Since this has been the most responded-to topic since we reinstituted Roundtable in May 1999, I thought it would be interesting to provide some statistical information compiled from combined responses to the question. Here are the answers from the 21 respondents.
- Establish cardiovascular health programs: 81% (17 respondents).
- Develop safe driving practices: 66% (14 respondents).
- Develop “safety attitudes”: 23% (5 respondents).
- Train firefighters better: 19% (4 respondents).
- Develop better SOPs: 9% (2 respondents).
- Better on-scene accountability: 9% (2 res-pondents).
- Provide firefighter survival training: 9% (2 respondents).
- Establish risk assessment policies: 9% (2 respondents).
- Provide SCBA training: 9% (2 respondents).
- Better preincident planning: 9% (2 respondents).
The responses speak for themselves. All were good, positive measures that, if enacted, would reduce firefighter injury and death rates. We all know what needs to be done; however, it isn’t as glamorous or as macho as running into a fire in a vacant burning building or unoccupied body shop or fast food restaurant.
Consider this quote from a speech Vina Drennan, widow of Captain John Drennan of FDNY, gave at the Fire Department Instructors Conference in Indianapolis, Indiana, a few years ago: “Let’s imagine that 100 CEOs were dying a year in America! Or 100 lawyers! Or 100 doctors or teachers. Do you think their professional organizations would accept this? They’d demand changes. They’d throw out leadership and elect new ones that would demand changes in health and safety—and not just talk about it! No one should die doing their jobs in America. Professionals do not accept 100 deaths a year. I stand before you today and say ‘firefighters are not roadkill.’ ”
So, we’ve all read the responses, and now we sit in our kitchens at the station or on the apparatus floor and look at each other. We can either change the subject to talk about football or last night’s TV offerings, or ….
—John “Skip” Coleman, deputy chief of fire prevention, Toledo (OH) Department of Fire and Rescue, is the author of Incident Management for the Street-Smart Fire Officer (Fire Engineering, 1997) and Managing Major Fires (Fire Engineering, 2000). He is an editorial advisory board member of Fire Engineering and a member of the FDIC Educational Advisory Board.
Question: Each year, the number of firefighter deaths and injuries remains constant or increases. Annually, the National Fire Protection Association publishes a detailed accounting of the previous year’s death and injury statistics. What do you think are three things that departments must do to impact this record positively for good?
Peter Sells, District Chief—Officer
Development, Toronto (ON)
Fire Services
Response: It is always disheartening to see the same major factors contributing to the majority of firefighter deaths and injuries year after year without significant variation. I believe that the three changes needed in the fire service to increase the ratio of retirement parties vs. line-of-duty funerals are as follows:
Increased emphasis on firefighter health and fitness. We will never be able to reduce the incredible physical demand that firefighting places on the human body. We have complete control as individuals, however, over making improvements to our bodies to defend against the anticipated demands of our profession. Mandatory fitness standards, nutritional education, and (with all due respect) appropriate age limits for emergency responders (including volunteers) should be implemented. Compliance with NFPA 1500, 1582, and 1583 should be considered as a minimum.
Comprehensive training in emergency vehicle response driving. The learning process involves the acquisition of knowledge, skills, and attitudes. For example, firefighters are aware of their legislated responsibility to wear seatbelts. They all know how to buckle up and possess the dexterity to do so. I can only conclude that they do not believe it is necessary. Until our training programs focus on behavioral change, and they are reinforced with proactive supervision, coaching, and corrective discipline, the statistics will continue to include firefighters killed while responding and citizens killed by responding firefighters.
Improvement in emergency scene command and control. A depressingly significant number of line-of-duty death notices seem like reprints with the names, dates, and locations changed. There should not be any excuses for lapses in fireground accountability resulting in a lost firefighter, and yet this continues to occur. We are all aware of case histories of heroic firefighters ignoring orders to withdraw from a building or even rushing past an incident commander who has ordered that no one is to enter, but such actions, however noble and altruistic their intent, are neither wise nor professional. The ideal situation of a highly competent incident commander coordinating a disciplined team of skilled firefighters is essential to the reduction of firefighter deaths and injuries.
Marc D. Greenwood, lieutenant,
Akron (OH) Fire Department
Response: SCBAs are standard issue, aggressive smoke detector distribution has decreased structure fires by 40 percent, rapid intervention teams are commonplace, thermal imaging cameras proliferate, and incident management systems are used, yet line-of-duty deaths per 100,000 incidents have increased in the past five years, per the USFA.
