Author(s): Hylton Haynes. Published on November 1, 2017.

U.S. Firefighter Injuries in 2016

An estimated 62,085 firefighter injuries occurred in the line of duty in 2016, a decrease of nearly 9 percent from the year before and the lowest rate since NFPA began analyzing this data in 1981

BY HYLTON J.G. HAYNES AND JOSEPH L. MOLIS

Each year, NFPA studies firefighter deaths and injuries to provide national statistics on their frequency, extent, and characteristics. In the July/August issue of NFPA Journal, NFPA reported that there were 69 firefighter fatalities while on duty in 2016; the full firefighter fatalities report is available online. A better understanding of how these fatalities, nonfatal injuries, and illnesses occur can assist in identifying corrective actions that could help minimize the inherent risks of firefighter work.

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This report addresses 2016 firefighter injuries in the United States. The results are based on data collected during the NFPA Survey of Fire Departments for U.S. Fire Experience (2016). An earlier report, “Fire Loss in the United States during 2016”, measured the national fire experience in terms of the number of fires that fire departments responded to and the resulting civilian deaths, civilian injuries, and property losses that occurred.

Based on data reported by fire departments responding to the 2016 National Fire Experience Survey, we estimate that 62,085 firefighter injuries occurred in the line of duty in 2016. This is a decrease of 8.8 percent from the year before, and the lowest rate since NFPA began analyzing this data in 1981. In recent years, the number of reported firefighter injuries has been considerably lower than it was in the 1980s and 1990s, due in part to additional survey questions on exposures to hazardous conditions and infectious diseases, information that allows us to place them in their own categories. Previously, some of these exposures might have been included in total injuries under other categories.

NFPA estimates that there were 9,275 exposures to infectious diseases such as hepatitis, meningitis, and HIV in 2016. This amounts to 0.4 exposures per 1,000 emergency medical service runs by fire departments in 2016.

We also estimate there were 36,475 exposures to hazardous conditions such as asbestos, radioactive materials, chemicals, and fumes last year, which amounts to 32.9 exposures per 1,000 hazardous condition runs, a 34 percent increase in exposures from the year before. This increase can in part be explained by the heightened awareness about cancer and other chronic illnesses in the fire service and the importance of documentation. This is a large increase from previous years and could be a result of improved reporting for such exposures.

An estimated 19,050 injuries, or 30.6 percent of all firefighter injuries, resulted in lost time.

This year’s firefighter injury report includes among its results an estimate of the total number of 2016 firefighter injuries; estimates of the number of injuries by type of duty; an estimate of the number of exposures to infectious diseases; trends in firefighter injuries and rates; fireground injuries by cause; fire department vehicle accidents and resulting firefighter injuries; the average number of fires and fireground injuries per department by population of community protected; and descriptions of selected incidents that illustrate firefighter safety problems.

Methods and results

NFPA annually surveys a sample of fire departments in the U.S. to make national projections of the fire problem. The sample is stratified by the size of the community protected by the fire department and includes all U.S. fire departments that protect communities with a population larger than 5,000. The 8,635 fire departments in the eight highest strata protect a population of 246,000,000, or 76 percent of the U.S. population as of July 2016. The rest of the sample includes 11,855 randomly selected departments that protect populations under 5,000, for a total sample size of 20,490, or 69 percent of all known departments to NFPA in the U.S.

The estimation method used for the survey was ratio estimation with stratification by community size. For each firefighter injury statistic, a sample injury rate was computed for each stratum. This rate consisted of the total for that particular statistic from all departments reporting it, divided by the total population protected by the departments reporting the statistic. Note that this means the departments used in calculating each statistic could be different, reflecting differences in unreported statistics. The national projections are made by weighting the sample results according to the proportion of total U.S. population accounted for by communities of each size. Around any estimate based on a sample survey, there is a confidence interval that measures the statistical certainty or uncertainty of the estimate. We are confident that the actual number of total firefighter injuries falls within 5 percent of the estimate.

A total of 2,769 departments responded to the 2016 fire experience survey. The results are based on injuries that occurred during incidents attended by public fire departments. No state or federal firefighting entities were included in this sample, and no adjustments were made for injuries that occurred during fires attended solely by private fire brigades, such as those at industrial or military installations. We enhanced the data collection for the selected incident summaries by sending the fire departments a form requesting information on the type of protective equipment worn, the ages and ranks of the firefighters injured, and a description of circumstances that led to injury.

