NFPA: Cardiac Issues Still Top Killer of Firefighters Across Nation

June 22, 2023
Overexertion and stress accounted for just over one-half of the 96 deaths in 2022, the NFPA's annual report showed.

Last year, 96 firefighters died on duty across the United States.

Of those who died last year, 51 were volunteers, 38 career, six contractors and one full-time federal land management employee, according to the NFPA's annual firefighter fatality report released this week. 

The count in 2022 is higher than recent years and the highest since 2013, when 98 on-duty deaths were reported, the document shows.

In 2021, NFPA authors noted that of the 135 firefighters who perished, 65 died of COVID-related issues.  

“Sudden cardiac deaths or cardiac conditions regularly account for the largest share of on-duty firefighter deaths. By adjusting the reporting period by 24 hours, we were able to more fully capture cardiac failure among firefighters, allowing us to more accurately identify the serious health risks firefighters face on the job,” Richard Campbell, a senior research analyst at NFPA, wrote in the most recent report.

He went on to explain that the report this year includes fatal injuries and cardiac-related deaths that occurred within 24 hours of duty regardless of whether they complained of symptoms. For those reasons, Campbell said the number associated with those causes is higher than in previous years. 

However, an unknown number of deaths due to unspecified medical causes in 2022 were likely cardiac related, so the reported number of cardiac deaths likely continues to understate the true total.

Excluding the 340 firefighter deaths that occurred on 9/11, the highest death toll occurred in 1978 with 174 firefighters answering their final alarm. The lowest was in 2019 when 48 perished.

The firefighters who died last year ranged from 19 to 85.

This overall downward trend is an encouraging indication that firefighter injury prevention and health and wellness efforts through the years are being met with success, Campbell, the author, wrote. 

“While significant strides have been made over time to better protect firefighters on the job, firefighters continue to take on more roles and responsibilities, placing significant physical and mental stresses on them that can have fatal consequences. Ongoing efforts to adequately address these issues will be needed in order to see meaningful reductions.”

Among his findings included in the report:

  • Trauma injuries accounted for 33 firefighter deaths, including 20 internal trauma deaths, six deaths by crushing, five deaths due to unspecified traumatic injuries, and two deaths due to gunshot injuries or projectile wounds.
  • Six multiple fatality incidents occurred in 2022, tying for the highest number of multiple fatality incidents since 2009. Four of the incidents involved vehicles, each resulting in two fatalities. The two remaining incidents involved structure fires, one in which three firefighters were killed in a building collapse and the other in which two firefighters died after sending a mayday from the second floor of a house.
  • Just over one-fifth of firefighter deaths (21) occurred while responding to or returning from emergencies. The report also showed that overexertion and stress accounted for just over one-half of the deaths in 2022. Of the 49 deaths in this category:
  • 34 were sudden cardiac incidents and one was due to cardiac symptoms
  • 11 deaths included an unspecified medical cause
  • One was due to a stroke or aneurysm
  • Two deaths were the result of drug overdoses.

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