A Boston Fire Department ladder truck is seen after it plowed through an intersection and crashed into a high-rise apartment building, killing one firefighter and injuring several others. (Photo: AP/Wide World)

Firefighter Fatalities in the United States — 2009
Last year’s 82 deaths was the lowest total since 1993

NFPA Journal®, July/August 2010

By Rita F. Fahy, Paul R. LeBlanc, and Joseph L. Molis 

 Download the full 2009 Firefighter Fatalities Report (PDF, 267 KB) 

In 2009, a total of 82 on-duty firefighter deaths occurred in the United States. This is a sharp drop from the 105 on-duty deaths that occurred in the U.S. in 2008, and the lowest annual total since 79 deaths in 1993. The average number of deaths annually over the past 10 years is 98. 

Of the 82 firefighters who died while on duty in 2009, 41 were volunteer firefighters, 31 were career firefighters, four were employees of federal land management agencies, four were contractors with federal land management agencies, one was an employee of a state land management agency, and one was a member of a race track fire safety crew.

Type of duty
The largest share of deaths occurred while firefighters were operating on the fire ground (27 deaths). This total is well below the average 34 deaths per year on the fire ground over the past 10 years, and half the average number of deaths in the first 10 years of this study (69 deaths per year from 1977 through 1986).

Twenty firefighters died while responding to or returning from emergency calls. It is important to note that just half of these deaths were the result of crashes. Eight were due to sudden cardiac events or stroke. One firefighter fell from the back of a responding rescue vehicle, and one firefighter died as a result of complications from surgery after injuring his knee when he slipped on ice during an EMS response.

Eleven deaths occurred during training activities. Two firefighters fell from an elevated aerial platform during a training exercise to familiarize firefighters with the new equipment, three firefighters collapsed after training runs or other physical fitness activities, two died while attending seminars or training sessions, one collapsed during pump operation training, one suffered a stroke during fitness training at the station, one was struck by a falling tree during tree felling training, and one firefighter fell while rappelling from a helicopter.

Ten firefighters died at non-fire emergencies, including five at the scene of motor vehicle crashes, three at emergency medical calls, one during a water rescue at a frozen pond, and one while clearing a fallen tree from the road.

The remaining 14 firefighters died while involved in a variety of non-emergency-related on-duty activities. These activities included normal administrative or station duties (nine deaths), community events (two deaths), patrolling for downed trees (one death), fuel reduction in a wildland area (one death) and a marijuana eradication project (one death).

Fire ground deaths
Of the 27 fire ground fatalities in 2009, 17 were killed at structure fires, seven on wildland fires or a prescribed burn, one at a dumpster fire, one at an outside fire involving structural demolition debris, and one at a vehicle fire.
 
Nine of the 17 firefighter deaths at structure fires occurred in residential properties. Fires in one- and two-family dwellings killed seven of the nine and two died in fires in apartment buildings. Four firefighters were killed in fires in vacant houses. Two firefighters were killed in a fire in a delicatessen, one died at a restaurant fire, and one was killed at a fire involving a grain silo. None of the structures had automatic fire suppression systems. 
 
Cause and nature of fatal injury or illness
Deaths resulting from overexertion, stress, and related medical issues made up the largest category of fatalities. Of the 44 deaths in this category, 35 were classified as sudden cardiac deaths (usually heart attacks), five were due to strokes, one due to complications from hypothermia, one to an aneurysm, and one was from a blood clot. In the remaining incident, a seizure caused a firefighter to fall, striking his head on the floor.

The second leading cause of fatal injury was being struck by an object or coming into contact with an object. The 22 firefighters killed included 14 in motor vehicle crashes and four struck by motor vehicles. Two firefighters were struck by falling trees. One firefighter was struck by debris when a dumpster exploded. One firefighter was electrocuted at a motor vehicle crash when he came into contact with a downed power line when he slipped or fell while trying to avoid walking into it.

Nine firefighters were killed in jumps or falls. Two fell through the floor at a structure fire, two fell from an elevated aerial platform during training, one fell on ice, one fell from the back of a responding rescue vehicle, one fell off a parked fire department vehicle after a parade, one fell while rapelling from a helicopter, and one jumped from a third-story window when trapped by intense fire conditions.

The next leading cause of fatal injury was being caught or trapped, resulting in six deaths. Four of the six firefighters were trapped by fire progress in two separate fires; two of them died of smoke inhalation and two died of burns. One firefighter became trapped in a silo and was asphyxiated. One became pinned between the top guardrail on an elevating platform of the bay door header while doing maintenance at a fire station.

