Features

Fire Fighter Injuries for 2006

NFPA Journal®, November/December 2007

By Michael J. Karter Jr., and Joseph L. Molis

Overview of 2006 Fire Fighter Injuries

RELATED NFPA REPORTS Fire fighter injuries for 2006 In 2006, 83,400 fire fighter injuries occurred in the line of duty, an increase of 4.1 percent from 2005. Fire fighter injury incidents Narratives from ten incidents in which injury occured. FIREFIGHTER INJURY FIGURES  Table 1: Injuries at the fireground, and nonfire emergencies, 1981-2006  Figure 1: Total injuries by year (1981-2006)  Table 2: Injuries by nature of injury and type of duty, 2006  Figure 2: The decrease in fireground injuries is similar to the decrease in fires  Table 3: Fire department vehicle collisions and resulting injuries while responding or returning from incidents, 1990-2006  Figure 3: Total firefighter injuries by type of duty, 2006  Table 4: Average number of fires, fireground injuries and injury rates by population of community protected, 2006  Figure 4: Fireground injuries by cause, 2006 PREVIOUS INJURY REPORTS  Injury Report - 2005 (PDF 79 KB)  Injury Report - 2004 (PDF 332 KB)  Injury Report - 2003 (PDF 3 MB)  Injury Report - 2002 (PDF 2.9 MB)  More NFPA statistics RELATED INFORMATION/REPORTS  Firefighter fatality studies 1977-2006 (July/Aug 2007)  US Fire fatalities in 2006 (July/Aug 2007)  Firefighter fatality incidents - 2006 (July/Aug 2007)  Firefighter injuries 2005 (Nov/Dec 2006)  2005 firefighter injury incidents (Nov/Dec 2006) NFPA CODES/STANDARDS  NFPA 901: Uniform Coding for Fire Protection  NFPA 1500: Fire Department Occupational Safety and Health Program  NFPA 1710: Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments  NFPA 1720: Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Volunteer Fire Departments  NFPA 1582: Comprehensive Occupational Medical Program for Fire Departments  NFPA 1583: Standard on Health-Related Fitness Programs for Fire Department Members  NFPA 1561: Standard on Emergency Services Incident Management System  NFPA 1: Uniform Fire Code™  NFPA 101: Life Safety Code®  NFPA 5000®: Building Construction and Safety Code®  NFPA 1201: Standard for Providing Emergency Services to the Public "Everybody Goes Home" Find out more information about the National Fallen Firefighters Foundation.

• 83,400 fire fighter injuries occurred in the line of duty in 2006, an increase of 4.1 percent from the year before.
• 44,210 or 53.0 percent of all fire fighter injuries occurred during fireground operations. An estimated 13,690 occurred during other on duty activities, while 13,090 occurred at non-fire emergency incidents.
• Regionally, the Northeast had the highest fireground injury rate with 5.0 injuries occurring per 100 fires; this was more than twice the rate for the rest of the country.
• The major types of injuries received during fireground operations were: strain, sprain, muscular pain (46.7 percent); wound, cut, bleeding, bruise (17.3 percent); burns (5.9 percent); smoke or gas inhalation (5.6 percent). Strains, sprains, and muscular pain accounted for 56.7 percent of all nonfireground injuries.

Background
Fire fighters work in varied and complex environments that increase their risk of on-the-job death and injury. A better understanding of how these fatal accidents, nonfatal injuries, and illnesses occur can help identify corrective actions, which may minimize the inherent risks.

Each year, NFPA studies fire fighter deaths and injuries to provide national statistics on their frequency, extent, and characteristics. Earlier this year, the NFPA reported 89 fire fighters died on duty (See, "2006 Fire Fighter Fatalities ," NFPA Journal®, July/August 2007).

This report addresses 2006 fire fighter injuries in the United States. The results are based on data collected during the NFPA Survey of Fire Departments for U.S. Fire Experience (2006). 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 occurred¹ .

This year's report includes among its results:

• An estimate of the total number of 2006 fire fighter injuries.
• Estimates of the number of injuries by type of duty.
• An estimate of the number of exposures to infectious diseases.
• Trends in fire fighter injuries and rates.
• Fireground injuries by cause.
• Fire department vehicle accidents and resulting fire fighter injuries.
• The average number of fires and fireground injuries per department by population of community protected.
• Descriptions of selected incidents that illustrate fire fighter safety problems.

Overall results
Based on survey data reported by fire departments, NFPA estimates that 83,400 fire fighter injuries occurred in the line of duty in 2006. This is an increase of 4.1 percent and the highest it’s been since 2000.

