By Rita F. Fahy and Paul R. LeBlanc, NFPA Fire Analysis and Research Division
The term on-duty refers to being at the scene of an alarm, whether a fire or non-fire incident; while responding to or returning from an alarm; while participating in other fire department duties such as training, maintenance, public education, inspection, investigation, court testimony or fund raising; and being on call or stand-by for assignment at a location other than at the firefighter’s home or place of business.
On-duty fatalities include any injury sustained in the line of duty that proves fatal, any illness that was incurred as a result of actions while on duty that proves fatal, and fatal mishaps involving non-emergency occupational hazards that occur while on duty. The types of injuries included in the first category are mainly those that occur at an incident scene, in training, or in crashes while responding to or returning from alarms. Illnesses (including heart attacks) are included when the exposure or onset of symptoms are tied to a specific incident or on-duty activity.
Fatal injuries and illnesses are included even in cases where death is considerably delayed. When the onset of the condition and the death occur in different years, the incident is counted in the year of the condition’s onset. The NFPA recognizes that a comprehensive study of firefighter on-duty fatalities would include chronic illnesses (such as cancer or heart disease) that prove fatal and that arise from occupational factors. In practice, there is no mechanism for identifying fatalities that are due to illnesses that develop over long periods of time. This creates an incomplete picture when comparing occupational illnesses to other factors as causes of firefighter deaths. This is recognized as a gap the size of which cannot be identified at this time because of the limitations in tracking the exposure of firefighters to toxic environments and substances and the potential long-term effects of such exposures.
In 2005, there were three multiple-fatality incidents – one was a helicopter crash at a prescribed burn that claimed three lives and two were double-fatality fires in apartment buildings.
Analyses in this report will examine the types of duty associated with firefighter deaths, the cause and nature of fatal injuries to firefighters, and the ages of the firefighters who died. They will highlight deaths in intentionally-set fires and in motor vehicle-related incidents.2 A special 10-year analysis will look more closely at deaths that occurred during training.
Finally, the study presents summaries of individual incidents that illustrate important problems or concerns in firefighter safety.
Of the 26 deaths while responding to or returning from alarms, the largest share (13 deaths) were due to sudden cardiac death. Another 10 deaths were due to vehicle collisions or rollovers. Motor vehicle crashes and sudden cardiac death are discussed in more detail later in this report. One firefighter fell from a fire apparatus, one suffered a stroke and one collapsed due to a drug overdose. Twenty-one of the 26 victims were volunteer firefighters and five were career firefighters.3
The 25 fire ground deaths in 2005 represent the lowest number of deaths at the scene of fires since 1977 when NFPA began collecting information on all on-duty fatalities. Of these 25 deaths, 11 were due to sudden cardiac death, five to asphyxiation, four to internal trauma, two to electrocution and one each to burns, crushing injuries and stroke. Sixteen of the victims were municipal volunteer firefighters and nine were municipal career firefighters.
Eleven deaths occurred during training activities. Seven firefighters suffered sudden cardiac death and another firefighter suffered a stroke. One firefighter drowned during SCUBA training, one died of heat stroke during recruit training and one fell off a roof during recruit training. Firefighter deaths during training over the past 10 years are described in detail in a separate section of this report.
Twenty-one firefighters died during the performance of non-emergency-related on-duty activities. Five of them suffered sudden cardiac death and one suffered a fatal stroke while engaged in normal administrative or station activities. Sudden cardiac death or stroke claimed the lives of four other firefighters while they were engaged in activities including a funeral detail, a parade, attendance at a convention, and fire apparatus maintenance. Three firefighters died when their helicopter crashed while they were igniting fires at a prescribed burn. Five other firefighters died as a result of crashes – one each during a conservation project, while driving to a meeting, while en route to get a vehicle inspection sticker, while en route to pump out a residence, and after a boat parade. One died in her sleep at the station, apparently of a drug overdose (oxycodone). A firefighter was run over while on standby at a race track. A firefighter was shot and killed while dropping off a department vehicle at a state facility for repairs.
