Sure way to reduce LODDs each year.........but what is the give and take?

I've been away from this site for a bit, so thought I'd come back with what potentially could be an interesting discussion. While on Firehouse, at the NFA, and even a recent "safety stand down" day at the dept, there is talk about the number of LODDs a year and they unfortunately tend to hold steady.

It is no doubt that this job is inherently dangerous, despite what safety measures, precautions and training we take. However, we hear the preaching from many about the number of LODDs each year and we keep losing about the same amount despite our "best" efforts. Not only fireground, but seatbelts, to heart attacks are contributors to many LODD. Thing of it is, there is an easy way to reduce the number of LODDs each year just by changing the definition and timeline of what constitutes a LODD.
The kicker is what is the give and take of changing such definitions, and even me personally am at odds with this.....so maybe this will spark a discussion.

Here is the issue, today a LODD is pretty much a firefighter dying within 24 hours of a shift or a call. While the call or shift may have contributed to the death, is it really fair to call the death a LODD just because it falls in a time frame? Recently a FF became a LODD after working a shift and was busy in their second job when they died. Was it because of the shift? Moreso we hear about LODD from the volly world where a FF died 24 hours after responding to a call or something. Point is, the person could be at a pump panel for a false alarm, goes home and chops firewood and dies from an MI, but because it falls within the definition of a LODD it is one. A paper mill worker may have worked a double shift, may have been busy, leaves work and dies from an MI. No denying the job could definately play a factor in the death, but it isn't considered a "loss time" accident.

Now the flip side here is that changing the definition can reduce the number of LODDs each year, but that would mean a reduction in benefits for the member's family. Is this something we would want to give up to lower the number of LODDs a year?

I'm really not trying to be callous here, but we know that lowering your B/P, cholesterol and so forth will help us live healthier and longer, but is a cardiac related event 24 hours after a shift or call really the result of the job, or are there other factors involved? I too would love to get our LODDs to ZERO, yet it makes me wonder how we can call some deaths LODD when most other occupations wouldn't.

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The difference in your example is that the firefighter is on duty. Also note that I said that being the operator MAY not meet the requirement. Stress on a firefighter's heart starts from the time the tones drop.

Requiring physicals at least every two years for all firefighters, career or volunteer, would be a great step towards reducing heart attack LODDs.

This is why it is important to always tell someone if you're not feeling well during/after a call. If you have it documented and then have a heart attack doing something else strenuous, at least there's proof that it started on the job.
Billy Goldfeder had a good point on all of this years ago. He said that maybe we need to have two categories - LODD and on-duty. LODDs would be real-killed in a collapse, apparatus MVC, and on-duty would be everything else, such as heart attacks in the station, etc. Maybe we need to think about it.
So the numbers have remained stagnant, I will agree on the face of that statement. It has been holding around 100 per year for a long time. I personally embraced the NFFF Courage to be Safe Program and the thought of really reducing the numbers by 50%. So much that I was recently recognized for my efforts. But seeing the "numbers" remain the same or climb slightly bothers me.

Lets get back to the authors original post here: when the PSOB opened up the window to allow post emergency response LODD's, they essentially expanded the "pool" of what we now understand to be official LODD's. This is an excellent benefit for everyone!

So if the pool, was expanded and we have remained as some call "stagnant" In my mind, with the upgraded protection, safer gear, push for seat belt use and the educational wave of the message "Everyone Goes Home".... we must have made an impact on the numbers, otherwise when the pool expanded, so should have the actual overall LODD - numbers.

Does anyone agree?
I would not have a problem with adding a second category of Directly-Related LODDs.

I would hate to see the old definition dropped. We have a statistical record, and it should be maintained. There are definitely problems with the old data, but changing the way it's measured makes the history much less valuable, since it can no longer be compared to current values.

Finally, the old data shows that that time frame "24 hours after a shift or call" is much more dangerous for firefighters than for people in general. In other words, a firefighter is more likely to have that MI splitting wood, if he splits wood in the 24 hours after a shift or call. Some attribute that to carbon monoxide exposure or the after effects of exertion or adrenaline. I don't know why, but the effect is there, and you can see it in the numbers. That's another reason not to stop collecting them.

I have no problem with collecting a second series (DRLODDs) simultaneously.
I agree, there is no doubt that an impact has been made to reduce the numbers of LODDs, even with the new definitions involved. The issue at hand for the start of this topic though is that if the definitions were not there the number of LODDs would drop. No doubt though that gear improvements, education, seat belts and so forth has decreased the number of LODDs annually.
The 24 hours could be applied to any job out there, so why is it that firefighters are the ones using a call, shift, training, etc as the reason for a death being a LODD? How many police officers are considered an LODD if they died from chopping wood after a shift where they were on a shootout or high speed chase? Exertion or adrenaline could be applied to any job out there, but a death after a shift isn't considered loss time or LODD, but we do.

Just playing devil's advocate here, I also like the idea of a direct-related LODD.
However, we hear the preaching from many about the number of LODDs each year and we keep losing about the same amount despite our "best" efforts. Not only fireground, but seatbelts, to heart attacks are contributors to many LODD.

