Author(s): Rita Fahy, Paul LeBlanc, Joseph Molis. Published on July 1, 2016.

Firefighter Fatalities in the United States, 2015

A detailed look at last year’s on duty firefighter deaths nationwide. Plus, an update on behavioral health in the fire service, including firefighter suicide.

BY RITA F. FAHY, PAUL R. LeBLANC, JOSEPH L. MOLIS

In 2015, 68 firefighters died while on duty in the United States, the fourth time in the past five years that the total number of deaths has been below 70. For quite a few years, the number of on-duty deaths annually had averaged around 100 deaths per year, but recently we have seen a fairly consistent decrease in the annual totals. The exception in the past five years was 2013, when the total number of deaths was 97, resulting in part from two fires that claimed a total of 28 lives.

Of the 68 firefighters who died while on duty in 2015, 32 were volunteer firefighters, 24 were career firefighters, six were employees of federal land management agencies, three were federal contractors, one was an employee of a state land management agency, one was a civilian employee of the military, and one was a state prison inmate.

There were three multiple-fatality incidents in 2015: an apparatus crash on a wildland fire killed three wildland firefighters, a helicopter crash killed two contract firefighters working on a prescribed burn, and a wall collapse at a structure fire killed two firefighters.

One firefighter was murdered last year, when he was deliberately struck and killed by a motorist during a fundraising event. One firefighter died by suicide while on duty.

Activities when fatal injuries occurred

The largest share of deaths occurred while firefighters were operating at fires (24 deaths), accounting for just over one-third of the on-duty deaths in 2015. This is the fourth time in the last six years that that total has been fewer than 25. There has been an average of 30.5 fire ground deaths over the past 10 years (2006 through 2015). Seventeen of the 24 fire ground deaths in 2015 occurred at 16 structure fires. In addition, there were five deaths at three wildland fires and two at two vehicle fires.

Eleven firefighters died while responding to or returning from emergency calls. Deaths in this category are often not the result of crashes. In fact, in 2015, eight of the deaths while responding to or returning from alarms were due to sudden cardiac death, and another death resulted from a stroke. One firefighter was killed in a collision while responding to a medical call, and another was struck by a passing vehicle while directing traffic at the station for apparatus responding to a mutual aid call. All 11 victims were volunteer firefighters. The number of deaths that occurred while responding to or returning from calls has averaged 20 per year over the past 10 years and 14 per year over the past five years. Over the first 10 years that NFPA conducted this study (1977 through 1986), the average number of deaths per year while responding to or returning from alarms was 36. There has been a marked reduction in both crash deaths and cardiac-related deaths while responding to or returning from alarms over the past 40 years.

Ten firefighters died at non-fire emergencies: five at medical emergencies, three at motor vehicle crashes, one while attempting to rescue people trapped by rising flood waters, and one while directing traffic at the scene of a possible gas leak. Four suffered sudden cardiac deaths, three were struck by vehicles, one died in a crash while transporting a patient, one had a stroke, and one drowned.

Nine deaths occurred during training activities. Sudden cardiac death claimed all nine firefighters. Five were working out or running at the station as part of routine physical fitness training. In addition, one was attending an air management training exercise, another was attending in-service apparatus training, one was undergoing a wildland firefighting fitness test, and one collapsed during wildland fire training.

The remaining 14 firefighters died while involved in a variety of non-emergency–related on-duty activities. Seven of the fatalities were due to sudden cardiac death; of those, six firefighters were engaged in normal administrative or station duties, and one was on standby at a racetrack. Two firefighters died of medical causes while at the station; one death was the result of a stroke, and the other the result of an aneurysm. Two federal contractors were killed when their helicopter crashed while they were involved in aerial ignition operations at a prescribed burn; a third contractor was seriously injured but survived. One firefighter was intentionally struck by an impatient driver at a fundraising event, and the driver was charged with murder. Another firefighter died by suicide at the station while on duty. One firefighter died of complications from traumatic injuries suffered in a collision while returning to the fire station after picking up equipment for maintenance.

Fire investigators work at the scene of a 2015 fire that killed two firefighters in Missouri

Federal investigators work at the scene of a 2015 fire that killed two firefighters in Missouri. Photograph: Getty Images

Fire ground deaths

The 24 fire ground deaths in 2015 marked the fourth time in the past six years that the total has been below 25. Seventeen of the 24 deaths occurred at 16 structure fires; five deaths occurred on three wildland fires, and two deaths occurred at vehicle fires.

