Firefighter Nation

The NIOSH Fire Fighter Fatality Investigation and Prevention Program has released the investigation report of the line of duty death of a Pennsylvania lieutenant who suffered a fatal heart attack while operating at a 2009 structure fire.

On October 24, 2009, a 41-year-old male volunteer lieutenant (LT) responded to a reported residential fire with possible entrapment. At the scene, the LT assisted in stretching a 2-inch hoseline and participated in extinguishing the fire. After about 16 minutes, the water supply ran low, and crews took a break. The LT complained of a headache as he climbed into his engine’s cab.

The on-scene ambulance crew found the LT in the cab sweating heavily, complaining of tightness in his chest and shortness of breath. The LT became semiconscious and was helped to the ground and then carried to the ambulance. The cardiac monitor showed changes diagnostic of a heart attack.
While en route to the hospital’s emergency department (ED), the LT’s condition worsened and, as the ambulance arrived at the ED, the LT suffered cardiac arrest. Cardiopulmonary resuscitation (CPR) and advanced life support were begun and continued in the ED for over an hour until the ED physician pronounced him dead.

The death certificate and the autopsy listed “severe atherosclerotic coronary artery disease (CAD) and hypertensive cardiomyopathy” as the cause of death. Given the LT’s severe underlying CAD, NIOSH investigators concluded that the physical exertion involved in responding to the call, stretching the fire hose, and extinguishing the fire triggered a heart attack and sudden cardiac death.

The NIOSH investigation offers the following recommendations to address firefighter health and safety issues:

• Provide preplacement and annual medical evaluations to all fire fighters.
• Perform a preplacement and an annual physical performance (physical ability) evaluation.
• Ensure fire fighters are cleared for return to duty by a physician knowledgeable about the physical demands of fire fighting, the personal protective equipment used by fire fighters, and the various components of National Fire Protection Association (NFPA) 1582.
• Phase in a comprehensive wellness and fitness program for fire fighters.
• Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA).
• Conduct annual respirator fit testing.

Read the Report
Lieutenant Suffers Fatal Heart Attack During Fire Operations – Pennsylvania