How can we call it "our best efforts" when members still argue against the use of seatbelts or where members still don't eat and exercise accordingly and so on?

Whilst I don't disagree with your sentiments about deaths outside of the workplace, we're certainly a long way from doing our best effort....
John, you present a good post and the comments are encouraging as well. I started writing about this last year, and my most recent blog entries are about looking at the first half of the 2009 line of duty deaths in a different light. Specifically, I've been going through and reading the information available so far and placing the deaths in different categories. Finally, in the next two posts on the subject, I take away those deaths that would be covered under the PSOB Survivors Act and then propose redefining line of duty and on duty.
2009 LODD 6-Month Summary
2009 LODD; Position, Fireground
Congressional testimony about the PSOB Survivors Act is interesting in that only, at least as far as I have read, law enforcement proposes determining between line of duty and on duty. This is an obstacle that the career and volunteer sides of the fire service will spend a long time working out among themselves. The biggest problem each will have is trying to separate heart and mind when dealing with a member’s death. Culturally, we’d all like to reward the survivors of the fallen with as much as possible given the value and length of service the member gave to the department. The problem is in being rational about that process as well as “employment” parameters. Members of career departments who die in acts related to their employment contract (note, I don’t say in the line of duty or on duty) are able to receive benefits unless overwhelming evidence proves contrary. The same is true of volunteer firefighter deaths related to station duties and assignments.

In the 2009 data, there is one death that is linked to attending a volunteer association meeting. Does this death, or should it, receive the same cultural value as the two in the Houston house fire? That is a decision that many leaders do not want to make. Personally I say no, they do not have the same cultural value, as a body defines “line of duty”, but they do hold the same legal value according to the definition of “line of duty”. I asked a coworker, if he was going to a union event, not as a member, but as a committee member or part of the local’s leadership, and was killed in an accident, would his family be eligible for PSOB benefits? It is hard to determine and can be easily argued, especially if you have a volunteer firefighter’s death defined as an official LODD, when he is killed in an accident on the way to an association meeting. The point is not to give more divide between career and volunteer, but to emphasize that cultural value on the fallen that influences benefit delivery. This is where law enforcement has better rationale than the fire service. Law enforcement says that the medical death of an officer who is serving a summons or doing other administrative work is to be considered “on duty”. The death of an officer on vehicle patrol, shot and killed by a criminal is to be considered “line of duty”. The fire service does not make these determinations. Instead, we lump nearly everything into “line of duty”. Making a determination between the two will be the hardest battle.

The easiest, and to do better efforts as lutan1 asks us, is in the area of medical deaths. If PSOB benefits are no longer given, or are given in reduced amounts, to survivors of the fallen who are proven known to have poor medical and physical health, or departments that do nothing to promote wellness and fitness, then we will see a change in the number of line of duty deaths. Here is a reply to a similar question:

The most efficient ways to reduce the medically caused, and other, line of duty deaths will have to take a three part approach. First, the larger bodies of fire service representation (IAFF, IAFC, NVFC, NFFF, USFA, NFA) as well as the well known mediums (Firehouse, Fire Engineering, Fire Chief, Fire Rescue Magazine) will have to collectively state that quality personal health is paramount to all fire and EMS operations. They will then have to begin working on redirecting the awarding of grant money from those who need equipment, to those who need pre-placement and annual medical and fitness screening. Finally, they will have to work with crafting legislation to amend the PSOB law to not allow payment (or lesser amount) of benefits to departments that willingly allowed its members to participate in emergency operations while in poor physical health.
This will be the largest ‘battle’ in reducing this category of deaths because the fire service, volunteer in general, recognizes a member’s death cumulative with his or her length of service. Old Tom has been in the department for nearly 30 years, and his family should get those benefits since he dedicated so much of his life to the community. True and well intentioned, but if Old Tom smoked 3-4 packs a day, hadn’t seen the doctor in more than three years, had hypertension and other poor health, and his department had not even suggested its members have yearly exams, then his heart attack on the way to the station to be fire-police for a post-accident wash-down shouldn’t receive the same benefit as those members who maintain good physical and medical health.

We saw a slightly similar response in Boston when Firefighters Cahill and Payne died and it was alleged that alcohol and cocaine were related somehow to their tragedy. Public opinion as well as a Firehouse.com viewer poll showed that a majority believed that Cahill’s and Payne’s families should not receive benefits if it were proven that personal illegal activity was to be the cause of their death. If in the case of illegal activity a majority can approve to deny benefits, how much more attention needs to be given to eating healthy, seeing a doctor regularly and changing our apparatus or POV driving habits? The same bluntness should apply to the dead horse – seatbelts. If, as in many states, it is against the law to drive without wearing a seatbelt, then why should we award benefits to the deceased firefighter’s family when he was killed after being ejected (as well as proven seatbelt was not used) from the rig? Recognizing both the fallen member’s cumulative service to his department and community, and if warranted, his failure to act responsibly, will be hardest area to come to agreement on. However, unless we are comfortable buying into the traditional belief that 100 of us on average die each year ‘fighting fire’, nothing will change.