Four deaths occurred at non-fire emergencies. Two were the result of sudden cardiac events – one at an
Stress and overexertion, which usually results in heart attacks or other sudden cardiac events, continued to be the leading cause of fatal injury, as it has been in almost all of the years of this study. Of the 47 stress-related deaths in 2005, 40 were classified as sudden cardiac deaths(usually heart attacks). In addition to these 40 deaths, there were six deaths due to stroke and one death due to heat stroke.
The second leading cause of fatal injury was struck by an object or contact with an object (25 percent). The 22 firefighters killed included 18 in motor vehicle crashes, three struck by motor vehicles, and one struck by a falling tree limb.
The next leading cause of fatal injury was caught or trapped, resulting in eight deaths.
Three firefighters were trapped by fire progress; one of them at a wildland fire. Two firefighters became lost inside fire-involved structures and ran out of air. One firefighter was killed when a roof collapsed. One firefighter became trapped under water and drowned. One firefighter became caught between a manlift and a conveyor belt at a fire in a grain elevator and was crushed.
Four firefighters were killed when they jumped or fell. Two of the four became trapped by a fire on the upper story of an apartment building and were forced to jump. One firefighter, mentioned earlier, fell off the roof during recruit training. One firefighter fell from a fire apparatus while responding to a fire call.
Two firefighters died as a result of accidental overdoses to prescription medication. Two were electrocuted. One was overcome and poisoned by hydrogen sulfide fumes. One firefighter died of a gunshot wound.
Figure 4 shows the distribution of deaths by nature of fatal injury or illness. The largest proportion of deaths (46 percent) fell into the category of sudden cardiac death. All of these deaths in 2005 were attributed to stress or overexertion. The number of such deaths dropped from the recent highs of 47 and 48 deaths in 2003 and 2004 to 40 deaths in 2005. Sudden cardiac death, most often the result of heart attack, is typically the leading nature of injury and usually accounts for close to half of the total deaths. Since NFPA began publishing this study in 1977, the number of deaths annually in this category has dropped by a third; however, over the past 15 years, the number of sudden cardiac deaths has leveled off, with between 40 and 50 occurring each year.
Of the 40 victims of sudden cardiac events in 2005, 13 were reported to have had prior heart problems – usually prior heart attacks, bypass surgery or angioplasty/stent placement – and post mortem medical documentation showed that another 14 had severe arteriosclerotic heart disease. Over the past 25 years, post mortem information or other details on the victims' medical histories have been available for 711 of the 1,216 sudden cardiac death victims. Of those 711 victims, 46.8 percent had suffered prior heart attacks or had undergone bypass surgery or angioplasty/stent placement and another 33.3 percent had severe arteriosclerotic heart disease.
In 2005, the other major categories were internal trauma (21 deaths), asphyxiation (six deaths), strokes (six deaths) and crushing injuries (four deaths). The remaining deaths included two drownings, two drug overdoses, two electrocutions and one each due to burns, gunshot, hydrogen sulfide poisoning, and heat stroke.
Ages of Firefighters
The firefighters who died in 2005 ranged in age from 18 to 74, with a median age of 48 years. Figure 5 shows the distribution of firefighter deaths by age and cause of death (sudden cardiac death versus other causes).
Figure 6 shows death rates by age, using career and volunteer firefighter fatality data for the five-year period from 2001 through 2005 and estimates of the number of career and volunteer firefighters in each age group from the NFPA’s 2003 profile of fire departments (the mid-year in the range).5
The lowest death rates were for firefighters in their 20s. Their death rate was a little more than half the all-age average. Firefighters in the 30s had a death rate approximately two-thirds the all-age average. The rate for firefighters in their fifties was almost twice the average and for firefighters age 60 and over, it was four times the average. Firefighters age 50 and over accounted for two-fifths of all firefighter deaths over the five-year period although they account for fewer than one-fifth of all firefighters.
