An official website of the United States government
Fire Fighter Suffers Sudden Cardiac Death While Working at a Grass Fire – Mississippi
Death in the Line of Duty…A summary of a NIOSH fire fighter fatality investigation
F2014-11 Date Released: August 2014
Executive Summary
On February 1, 2014, a 57-year-old male volunteer fire fighter (“FF”) spotted a grass fire threatening a local residence and nearby barn. After notifying dispatch, he assisted the local fire department in extinguishing the fire. He pulled a 1½-inch hoseline to the fire in two locations and to the top of the engine’s hosebed. While atop the engine hosebed, the FF was found unresponsive and not breathing (1341 hours). The incident commander of the responding fire department notified dispatch, then began cardiopulmonary resuscitation (CPR). The FF was placed into the bed of a pickup truck and driven to the ambulance station with CPR administered en route. Upon arrival, the ambulance paramedics began advanced life support including cardiac monitoring with defibrillations, intravenous cardiac resuscitation medications, and intubation. The ambulance transported the FF to the hospital’s emergency department (ED) where advanced life support continued an additional 12 minutes without a change in the FF’s clinical status. At 1424 hours the attending physician pronounced the FF dead, and resuscitation efforts were discontinued.
The death certificate, completed by the county coroner, listed “sudden cardiac death due to stress/overexertion at fire scene due to intentionally set fire due to hypertensive heart disease” as the cause of death. No autopsy was performed. Blood tests for carboxyhemoglobin were negative, suggesting the FF had minimal exposure to the carbon monoxide in fire smoke. National Institute for Occupational Safety and Health (NIOSH) investigators concluded that assisting with fire suppression activities probably triggered either a heart attack or a cardiac arrhythmia resulting in sudden cardiac death.
NIOSH investigators offer the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among fire fighters at this and other fire departments.
- Provide preplacement and annual medical evaluations to all fire fighters in accordance with NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to identify fire fighters at increased risk for coronary heart disease (CHD).
- Ensure exercise stress tests are performed on fire fighters at increased risk for CHD.
- Ensure that 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 components of NFPA 1582.
- Phase in a mandatory comprehensive wellness and fitness program for fire fighters.
- Perform a candidate and member physical ability evaluation.
- Provide fire fighters with medical clearance to wear a self-contained breathing apparatus (SCBA) as part of the fire department’s medical evaluation program.
- Conduct annual respirator fit testing.
- Perform an autopsy on all on-duty fire fighter fatalities.
The National Institute for Occupational Safety and Health (NIOSH), an institute within the Centers for Disease Control and Prevention (CDC), is the federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. In 1998, Congress appropriated funds to NIOSH to conduct a fire fighter initiative that resulted in the NIOSH Fire Fighter Fatality Investigation and Prevention Program which examines line-of-duty-deaths or on duty deaths of fire fighters to assist fire departments, fire fighters, the fire service and others to prevent similar fire fighter deaths in the future. The agency does not enforce compliance with State or Federal occupational safety and health standards and does not determine fault or assign blame. Participation of fire departments and individuals in NIOSH investigations is voluntary. Under its program, NIOSH investigators interview persons with knowledge of the incident who agree to be interviewed and review available records to develop a description of the conditions and circumstances leading to the death(s). Interviewees are not asked to sign sworn statements and interviews are not recorded. The agency’s reports do not name the victim, the fire department or those interviewed. The NIOSH report’s summary of the conditions and circumstances surrounding the fatality is intended to provide context to the agency’s recommendations and is not intended to be definitive for purposes of determining any claim or benefit.