Rescuers vs. Rescued: Are Our Priorities Backward?

Is the focus on firefighter safety moving the fire service away from its traditional emphasis on rescuing citizens?

Firefighter in a smoky doorway
Photo: Eau Claire (WI) Fire Rescue

Currently, the United States Fire Service is in a precarious position because of several factors such as current political climate, the continually rising use and abuse of the emergency system, decreasing budgetary resources, and the overall safety and liability climate. We must focus on the fire service’s current safety and liability climate to raise awareness of how fire departments are being compelled into deciding who is more important: the firefighters themselves or the public they are supposed to be serving.

Civilian Rescue: The Reason We Exist

Aggressive and Practical Search: It’s Still About the Victim

Search That Saves Lives

Thousands of fire departments and firefighters are facing controversy in the United States; several factors are to blame. Some fire service representatives believe that we are killing far too many firefighters inside of burning structures when no civilian lives are at stake and for no evident gain. Some advocate for reducing or eliminating interior firefighting operations altogether.

For example, Battalion Chief (Ret.) Robert Avsec from the Chesterfield (VA) Fire Department advocates eliminating interior firefighting operations from fire departments’ repertoire of tactics, stating, “Our approach to interior structural firefighting needs some serious restructuring lest we will only see more firefighters encountering flashovers on arrival, structures weakened to their collapse point before firefighters arrive, and firefighters developing cancers more frequently from airborne and skin exposure hazards.”1

However, looking at the data objectively, the most recent information suggests otherwise. The National Fire Protection Association reported, “For overall home fires, the death rate per 1,000 fires was 15 percent higher in 2019 than in 1980”2 while firefighter fatalities per 100,000 fires are at a record low of 2.01, down from 3.4 per 100,000 10 years ago.3 Civilians are as likely if not more so to perish at a fire today than 40 years ago, yet firefighters are safer than ever.

Line-of-Duty Deaths

What constitutes a line-of-duty death (LODD) was expanded in 2003 by the Hometown Heroes Survivors Benefit Act, yet the data shows a consistent decline in the number of LODDs over the past 10-year period. Where is the misunderstanding among those advocating for a more safety-conscious and firefighter-first mentality? If both civilian and firefighter deaths are at all-time lows, why are some fire service experts advocating for exterior operations only? The number of firefighter fatalities is lower than ever, and by educating and informing municipal leaders on some of the real causes of firefighter fatalities (e.g., poor firefighter physical fitness), these leaders can effectively address them.

Breakdown of Fatalities

The United States Fire Administration (USFA) data also breaks down the data into emergency and nonemergency deaths; according to the data, 51% are emergency- and 49% are nonemergency-related LODDs. This statistic alone already shows how some misrepresent the data to highlight the “dangers” of firefighting. When almost half of all LODDs result from a nonemergency situation, it seems this information is being misused and publicized.

Further breaking down the USFA data, of the 30 fireground fatalities from 2018, “15 were at the scene of a structure fire, and 11 were on the scene of a wildland fire or outside of the fire.”4 Although this breakdown is useful for analysis, it does not indicate whether the fatality was in the structure. Of the 15 fatalities on the scene of a structure fire, 12 were the result of advancing hoselines, but the data does not tell if those fatalities occurred inside a structure fire or at a wildland fire scene. The data in this case alone is not clear. Did a building collapse cause the fatality? Did a heart attack or other pathophysiological event cause the fatality? The data is repeatedly not clear.

Data: Incomplete, Misunderstood, and Misrepresented

The data is also not broken down to indicate if the fatality resulted from a heart attack, a stroke, or possibly fatal burns or asphyxiation. A pattern is repeated in all the data across the fire service—the data is incomplete, misunderstood, and misrepresented and does not tell the whole story. As a result, some have used bits and pieces of the data to advocate for placing a higher priority on firefighter safety when the overall picture does tell us that firefighters are safer now than ever. By analyzing the data at a deeper level and not simply taking it all at face value, audiences can take away critical components of the data that are not being publicized.

According to Bill Carey, a key contributor among several firefighting magazines and trade journals, “Ninety-three firefighters are listed as on-duty deaths for 2017, up over the past five years, yet only one firefighter was killed inside a burning structure.”5 This statement is based on the same information that states, “Seventeen firefighters experienced fatal injuries during fireground operations in 2017. Of these fatalities, 10 were at the scene of a structure fire, and seven were at the scene of a wildland or outside fire.”3 A simple assumption based on the statement would lead you to believe that there were 10 LODDs as a result of structural firefighting operations, yet of those 10, only one was inside the structure when the fatality occurred. A further breakdown of the 93 LODDs and one resulting interior fatality means that only 1% of all LODDs from 2017 can be directly attributed to interior firefighting.

If 1% of all firefighting fatalities occurred while the victim was inside a burning structure, what were the causes of the remaining 99%? A breakdown of the USFA’s data shows that 60.2% of all 2017 LODDs resulted from overexertion/stress. What is even more concerning is that in that same table of information, a total percentage of overexertion/stress fatalities for the past decade comes in at a staggering 56%.