One firefighter was shot by an agitated patient at an EMS call.

Sudden cardiac deaths
Overall, sudden cardiac death is the number-one cause of on-duty firefighter fatalities in the U.S. and almost always accounts for the largest share of deaths in any given year. These are cases where the onset of symptoms occurred while the victim was on duty and death occurred immediately or shortly thereafter. The number of deaths in this category has fallen significantly since the early years of this study. From 1977 through 1986, an average of 60 on-duty firefighters a year suffered sudden cardiac deaths. The average fell to 44 a year in the 1990s and to under 40 in the past decade.  In spite of this reduction, sudden cardiac death still accounted for 39 percent of the on-duty deaths in the last five years, and 42 percent in 2009 alone.

For 19 of the 35 victims of sudden cardiac events in 2009, post mortem medical documentation was available and showed that eight had severe arteriosclerotic heart disease, five were hypertensive, two were diabetic, and eight were reported to have had prior heart problems, such as prior heart attacks, bypass surgery, or angioplasty/stent placement. Some of the victims had more than one condition. Other risk factors were represented among the victims of sudden cardiac death, including obesity, smoking, and family history.

Sudden cardiac death accounts for a higher proportion of the deaths among older firefighters, as might be expected. More than half of the firefighters over age 40 who died in 2009 died of heart attacks or other cardiac events. The youngest victim of sudden cardiac death was aged 24. 

Vehicle crashes
In 2009, 14 firefighters died in 11 vehicle crashes. Five of the 14 were killed in three aircraft crashes. Two firefighters were killed in two separate crashes involving wildland apparatus, two were killed in a fire department pickup truck, and one each died in crashes involving a chief’s vehicle, a personally owned vehicle, a rescue vehicle, a ladder truck, and a water tender (tanker). Eight were killed in six crashes while responding to incidents, two were killed while returning from incidents, and four were killed in three crashes on wildland fires.

Of the nine deaths in road vehicles mentioned above, six of the victims were not wearing seatbelts (four were ejected and two were not ejected), one was wearing his seatbelt, and no information on seatbelt use was available for two of the victims (neither of whom was ejected). Excessive speed was a factor in at least two of the eight crashes. Other factors reported were driver inexperience, driver inattention, weather conditions, lack of maintenance of vehicles, and minimal safety features on older apparatus.

Other findings
There were six deaths at five intentionally set fires in 2009. Three were sudden cardiac deaths: two at fires in vacant houses and one at a grass fire. Two firefighters were killed in an apparatus crash on an intentionally set wildland fire, and one firefighter was run over by a fire department vehicle at the scene of a vacant house fire. From 2000 through 2009, 60 firefighters (6.1 percent of all on-duty deaths) died in connection with intentionally set fires. The number of these deaths annually has been dropping since 1985.

Over the past 10 years, 29 firefighter deaths have resulted from false calls, including malicious false alarms and alarm malfunctions. In 2009, sudden cardiac death claimed the lives of two firefighters, one shortly after returning from a system malfunction at an apartment building, and the other while returning from the false report of a motor vehicle crash.

The firefighters who died in 2009 ranged in age from 18 to 78, with a median age of 47 years. Three were over age 70. Over the past five years, the lowest death rates were for firefighters in their 20s. Their death rate was half the all-age average. The rate for firefighters aged 60 and over was three-and-a-half-times the average. Firefighters aged 50 and over accounted for two-fifths of all firefighter deaths over the five-year period, although they represent only one-fifth of all career and volunteer firefighters in the U.S.

Summary
There were 82 on-duty firefighter deaths in 2009, the lowest total since 1993 and the third-lowest total since NFPA began this study in 1977. The sharp drop from the number of deaths in 2008 and 2007 is explained only in part by the presence in those years of single incidents that resulted in nine deaths.

Another promising development is the low number of deaths in road crashes in 2009. There were nine deaths in crashes of road vehicles in 2009. This is the lowest total since 1983, when there were only six. Over the past 10 years, the number of deaths in road vehicle crashes has averaged 15 a year, ranging from this year’s low of nine to a high of 25 in 2003 and 2007. Although significant declines in the overall death total and in the category that regularly accounts for the second largest share of deaths (crashes) are positive findings, a single year’s results cannot be interpreted as a trend.