Second, the same bodies should push for financial penalties as well, for grant recipients. If department XYZ is awarded a grant to buy a TIC, and as time goes by a firefighter dies disoriented in some building, and the investigation reveals the TIC was left of the rig, the department should have to pay a portion of the grant money used for that TIC, back. Money is the means to the end, in the case of reducing the majority of LODDs; unfortunately it is not yet recognized in this way.

Finally, we need departments, individually, that are willing to be transparent with the changes they are trying to make in the areas of health and safety. Many have spoken of cultural changes and such, but nothing will truly happen until departments are willing to share how they are trying to give longevity to their members, even if it flies in the face of tradition. The traumatic, or fireground, deaths will always be significant due to the complexities. No two fires are the same of course, and there can be something to learn from the guy falling into the basement in Maryland as well as the guy falling into the basement in California. SOPs; fire conditions; building construction; all have their eccentricities. What we fail to realize is this:
A 18-year old racing up to the fire house in the middle of the night for a AFA, and wrapping his car around a tree, is the same in Maryland as in California
A 62-year old being found dead in the bunk room from a stroke, due to poor health, is the same in Maryland as in California
We can find plenty of details about how departments operate and why when they have a firefighting LODD (Charleston, for example), but if we read the medical cause death reports, we should be able to clearly see the universal traits: history of poor health or cardiac condition; no medical screening, no fitness program; no departmental fitness and health guidance. Departments that stand up and say, hey we have a hard time with staffing, but until you bring a note from the doc saying you’re in good physical and medical health, you have to stay home when the pager goes off; that department will set the trend for the nation as well as invest deeper in its members, and possible save a life of one of their own.


The biggest argument I have heard against this is that departments will end up disqualifying nearly all of its members (the “we’ll have no one able to run calls if we have physical requirements” swan song). This usually comes from volunteer firefighters. It is a knee-jerk reaction, thinking that a mandated wellness and fitness program once enacted would virtually shut down the firehouse on day one. Rational thought says that the process doesn’t work like this but moves much slower with debate and negotiation. However, once all departments begin to require fitness and wellness of its members, we will then see the numbers go down, even if there is no change to the definition of line of duty.

Finally, the fire service should exercise caution though when trying to redefine "line of duty" or to recalculate the numbers of the fallen. Simply shifting numbers or inserting the asterisk doesn't change the causes of death. It only makes us passively comfortable with death.
We should start with the things we can fix today. STOP at red signals and STOP signs. Wear seat belts. Enforce POV safe operations.

Train officers continuously in size up and risk management. Actively manage incidents and use the right manpower for structural fires.

I don't agree with a fitness assessment to collect PSOB funds. While some of the LODD claims astound me and I think really serve to skew our actually LODD numbers, I wouldn't support screwing a brothers family because his department wouldn't provide a screening.
I agree with you and will add that the intentions, starting with what we can fix today, will always only be intentions. At a conference two years ago that involved FH mag, FE.com, Close Calls and others, the point was made that our intentions are just lip service unless there is some reward and punishment involved. That's why I include in my reasoning that unless efforts to reduce LODDs also involve the financial part of the PSOB Survivors Act, then very little will change.

The odds are, very likely looking at the past, that before this year is over another firefighter will die in an apparatus accident most likely involving not having worn a seatbelt or having apparatus driven carelessly. The only interventions currently available are proactive in reinforcing good habits, but we have nothing in the form of a punishment, that also reinforces good habits. The only thing that will happen will be the rally to sign the seatbelt petition and more discussions on slowing down when responding.

I'm also not advocating hurting the survivors of the fallen, but you create another discussion, that of personal responsibility. If a member choses not to take care of his or her health, and still engage in firefighting operations and activities, does the leadership of the department now step in? Do they make a start by taking responsibility, in an effort to reduce the number of line of duty deaths, by requiring fitness and wellness? Read some of the past reports and we see that by being proactive towards good health departments can intervene and reduce the number of deaths. In D.C. a department physical found a large blockage in one member's cardiovascular system that had the potential to kill him. He was immediatley sent into surgery and had the blockage removed. A annual department physical revealed what could have killed him. In some of the past reports, there are departments, career and volunteer, that have no initial medical screenings; some do not even have regular fit-testing and SCBA medical screenings.

I agree members' families should not be penalized for a department's failures and shortcomings, but if we find that a majority of medically related deaths involve a lack of personal responsibility, then where do departments fit in when trying to lower that number?
I thnk stretching the definition is somewhat of a political ploy by certain organizations. There are those who take pride in the high number of deaths but no one will ever admit that and many won't believe it could happen. Is the death of an 87 year old member who is setting up for bingo when the alarm comes in and is logged as responding, really a LODD? It happens. I think it's not fair to look back over the last 20 or 30 years and calculate these figures because the definition has changed dramatically. We should actually look at causes directly related to firefighting and fire ground operations and establish a related category of LODD related deaths
Has there not been in increase in seatbelt use, wellness programs, etc? There is still a push and people are buckling up more or being made aware of wellness, exercise etc, yes you will always get those who argue against, but are they really against or playing "devil's advocate"?

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