Building on an existing research project in which the components of a national firefighter nonfatal injury data system and tools to improve on-the-job safety for firefighters have been developed, Drexel University is now undertaking a new project to create a survey that will measure the safety climate of a fire department-the organization’s attitudes toward safe behavior, or a “culture of safety.” Dr. Jennifer A. Taylor, an assistant professor in Drexel’s School of Public Health, is the head researcher in these projects. The research is being funded by Assistance to Firefighters Fire Prevention and Safety grants, administered by the Federal Emergency Management Agency and the Department of Homeland Security.
“When there is a positive safety climate in a firehouse,” Taylor asserts, “that means the leadership puts a high value on being safe. That value gets out to the frontline workers, who change their behaviors to safe ones.” She cites “simple steps” such as buckling seat belts. Officers who insist on firefighters’ buckling their seat belts before leaving the firehouse to respond to an emergency demonstrate “the value placed on safety,” Taylor points out. On the other hand, neglecting to ensure safety by buckling up, Taylor explains, could lead to other actions that “shortcut safety and increase the risk of preventable harm.”
According to a Drexel University press release, more than 200 studies across a multitude of countries and industries have concluded that the safety climate is a robust predictor of safety outcomes. The objective of this second research project is to determine how strong an organization’s culture of safety is so that it can be improved if necessary. According to Drexel, “The safety climate of fire departments is largely unmeasured.”
Once completed, the safety climate in fire safety survey will be made available without charge to fire departments nationwide. Researchers will then measure a department’s safety climate before and after implementing safety-related interventions to determine whether the safety culture has improved.
The National Fallen Firefighters Foundation (NFFF) has identified the firefighter safety culture as a “major gap” in firefighter safety, citing 70 to 80 line-of-duty firefighter deaths each year and nonfatal injuries estimated to be in the tens of thousands.
Chief Ron Siarnicki, NFFF’s executive director, views the Drexel research project as a natural extension of the commitment to safety made in 2004. At that time, the 16 Life Safety Initiatives were adopted. The Drexel project speaks directly to Initiative #1: “Define and advocate the need for a cultural change within the fire service relating to safety, incorporating leadership, management, supervision, accountability, and personal responsibility.” It relates to the need for “the fire service in the United States to change the culture of accepting the loss of firefighters as a normal way of doing business,” Siarnicki adds.
In addition to Taylor, the Drexel researchers include co-investigators who are national and international scholars. Academic and community partners, including an advisory council comprising career and volunteer fire service leaders representing the NFFF, the International Association of Fire Fighters, the National Volunteer Fire Council, the International Association of Fire Chiefs, FireRescue magazine, and The Secret List will advise the project team regarding research site recruitment, survey item development, and dissemination of the project results and survey.
Line-of-Duty Deaths
September 27. Junior Firefighter Justin Townsend, 17, Dagsboro (DE) Volunteer Fire Department: motor vehicle crash while responding to an outside fire in a wooded area; incident is under investigation.
October 1. Lieutenant John Grabowski, 49, Riverview (MI) Fire Department: official cause of death to be determined.
October 9. Chief Larry D. Nielsen, 60, Gilmore City (IA) Fire Department: apparent heart attack.
Source: USFA Firefighters Memorial Database
CDC: fungal meningitis linked to injections
At press time, the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA) were coordinating a multistate investigation of fungal meningitis among patients who received an epidural steroid injection with a potentially contaminated product. Several of these patients also suffered strokes believed to have resulted from their infection.
All infected patients had received preservative-free (PF) methylprednisolone acetate (80 mg/ml) from among three lots voluntarily recalled by the New England Compounding Center (NECC) in Framingham, Massachusetts, on September 26, 2012:
- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #05212012@68, BUD 11/17/2012.
- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #06292012@26, BUD 12/26/2012.
- Methylprednisolone Acetate (PF) 80 mg/ml Injection, Lot #08102012@51, BUD 2/6/2013.
More than 17,000 vials of the injectable steroid were shipped to 75 facilities in the following states: California, Connecticut, Florida, Georgia, Idaho, Illinois, Indiana, Maryland, Michigan, Minnesota, North Carolina, New Hampshire, New Jersey, Nevada, New York, Ohio, Pennsylvania, Rhode Island, South Carolina, Tennessee, Virginia, Texas, and West Virginia. The names of the facilities that have received medication from one of these lots are at http://www.cdc.gov/hai/outbreaks/meningitis-facilities-map.html. Updates about the investigation, including case counts, are available at http://www.cdc.gov/hai/outbreaks/ meningitis.html.
Fungal meningitis is not transmitted from person to person. These cases are associated with a potentially contaminated medication.
As of October 15, 214 cases of fungal infections linked to steroid injections had been reported: Florida (10, including two deaths), Idaho (1), Illinois (1), Indiana (28, including two deaths), Maryland (15, including one death), Michigan (46, including three deaths), Minnesota (5), New Hampshire (4), New Jersey (8), North Carolina (2), Ohio (5), Pennsylvania (1), Tennessee (53, including six deaths), Texas (1), and Virginia (34, including one death).
Infected patients have presented approximately one to four weeks following their injection with a variety of symptoms, including fever, new or worsening headache, nausea, and new neurological deficit (consistent with deep brain stroke). Some of these patients’ symptoms were very mild.
On October 3, 2012, the compounding center ceased all production and initiated recall of all methylprednisolone acetate and other drug products prepared for intrathecal administration.
Although meningitis cases reported up to press time occurred after injections with one of the above products, the CDC and the FDA have recommended that healthcare professionals stop using any product produced by the NECC until further information is available.