The 17 deaths at structure fires included 10 in fires involving one- and two-family dwellings, two in apartment building fires, two in vacant warehouse fires, two in a fire that started in a nail salon, and one in a fire at a large commercial structure. None of the structures in which firefighters died was reported to have included an automatic fire suppression system.

Among the non-structure fire deaths, five firefighters died at three wildland fire incidents: three firefighters were killed in an apparatus crash, one was overrun by fire, and one was struck by a falling tree. Two firefighters were killed at the scene of motor vehicle fires: one was struck by a falling tree and the other suffered a sudden cardiac event.

Cause and nature of fatal injury or illness

Overexertion, stress, and medical issues accounted for by far the largest share of firefighter deaths. Of the 40 deaths in this category, 35 were classified as sudden cardiac deaths, usually heart attacks; three were due to strokes; and one was the result of an aneurysm. The suicide death by gunshot falls into this category as well.

The second leading cause of fatal injury was vehicle crashes, which claimed eight lives. Another five firefighters were struck and killed by vehicles: four at or during emergency responses and one in a deliberate act against the victim. Structural collapses resulted in six deaths. Two firefighters were killed when a wall collapsed at a fire that began in a nail salon and spread throughout the apartments above; the area had been declared a collapse zone, but the victims and other firefighters had not yet left the area when the collapse occurred. Investigations into the incident are ongoing. In separate incidents, three firefighters fell into basements when floors collapsed while they were operating at fires in single-family dwellings. All three died of smoke inhalation. One firefighter was crushed under a collapsing porch roof as he and two other firefighters were exiting the structure due to deteriorating conditions inside.

Four firefighters died in fatal falls. In separate incidents, two firefighters fell down elevator shafts: one in an apartment building and one in a vacant warehouse. In another vacant warehouse fire, a firefighter stepped on a skylight and fell 20 feet (six meters) to a concrete floor. One firefighter fell through the ceiling of an underground bunker while fighting a grass and structure fire and died of complications from burn injuries and trauma.

Two firefighters were struck and killed by falling trees: one on a wildland fire and the other at a vehicle fire. One firefighter was caught or trapped by rapid fire progress on a wildland fire when the wind shifted. One firefighter became separated from the rest of his crew while fighting a basement fire and died as the result of inhalation of superheated gases.

Firefighters attempt to protect a home and outbuilding from a wildfire in Washington state.

Firefighters attempt to protect a home and outbuildings from a wildfire in Washington state. Three firefighters were killed and four injured while battling the fire. Photograph: Reuters/David Ryder

Sudden cardiac deaths

In 2015, the 35 sudden cardiac deaths with onset while the victim was on duty is only one less than the 2014 total and reinforces last year’s finding that the general downward trend in on-duty sudden cardiac deaths since 2007 has stopped. Cardiac-related events accounted for 51 percent of the deaths in 2015, and 42 percent over the past 10 years.

The number of deaths in this category is, however, significantly lower than in the early years of this study. From 1977 through 1986, an average of 60 firefighters a year suffered sudden cardiac deaths while on duty, or 44.7 percent of the on-duty deaths during that period. These are cases in which the onset of symptoms occurred while the victims were on duty and death occurred immediately or shortly thereafter. The average number of deaths fell to 44 a year in the 1990s and to 34 in the last decade. In spite of this reduction, sudden cardiac death continues to be the leading cause of on-duty firefighter fatalities in the United States and, with exceptions in 1984 and 2013, has accounted for the single largest share of deaths in any given year.

Sudden cardiac death accounts for a higher proportion of the deaths among older firefighters, as might be expected. Almost two-thirds of the firefighters over age 40 who died in 2015 died of heart attacks or other cardiac events.

Vehicle-related deaths

In 2015, 13 firefighters died in vehicle-related incidents, including eight firefighters who died in vehicle crashes. Five other firefighters were struck and killed by vehicles, including one in a deliberate act.

One of the crashes involved a helicopter operating at a prescribed burn. The crash, which killed two contractors, is being investigated by the National Transportation Safety Board, but the final report has not yet been released.

Three firefighters were killed in a crash in zero visibility on a wildland fire. Additionally, one firefighter died when his ambulance crashed while transporting a patient to a hospital, and another died in an ambulance crash while responding to a medical call. One firefighter died of complications from injuries suffered when a fire department pickup truck crashed while out to pick up equipment. No information on seatbelt use was available for any of the road vehicle crashes.

