Keeping It Safe Robert Tutterow
Each year, the National Fire Protection Association (NFPA) releases its annual U.S. firefighter line-of-duty-death (LODD) report for the past year. For 2022, there were 96 LODDs reported, which was the highest in the past nine years.
However, there is a caveat. This was the first time the NFPA included deaths that occurred within 24 hours of duty. As of now, the number represents an outlier of the general trend of decreased annual death numbers since tracking began in 1977. Hopefully it will remain an outlier and not be the start of an upward trend. For perspective, for the first 10 years the numbers were tracked, there was an average of more than 130 LODDs with a high of 174 in 1978—these numbers exclude deaths resulting from the World Trade Center attack in 2001. It is no coincidence that the numbers show a pronounced decline following the first edition of NFPA 1500, Standard on Fire Department Occupational Safety, Health, and Wellness Program, and the subsequent overall focus on firefighter health and safety.
The report looks at four major categories when determining the type of duty:
- On the fireground.
- Nonfire emergencies.
- Responding to and returning from emergency calls.
- Training.
Thirty-four of the 96 LODDs occurred on the fireground. Twenty-one occurred while responding to or returning from emergencies. Ten occurred during training activities. In reviewing these numbers, the burning question remains—why? When discussing U.S. firefighter LODDs with firefighters from other countries, primarily in Europe, that is their question—why? From a risk management perspective, every one of these deaths was preventable. None, repeating none, were attributed to equipment failure. Most, if not all, can be attributed to human decision making. This can be from a strategic or tactical level. The most inexplicable category is the 10 who lost their lives during training.
The cause of death is broken down into the following eight categories:
- Overexertion/stress.
- Crashes.
- Struck by vehicle, equipment.
- Rapid fire progress.
- Structural collapse.
- Struck by falling object.
- Fall from height.
- Other.
More than half of the deaths (49) fell within the latter category, with 36 of them being sudden cardiac arrest. Eleven were unspecified, one was from a stroke, and two were from drug overdoses. Fourteen firefighters lost their lives in vehicle crashes. Half of these were collisions with other vehicles, four with stationary objects, and three from the vehicle overturning. In addition, eight firefighters lost their lives after being struck by other vehicles. This number is interesting in that it is one more than the LODDs from rapid fire progress. From an outside perspective, the public thinks we lose our lives by being burned to death while fighting fires.
Of the 36 LODDs from cardiac arrest, 20 occurred while on duty (10 career and 10 volunteer) and 16 occurred within 24 hours of being on duty (four career and 12 volunteer). The report aptly states, “The large share of volunteer firefighters among the cardiac deaths within 24 hours is an indication of a need for special attention to the fitness and medical monitoring for the volunteer firefighter population.”
With all of this in perspective, there are two other causes of firefighter fatalities that are not included in the report: suicide and cancer. According to the Firefighter Behavioral Health Alliance, 80 firefighters committed suicide in 2022; this number is likely low because of reporting issues, especially among volunteer firefighters. This number is overwhelming, and efforts to manage behavioral health cannot be overstressed. There are multifaceted aspects to addressing this issue, and none can be ignored.
As for the highly focused area of firefighter cancer, the numbers continue to be staggering. As with tracking the numbers, there are reporting issues, especially as it relates to volunteers, and the known numbers are likely understated. The National Fallen Firefighters Foundation added 348 names to its memorial in 2022 because of cancer. The composition of materials in fires burning today is clearly far more hazardous than before, and the fire service needs to double down on managing contamination from the products of combustion.
With publication of this column, 2023 will basically be in the history books. However, we should all do everything we can to make 2024 the lowest on record for firefighter LODDs.
ROBERT TUTTEROW retired as safety coordinator for the Charlotte (NC) Fire Department and is a member of the Fire Apparatus & Emergency Equipment Editorial Advisory Board. His 44-year career includes 10 as a volunteer. He has been very active in the National Fire Protection Association through service on the Fire Service Section Executive Board and technical committees involved with safety, apparatus, and personal protective equipment. He is a founding member and president of the Fire Industry Education Resource Organization (F.I.E.R.O.).
