By: Tom Hofland
In firefighting, everyone wants to save lives, including our own when needed based upon the inherent risks faced by firefighters; of course.
Firefighters want to save lives of people trapped in buildings or other precarious positions, and, honorably, develop local and national programs to protect and save their own lives, too. And that should never be deemed a losing proposition in any fire department.
Reducing deaths in the line of duty should be a common goal for everyone involved in the fire service. And though there’s been plenty of time, money, passion and effort put into programs to keep firefighters safe, there’s been remarkably little progress. Why? It’s possible that these local and national strategies may not be targeting the underlying causes of individual line of duty deaths. Rather, they seem to fail in ‘pulling back the layers’ of what we typically do- and analyze on the surface- regarding the causes and circumstances of line of duty deaths (LODD). This seems particularly evident when analyzing LODD in the urban fire service.
The very nature of firefighting risk varies across the nation, both geographically and demographically; it even may vary within the same fire department. While no two fire departments are exactly the same, many can be lumped together based on common risks and capabilities. To understand the best way to reduce deaths in the line of duty, perhaps it’s actually best to analyze data based upon said demographics and geography.
According to a National Fire Protection Association’s (NFPA)1 report – U.S. Fire Department Profile through 2006 – there are more than 31,000 fire departments in the US, totaling over 1,140,000 firefighters. However, there are only 118 fire departments – a miniscule 0.004% – which protect cities with a population of more than 250,000 citizens. Furthermore, these 118 fire departments employ 96,000 career firefighters. This represents 8.4% of all US firefighters and 30% of all career firefighters in the country.
As a retrospective analysis, this article examines the causes of death for only members of urban fire departments – the 118 crews mentioned above – as recorded by reports made by the National Institute of Occupational Safety and Health (NIOSH) Firefighter Fatality Investigation Program. The NIOSH reports analyzed illustrated deaths occurring only between 1999 and 2008. And, for the purpose of this article, “emergency operations”2 are actions taken by a fire company after receiving an alarm and prior to being returned to service. (Injuries suffered during these operations that resulted in subsequent hospitalization and death count, too.)
In 1965, the International Association of Fire Chiefs (IAFC) formed the Metropolitan Fire Chiefs Section because they recognized that different leadership and management challenges were routinely faced by large (more than 400 members) urban fire departments.3 In addition to unique leadership and management challenges, large urban fire departments also face unique operational and emergency scene risks. But outside of the IAFC, recognition of these hurdles that urban firefighters face is not really acknowledged or even researched by the fire service. The fatalities highlighted in this article all fall within the IAFC’s criteria for “urban.” In this case, “urban” refers to fire departments with over 400 members. As an aside, the use of “urban” aids in contextualizing the sample and analysis, rather than inferring elitism or a dismissive overtone to those smaller urban fire departments not meeting the criteria set forth in the article’s analysis.
All in all, 45 NIOSH reports of fatal incidents best fell within these criteria, and these 45 incidents are the ones highlighted in this article.* It’s possible that many more could have, but some incidents are not investigated by NIOSH; for instance, many medical emergencies not occurring at the scene of an emergency are brushed aside. Still, the vast majority are. Though the NIOSH system is not a panacea, it still provides the best, most comprehensive national database of LODD information. At present, there is no legal requirement to report traumatic LODD to NIOSH, a dangerous oversight that should be replaced by more stringent regulations.
In the aforementioned time period, NIOSH investigated forty-five fatal incidents. These resulted in 61 LODD in urban fire departments while conducting emergency operations – a mere 6 LODD per year, or an annual mortality rate of 0.06 per thousand firefighters – which is dramatically smaller than the estimates of (100 or more deaths per year) in the collective fire service.
While these numbers and stats may help illuminate and suggest facets of firefighting to pay attention to, it’s most important to investigate the details of the deaths to fully understand risks involved. While these numbers help define the overall problem, they do not expose specific challenges which may be possible to extinguish through specific measures. In order to identify these specific risks, a detailed analysis is required; thus becoming the impetus for this article.
Each of these 45 NIOSH reports4 were analyzed with a specific emphasis on the narrative section regarding the details of how each LODD occurred. It’s important to add that the person who wrote the NIOSH report also determined the subsequent cause of death and remains their sole opinion. Fundamentally, the cause of death on a NIOSH report is subjective and it’s different than the cause listed by the respective medical examiners.