Five firefighters were struck and killed by vehicles, including one struck in a deliberate act. That firefighter was participating in a charity fundraiser in an intersection when a driver who was annoyed by the slowed traffic deliberately struck him with his vehicle. The other incidents occurred during emergency calls. One firefighter was directing traffic at the scene of a motor vehicle crash within a safe zone established using fire apparatus and police vehicles when he was struck by a drunk driver who drove into the safe zone. At another motor vehicle crash, a firefighter was killed on a highway by a driver who swerved to avoid hitting a parked fire truck and struck the victim. A firefighter wearing a fire police vest was directing traffic at a fire station while department vehicles were responding to a call when he was hit by a driver who did not see him. Solar glare was cited as a factor in that incident. In violation of fire department policy, a firefighter rode on the back step of an engine while it was driven to a helicopter landing site during a medical aid call. The driver was not aware that the firefighter was on the back step. The victim slipped or fell on dismounting and was crushed when the driver reversed the vehicle to put it in position.

Firefighters change next to an fire apparatus that is parked next to a high rise apartment building

A firefigher was killed fighting a blaze in an apartment building in Washington, D.C. Photograph: Getty Images

Other findings

Four firefighters were killed as a result of three intentionally set fires in 2015: two in the wall collapse at the nail salon fire, one when a floor collapsed in a single-family home, and another who suffered a fatal cardiac event while responding to a set fire in a single-family home. From 2006 through 2015, 50 firefighters (six percent of all on-duty deaths) died in connection with intentionally set fires, either at the fire or while responding to or returning from the fire. The 2013 explosion and fire in West, Texas, resulting in the deaths of nine firefighters, was recently reported to have been deliberately set.

In 2015, no deaths resulted during a false call. Over the past 10 years, 10 firefighter deaths have resulted from false calls, including malicious false alarms and alarm malfunctions.

The firefighters who died in 2015 ranged in age from 18 to 92, with a median age of 49.5 years. The lowest death rates were for firefighters under age 40. Their death rate was about half to three-quarters of the all-age average. The rate for firefighters aged 60 and over was two-and-a-half times the average. Firefighters aged 50 and over accounted for almost half of all firefighter deaths over the five-year period, although they represent one-quarter of all career and volunteer firefighters in the United States.

The 32 deaths of volunteer firefighters while on duty in 2015 is the second lowest total for volunteers and well below the annual average of 42 deaths per year. It is the fourth time in the past five years that the total has been at or below 35 deaths. In the earliest years of this study, the annual average number of deaths of volunteers while on duty was 67. The 24 deaths of career firefighters marks the sixth consecutive year that the total has been at or below 25. The trend for career firefighters has been relatively flat over the past 10 years, except for a spike in 2007 due to a single nine-fatality incident.

Chronic conditions and behavioral health

This report focuses on the deaths of firefighters that are due to specific events while on duty. NFPA recognizes that a comprehensive study of firefighter fatalities would include chronic illnesses such as cancer and heart disease that prove fatal and that arise from occupational factors. This is recognized as a gap, the size of which cannot be identified at this time because of limitations in tracking the exposure of firefighters to toxic environments and substances and the potential long-term effects of such exposures.

Besides the challenges that firefighter illnesses pose for gaining a complete picture of the firefighter fatality problem, we would be remiss if we did not also monitor the increasingly well-publicized problem of firefighter suicide. According to the Firefighter Behavioral Health Alliance (FBHA), 94 firefighters and 23 EMTs and paramedics died by suicide in 2015. As reported in this article, one firefighter died by suicide while on duty.

Due to the efforts of the FBHA and others, recognition of the importance of behavioral health programs and peer support for firefighters is becoming more widespread. As with heart disease and cancer, this is a problem that follows firefighters after their careers end, whether in retirement or some other form of separation from the fire service. The Alliance recently produced a report on behavioral health and suicide prevention that was published by the National Volunteer Fire Council, with support from U.S. Fire Administration. In collaboration with the National Fallen Firefighters Foundation, the Medical University of South Carolina has developed a training course for counselors who work with firefighters.

NFPA 1500, Fire Department Occupational Safety and Health Program, requires access to a behavioral health program that provides assessment, counseling, and treatment for such issues as stress, anxiety, and depression. The goal of such programs is to change the culture of the fire service, help people identify the warning signs, eliminate stigmas associated with mental health issues and asking for help, and provide training and assistance with retirement planning. According to FBHA statistics, almost one-fifth of the firefighters and EMTs who died by suicide were retired firefighters and EMTs. Early recognition and treatment of behavioral health issues are key to addressing this problem.

Regarding the long-term health effects of firefighting, there has been a vast change in the attention now paid to cancer risk and cancer prevention in the fire service. These efforts include research, education, behavioral changes, and a variety of controls to minimize exposure to contaminants. Although we cannot identify the total number of fire service–related cancer deaths that occur each year, the International Association of Fire Fighters alone lists almost 80 firefighter cancer deaths that were reported to the IAFF in 2015.