In recent years, the number of fire fighter injuries have been considerably lower than they were in the 1990s (Figure 1), but this is due in part to additional questions on exposures, which allows us to place them in their own categories. Previously, some of these exposures may have been included in total injuries under other categories.²

NFPA estimates that there were 11,890 exposures to infectious diseases (e.g., hepatitis, meningitis, HIV, others) in 2006. This amounts to 0.8 exposures per 1,000 emergency medical runs by fire departments in 2006.

NFPA estimates that there were 23,580 exposures to hazardous conditions (e.g., asbestos, radioactive materials, chemicals, fumes, other) in 2006. This amounts to 22.5 exposures per 1,000 hazardous condition runs in 2006.

An estimated 15,950 injuries or 19.1 percent of all fire fighter injuries resulted in lost time in 2006.

Injuries by type of duty
Estimates of fire fighter injuries by type of duty are displayed in Figure 2 . As in past reports, type of duty is divided into five categories:

• Responding to or returning from an incident (includes fire and nonfire emergencies).
• Fireground (includes structure fires, vehicle fires, brush fires, etc.), and refers to all activities from the moment of arrival at the scene to departure time (e.g., setup, extinguishment, overhaul).
• Nonfire emergency (includes rescue calls, hazardous calls, such as spills, and natural disaster calls).
• Training
• Other on-duty activities (e.g., inspection or maintenance duties).

Results by type of duty indicate that the largest share of injuries occurs during fireground operations: 44,210 or 53.0 percent of all fire fighter injuries in 2006 and the highest it’s been since 1999. Table 1  displays fire fighter injuries at the fireground and injury rates for the 1981 to 2006 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 has generally decreased during the period except for 2005-06. This is because the number of fire incidents 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 13,690 or 16.4 percent occurred during other on-duty activities, while 13,090 or 15.7 percent occurred at nonfire emergencies.

Nature of fireground injuries
Estimates of 2006 fire fighter 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 strain, sprain (46.7 percent); wound, cut, bleeding, bruise (17.3 percent); burns (6.9 percent); smoke or gas inhalation (5.6 percent); thermal stress (5.1 percent).

Results were fairly consistent during all non-fireground activities, with strains, sprains, and muscular pain accounting for 56.7 percent of all non-fireground injuries, and wound, cut, bleeding, bruise accounting for 17.8 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, Uniform Coding for Fire Protection. Overexertion, strain (25.5 percent), fall, slip, jump (23.9 percent), were the leading causes of fireground injuries. Other major causes were contact with object (10.8 percent); and exposure to fire products (8.1 percent), and struck by (8.0 percent).

Fire department vehicle collisions
NFPA reported earlier that 19 fire fighters died in motor vehicle collisions in 2006. (See “2006 Fire Fighter Fatalities” July/August 2007, NFPA Journal).

In 2006, there were an estimated 16,020 collisions involving fire department emergency vehicles, where departments were responding to or returning from incidents (see Table 3 ).

To put this number in perspective however, fire departments responded to more than 24.5 million incidents in 2006, so that the number of collisions represents about one tenth of 1 percent of total responses. However, these collisions resulted in 1,250 fire fighter injuries or 1.5 percent of all fire fighter injuries.

Also, 1,070 collisions involving fire fighters’ personal vehicles occurred in 2006 while departments were responding to or returning from incidents. These collisions resulted in an estimated 210 injuries.

Average fires and fireground injuries per department by population protected
The average number of fires and fireground injuries per department by population of community protected in 2005 are displayed in Table 4 . These tabulations show (1) that the number of fires a fire department responds to is directly related to the population protected, and (2) that the number of fireground injuries incurred by a department is directly related to its exposure to fire, i.e., and 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 149.4 for departments that protect communities of 500,000 to 999,999 to a low of 0.2 for departments that protect communities of less than 2,500.

A useful way to look at fire fighter 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 more direct comparison between 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 4.7 for departments that protect communities 500,000 to 999,999 to a low of 1.4 for departments that protect communities of less than 2,500 population. Thus, the wide range noted in average fireground injuries by population protected narrows when relative fire experience is taken into account. The overall injury rate for departments protecting communities of 50,000 population or more was 3.2 injuries per 100 fires or 77 percent higher than the injury rate for departments protecting communities of less than 50,000 population.

The risk of fireground injury per 100 fire fighters by size of 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 500,000 to 999,999 having the highest rate with 12.7 injuries per 100 fire fighters. As community size decreases, the rate drops quite steadily to a low of 1.0 for departments protecting less than 2,500 people. That is a more than a twelve-to-one difference in risk of injury between communities of 500,000 to 999,999, and the smallest communities (less than 2,500).