Fire professionals shake their heads, wring their hands, and wail and lament as they gaze at the bleak statistics compiled by the USFA. Benevolent autocrats who seize opportunities to reformat their departments and increase efficiency, safety, and service are needed now.
Heart attacks account for 44 percent of line-of-duty deaths. Predisposing factors include smoking (smokers sustain heart attacks double that of nonsmokers), hypertension, sedentary lifestyle, diabetes, age, obesity, and stress.
First, departments must implement, in conjunction with unions, a holistic health and fitness program. An aggressive approach is essential in decreasing heart attacks. Programs should include mandatory physicals performed by a physician. Palm Beach County (FL) Fire-Rescue has the prototype system. Its firefighters have been diagnosed with diabetes, cardiac problems, infectious diseases, and various cancers. Allocate time for firefighter fitness training on shift.
Members refusing fitness training, annual medical exams, or any other component of the program will suffer suspension with loss of pay. Chief officers have an obligation to save the lives of firefighters, even obstinate ones. Economic reprisal motivates when other methods fail. Fitness programs should include line and staff.
Second, incident commanders must ensure that firefighters wear breathing apparatus at structure and vehicle fires. During overhaul, the atmosphere must be monitored to determine acceptable levels when firefighters are permitted inside without breathing protection. Here’s where command officers earn their money. They must make tough decisions and be prepared to back them up. Issues impacting firefighter safety aren’t open for debate. A 1994 Ontario Industrial Standards Panel report estimated that “more than 80 percent of firefighter injuries are caused by smoke inhalation or oxygen deficiency and that more than 50 percent of line-of-duty deaths are caused by smoke exposures.” During overhaul, ICs must provide sufficient rehabilitation for firefighters. A refreshed firefighter will be more inclined to wear breathing apparatus than an exhausted firefighter.
Third, departments must enforce seatbelt policies. Only 21 percent of firefighters killed in motor vehicle accidents were wearing seatbelts. Three decades ago, some agencies were limiting their hot responses. When Salt Lake City discussed nonemergency calls for EMT/engines, a paramedic/captain wailed, “What are you guys going to do, take away the last thing on the job that’s fun?” This attitude and myopia must be stamped out.
Jimmy Taylor, battalion chief,
Cobb County (GA) Fire
and Emergency Services
Response: The greatest killer of firefighters is heart attacks. This is where we can make the greatest difference in line-of-duty deaths. It will take a great commitment from department brass to enact guidelines that will reduce the number of firefighters who suffer heart attacks. These guidelines are the easiest to get rid of when a budget crunch comes along.
First, every firefighter should have a complete physical at regular intervals. These physicals should include blood work. The interval should be determined by age: up to age 30, every three to five years; ages 30 to 40, every two to three years; ages 40 to 50, every one to two years; and over age 50, every year.
Second, there should be yearly fitness evaluations conducted by properly trained personnel. A minimum fitness standard should be set, and anyone scoring under the minimum should be removed from the field. Fitness should be encouraged and never discouraged. It should be part of daily station duties just as prefire planning is.
Third, departments should give yearly benefits for medical procedures not covered by medical insurance—a flat $200 benefit to be used for some type of medical procedure or test. Firefighters could use this benefit for cancer screenings, diabetes testing, sleep disorder testing, or whatever they choose. Doing away with deductibles for certain medical tests for firefighters would also be an encouraging way for firefighters to seek medical attention they would normally decline because of cost.
Leigh Hollins, battalion chief,
Cedar-Hammock (FL) Fire Rescue
Response: The three ways to reduce the annual death rate of firefighters are very simple to identify but much harder to implement successfully.
We need to look no further than the NFPA or USFA’s records. The number one killer is cardiovascular in nature, and the number two killer is vehicle-related. These two causes make up about 60 percent of the deaths each year.
Thus, I offer three remedies.
1. Firefighters need to be physically fit. Every fire department should have a mandatory physical fitness training program.
2. Firefighters need to be fit for duty. Firefighters should be medically evaluated each year to determine if there are any major medical problems that could cause their death if they continued in their present job duties.
3. Firefighters need to be better trained in emergency vehicle operations and in-the-street safety. Also, firefighters responding to the station or scene in private vehicles should be required to follow ALL traffic laws.