Patients who have received an epidural injection and have symptoms of meningitis or basilar stroke should undergo a diagnostic lumbar puncture (LP), if it is not contraindicated. The CDC and the FDA say that because presenting symptoms of some patients with meningitis have been mild and not classic for meningitis (e.g., new or worsening headache without fever or neck stiffness), physicians should have a low threshold for LP. Patients who received other types of injection (e.g., knee) with methylprednisolone acetate from those three lots should also be assessed for signs of infection (e.g., swelling, increasing pain, redness, warmth at the injection site) and should seek evaluation (e.g., arthrocentesis) if such symptoms exist.
A list of products produced by the NECC can be found through the FDA Web site at http://www.fda.gov/Drugs/DrugSafety/ucm322734.htm. Around the middle of October, the FDA received reports of three new cases of infections related to steroid triamcinolone acetonide and a medication used during heart transplant surgery. Patients who have taken or used medications from the NECC who are concerned that they are ill because of the use of one of these products should seek medical attention.
Note: In an update on October 18, the CDC and the FDA reported that they had confirmed the presence of the fungus Exserohilum rostratum in unopened vials of PF methylprednisolone acetate (80 mg/ml) from NECC Lot #08102012@51, BUD 2/6/2013. In addition, the laboratory confirmation further links steroid injections from the three above mentioned lots from NECC to the multistate outbreak of fungal meningitis and joint infections. Tests on the other two lots of methylprednisolone acetate and other NECC injectables continue.
The CDC and state health departments estimate that approximately 14,000 patients may have received injections with medication from these three lots of methylprednisolone; nearly 97 percent of these patients had been contacted for further follow-up.
Read the MedWatch Alert, including a link to the FDA Statement at: http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm323946.htm.
Chicago (IL) firefighter suspected to be victim of West Nile virus
Lieutenant Thomas Flahive, 58, of the Chicago (IL) Fire Department (CFD), succumbed in October, CFD Media Affairs Director Larry Langford reported in a Chicago Tribune report. Flahive’s family suspects his death was caused by the West Nile virus. According to Langford, Flahive was on vacation in Wisconsin two weeks before his death when he was bitten in the neck by a mosquito.
He started to experience flulike symptoms at the firehouse about 10 days before his death and left the firehouse and went to the hospital. Flahive had been a member of CFD since 1989, assigned to Engine 108’s firehouse at Milwaukee and Laramie avenues on the Far Northwest Side. Flahive is survived by his wife and three adult children, Langford said. Rosemary R. Sobol, reporter, chicagotribune.com, Oct. 5, 2012
FEMA partners with UNCF for community education
The Federal Emergency Management Agency (FEMA) Administrator Craig Fugate and United Negro College Fund Special Programs Corporation (UNCFSP) Interim President and Chief Executive Officer Michael J. Hester have formed a new partnership to coordinate mutual engagement on job opportunities, preparedness, response, and recovery. UNCFSP has a constituency of more than 300 minority institutions of higher education. “This agreement,” Fugate explains, “builds on FEMA’s existing successful partnership with this organization and the institutions it serves. We look forward to working together so that every community is engaged in disaster preparedness, response, and recovery.”
Among the terms of the agreement, FEMA will participate in lectures, conferences, and other events at minority institutions. UNCFSP will work with FEMA to distribute messaging, tools, training, and other educational and organizational resources available to support community-based disaster preparedness efforts.
The two organizations, through FEMA’s Emergency Management Institute and UNCFSP’s minority serving institutions, have been engaged in emergency management training since 2008. The new agreement stipulates that officials of the two organizations will meet quarterly on the principles of engagement. UNCFSP works to create connections between the diverse, high-performing workforce of the minority education community and private industry to address the nation’s imperatives.
AFG ends funding of Near-Miss Reporting System
The International Association of Fire Chiefs (IAFC) announced at press time that the federal Assistance to Firefighter Grant (AFG) program was not renewing funding of the National Fire Fighter Near-Miss Reporting System and that funding was to end possibly as soon as September 28. “This program has allowed the fire and emergency service to come so far in reducing line-of-duty deaths, and we’re going to take aggressive action to be sure fire departments don’t lose that ground,” said Mark Light, IAFC CEO and executive director. “We’ll be working to understand what areas the reviewers perceived as deficient and what we can do to come back with a strong proposal for future funding.”
The IAFC announced a short-term plan to self-fund the Reporting System through the end of October so that the association could explore alternative funding options. Light indicated that a number of private funders have expressed an interest in preserving the program but that no firm funding commitments had been made at press time. IAFC President and Chairman of the Board Chief Hank Clemmensen was to develop a task force to assist in the effort. The program Web site is at www.FireFighterNearMiss.com.
USFA: 41 percent of set residential fires in vacants
“An estimated 16,800 intentionally set fires in residential buildings occur annually in the United States, and they cause an estimated average of 280 deaths, 775 injuries, and $593 million in property loss each year,” according to the “Intentionally Set Fires in Residential Buildings (2008-2010)” report released in October by the U.S. Fire Administration (USFA). The report noted also that 41 percent of intentionally set residential fires occurred in vacant buildings.
Other findings cited in the report are the following:
- Intentionally set fires accounted for 5 percent of all residential building fires.
- Lighters (22 percent), heat from other open flame or smoking materials (19 percent), and matches (15 percent) were the leading heat sources of intentionally set fires in residential buildings.
- The majority (76 percent) of intentionally set fires in residential buildings occurred in one- or two-family dwellings. An additional 19 percent of fires occurred in multifamily dwellings.
Data for this topical report were obtained from the National Fire Incident Reporting System (NFIRS) database. Information regarding other topical reports is at www.usfa.fema.gov.