Almost all of the 18 structure fire deaths occurred in residential properties. Fires in one- and two-family dwellings killed 11 firefighters and fires in two apartment buildings killed 2 firefighters each. There were also two deaths in fires in vacant buildings, and one death at a grain elevator fire. None of the structures involved in fatal fires in 2005 were reported to have had sprinklers installed.
In addition, there were five deaths on wildland fires and one death each at a hay fire and a vehicle fire.
To put the hazards of firefighting in various types of structures into perspective, the authors examined the number of fire ground deaths per 100,000 structure fires by property use. Estimates of the structure fire experience in each type of property were obtained from the NFPA’s annual fire loss studies from 2000 through 2004 (the 2005 results are not yet available) and from the updated firefighter fatality data for the corresponding years. The results are shown in Figure 8 .
This figure illustrates that, although more firefighter deaths occur at residential structure fires than at fires in any other type of structure, fires in vacant buildings and some nonresidential structures, such as mercantile and public assembly properties, are more hazardous to firefighters, on average. There were 6.9 fire ground deaths per 100,000 nonresidential structure fires from 2000 through 2004, compared to 3.8 deaths per 100,000 residential structure fires. The highest death rates over the five-year period occurred in stores and offices. The low rate in health care/correctional and educational buildings may reflect the fact that these occupancies are among the most regulated and most-frequently inspected and that their occupants are among the most likely to call the fire department to report fires while the fires are still in their early stages. The low rate in that five-year period for storage properties reflects the small number of fatalities that have occurred in such structures in recent years.
In 2005, 18 firefighters died in vehicle crashes. In addition to those deaths, three others were fatally struck by vehicles and one firefighter fell from the jump seat of an engine.
Ten of the 18 firefighters killed in crashes were responding to or returning from incidents when the crashes occurred. All were single-fatality crashes.
Three of these 10 victims were driving water tenders:
Another three were driving or riding in pumpers:
Two of the crashes while responding to alarms involved personal vehicles:
In the other fatal crashes while firefighters were responding to or returning from emergency calls:
There was one fatal aircraft crash in 2005, which resulted in three deaths:
The remaining fatal crashes occurred while firefighters were engaged in a variety of onduty activities:
Of the 13 deaths in road vehicles mentioned above, five of the victims were not wearing seatbelts and four were wearing seatbelts. Seatbelt use was not reported in the other four crashes. Excessive speed was a factor in at least three of the 13 crashes.
Three firefighters were struck by vehicles and killed. The first was directing traffic at a chemical spill at a high school when he was struck by a drunk driver. He was wearing his reflective safety vest and using a flashlight when he was struck. The other two firefighters were struck by driverless vehicles. The first was working as a safety officer at a racetrack. He was run over on the track by a service vehicle that he was trying to stop as it was rolling backwards toward a crowd of spectators. (A crash had occurred moments before on the track, and the driver of the service vehicle had left his vehicle's engine running while he spoke to one of the race drivers stopped on the track. The race car driver backed into the service vehicle while trying to get out of its way, causing it to begin rolling.) The other firefighter, who was driving a vehicle shuttling water to the scene of a structure fire, had arrived with his fourth load of water. When he got out of his truck to wait to unload the water tank, the truck rolled forward into a ditch, pinning him underneath.
And, finally, a firefighter fell from the back seat of a responding ladder truck striking his head on the pavement. The victim was preparing to don his SCBA and was not wearing his seatbelt when the door opened while the vehicle was making a right turn at an intersection.
Two firefighters died at intentionally-set structure fires. From 1996 through 2005, 66 firefighters (6.6 percent of all on-duty deaths) died in connection with intentionally set fires. The share of these deaths annually has been dropping fairly steadily since 1985, which is, in part, a reflection of the decline in intentionally-set fires over the same period.
Four firefighters died as a result of false alarms in 2005. Over the past 10 years, 36 firefighter deaths have resulted from false calls, whether malicious or alarm malfunctions.
