NFPA Journal®, November/December 2008

By Michael J. Karter and Joseph L. Molis

Each year, NFPA studies firefighter deaths and injuries to provide national statistics on their frequency, extent, and characteristics. Earlier this year, NFPA reported that 103 firefighters died on duty (see “2007 Firefighter Fatalities,” NFPA Journal July/August 2008).

This report addresses 2007 firefighter injuries in the United States. The results are based on data collected during the 2007 NFPA Survey of Fire Departments for U.S. Fire Experience. An earlier report measured the national fire experience in terms of the number of fires that fire departments attended and the resulting civilian deaths, civilian injuries, and property losses that occurred.¹

This year’s report includes among its results:

• An estimate of the total number of 2007 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 the population of the community protected.
• Descriptions of selected incidents that illustrate firefighter safety problems.

Overall results
Based on survey data reported by fire departments, NFPA estimates that 80,100 firefighter injuries occurred in the line of duty in 2007.² This is a decrease of 4 percent and back to the 2005 level. In recent years, the number of firefighter injuries has been considerably lower than it was in the 1980s and 1990s, but this is due in part to additional questions about exposures, which allow us to place them in their own categories (see Figure 1 ). Previously, some of these exposures may have been included in total injuries under other categories.

NFPA estimates that there were 13,450 exposures to infectious diseases, such as hepatitis, meningitis, HIV, and others in 2007. This amounts to 0.9 exposures per 1,000 emergency medical runs by fire departments in 2007.

NFPA estimates that there were 28,300 exposures to hazardous conditions such as asbestos, radioactive materials, chemicals, fumes, and others in 2007. This amounts to 26.2 exposures per 1,000 hazardous condition runs in 2007.

An estimated 16,350 injuries, or 20.4 percent of all firefighter injuries, resulted in lost time in 2007.

Injuries by type of duty
Estimates of firefighter injuries by type of duty are displayed in Table 2 and Figure 3. As in past reports, type of duty is divided into five categories:

Responding to, or returning from, an incident, including both fires and nonfire emergencies.

• Fireground, which includes structure fires, vehicle fires, brush fires, and so on, refers to all activities from the moment of arrival at the scene to departure time, such as set-up, extinguishment, and overhaul.
• Nonfire emergency, which includes rescue calls, hazardous calls such as spills, and natural disaster calls.
• Training.
• Other on-duty activities, such as inspection or maintenance duties.

Results by type of duty indicate, not surprisingly, that the largest share of injuries occurs during fireground operations: 38,340 or 47.9 percent of all firefighter injuries in 2007, similar to the 2002–2003 level. Table 1 displays firefighter injuries at the fireground and injury rates for the 19812007 period. Injuries at the fireground decreased from their high of 67,500 in 1981 to a low of 36,880 in 2004, for a decrease of 45.4 percent. The rate of injuries per 1,000 fires generally decreased during the period except for 2005–2006. This is because the number of fires also decreased a considerable 46.4 percent for the 1981 to 2004 period (see Figure 2 ).

In addition to injuries at the fireground, an estimated 15,435 or 19.3 percent of injuries occurred at nonfire emergencies, while 13,665 or 17.1 percent occurred during other on-duty activities.

The nature of fireground injuries
Estimates of 2007 firefighter injuries by nature of injury and type of duty are displayed in Table 2. The nature of injury cause categories are based, with modifications, on NFPA 901, Uniform Coding for Fire Protection. Table 2 indicates that the four major types of injuries that occur during fireground operations are strains and sprains, responsible for 45.1 percent; wounds, cuts, bleeding, and bruises for 18.2 percent; burns for 6.9 percent; thermal stress for 6.3 percent; and smoke or gas inhalation for 5.6 percent.

Results were fairly consistent during all non-fireground activities, with strains, sprains, and muscular pain comprising 57.8 percent of all non-fireground injuries and wounds, cuts, bleeding, and bruises comprising 17.7 percent.

Causes of fireground injuries
Because fireground injuries are of particular concern, their causes were examined (see Figure 4 ). The definition of cause here refers to the initial circumstance leading to the injury. The cause categories included on the survey were also based on NFPA 901. Falls, slips, and jumps at 27.3 percent and overexertion and strains at 24.4 percent were the leading causes of fireground injuries. Other major causes were contacts with an object at 11.9 percent, exposure to fire products at 8.8 percent, and being struck by an object at 8.8 percent.

Fire department vehicle collisions
NFPA reported earlier that 27 firefighters died in motor vehicle collisions in 2007 (see “2007 Firefighter Fatalities,” NFPA Journal, July/August 2008).

In 2007, there were an estimated 14,650 collisions involving fire department emergency vehicles, where departments were responding to, or returning from, incidents (see Table 3 ). To put this number in perspective, fire departments responded to over 25.3 million incidents in 2007, so the number of collisions represents about one-tenth of 1 percent of total responses. However, these collisions resulted in 915 firefighter injuries or 1.1 percent of all firefighter injuries.

In addition, 665 collisions involving firefighters’ personal vehicles occurred in 2007 as they responded to, or returned from, incidents. These collisions resulted in an estimated 120 injuries.

Average fires and fireground injuries per department by population protected
The average number of fires and fireground injuries per department by the population of community protected in 2007 are displayed in Table 4. These tabulations show that the number of fires a fire department responds to is directly related to the population protected and that the number of fireground injuries incurred by a department is directly related to its exposure to fire, or the number of fires attended by the department. The second point is clearly demonstrated when we examine the range of the statistic: from a high of 100.5 fireground injuries for departments that protect communities of 500,000 to 999,999 to a low of 0.2 for those that protect communities of less than 2,500.