Workers clean up after a gas explosion leveled a building in Oregon

Workers clean up after a gas explosion leveled a building Oregon, injuring three firefighters and two police officers. Photograph: Newscom

In this report, “fire” refers to any instance of uncontrolled burning, excluding combustion explosions and fires out on arrival (whether authorized or not); overpressure rupture without combustion; mutual aid responses; smoke scares; and hazardous materials responses, e.g., flammable gas, liquid, or chemical spills without fire. “Incident” refers to the movement of a piece or pieces of fire service apparatus or equipment in response to an alarm. “Injury” refers to physical damage suffered by a person that requires (or should require) treatment by a practitioner of medicine (physician, nurse, paramedic, EMT) within one year of the incident, regardless of whether treatment was actually received, or that results in at least one day of restricted activity immediately following the incident.

Injuries by type of duty

As in past reports, type of duty is divided into five categories, including responding to or returning from an incident (including fire and non-fire emergencies); fireground (including structure fires, vehicle fires, brush fires, etc.), referring to all activities from the moment of arrival at the scene to departure time (e.g., setup, extinguishment, and overhaul); non-fire emergency (including rescue calls, hazardous calls such as spills, and natural disaster calls; training; and other on-duty activities (e.g., inspection or maintenance duties).

Firefighters were more likely to be injured at fireground operations than at other types of duties. In 2016, 24,325, or 39.2 percent, of all firefighter injuries occurred at the fireground. This was a decrease of 8.8 percent from the previous year, which was the lowest number since 1981. Injuries at the fireground decreased from a high of 67,500 in 1981 to 24,325 in 2016, a drop of 64 percent. The number of fires also declined steadily, for an overall decrease of 53.6 percent, and the rate of injuries per 1,000 fires over the past 35 years has fluctuated between a high of 28.3 injuries per 1,000 fires in 1990 and a low of 18.1 injuries per 1,000 fires in 2016. These results suggest that even though the number of fires and fireground injuries declined during the period, the injury rate did not, meaning the fireground injury rate per fire risk has not changed much since 1981.

Firefighters work to prevent hot spots from flaring up at a restaurant fire in California

Firefighters work to prevent hot spots from flaring up at a restaurant fire in California that injured three firefighters. Photograph: Orange County Register/AP/Wide World

Overall, the number of injuries at non-fire emergencies increased 33.1 percent between 1981 and 2016, from 9,600 to 12,780. During the same period, the number of non-fire emergencies also increased 340 percent, due in large part to an increase in the number of fire department responses to medical emergencies. The injury rate per 1,000 non-fire emergencies declined between 1981 and 2016, from 1.24 to 0.38, largely because the number of non-fire emergencies increased at a higher rate than the number of injuries at non-fire emergencies.

In addition, 5,200 firefighter injuries occurred while responding to or returning from an incident in 2016. Another 8,480 firefighter injuries occurred during training activities, and 11,300 injuries occurred during other on-duty activities.

Nature and causes of fireground injuries

The major types of injuries that occurred during fireground operations were strains and sprains, which accounted for 45.7 percent of the injuries; wounds, cuts, bleeding, and bruises, which accounted for 14.2 percent; smoke or gas inhalation, which accounted for 2.6 percent; and burns, which accounted for 7.5 percent. These results were fairly consistent during all non-fireground activities, with strains, sprains, and muscular pain accounting for 57 percent of all non-fireground injuries, and wounds, cuts, bleeding, and bruises accounting for 15.9 percent.

Because fireground injuries are of particular concern from an occupational hazard perspective, we examined their causes, defined here as the initial circumstance leading to the injury. Overexertion or strain, which accounted for 27.1 percent, was the leading cause of fireground injuries. Other major causes were falls, jumps, or slips, which accounted for 21 percent, and exposure to fire products, which accounted for 13.6 percent.

Fire department vehicle collisions

NFPA reported previously that 19 firefighters died in vehicle-related incidents in 2016, including 17 firefighters who died in vehicle crashes and two who were struck by vehicles (see the 2016 firefighter fatalities report online at nfpa.org/firefighterfatalities.)

