These are notable because they appear again and again and because they point out things that could be done differently to change outcomes.

We could save lives if every incident was managed from the outset by a qualified incident commander using a standard incident management system. This should also involve everyone working in organized companies which go where they are assigned to go and do what they are supposed to do. Every company should be supervised by a company officer who supervises the members, ensures their actions are consistent with the incident commander's plan and coordinates their activities with other companies.

Every member operating in a potentially dangerous area should be tracked by an effective accountability system. (An effective accountability system actually keeps track if the individuals, not just the tags that represent them). That system should continuously identify who is where and what they are doing and should regularly check to make sure that everyone is still OK. When something goes wrong, the incident commander should be able to find out if anyone is missing, who is missing and where they should be within two minutes or less.

The great majority of firefighters are wearing personal alert safety system (PASS) devices when they enter burning buildings. Our next challenge is how to make sure they are turned on. A tremendous amount of money has been spent on PASS devices that false alarm so often that most of them are not turned on and no one has ever been saved by a silent PASS. A PASS that is less prone to false alarms and is automatically activated by the air pressure of self-contained breathing apparatus (SCBA) appears to be the best answer.

In this age of communications, at least one member of every entry team should carry a portable radio. There should be a standard "mayday" procedure to request emergency assistance and there should always be somebody on the fireground channel listening for that message. At every working fire there should be a rapid intervention team standing by, ready to respond (see related stories on pages 54 and 58).

The radio system should provide enough channels to endure that every working incident has a clear channel without having to compete for air time with everything else that might be going on at the same time. When we check our breathing apparatus, we should not be satisfied if it just flows air. We should insist that it must be maintained in perfect working condition as if our lives depended on it. When was the last time your SCBA was checked, tested and calibrated by a certified SCBA technician?

We should not have to explain why we didn't know anything about a building that has been standing for over 50 years a block from the first-due fire station. We should know which buildings have truss roofs or hazardous contents or complicated interior arrangements. We should know which buildings are interconnected and which ones have ground-level entrances on different sides that lead to different floors. We have the technology available to give the incident commander a briefcase with a laptop computer and tens of thousands of pre-fire plans. Do companies have something more important to do between calls than to get out and gather information about the buildings they are supposed to protect?

Thinking Safety

We can't count on someone to meet us at the front door of the fires where something is likely to go wrong, waving red flags and shouting, "This one is dangerous! Follow all of your safety procedures!" Our only answer is to be as safe as possible and to consistently follow all of the safety procedures all of the time.

We know how to work safely when we are thinking about working safely but we often focus on attacking the fire without thinking about how to do it safely. We need to incorporate safety into our standard approach to every situation and every task, so we don't have to think about it. We have to adjust the organizational culture if we still think that injuries come with the job and generous death benefits encourage maximum performance.

Part 2 will report on case histories of recent fatal fires.

J. Gordon Routley, Reade Bush and Jeffrey Stern are employed by TriData Corp., which contracts with the U.S. Fire Administration to conduct an annual analysis of line-of-duty deaths and to develop reports on individual major incidents. They are active members of fire departments in Prince George's, Arlington and Montgomery counties, respectively. The reports are available through the U.S. Fire Administration in Emmitsburg, MD.

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