As in most years, the leading cause of on-duty firefighter fatalities was sudden cardiac death. The number of such deaths has been trending downward since the late 1970s, but they have leveled off at under 40 deaths while on duty each year and continue to account for approximately 40 percent of the deaths annually.

NFPA has several standards that focus on the health risks to firefighters. For example, NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments, outlines for fire departments the procedures for screening candidate firefighters and handling health problems that might arise during an individual’s fire service career. NFPA 1500, Fire Department Occupational Safety and Health Program, calls for fire departments to establish a firefighter health and fitness program based on NFPA 1583, Health-Related Fitness Programs for Fire Department Members, and requires that firefighters meet the medical requirements of NFPA 1582.

NFPA publishes several standards related to road safety issues. NFPA 1002, 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, 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 1911, Inspection, Maintenance, Testing, and Retirement of In-Service Automotive Fire Apparatus, details a program to ensure that fire apparatus are serviced and maintained to keep them in safe operating condition. NFPA 1901, Automotive Fire Apparatus, addresses vehicle stability to prevent rollovers, and gives manufacturers options on how to provide it. New vehicles will have their maximum speed limited, based on their weight, and will have vehicle data recorders to monitor, among other things, acceleration and deceleration, and seatbelt use.

The provisions of NFPA 1500 include requirements that operators successfully complete an approved driver-training program, possess a valid driver’s license for the class of vehicle, and operate the vehicle in compliance with applicable traffic laws. All vehicle occupants must be seated in approved riding positions and secured with seatbelts before drivers move the apparatus, and drivers must obey all traffic signals and signs and all laws and rules of the road, coming to a complete stop when encountering red traffic lights, stop signs, stopped school buses with flashing warning lights, blind intersections and other intersection hazards, and unguarded railroad grade crossings. Passengers are required to be seated and belted securely, and must not release or loosen seatbelts for any reason while the vehicle is in motion.

In related efforts, the USFA has formed partnerships with the International Association of Fire Fighters, the National Volunteer Fire Council, and the International Association of Fire Chiefs to focus attention on safety while responding in emergency apparatus. Details can be found at www.usfa.dhs.gov/fireservice/research/safety/vehicle.shtm.

But the focus of vehicle safety programs is not exclusively on fire department apparatus; over the years, personal vehicles have been the vehicles most frequently involved in road crashes. NFPA 1500 includes a requirement that when members are authorized to respond to incidents or to fire stations in private vehicles, the fire department must establish specific rules, regulations, and procedures relating to the operation of private vehicles in an emergency mode.

Requirements are also in effect for emergency personnel operating on roadways. In late 2008, Federal Rule 23 C.F.R. Part 634–Worker Visibility (High-Visibility Vests) became law, requiring anyone working on a federally funded roadway to wear an ANSI 107–compliant high-visibility vest. An interim rule was also published that created an exemption for firefighters and others engaged on such roadways that allows them to wear NFPA-compliant retroreflective turn-out gear when directly exposed to flames, heat, and hazardous material. NFPA 1500 requires firefighters working on traffic assignments where they are endangered by motor vehicle traffic to wear clothing with fluorescent and retroreflective material. The 2009 edition of NFPA 1901 requires that ANSI 207 – compliant breakaway high-visibility vests be carried on all new fire apparatus. Advice on compliance with the new federal rule can be found at www.respondersafety.com/.

NFPA 1901 also requires reflective striping for improved visibility on new apparatus and a reflective chevron on the rear of fire apparatus. Advice on how to improve visibility of existing apparatus can be found at www.respondersafety.com/MarkedAndSeen.aspx.

Credits
This study is made possible with the cooperation and assistance of the United States fire service, the Public Safety Officers’ Benefits (PSOB) Program of the Department of Justice, the National Institute for Occupational Safety and Health at the Centers for Disease Control and Prevention, the United States Fire Administration, and all state and federal land management agencies. 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. For information on PSOB death, disability, and educational benefits to survivors, visit www.ojp.usdoj.gov/BJA/grant/psob/psob_main.html.

Rita F. Fahy is manager of Fire Databases and Systems in the Fire Analysis and Research Division at NFPA. Paul R. LeBlanc is a fire data assistant at NFPA and a lieutenant with the fire department in Boston, Massachusetts. Joseph L. Molis is a fire data assistant at NFPA and a lieutenant with the fire department in Providence, Rhode Island.