Do these “mandates” cause “issues” and “problems”? Sure they do. But, if they were only 50 percent effective in reaching their goal of reducing LODDs, approximately 30 firefighter lives would be saved each and every year. Thirty a year for 10 years is 300 firefighters! And that’s estimating at a low success rate of 50 percent.
The fire service is heading in the right direction, but there is still a long way to go. Implementing such changes now, along with sound firefighting tactics and strategies, RIT/survival training, and smart operating guidelines, will go a long way in reducing LODDs in this country.
Lance Peeples, firefighter/paramedic,
Webster Groves (MO) Fire Department
Response: I have had the great misfortune during my career to attend the funerals of a number of firefighters who have died in the line of duty—most recently, those of St. Louis (MO) Fire Department Captains Derrick Martin and Rob Morrison, who lost their lives while attempting to locate a missing firefighter at a fire in a business occupancy. If we are to reduce the number of firefighters killed annually, we must first identify the leading causes of firefighter deaths. The National Fire Protection Association has identified the causes of many of these deaths:
Stress. We must require firefighters to participate in mandatory wellness programs designed to ensure that they are capable of handling the physical challenges of the job.
Motor vehicle crashes. Note that I avoided using the word “accident.” Company and chief officers must take all measures necessary to ensure that only mature, responsible, and trained individuals operate fire department apparatus or personally owned vehicles while responding to emergencies.
Fireground operations. Many of the deaths that occur on the fireground can be prevented through training—not pseudo training where a bored-stiff training officer recites some verbiage out of a government handout to get the requisite number of training hours in, but rather hands-on, “learn or burn,” back-to-basics training by experienced instructors who are committed to reducing the unnecessary deaths of their brothers and sisters.
Firefighters will continue to die in the performance of their duties. But it is the unnecessary deaths that are especially tragic. The 18-year-old “blue light special” who races to the station at breakneck speed so that he can drive the engine and crashes into a tree; the 68-year-old, obese assistant fire chief who keels over dead while rolling hose; and the 10-year “vet” in a slow suburban outfit who falls through a truss roof—these are the deaths that CAN be prevented. These are the deaths it is OUR responsibility to prevent.
Joe Floyd, assistant chief,
Columbia (SC) Fire Department
Response: After careful study and analysis, I believe the three things departments can do are training and awareness programs, health and fitness programs, and improved strategy and tactics. Departments can do better in all of these areas and provide a better work environment for firefighters.
Some things are unexpected and simply beyond our control. However, there are things we can control, and we must make sure we do that. One is training. We have total control over what we teach firefighters from the newest recruit to the oldest veteran. It should begin with recruit school. Safety and correct strategy and tactics should be instilled from the very beginning; training and awareness should continue throughout the firefighter’s career. It could be the difference between life and death.
Health and fitness should also be instilled in our firefighters. Studies have shown that older firefighters account for a higher percentage of deaths among firefighters. Reducing the chance of heart attacks and strokes by having a good heath and fitness program will reduce the number of deaths among firefighters. In addition, such a program will benefit all firefighters by increasing self-awareness of physical capabilities and increasing morale.
Staying abreast of new strategy and tactics and improving operations to better serve firefighters on the fireground will also reduce firefighter injuries and deaths. It is essential that fire departments stay up-to-date on new and better tactics; so often, new and better tactics come from lessons learned the hard way on the fireground.
Josh Thompson, lieutenant,
Avon (IN) Fire Department
Response: As a new lieutenant, I have direct responsibility for six firefighters, two of which are probationary. It is my goal to return each of these men—and myself— safely to their families at the end of every shift. The three issues I emphasize to reduce the risk of “not coming home” include fitness/wellness programs, operator/vehicle safety, and preincident planning. Each of these issues is relevant not only to these six men but to every firefighter in the nation.
Fitness and wellness are often controversial issues in fire departments. Though the majority understand the obvious importance of remaining physically fit, mandating physical training (PT) and setting fitness “minimum standards” are often resisted. Our job requires strenuous physical activity involving strength and stamina, each a component of fitness. Yet PT also contributes to the reduction of stress by releasing “feel good” hormones (natural endorphins) into the body and allowing healthy “release” of daily frustrations, thereby contributing to overall wellness. As a leading factor in cardiac disease, it would behoove any firefighter to reduce stress-released chemicals into the body by participating in PT.
