Brothers and Sisters,

 

I'm writing a paper on firefighter LODD in the U.S. and as a part of my research, I'd like to perform an informal survey on what I believe are the two leading causes of LODD, and are the most preventable.  The survey is located here

 

http://FreeOnlineSurveys.com/rendersurvey.asp?sid=g75p28lw0zycfrr778041

 

The attachment is the same survey in MS word format.  Please be brutally honest when answering the survey . . . and as always comments from the group are welcome. 

 

Chiefs, if you feel it's appropriate for your department, please ask members of your department to participate, the more responses I can get, the better. 

 

NO departments or personnel will be identified unless I get written permission from the member or the Dept Chief to identify them in the paper.  All results will remain private.

 

Hopefully, if I get enough data it will offer some real solutions, I we will be able to continue the downward trend in firefighter deaths.

 

One last thing, even though I will only be looking at U.S. Fire Deaths, if anyone outside the U.S has insight to what is working for you. . . please respond to the word document and indicate in the remarks that you are not a U.S. firefighter.

 

Thanks in advance for your help and participation.

 

As always, TCSS

 

Shawn

 

 

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This has been discussed before and the debate remains. There are several issues that do contribute to LODD, some are touched on with your survey. Regarding physicals, etc, a big issue plain and simple is many depts don't subscribe to recommended standards because they "take what they can get" type of approach. Another issue stems from the LODD classifications.....if one seriously looks at the number of LODD's and then actually looks at the cause of death, many times these LODD are not LODD's at all.

Take for instance the FF's killed in the traffic accident after leaving a training. Because the training was fire related, they are considered LODD. However, as it turns out, they were racing another vehicle of other members at extreme speeds when they lost control of the vehicle and died. So the debate is there, does it mean it isn't a tragic loss? Absolutely not, but is it really a LODD?

Same thing goes for many cardiac related type of deaths which can occur up to 24 hours after a fire related event. A person could respond to a false alarm, sit at a pump panel, go back home and chop firewood, die from a heart attack six hours later, and it is classified as a LODD. Does it mean that there should not be an awareness for one's health and to focus on heart issues? No, but is this necessarily a LODD?

Yes, we should focus on what kills firefighters and we should strive for no LODD's, but along the same breaths, perhaps we need to stop viewing some deaths as LODD. Perhaps the standards should be changed, but that just leads into the nice Catch 22, when it comes to what is considered a LODD for survivor benefits. Yes, I would love to see no more LODD's, but it also means that such physical standards and screenings should be done, despite a "take what you can get approach".
john i totally agree with the fact that these guys were racing and was immature as can be but a lodd
is when a person is on duty no matter at the station at home that doesnt matter its still a lodd as long as considered on duty so no matter what immature or not these guys should be treated like any other firefighter
So is what you are saying is that seems I am a Volunteer and am on duty 25/8/366 that if I am walking across the street from my house not the station house or a scene and I get hit by a car and die that should be a LODD
Actually Brandi, the limitations for a LODD is 24 hours after a shift, training, incident, etc. The problem is that in many of these cases, considering a death a LODD is a stretch, but they do meet the parameters for it. I am not saying anything against such people, nor their dedication to the fire service, but I am not a proponent of the current definition of constituting a LODD.
This has been studied by the NFFF. Heart attacks (stress and overexertion) and motor vehicle related collisions are the two leading categories.

Which are the most preventable.
Vehicle accidents are much more preventable than are heart attacks. Many of the heart attack LODDs are young and healthy folks who die from one of four causes - or a combination. The mechanisms are thought to be:

1) Dehydration heart attacks. The dehydration thickens the blood, makes it easier to clot, a clot forms, and the heart attack occurs.

2) Chemical-induced heart attacks. These occur when cyanide and other chemicals are either inhaled during unmasked overhaul or absorbed through the skin during a masked-up firefight.

3) Cardiac electrical disturbances. Anyone can have these, and they can kill you without any coronary blockage whatsoever. Some people are genetically disposed to these, some have them due to overconsumption of stimulants such as caffiene, and some occur from unknown causes.

Good physical fitness has essentially no impact upon these three types of "heart attack".

4) The traditional STEMI heart attack (S-T Elevation Myocardial Infarction) caused from coronary artery disease secondary to an unhealthy lifestyle and/or poor physical condition. This one is preventable - but indirectly.

That was my point about vehicle accidents being the most preventable. The cause for most of those is acute, and therefore more preventable than the chronic issues that lead to the STEMI heart attacks.

The issues in the first three heart attack types are less well known, but they seem to disproportionately impact young, healthy firefighters.
John,

I agree with most of your points. The classification of LODDs seems arbitrary, but I can’t think of a better way than to have a time stamp on it, especially when it come to stress related issues. Your point about firefighters returning from training, if the dept paid for the training, allowed FF to use POV and pay for gas/lodging and all of that. Looking between NFPA and USFA number of deaths for 2009, there is a difference in the numbers but I don’t know the criteria used by each organization.
The biggest problem in regard to no seat belts is that, even though we as public safety folks know that they save lives, but still don’t wear them. And in your example if the FF was at the pump panel, went home, chopped firewood, and had a cardiac event, did he have a pre-existing condition? Risk factors? Where do you draw the line? Personally, I’m lucky enough to get my lipids checked each year as part of my employee benefits (hospital employee). I think even something as simple as knowing your blood work results, weight, BMI, and BP would go a long way toward a little preventative medicine.

TCSS

Shawn
Ben,
The NFPA report for last years LODD had some interesting facts in it. Of the thirty-five cardiac related deaths, nineteen had postmortem results available. Of those nineteen, eight had severe arteriosclerotic heart disease, two were diabetic and five were hypertensive. Also, eight of the nineteen had prior cardiac issues (stents, prior heart attacks or bypass). Other risk factors presented.
I guess the big question is are we doing enough to educate our firefighters on heart healthy living, quitting smoking, managing weight and managing stress?

TCSS

Shawn
Thanks for all of the responses to the survey so far. . . keep them coming.

TCSS

Shawn
I agree, but my point is that being healthy, being a non-smoker, avoiding obesity, and good stress management do not prevent three of the four types of cardiac-related LODDs.

Doing all of the good stuff helps, but it can also create a false sense of security.
brandie hughes is my wife i replied to this under her page by accident but i see your point as far as not being in front of the firehouse but in front of yours however you are still also on duty at the time so it actually pretty complicated when it comes down to stuff like that i think the fire service these days classify a lodd as when your on duty no matter what the fatality was caused by so yes its controversial but thats just the same as if a career cheif 60 yrs old is just getting to the house to start his tour and has a sudden massive heart attack and dies and its not fire related then its classified as a lodd just because he was on duty at the time the heart attack happened
An ounce of prevention is worth a pound of cure.

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