The USFA describes its stress or overexertion category as “a general category that includes all firefighter deaths that are cardiac or cerebrovascular in nature, such as heart attacks and strokes, as well as other events, such as extreme climatic thermal exposure. Classification of a firefighter fatality in this ‘cause of fatal injury category’ does not necessarily indicate that a firefighter was in poor physical condition.” Overwork and stress are causing most firefighter LODDs, not perishing in a fully involved structure fire and burning alive.

The next two most common causes for firefighter LODDs are being struck by objects and vehicle collisions. Perishing inside of a burning structure does not even make the top five LODD causes, yet critics tout aggressive interior attack strategies as the primary reason the American fire service is killing firefighters.

Although certainly information and case studies potentially call for alarm to the way firefighting operations are performed, looking only at select data out of context and without regard to the more complete picture will only diminish the fire service’s mission—to serve the public and save lives.

Dangerous Tactics

As a result of aggressive interior firefighting, firefighters across the United States have lost their lives, sometimes in the absence of any discernible life threat or hazard. Battalion Chief Stephen Marsar from the Fire Department of New York (FDNY), who has more than three decades of firefighting experience, writes that firefighters need to reevaluate their current tactics and firefighting operations, “As a national service, we should take a close look at the present ‘aggressive attack strategy’ (especially in understaffed departments); it is killing us—literally.”6 Marsar cites sources from the Boston Globe that evaluated LODDs from 1997-2004, stating that over that period, 80 firefighters died at 52 fires in the United States, highlighting that of the 52, only 14 had “even a suspicion of trapped occupants.”6

If you read only Marsar’s article, you could infer that we are egregiously sacrificing firefighters for little to no apparent gain. Also, incriminating the aggressive attack strategies relating to those firefighter fatalities is the fact that of those 52 fires, not one civilian casualty occurred. Based on the results of that study, a loss of 80 firefighters to 0 civilian lives lost, clearly there is cause for not only concern but an immediate halt and thorough review to fire service strategy and tactical operational decisions.

The National Institute for Occupational Safety and Health (NIOSH) LODD reports that examine the deaths of firefighters that occurred while they were operating inside of burning structures lends further credibility to the argument that fire departments must carefully evaluate their tactics, determining whether civilian lives are truly savable and not risking lives for replaceable property. NIOSH investigated 71 cases involving trauma incidents at structure fires from January 1998 to February 2007. In its findings, NIOSH writes, “In these incidents, 96 firefighters died and 106 were injured. Fifty-four of the 71 incidents occurred at unoccupied structures. These 54 incidents accounted for 75% of the deaths (72 of 96) and 89% of the injuries (94 of 106) sustained during the 71 incidents.”7

This damning information shows the need for increased scrutiny by fire departments to better evaluate their operations and perform better risk management and risk vs. reward considerations. If 75% of LODDs occurring in unoccupied structures is an acceptable number to fire department officials, there is significant cause for concern as well as the potential for removal of fire service leaders.

Data for THEM

However, contrary to the belief of some, victims are found in “unoccupied” or “abandoned” structures every year. According to Nick Ledin, a contributor from the Web site Firefighter Rescue Survey,8 which tracks victim rescues and outcomes, approximately 28% of recorded rescues at fire scenes had no reports of victims inside the structure at all, and about 3% of all recorded rescues occurred after it was reported that all victims were out of the structure. Not all of these rescues resulted in lives saved, but all of these victims at least had a chance for survival because firefighters performed rapid and aggressive fire attacks and search and rescue operations.

How can we be certain that the structure is clear of victims or potential victims unless firefighters are willing to put themselves in harm’s way and occupy the interior spaces of structures and systematically clear the building? As a fire service, we need to be taught to assume and expect victims until it is proven otherwise. As long as firefighters can occupy the interior and perform fire attack and search and rescue operations, even if they don’t succeed or changing fire conditions push them out of the structure, then and only then can departments and firefighters say that survivability was zero.

LODDs: The Real Cause

As noted above, the 10-year average of all firefighter fatalities from overexertion/stress is around 56%. Firefighters are dying not as a result of extremely dangerous conditions of structure fires and the actions performed inside burning buildings but as a result of overexertion/stress (e.g., heart attacks and strokes).

The Cost of Safety and Prevention

In 2019, a National Institute of Standards and Technology (NIST) study found in a “conservative estimate” that “the estimated cost of firefighter injury is estimated to range between $1.6 billion and $5.9 billion annually. This cost results in a loss equivalent of approximately $50,000 to $200,000 per fire department per year or $1,500 to $5,500 per firefighter per year.”9 Figures outlined in the report put injury costs as low as $1.2 billion to as high as $18 billion.

A previous NIST estimate from more than 15 years ago found that nationwide, “The estimated cost of addressing firefighting injuries and of efforts to prevent them is $2.8 to $7.8 billion per year.”10

Fire services and municipalities have been spending billions per year in just dealing with firefighter injuries. The NIST study does not have data in regard to firefighter fatalities, and so you can only imagine the additional costs added to these figures. Firefighter fitness is paramount to effectively performing all aspects of the job; the NIST research reinforces this. According to the study, “Firefighters who are healthy and fit can better handle the physical requirements of the job and return to work faster if they are injured.” It is quickly followed by, “More fire departments need to take physical fitness seriously and adopt a formal program that monitors progress against goals and goals met against number and severity of injuries.”9 This study, conducted with several fire service experts, concluded in 2004 that the fire service needed to increase its focus and devote resources to better physical fitness programs and requirements.