A useful way to look at firefighter injury experience and to obtain a reading on the relative risk that departments face is to examine the number of fireground injuries that occur for every 100 fires attended. This takes into account relative fire experience and allows a more direct comparison among departments protecting communities of different sizes. The number of fireground injuries per 100 fires is displayed in Column 4 of Table 4. The overall range of rates varied little from a high of 3.4 for departments that protect communities of 250,000 to 499,999 people to a low of 1.6 for departments that protect communities with less than 5,000 people.

Thus, the wide range noted in average fireground injuries by the population protected narrows when relative fire experience is considered. The overall injury rate for departments protecting communities with populations of 50,000 or more was 2.5 injuries per 100 fires or 39 percent higher than the injury rate for departments protecting communities with less than 50,000 people.

The risk of fireground injury per 100 firefighters by the size of the community protected was also calculated and is displayed in Column 5 of Table 4. Larger departments generally had the highest rates, with departments protecting communities of 250,000 to 499,999 having the highest rate of 9.4 injuries per 100 firefighters. As community size decreases, the rate drops quite steadily to a low of 1 for departments protecting fewer than 2,500 people. That is a more than a nine-to-one difference in risk of injury between communities of 250,000 to 499,999 and the smallest communities, those with less than 2,500.

An explanation for this difference is that, although a department protecting a community with a population of 250,000 to 499,999 has, on average, more than 22 times as many firefighters as a department protecting a population of less than 2,500, the larger department attends more than 100 times as many fires, and as a result, it incurs considerably more fireground injuries.

Average fires and fireground injuries by population protected and region
Table 5 displays the average number of fires and fireground injuries per department by the population of community protected and region of the country.³ As in the nationwide results in Table 4, 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 that the number of fireground injuries incurred by a department is directly related to the number of fires attended. The Northeast reported a substantially higher number of fireground injuries for most community sizes where all departments reported sufficient data by region.

Improving firefighter safety
As the statistics in this report and previous reports attest, firefighting presents great risks of personal injury to firefighters. Moreover, because of the kind of work performed and the hazards of the incident scene environment, it is unlikely all firefighter injuries can be eliminated. However, a risk management system and the application of existing technology can offer options to reduce present injury levels and bring about the corresponding reductions that NFPA recommends be taken at the local level. The reference to the appropriate NFPA standard is shown with the example in parentheses:

• Commitment on the part of top fire service management to reducing injuries (NFPA 1500, Fire Department Occupational Safety and Health Program, Section 4.3).
• Establishment of a safety committee, led by a safety officer, to recommend a safety policy and the means of implementing it (NFPA 1500, Section 4.5).
• Development and implementation of an investigation procedure that includes all accidents, near misses, injuries, fatalities, occupational illnesses, and exposures involving members (NFPA 1500, Sections 4.4.4 and 4.4.5).
• Provision of appropriate protective equipment and a mandate to use it (NFPA 1500, Sections 7.1 through 7.8).
• Development and enforcement of a program on the use and maintenance of self-contained breathing apparatus (NFPA 1500, Sections 7.9 through 7.14).
• Development and enforcement of policies on safe practices for drivers and passengers of fire apparatus (NFPA 1500, Sections 6.2 and 6.3).
• Development of procedures to ensure response of sufficient personnel for both firefighting and overhaul duties (NFPA 1500, Section 4.1.2; NFPA 1710, Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments; and NFPA 1720, Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Volunteer Fire Departments ).
• Implementation of regular medical examinations and a physical fitness program (NFPA 1500, Sections 10.1 through 10.3; NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments; and NFPA 1583, Health-Related Fitness Programs for Firefighters ).
• Adoption and implementation of an incident management system (NFPA 1500, Section 8.1; and NFPA 1561, Emergency Services Incident Management System ).
• Training and education for all members related to emergency operations (NFPA 1500, Chapter 5)
• Implementation of programs for the installation of private fire protection systems, so that fires are discovered at an earlier stage, exposing the firefighter to a less hostile environment (NFPA 1, Uniform Fire CodeTM; NFPA 101®, Life Safety Code®; and NFPA 5000®, Building Construction and Safety Code® ).
• Increased efforts in the area of fire-safety education programs, so that citizens are made aware of measures to prevent fires and of correct reactions to a fire (NFPA 1201, Providing Emergency Services to the Public, Chapter 6).

Efforts need to be made to recognize that firefighter injuries can be reduced. By addressing the priorities listed above, fire service organizations can make significant strides toward reducing the number and impact of such injuries.

References

1. Michael J. Karter, Jr., “2007 Fire Loss in the United States,” NFPA Journal, Vol. 102, No. 5 (September/October 2008).
2. Around any estimate based on a sample survey, a confidence interval measures the statistical certainty or uncertainty of the estimate. Based on data reported by fire departments responding to the 2007 NFPA Survey for U.S. Fire Experience, NFPA is very confident that the actual number of firefighter injuries falls within the range of 75,100 to 85,100.
3. The four regions, as defined by the U.S. Census Bureau, include the following 50 states and the District of Columbia: Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and WisconsinSouth: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.

Acknowledgments
NFPA thanks the many fire departments that responded to the 2007 NFPA Survey for U.S. Fire Experience for their continuing efforts to provide in a timely manner the data so necessary to make national projections of firefighter injuries. The authors thank the many NFPA staff members who worked on this year’s survey, including Frank Deely, John Baldi, and John Conlon for editing and keying the survey forms and their follow-up calls to fire departments and Norma Candeloro for handling the processing of survey forms and keying in this report.