Again, there were 61 LODD in 45 events. 1 LODD (2% of the total) was due to violence on an EMS alarm5, one (2%) occurred during a technical rescue alarm6, five (8%) were due to vehicular accidents; eight (13%) were due to medical emergencies; and 46 (75%) occurred while conducting combat fire operations.
So let’s break it down here: there were deaths that occurred while conducting fire combat, and there were deaths that happened due to other extraneous accidents. But all of the deaths considered in this article occurred while in the line of duty. That’s important to remember.
There were, in total, five LODD that resulted from vehicular mishaps:
Two of these deaths were company officers who failed to wear their seat belts and were ejected from responding engine companies. Two firefighters died while boarding or riding on the exterior of a moving apparatus. One fell from an open rear cab of a moving apparatus while standing up.
While all of these LODD were likely preventable through the strict adherence to a seat belt policy and the use of enclosed cabs, the fact that seemingly few firefighters were killed in vehicle-related incidents stands out. While every death is serious, vehicular incidents don’t seem to warrant the disproportionate share of safety concern given to them. Over a ten-year span, only two firefighters were killed in vehicle-related collisions while responding to alarms, suggesting that the current system of frequent, short responses made by experienced drivers – as well as strict seat belt policies – has created excellent vehicle safety for urban firefighters.
There were, in total, eight LODD that resulted from medical conditions:
Seven of these medical LODD occurred in members who had pre-existing moderate or severe coronary artery disease. Five of these victims smoked cigarettes, three were considered obese and the eighth individual had an undiagnosed congenital cardiac defect.
The infrequent nature of these LODD seems to indicate that urban fire services do not have a significant problem with medical LODD during emergency operations. Cutting back on risks is always a wise idea. It is painfully obvious that firefighters should be fit, not smoke tobacco and keep their cholesterol and blood pressure within healthy margins. However, firefighters do not exist in a bubble; coronary problems are a killer for the public as a whole, and firefighters aren’t immune. These problems are likely representative of the population at large.
Fire Combat LODD9
There were, in total, 46 LODD that resulted from fire combat:
Twenty-nine (63% of urban LODD examined) of these fatalities occurred in commercial occupancies and 17 occurred in residential occupancies. The NFPA reports that, in 2008, there were 515,000 structure fires in the US. Of these, non-residential properties accounted for 112,000, or 22%, of all fires.10 The most significant cause of emergency operations LODD is fire combat. Although these numbers are not specific to urban fires in particular, they nonetheless ring true to the fact that most fire combat LODD (63%) occur at the minority of fires (22%).
In total, 75% of urban LODD were the result of fire combat. In order to effectively address these LODD, urban fire departments need to focus safety efforts and training on fire combat operations, not anything else.
Urban fire departments suffered the majority of their combat LODD in commercial occupancies.
15 LODD (52% of all combat LODD) occurred in small commercial occupancies such as strip malls, taxpayers and restaurants. Fourteen LODD (48%) occurred in larger commercial spaces, like warehouses, office buildings and supermarkets.
Of these, only nine fires in commercial occupancies resulted in twenty-three LODD (79%).12 The urban fire service averages one significant multi-fatality commercial fire per year. These occurrences, thankfully relatively uncommon (about 1.5 occurrences per year), account for 50% of fire combat LODD and 38% of all line of duty deaths. Commercial buildings are the most lethal occupancies in terms of the number of firefighters killed (29 LODD) as well as the most common location of fatal events (15 incidents).
Going even more in-depth with commercial fires, let’s further examine the 15 LODD at small commercial fires:
Eleven line of the 15 LODD in small commercial structures were suffered by engine company personnel13 and nine (60%) occurred during fire attack.14 Seven of these LODD were the result of structural collapse15; and six were the result of hostile fire events16 . Eleven LODD were suffered by engine companies, of which seven were operating small diameter handlines17 (47%).
Fatal, small commercial fires have a common theme resonating in the majority of the NIOSH reports analyzed: Firefighters penetrate the occupancy aggressively, and are then overrun by an unrecognized, large volume of fire in a void, overhead space. This trove of fire subsequently breaks out behind them or causes structural collapse. The failure to adhere to tested, basic tactics and mistreatment of a commercial fire as a house fire appear to be the overlying cause of LODD in these small commercial occupancies.