Strength is a vital aspect of firefighting; yet, if the concept “work smarter, not harder” is followed, strength can be eliminated as the primary goal of fitness. Just because a given firefighter can “do” the job strengthwise does not mean he will survive the job. PT emphasizing cardiovascular endurance trains the body to survive the job. As mentioned earlier, cardiovascular fitness contributes to reducing the risk of cardiac disease by releasing natural endorphins and combating stress-released chemicals in the body. Yet there is a second vital benefit of cardiovascular health. It is a physiological certainty that every firefighter will experience an elevated heart rate on every run because of the release of adrenalin into the bloodstream. Yet many times, this heart rate remains elevated throughout the run because of the combination of adrenalin and increased physical activity. Cardiovascular fitness is the ability to sustain a workload for a given period of time without overloading the heart. It allows the body to sustain these elevated heart rates and accommodate the increased workload, thereby reducing the risk of myocardial infarction or, worse, cardiac arrest.
Wellness addresses lifestyle issues. I don’t want to live forever, but I do want to live a full life professionally and personally. As I described, physical exercise reduces the effects of stress in life. We can discuss numerous lifestyle issues that contribute to early death—tobacco, drugs, and poor eating habits are just a few.
I have addressed the main benefits of a fitness and wellness program, yet how do we implement it? Because “minimum standards” are hard to define and enforce, our department is discussing the possibility of an incentive-based program. The option to which I am partial sets increasing standards for the program. Each standard met (minimum standard and above standard) correlates with a percentage incentive pay the department will contribute to retirement insurance. For example, the department pays 25 percent retirement insurance if you meet the minimum standard and more if you go beyond the minimum.
The second topic vital to a firefighter’s survival is operator and vehicle safety. In my department, the “operator” is the paid chauffeur of the fire apparatus, the assigned driver of the ambulance, or the personnel of a staff vehicle. The operator has many responsibilities, yet that should not cloud the understanding of the most important responsibility: safe operation of the apparatus/vehicle, thereby reducing any risk of life. A response to any given “emergency” should not differ from any other “emergency.” You are not going to help people if you don’t get to them. Drive safely.
On scenes, particularly at motor vehicle accidents, it is everyone’s responsibility to look out for the safety of others. The operator can help with traffic/visibility simply by positioning the apparatus. There are steps we can take to reduce the chance of an accident occurring. One step is to increase driver/operator awareness. A clear explanation and understanding of responsibilities should be followed by strict enforcement of the set operator standards. Should these standards not be followed, a strict nontolerance approach to unsafe driving is essential.
Regarding personal vehicle safety for volunteers, I work in a small combination department that does not allow the “blue light.” This is a great concept: If you don’t have the “blue light,” you are less inclined to operate your vehicle below the department’s “operator standard.” Personal vehicle safety adheres to the same motto as department-owned vehicles: If you don’t arrive at the incident, how can you help?
Another component that increases safety in our job is preincident planning. As new construction and manufacturing processes evolve and “remodeling” of older structures occurs, we must become increasingly educated on the problems they present.
Ronald W. Endle, division chief (ret.),
Buffalo (NY) Fire Department
Response: If there is a fire triangle, why not a safety triangle (education, attitude, and enforcement) to lessen its effects on our members?
Let’s start with education. I chose this word over training because of the need to understand what happens when we do the various things we have been trained to do at an incident. An example is opening a vent hole in the roof. We know we do this to let out heat and products of combustion, but how many people also realize that we are also working on the fire triangle by allowing the three sides to come together again to produce fire if the mixture of these three products is right? If we put this vent hole in and then go up the roof ladder and do some other things, we may find that the vent hole worked and is now spouting flames that we will need to go through to get down or find another route of escape. Even if we do not get flame production at the vent hole, we have weakened the structure, giving us another reason to go no farther. Education tells us the effects of doing something—not just the reason for doing it.
The next area is attitude. First, there’s the “It cannot happen to me” syndrome: “We have done things in the past and have gotten away with them—we can always get away with them. I have always operated this way because I had good training on how to do things.” When we look back on near misses from an incident, we say, “Well, nothing happened, so it must be okay to keep doing it that way.” The second part of the attitude problem is the notion that you cannot be an aggressive firefighter and practice safety. When we start off as firefighters, we strive to gain the respect of our peers by being known as aggressive. When we start to go up the leadership ladder, we tend to think more about safety because now we are responsible not only for ourselves but for other firefighters. We may change our attitude and decide that the risk at this incident is not worth it.