NIST researchers analyzed the nature of injuries across the fire service and found that of the more than 80,000 injuries incurred on the job, 1,020 (1.3%) were heart attacks and strokes, which seems insignificant when it comes to injuries alone; however, when 1.3% of injuries are the cause of more than 56% of firefighter fatalities, it is time to take notice and investigate options for resolving these fatalities’ causes.

Prevention Pays for Itself

NIST data collection also revealed that, across the fire service annually, anywhere in the range of $65 million to $147 million were spent on basic safety and injury prevention. This figure was based on calculating training hours and the associated costs for instructors and materials.

Now there is an enormous difference between spending between $65 million and $147 million for basic safety training and injury prevention and spending between $2.8 billion and $7.8 billion in injury costs. The Father of the American fire service, Benjamin Franklin, once said, “An ounce of prevention is worth a pound of cure.” If additional spending were put into basic safety and injury prevention, injury costs would drop.

According to the article, “Most departments do not have an in-place [wellness] program. Wellness programs appear to be the exception and not the rule. Using $50,000 as an average annualized cost (startup costs would be more expensive; however, once programs are initiated, the annual cost could be relatively low) for five percent of the estimated 30,000 fire departments, the annual cost of these programs would be $75 million.”9

Spending $75 million to implement a physical fitness program for five percent of all U.S. fire departments is significant, but if those numbers were calculated on a larger scale to include all the estimated 30,000 departments in the United States, the total costs for annual fitness programs would be $1.5 billion. The article also says that those costs can be expected to decrease after implementing the physical fitness programs. If fire service and municipal leaders want to get serious about reducing firefighter injuries and fatalities, it is obvious from 15-year-old studies that funding for physical fitness and injury and fatality prevention need to be prioritized.


Firefighters save hundreds if not thousands of lives every year and protect unknown millions if not billions of dollars in property. We can continue to do so while understanding the causes of and preventing fire fatalities. Even with firefighter fatalities lower than ever, continued misinterpretation and misrepresentation of the facts plague the fire service. The fire service must continue to emphasize firefighter safety but not at the cost of civilian lives. To reduce firefighter injuries and fatalities, we must properly educate and inform leaders and elected officials of the current causes and the best way to remedy them.

There are times when fire departments and individual firefighters are reckless and endanger not only themselves and their fellow firefighters but the victims they are there to save. For individuals to make blanket statements that the fire service as a whole is overly aggressive and is the direct cause of firefighter fatalities is irresponsible and discredits hundreds of thousands of honorable, professional, and dedicated firefighters everywhere.

Further study regarding funding for injury and fatality prevention needs to be heavily considered and implemented as well as the implementation of required physical fitness programs and physicals on an annual basis. With the overemphasis on firefighter lives and safety and the apparent diminishing value on the lives of the civilians firefighters serve, the fire service moves farther and farther away from the time-honored traditions and callings that have been hallmarks in the fire service for hundreds of years. Only by fully investing in preventive actions and taking a proactive approach to firefighter safety and wellness can we begin to actually reduce total firefighter injuries and fatalities while concurrently providing the best possible service to civilians in their time of need.


1. Avsec, Robert. “Interior Firefighting is Becoming Obsolete-We Just Don’t Know It.” Fire & EMS Leader Pro. [Online] October 17, 2017.

2. Ahrens, Marty; Evarts, Ben. Fire Loss in the United States During 2019. National Fire Protection Association. [Online] September 2020.

3. United States Fire Administration. “U.S. fire deaths, fire death rates, and risk of dying in a fire.” [Online] August 27, 2018.

4. United States Fire Administration. Fire Fatalities in the United States in 2018. United States Fire Administration. [Online] September 2019.

5. Carey, Bill. “One Out of 93.” Backstep Firefighter. [Online] January 2, 2018.

6. Marsar, Stephen. “Survivability Profiling: Are the Victims Savable?” Fire Engineering. [Online] December 1, 2009.

7. National Institute for Occupational Safety and Health. NIOSH ALERT: Preventing Deaths and Injuries of Fire Fighters When Fighting Fires in Unoccupied Structures. [Online] February 2009.

8. Ledin, Nick. “The First 1,000 (and Change) Rescues: Just the Numbers.” [Online] May 14, 2020.

9. Butry, David, et al. Technical Note 2078: The Economics of Firefighter Injuries in the United States. National Institute of Standards and Technology. [Online] December 2019.

10. National Institute of Standards and Technology. NIST GCR 05-874: The Economic Consequences of Firefighter Injuries and Their Prevention. Final Report. [Online] August 2004.

Taylor J. Quinnell is a 13-year veteran of the fire service and a firefighter paramedic with the Eau Claire (WI) Fire Department, assigned to Engine 2. He is an instructor for Chippewa Valley Technical College.

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