The discipline of an engine company is critical to reducing small commercial LODD. The potential volume of fire in an unconfined space is often greater than a 1 ¾” handline can control. In addition to selecting the correct size of hoseline, engine companies must not advance into the building without assessing conditions in overhead void spaces from the entry point. Fire departments can have a direct, positive impact on these LODD by creating and enforcing fundamental operating procedures for operations in these tricky occupancies.
As far as large commercial occupancies go, roughly the same concepts ring true18:
There were 14 LODD in large commercial fires. Truck and rescue companies suffered eight LODD in these buildings.19 Nine LODD were the result of smoke disorientation20 and eight deaths occurred while conducting search operations.21 The characteristics of large commercial occupancies – in particular, lack of compartmentalization – do not lend themselves to easy searches, and therefore contribute heavily to the total loss of life.
Firefighters are at a massive risk of disorientation in these large structures. In addition to staying in touch with a rope or hose line, aggressive ventilation is needed to raise the smoke level. The behemoth size of these buildings may make ventilation an effective means of saving occupants than trying in vain to locate and take them out in near-zero visibility. Standard operating procedures for this type of building needs to be developed in order to save lives and expedite rescues.
Urban fire departments could reduce LODD only by reducing the incidence of severe commercial fires. Though uncommon, these events take the most significant toll on life in the industry. Commercial firefighting is the most important area urban fire departments can focus on to protect their members and can be best addressed with creating and sticking to specific operating procedures based on particular commercial building types.
Unsurprisingly, residential fires are a beast of a different nature. In total, residential fires resulted in 17 LODD during the analyzed time period. Private dwellings (houses, etc.) accounted for LODD,23 and six LODD occurred at fires in apartment houses.24
What’s important to take out of these facts is this: less than two firefighters per year died in residential occupancies. While the frequency of residential fires is much higher than those in commercial buildings, the incidence of fatal fires was identical – 15 events. On average, urban firefighters experienced just 1.5 lethal residential fires per year, a surprisingly small number, considering the frequency of residential fires.
House fires account for the majority of urban LODD. Out of the 11 total house fire deaths, engine companies accounted for ten.25 Nine of these firefighters were engaged in fire attack when they died26 and eight fatalities were the result of fire hostility.27
Typically, the urban fire service experiences one fatal house fire per year. In context, this small number suggests how truly successful urban fire services are at aggressive, interior firefighting operations in private dwellings. Certainly urban fire departments can strive to lower this number further, but we should consider how many civilians have been saved as the result of the tactics already in place.
As far as apartment fires go, there were six LODD. Truck and rescue companies suffered four of these LODD,28 and three deaths were the result of fire hostility. The infrequent loss of firefighters at apartment fires seems to suggest urban fire services have an exceptional ability to handle these incidents and result in comparatively few problems. There’s no other type of fire that puts so many civilians or firefighters in harm’s way, but the traditional tactics used by firefighters to manage these situations seem to be effective in keeping everyone involved – both citizens and firefighters – safe.
Urban fire departments function in an environment much different than their suburban, exurban or rural counterparts. They face inherent risks, frequent fires and myriad more resources than their non-urban parallels – a reality faced by incumbent and smaller taxing bases to provide these resources. But it’s important to understand that many of these risks are unique to urban firefighting, and, in order to reduce LODD in the urban firefighting environment, fire departments need to comprehend what exactly these risks are. The best way of doing that is to examine precisely why deaths on the fireground occur.
No safety policy, procedure, risk analysis, cultural change, acronym or new paradigm will be effective if it does not focus on and address the basic hazards faced by the first responders to a fire.
It is never possible to eliminate risk. As long as firefighters respond, we face the possibility of injury, or death. Minimizing this risk while continuing to effectively perform our duties is the responsibility of every firefighter and administrator, and examining past faults resulting in LODD is just one way of improving tactics and identifying where urban fire departments should focus their efforts: firefighting in commercial occupancies.
It is imperative that fire departments investigate and discuss the scenarios – and their root causes –which comprise the majority of deaths on the fireground in order to create new plans of action, improved training and revamped standard operating procedures. It’s not effective to use statistics alone to drive a point. While every death in the line of duty is tragic, it’s similarly tragic to use these deaths as a manner of dismissing existing procedures as invalid and ineffective.
