Quincy, MA – Three-quarters of firefighters who died of heart attacks – the top cause of on-duty deaths – went to work with known or detectable heart conditions, according to a new analysis of firefighter fatalities from 1995 to 2004 by the National Fire Protection Association (NFPA).
The toll of heart disease is a major reason why firefighter deaths have not declined in recent years, even though fewer firefighters die in burning structures (and fewer structures catch fire). An average of 97 firefighters died per year in the 1990s. But since 2000, the yearly average has been 102, except for firefighters killed during the 9-11 attacks.
In 2004, there were 103 firefighters who died on the job, a rate similar to other recent years.
The new information points to ways to protect firefighters from the biggest threat to their lives. Just as self-contained breathing apparatus and heat-resistant protective clothing have saved firefighters during interior structural fire protection from many effects of fire, health promotion, screening, appropriate job restrictions and subsequent treatment can reduce the incidence of sudden cardiac death.
During the 10-year period studied in the NFPA report, 440 firefighters – 43.7 percent of those who died on the job – experienced sudden cardiac death (heart attacks and other heart-related sudden death), typically triggered by stress or exertion.
NFPA was able to obtain medical information for 308 of those 440 firefighters. It found that 134 had previously suffered a heart attack, undergone bypass surgery, or angioplasty/stent placement. The majority had known heart disease but were not on restricted duty. An additional 97 had severe blockage of the heart’s arteries but it is unclear whether this was known prior to their deaths.
Unfit firefighters pose a danger to themselves, fellow firefighters and the public if they become incapacitated during emergency response. NFPA has developed standards that, if adopted, could prevent many on-duty deaths. One requires health and fitness programs for firefighters. Another requires firefighters to meet health standards before joining the fire service, and to be carefully evaluated annually and if they develop certain health problems after joining.
The study on sudden cardiac death is part of the NFPA’s annual analyses of firefighter fatalities.
Most firefighters who die on duty do not die on the fireground. For the second consecutive year, less than 30 percent of the deaths occurred on the fire ground, the lowest rate on record. (And of these 29 fire-ground fatalities, 10 were caused by sudden cardiac death.)
The number of firefighters who died in vehicle crashes in 2004 (17) was half the number in 2003 (33), when deaths in crashes reached an all-time high.
Deaths during emergency medical responses, which had been dropping through the 1980s and 1990s, have risen sharply in the new century. In the past five years, there were 21 deaths at medical calls, compared with six deaths in the previous five-year period.
One positive finding was that there were no deaths in vacant or idle buildings, for the first time since NFPA began gathering this data in 1977. The number of deaths in fires in these types of buildings (including those under construction or renovation) dropped from a high of 37 in the first five years of the study to just eight in the five most recent years. Only once in the past 15 years have more than five firefighters died in such property; that was when six firefighters were killed in a vacant warehouse fire in Worcester, MA in 1999 when they entered thinking there were occupants.
This trend reflects a greater understanding by firefighters to battle fires from the outside when no lives are at stake inside.
The 10-year study will be available at http://www.nfpa.org/fatalityreport on June 1, 2005.