In 2016, an estimated 15,425 collisions involved fire department emergency vehicles responding to or returning from incidents. This figure is the seventh-highest number of collisions since NFPA began collecting this information in 1990. To put this number in perspective, fire departments responded to more than 35.3 million incidents in 2016, meaning that the number of collisions represents 0.04 percent of total responses. However, these collisions resulted in 700 injuries, or 1.1 percent, of all firefighter injuries.

Another 850 collisions involved firefighters’ personal vehicles, in which they were responding to or returning from incidents. These collisions resulted in an estimated 175 injuries, five injuries higher than the median estimate (170) since NFPA started collecting this statistic in 1990.

Average fires and fireground injuries per department by population protected

The number of fires a fire department responds to is directly related to the population protected, and the number of fireground injuries incurred by a department is directly related to the number of fires the department attends. The second point is clearly demonstrated when we examine the range of the average number of fireground injuries per year per fire department, which range from a high of 104.3, for departments that protect communities of 1,000,000 or more, to a low of 0.1, for departments that protect communities of fewer than 2,500 people.

One way to understand the risk that firefighters face is to examine the number of fireground injuries that occur for every 100 fires they attend. This takes into account relative fire experience and allows more direct comparison between departments protecting communities of different sizes. In 2016, the overall range of rates varied from a high of 2.5 injuries per 100 fires, for departments that protected communities with populations of 1,000,000 or more, to a low of 1.1 injuries per 100 fires, for departments that protected communities with populations fewer than 2,500. The wide range in the average number of fireground injuries by population protected narrows when relative fire experience is taken into account. The overall injury rate for departments that protect communities of 50,000 or more was 1.8 injuries per 100 fires, which is 26 percent higher than the injury rate of 1.4 injuries per 100 fires for departments protecting communities under 50,000.

Larger fire departments generally had the highest rates of fireground injuries; departments protecting communities of 1,000,000 or more had experienced 5.9 injuries per 100 firefighters. As the size of the community decreases, the rate of fireground injuries declines steadily, to a low of 0.6 for departments protecting fewer than 2,500 people. That is a difference in risk of injury of more than 10 to 1 between communities of 1,000,000 and communities of less than 2,500.

One explanation for this difference is that, although departments protecting communities with populations of 1,000,000 have, on average, more than 85 times as many firefighters as departments protecting populations smaller than 2,500, larger departments attend more than 360 times as many fires as the smaller departments and incur considerably more fireground injuries. Different policies for documenting minor injuries and different levels of fire engagement could also explain some of this difference.

Average number of fires and fireground injury rate by population protected and region of the U.S.

As in the nationwide results, the results of each region of the country indicate that the number of fires a fire department responds to is directly related to the population protected, and the number of fireground injuries incurred by a department is directly related to the number of fires attended.

In 2016, the Northeast region of the U.S. reported a higher fireground injury rate, at 1.8 fireground injuries per 100 fires. This observation is consistent with previous years, except in 2014, when the Western region reported a higher rate for the first time. It is important to note that historically this analysis has excluded New York City because it is the largest fire department in the country and is treated as an outlier in the reporting of this statistic. If New York City data were included in the analysis, the Northeast region would have an even higher number of fireground injuries per 100 fires.

Using the 10 regions designated by the Federal Emergency Management Agency (FEMA), FEMA region 3, which is made up of the District of Columbia, Delaware, Maryland, Pennsylvania, Virginia, and West Virginia, reported the highest fireground injury rate, at 3.7 fireground injuries per 100 fires.

Conclusions

As these statistics attest, firefighting presents risk of personal injury to firefighters, and because of the type of work they perform and the fire scene hazards they face, it is unlikely that all firefighter injuries can be eliminated. Since 1981, however, when firefighter injury data was first collected for this report, the overall trend is a decreasing number of firefighter injuries. The Northeastern region continues to report a higher fireground injury rate per 100 fires relative to the rest of the United States.

As the statistics in this report and previous reports attest, firefighting presents risks of personal injury to firefighters. A risk management system and the application of existing technology, however, can offer options to reduce present injury levels and bring about corresponding reductions that are recommended by NFPA that could be taken at the local level. Efforts need to be made to recognize that firefighter injuries can be reduced. By addressing priorities to further improve firefighter safety, fire service organizations can make significant strides toward reducing the number and impact of such injuries.

HYLTON J.G. HAYNES is a senior research analyst and JOSEPH L. MOLIS is a fire data assistant in the Research Division at NFPA. Top Photograph: Getty Images