The distribution of deaths of career and volunteer firefighters from local, municipal fire departments is shown in Figure 9 . Firefighter fatalities among career firefighters reached their lowest level in 1993, then rose between 1993 and 1999. Overall, there has been a general downward trend since 1985, but the number of on-duty deaths among career firefighters has fluctuated between 25 and 29 over the past six years. For volunteer firefighters, there tends to be a great deal of fluctuation from year to year, but there has been a downward trend since 1999. Over the past 10 years, there have been an average of 59 volunteer firefighter deaths and 29 career firefighter deaths annually. A comparison of the fatality experience of the 79 career and volunteer firefighters killed in 2005 is shown in Table 1 .
As we report each year, the largest share of on-duty firefighter fatalities are the result of sudden cardiac death – usually heart attacks. The risk factors for heart disease are well-known and NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, outlines procedures for fire departments to follow in screening candidate firefighters and handling health problems that might arise during an individual's fire service career. Additional information on developing a wellness-fitness program can be found in the Fire Service Joint Labor Management Wellness-Fitness Initiative developed by the IAFC and IAFF.
The National Volunteer Fire Council (NVFC) recently launched the Heart-Healthy Firefighter Program, which is intended to lower the incidence of cardiac-related problems in the fire service by educating firefighters and their families about nutrition, fitness and heart disease prevention. As part of that program, they have screened over 10,000 firefighters, both career and volunteer, at trade shows around the country and report disturbingly high incidence of high cholesterol, high blood pressure and obesity. The results of the screening were: six percent had Stage 2 hypertension; 24 percent had Stage 1 hypertension and 47 percent were prehypertensive. At three of the four trade shows, the average cholesterol level of those tested was close to or above 200 mg/dl. Screenings in 2006 will focus on blood pressure, cholesterol and glucose. This program, which is described fully on their website – www.healthy-firefighter.org – has been credited by many firefighters as the key to understanding their personal level of risk, and moving them to adopt a more heart-healthy lifestyle.
Deaths in crashes continue to account for a significant portion of the annual fatalities. In road crashes, failure to wear a seatbelt is an all-too-frequently reported factor in the deaths. Speed too fast for conditions is often cited as well. The IAFF and USFA have formed a partnership to develop an awareness program that will focus on safety while responding in emergency apparatus. However, attention must also be paid to the high proportion of deaths that involve personally-owned vehicles.
Deaths during training activities are the focus of the 10-year analysis that accompanies this article. Eleven firefighters have died during training activities in each of the past four years. These deaths are particularly distressing, since the purpose of training is to develop the skills, knowledge and abilities that firefighters need to protect themselves and the fellow firefighters when doing their job.
In 2005, NFPA and the National Institute for Occupational Safety and Health (NIOSH) National Personal Protective Technology Laboratory (NPPTL) entered into a Memorandum of Understanding (MOU) that focuses on emergency responder safety and protective clothing and equipment. In addition, NFPA joined several other fire service organizations in co-sponsoring the first annual National Firefighter Safety Stand Down where fire departments across the country were encouraged to devote the day to a focus on safety. This event is an important step in raising awareness across the fire service as to the steps fire departments and individual firefighters can take to reduce the risk of death and injury.
NFPA maintains standards that address a wide range of safety issues.
For road safety:
NFPA 1002, Standard on Fire Apparatus Driver/Operator Professional Qualifications, identifies the minimum job performance requirements for firefighters who drive and operate fire apparatus, in both emergency and nonemergency situations.
NFPA 1451, Standard for a Fire Service Vehicle Operations Training Program, provides for the development of a written vehicle operations training program, including the organizational procedures for training, vehicle maintenance, and identifying equipment deficiencies.
NFPA 1915, Standard Fire Apparatus Preventative Maintenance Program, details a program to ensure that fire apparatus are serviced and maintained to keep them in safe operating condition.