The National Institute for Occupational Safety and Health recently undertook two large studies focused on firefighter cancer. The first was a multi-year study to examine the cancer risk of firefighters, using health records of approximately 30,000 current and retired career firefighters from three large city fire departments to look at mortality and cancer incidents. The second looked at exposure response among 20,000 firefighters from the same fire departments. Results of the first phase, which reported evidence of a relationship between firefighting and cancer, were published in October 2013. Results of the second study, published in 2015, showed a relationship between firefighting and lung cancer and leukemia. The reports are available online at cdc.gov/niosh/firefighters.

In efforts to raise awareness in the fire service of the heightened risk of cancer and ways to reduce exposures, valuable video presentations have been produced by organizations, including the Boston Fire Department, the University of Cincinnati and Cincinnati Fire Department, and the National Fallen Firefighters Foundation. These videos can help inform firefighters of the steps they can take to address the hazards they face. Other efforts to inform the fire service of safe practices stem from research undertaken by the Fire Protection Research Foundation, including an ongoing four-phase study to enhance the cleaning procedures for PPE that are outlined in NFPA 1851, Selection, Care, and Maintenance of Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting, and an earlier respiratory exposure study that was completed in 2012. The Firefighter Cancer Support Network is an excellent resource for access to information on health-related topics and support and mentorship following a cancer diagnosis.

In contrast to the relatively recent strong focus on firefighter cancer and suicide, heart disease has been recognized as a serious health issue for the fire service for quite some time. Sudden cardiac death has consistently accounted for the largest share of on-duty firefighter deaths since NFPA began this study in 1977. NFPA has several standards that focus on the health risks to firefighters. For example, NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments, outlines the medical requirements that must be met by candidate firefighters and incumbent fire department members. NFPA 1500 calls for fire departments to establish a firefighter health and fitness program that meets NFPA 1583, Health-Related Fitness Programs for Fire Department Members, and requires that firefighters meet the medical requirements of NFPA 1582.

Information on developing a wellness-fitness program is available from other organizations, such as the IAFC/IAFF Fire Service Joint Labor-Management Wellness-Fitness Initiative. The National Volunteer Fire Council’s Heart-Healthy Firefighter Program was launched in 2003 to address heart attack prevention for all firefighters and EMS personnel through fitness, nutrition, and health awareness.

We will continue to cover deaths that result from specific on-duty activities in this study, but NFPA is focused on all aspects of health and safety in the fire service and EMS, as evidenced particularly by the Fire Protection Research Foundation’s work on cancer prevention behaviors and the health and wellness provisions of NFPA 1500 and NFPA 450, Guide for Emergency Medical Services and Systems.

In summary

There were 68 on-duty firefighter deaths in 2015. Considering that this is the fourth time in the last five years that the total has been below 70, we seem to have broken through the long-standing plateau of 100 deaths per year. The total annually is half what we observed in the late 1970s and has averaged 81 deaths per year over the past 10 years. Deaths among volunteer firefighters have shown a particularly marked decrease. We have seen substantial reductions in the number of deaths in road vehicle crashes in recent years, although it is too soon to consider that a solid trend.

These are positive developments, but we still see a high proportion of deaths due to cardiac issues. Sudden cardiac death accounted for more than half of the on-duty deaths in 2015, as it did in the previous year. A firefighter was also murdered while on duty in 2015, and violence against firefighters is not as rare as some might think. Since 1996, 22 firefighters have been fatally assaulted while on duty.

RITA F. FAHY, Ph.D., is manager of fire databases and systems in NFPA’s Fire Analysis and Research Division. PAUL R. LeBLANC is a fire data assistant at NFPA and a retired lieutenant with the Boston, Massachusetts, Fire Department. JOSEPH L. MOLIS is a fire data assistant at NFPA and a lieutenant with the Providence, Rhode Island, Fire Department. Top Photograph: Getty Images

This study is made possible by the cooperation and assistance of the United States fire service, the Public Safety Officers’ Benefits Program of the Department of Justice, CDC’s National Institute for Occupational Safety and Health, the United States Fire Administration, the Forest Service of the U.S. Department of Agriculture, and the Bureau of Indian Affairs and the Bureau of Land Management of the U.S. Department of the Interior. The authors would also like to thank Carl E. Peterson, retired from NFPA’s Public Fire Protection Division, and Thomas Hales, MD, MPH, of CDC-NIOSH, for their assistance on the study.