An explanation for this difference is that although a department protecting a community with a population of 500,000 to 999,999 has, on average, more than 50 times as many fire fighters than a department protecting a population of less than 2,500, the larger department attends more than 220 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 4 displays the average number of fires and fireground injuries per department by population of community protected and region of the country³. 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 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 fire fighter safety
As the statistics in this report and previous reports attest, fire fighting presents great risks of personal injury to fire fighters. Moreover, because of the kind of work performed and the hazards of the incident scene environment, it is unlikely that all fire fighter injuries can be eliminated. 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. The reference to the appropriate NFPA Standard is shown with the example in parenthesis:

• Commitment on the part of top fire service management to reducing injuries (NFPA 1500, Standard on Fire Department Occupational Safety and Health Program , Section 4.3)
• Establishment of a safety committee headed by a safety officer to recommend a safety policy and the means of implementing it
  (NFPA 1500, Section 4.5).
• Develop and implement an investigation procedure that includes all accidents, near misses, injuries, fatalities, occupational illnesses, and exposures involving members. (NFPA 1500, 4.4.4 and 4.4.5)
• Provision of appropriate protective equipment and a mandate to use it.
  (NFPA 1500, Section 7.1 through 7.8)
• Development and enforcement of a program on the use and maintenance of SCBA
  (NFPA 1500, Section 7.9 through 7.14
• Development and enforcement of policies on safe practices for drivers and passengers of fire apparatus
  (NFPA 1500, Section 6.2 and 6.3)
• Development of procedures to ensure response of sufficient personnel for both fire fighting and overhaul duties.
  (NFPA 1500, 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, Standard for the 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, Section 10.1 through 10.3; NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments ; and NFPA 1583, Health-Related Fitness Programs for Fire fighters )
• Adoption and implementation of an incident management system.
  (NFPA 1500, Section 8.1; and NFPA 1561, Standard on 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 fire fighter to a less hostile environment
  (NFPA 1, Uniform Fire Code^TM; NFPA 101®, Life Safety Code®; 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 the fire situation
  (NFPA 1201, Standard for Providing Emergency Services to the Public, Chapter 6)

Efforts need to be made to recognize that fire fighter injuries can be reduced. By addressing the priorities listed above Fire Service organizations can make significant strides towards reducing the number and impact of such injuries.

Definition of Terms

• Fire: Any instance of uncontrolled burning. Excludes 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: The movement of a piece of fire service apparatus or equipment in response to an alarm.
• Injury: 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.

Survey and data collection method
The NFPA annually surveys a sample of departments in the United States to make national projections of the fire problem. The sample is stratified by the size of the community protected by the fire department. All U.S. fire departments that protect communities of 100,000 or more are included in the sample, because they constitute a small number of departments with a large share of the total population protected. For departments that protect less than 100,000 population, stratifying the sample by community size permits greater precision in the estimates. Survey returns in recent years have ranged from 2,560 to 3,500 departments annually. The national projections are made by weighting 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 very confident that the actual number of total fire fighter injuries falls within 8.3 percent of the estimate.

The results in this report are based on injuries that occurred during incidents attended by public fire departments. No adjustments were made for injuries that occurred during fires attended solely by private fire brigades, e.g., industrial or military installations.

Data collection for the selected incident summaries was enhanced by a form that was sent to departments requesting information. The form included questions on type of protective equipment worn, age and rank of fire fighters injured, and description of circumstances that led to injury.

Footnotes

1. Michael J. Karter, Jr., "2006 Fire Loss in the United States ", NFPA Journal, Vol. 101, No. 5 (September/October 2007).
2. Around any estimate based on a sample survey, there is a confidence interval that measures the statistical certainty (or uncertainty) of the estimate. Based on data reported by fire departments responding to the NFPA Survey for U.S. Fire Experience (2005), the NFPA is very confident that the actual number of fire fighter injuries falls within the range of 76,400 to 90,400.
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.
   • Northcentral:  Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin.
   • South:  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 NFPA Survey for U.S. Fire Experience (2006) for their continuing efforts in providing in a timely manner the data so necessary to make national projections of fire fighter injuries.

The authors gratefully 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 typing this report.

---

Michael J. Karter Jr. is a Senior Statistician with the National Fire Protection Association’s Fire Analysis and Research Division. Joseph L. Molis is an NFPA Fire Data Assistant.

In this Section:
			Large Loss for 2006 In 2006, fire departments in the United States responded to an estimated 1,642,500 fires, which an estimated loss of $11.3 billion.
			Protecting Life and Property Significant changes in 2008 editions of NFPA 1141 and NFPA 1144
			U.S. Fire Fighter Injuries - 2006 83,400 fire fighter injuries occurred in the line of duty in 2006, an increase of 4.1 percent from the year before.
			2006 Firefighter Injury Incidents A company officer with 11 years experience suffered a fractured skull after he fell during a training session.