Emerging Health and Safety Issues in the Volunteer Fire Service

Firefighters, emergency medical technicians (EMTs), and other emergency responders face many dangers daily from exposure to smoke, deadly temperatures, and stress to issues surrounding personal protective equipment (PPE), vehicle safety, and personal health. Although publicized firefighter fatalities are associated more often with burns and smoke inhalation, cardiovascular events, such as sudden cardiac death, account for the largest number of nonincident firefighter fatalities. Both the United States Fire Administration (USFA) and the National Fire Protection Association (NFPA) have been tracking firefighter fatalities since 1977. According to NFPA statistics, the number of sudden cardiac deaths has averaged between 40 and 50 deaths per year since the early 1990s. USFA statistics show that firefighters, as a group, are more likely than other American workers to die of a heart attack while on duty (USFA, 2002). Additional pertinent findings in the NFPA's 2005 U.S. Firefighter Fatalities Due to Sudden Cardiac Death, 1995-2004 include: Four hundred and forty firefighters out of 1,006 (or 43.7 percent) who died on the job experienced sudden cardiac death, typically triggered by stress or exertion; Fifty percent of all volunteer firefighter deaths and 39-percent of career firefighter deaths resulted from a heart attack; Ninety-seven percent of the victims had at least a 50-percent arterial blockage; Seventy-five percent of the firefighters who died of a heart attack were working with known or detectable heart conditions or risk factors, such as high cholesterol, high blood pressure, and diabetes. While sudden cardiac death is the leading cause of death among firefighters, other factors affecting firefighters' health, wellness, and safety result in multiple deaths and injuries each and every year. Through the collection of information on firefighter deaths, the USFA has established goals to reduce loss of life among firefighters (USFA, 2006). In order to achieve this goal, emphasis must be placed on reducing the risk factors associated with cardiovascular disease as well as on the mitigation of other issues affecting the health and safety of the Nation's firefighters. As part of another effort to determine the specific issues affecting firefighter health and wellness, the National Volunteer Fire Council (NVFC) Foundation developed a questionnaire to determine personal health, well-being, and safety practices among firefighters. A summary of findings from this study was shared with the NVFC and USFA for use in this project. The questionnaire was distributed to a study population of 364 firefighters, of which 149 were career firefighters, 165 were volunteers, and 50 indicated they were both volunteer and career. Results from the questionnaire revealed several trends in this sample firefighter population; however, the study population was not large enough to generalize these trends for all firefighters. Results from the NVFC Foundation's questionnaire are presented here. Based on these findings, it is clear that a structured personal health and fitness program, as well as safe operations to, from, and while at emergency scenes, become critical to firefighters' safety, well-being, and survival. As a result, we present this document on emergent health and safety issues for the volunteer fire and emergency services.