We’re firefighters, but we’re also human and we make mistakes. We just want to save lives, and we need to look at where we went wrong in order to make everyone’s situation better.
* It’s worth noting that the tragic events of 9/11 were not included in this report, as no NIOSH reports were conducted on the loss of the 343 members of FDNY. The extraordinary circumstances faced on that day were unlike others faced – ever – and are far from routine. Furthermore, if these fatalities were analyzed in this article, they would account for a whopping 84% of all urban fire departments’ emergency operation LODD during the analyzed time period.
1 U.S. Fire Department Profile Through 2006, M. Karter, NFPA, 2007
2 Injuries suffered during emergency operations which resulted in immediate hospitalization and death prior to hospital discharge are included.
3 www.iafc.org/displaycommon.cfm?an=1&subarticlenbr=10 4 www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-37, 18, 11; 2007-37, 32, 19, 16, 2; 2006-28, 27, 19, 9; 2005-35, 9, 4, 3, 1; 2004-17, 14, 11, 5, 4; 2003-38, 31, 18, 12, 7; 2002-48, 47, 20, 14, 7; 2001-33, 23, 13, 2; 2000-41, 39, 13; 1999-F50, F48, F47, F34, F22, F21
5 www.CDC.GOV/NIOSH/FIRE/ Report: 2004-11
6 www.CDC.GOV/NIOSH/FIRE/ Report: 2001-2
7 www.CDC.GOV/NIOSH/FIRE/ Reports: 2005-35, 1; 2003-7; 2000-41, 39
www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-11; 2007-37, 32; 2006-27; 2004-17, 14, 4; 2003-18; 2002-20; 2001-23, 13; 2000-13; 1999-F48, F47, F34
11 www.CDC.GOV/NIOSH/FIRE/ Reports: 2007-37, 32; 2006-27; 2004-17; 2003-18; 2002-20; 2001-23; 2000-13; 1999-F47
12 www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-11; 2007-32; 2006-27; 2004-17, 14; 2003-18; 2002-20; 2000-13; 1999-F34
13 www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-11; 2007-32; 2006-27; 2004-17, 14; 2003-18; 2000-13; 1999-F34
14 www.CDC.GOV/NIOSH/FIRE/ Reports: 2007-32; 2006-27; 2004-14; 2003-18; 2000-13; 1999-F34
15 www.CDC.GOV/NIOSH/FIRE/ Reports: 2006-27; 2004-17; 2000-13; 1999-F34
16 www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-11; 2007-32; 2004-14; 2003-18
17 www.CDC.GOV/NIOSH/FIRE/ Reports: 2007-32, 2004-14, 2003-18, 2000-13, 1999-F34
18 www.CDC.GOV/NIOSH/FIRE/ Reports: 2004-4; 2001-23; 1999-F47
19 www.CDC.GOV/NIOSH/FIRE/ Reports: 2007-37; 2004-4; 2001-13; 1999-F48, 47
20 www.CDC.GOV/NIOSH/FIRE/ Reports: 2004-4; 2001-23; 1999-F47
21 www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-37; 2007-19, 16, 2; 2006-28, 19; 2005-9, 4, 3; 2004-5; 2003-12; 2002-14, 7; 2001-33; 1999-F21
22 www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-37; 2007-16, 2; 2006-28, 19; 2005-9, 4; 2004-5; 2003-12; 1999-F21
23 www.CDC.GOV/NIOSH/FIRE/ Reports: 2007-19; 2005-3; 2002-14, 7; 2001-33
24 www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-37; 2007-16, 2; 2006-28, 19; 2005-9, 4; 2004-5; 2003-12; 1999-F21
25 www.CDC.GOV/NIOSH/FIRE/ Reports: 2008-37; 2007-16, 2; 2006-28, 19; 2005-9; 2004-5; 2003-12; 1999-F21
26 www.CDC.GOV/NIOSH/FIRE/ Reports: 2007-16, 2; 2006-28, 19; 2005-4; 2003-12; 1999-F21
27 www.CDC.GOV/NIOSH/FIRE/ Reports: 2007-19; 2005-3; 2002-14, 7; 2001-33
28 www.CDC.GOV/NIOSH/FIRE/ Reports: 2005-3; 2001-33