As for enforcement, we can have the best training, SOPs, and equipment, but without enforcement, we will continue to get injured and killed. When I teach the Safety Officer course, I say to the students, “Asking me to overlook a simple safety violation would be asking me to compromise my entire attitude toward the value of your life” (author unknown). This explains why we need to enforce the rules we have.
The key to safety is being able to stop the chain of events that leads to an accident. Just as the key to putting out a fire is to remove one leg of the fire triangle, the key to safety is to put in any missing leg of the safety triangle.
Douglas Larson, firefighter,
Somerset County, New Jersey
Response: Departments need to enforce seatbelt usage as vigorously as rules pertaining to the wearing of PPE. Operators and front seat officers need to slow their vehicles down. If every firefighter reminded another about wearing a seatbelt, compliance would skyrocket. Sure, time is of the essence, but getting there safely is more critical.
Smoke-free fire stations (even incentives to quit may be appropriate), fitness drills, rewards and recognition for getting or staying in shape, and restricting certain high-risk members from stressful duties can help to reduce the cardiac-related deaths.
Fireground trauma is the most difficult statistic to impact, but it can be done. Getting more resources (personnel and equipment) to the scene earlier is one approach. Automatic-aid procedures and the automatic dispatch of a RIT may help. If you call early for what you may need, a safer and slower response will not impact the outcome as greatly as a delayed urgent request for badly needed resources. The worst that can happen is that they are not needed and are returned. Having relevent drills with required participation does two things. It identifies in advance strengths and weaknesses so we are better prepared for the real thing. Staying sharp with less real fire calls is critical. An organized, well-implemented use of the incident management system is another goal best acomplished by drilling and constant use of the system on even the simplest of calls.
Jim Murtagh, deputy chief (ret.),
Fire Department of New York
Response: The three issues that should be somewhere near the top of any chief’s “Firefighter Safety Plan” follow.
Communications—our ability to get and transmit important and relevant information. This can be best translated into “Every firefighter should have a radio,” and that radio should be 100 percent reliable in all weather conditions and able to work in any building and from any location in that building. To achieve this goal may mean market research and passing state and local legislation that requires supplemental communication devices be installed in buildings that have “dead spots” (areas in a building where radio communication is not possible using standard radio communication devices).
Chiefs and the technology community must also address the development of an accountability, tracking, and location device that would allow an incident commander, team leaders, and the rapid intervention team to rapidly identify and find a firefighter who is lost or in trouble. The device should be easily put into operation by the first-arriving unit, automatically identify all personnel who show up at the scene, make it possible to take a personnel accounting with minimal confusion or disruption to any firefighter working at the incident, and be set up to respond to a signal when activated from a local or remote location. What I am referring to is an instrument that would have the advantages of a stolen-vehicle tracking system and that neat little device on your key chain by which you can locate your lost car in a parking lot. This system would be used to establish a personnel resource list and to take a PAR at regular intervals. Unit officers can use the key chain locater to take a local accounting of their assigned members; RIT members can use it to home in on a lost or trapped firefighter’s location. These devices would be integrated into the fire clothing and have a distinct identifying characteristic for each user. They would not be part of the PASS device; this device is intended to notify those in the immediate area that a firefighter has stopped moving and might be in trouble. However, this new device would require industry support to develop the technology for this specific application and support from the fire service in the form of outfitting ALL firefighters with this safety device.
Chiefs also must address the other use of the concept of accountability—that is, firefighters, company officers, and chief officers being responsible for their actions or inactions. Firefighters need to be trained, drilled, and nurtured on what to do and what not to do; as we do this, we need to demonstrate competency and capability. When we do things that are not appropriate, we need to be corrected and shown how to integrate our newly learned skills, knowledge, and abilities into our professional lives. From time to time, we may need not only to be corrected but also to be admonished for failing to properly use the skills, knowledge, and abilities we have developed.
Firefighters, whether paid or volunteer, must be professional and accountable. The emergency medical sector of the fire service has a very clear-cut, well-defined set of systems and evaluations. When something happens that is suspected of not being in accordance with standard procedures, an investigation is conducted, conclusions are drawn, decisions are made, and appropriate actions are implemented.
The fire service needs to amend its “can-do, will-do” attitude by tempering it with an attitude that supports the concept of “accidents and injuries are not a part of the profession and are preventable.” We need to create a team atmosphere where each of us helps the other to be aware of the little things we do that may lead us down the path to the major accident.