For health issues in the fire service:
NFPA 1500, Standard on Fire Department Occupational Safety and Health Program, requires the establishment of a firefighter health and fitness program based on NFPA 1583, Standard on Health-Related Fitness Programs for Fire Fighters, and requires that firefighters to meet the medical requirements of NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments.
To maintain the low level of on-duty fatalities that occurred in 2005, it is essential that efforts continue to reduce the incidence of heart disease among firefighters, especially by reducing the risk factors for heart disease. Safe practices at the scene of fires, safe driving practices and careful planning and execution of training activities will contribute to establishing a positive trend in on-duty firefighter safety.
A study made possible by the cooperation and assistance of the United States fire service, the Public Safety Officers’ Benefits Program of the Department of Justice, the United States Fire Administration, the National Institute for Occupational Safety and Health, 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 Thomas Hales, MD, MPH, of NIOSH, Carl E. Peterson of NFPA's Public Fire Protection Division and Joseph Molis of NFPA's Fire Analysis and Research Division for their assistance on the study.
Line of duty deaths: The Public Safety Officers’ Benefits (PSOB) Act, signed into law in 1976, provides a federal death benefit to the survivors of the nation’s federal, state and local law enforcement officers, firefighters, and rescue and ambulance squad members, both career and volunteer, whose deaths are the direct and proximate result of a traumatic injury sustained in the line of duty. The Act was amended in 2000 to include FEMA employees performing official, hazardous duties related to a declared major disaster or emergency. Effective December 15, 2003, public safety officers are covered for line-on-duty deaths that are a direct and proximate result of a heart attack or stroke, as defined in the Hometown Heroes Survivors Benefits Act of 2003.
A 1988 amendment increased the amount of the benefit from $50,000 to $100,000 and included an annual cost-of-living escalator. On October 1 of each year, the benefit increases as a result. The enactment of the USA PATRIOT bill in 2001 increased the benefit to $250,000. The current benefit is $283,385, tax free.
A decedent’s spouse and minor children usually are the eligible beneficiaries. As a result of the 2002 Mychal Judge Act, when there is no spouse or eligible children, the PSOB Act now provides the benefits to the individual(s) designated on the officer’s most recently executed life insurance policy. Parents become eligible for the death benefit if they are named on the last executed policy or if there is no legitimate claim submitted by a life insurance policy beneficiary and the officer was not married and there are no eligible children.
Line of duty disability: In 1990, Congress amended the PSOB benefits program to include permanent and total disabilities that occur on or after November 29, 1990. The amendment covers public safety officers who are permanently unable to perform any gainful employment in the future. PSOB is intended for those few, tragic cases where an officer survives a catastrophic, line of duty injury. Only then, in the presence of the program’s statutory and regulatory qualifying criteria, will PSOB’s disability benefit be awarded. The bill’s supporters anticipated that few PSOB disability claims would be eligible annually.
Public Safety Officers’ Educational Assistance Program (PSOEA): An additional benefit, signed into law in October 1996 and amended in 1998, provides an educational assistance allowance to the spouse and children of public safety officers whose deaths or permanent and total disabilities qualify under the PSOB Act. This benefit is provided directly to dependents who attend a program of education at an eligible education institution and are the children or spouses of covered public safety officers. It is retroactive to January 1, 1978, for beneficiaries who have received or are eligible to receive the PSOB benefit. Students may apply for PSOEA funds for up to 45 months of full-time classes. As of October 1, 2005, the maximum benefit a student may receive is $827 per month of fulltime attendance.
Further benefits information: To initiate a claim for death benefits, to receive additional information on filing a disability claim or to receive additional information about coverage, call, email, or write the Public Safety Officers’ Benefits Program, Bureau of Justice Assistance, Office of Justice Programs, U.S. Department of Justice, 810 7th Street, N.W., Washington DC 20531. The telephone number is (888) 744-6513 and the email address is ASKPSOB@usdoj.gov.