Review and Analysis of Firefighter Line-of-Duty Fatalities

The occupational fatality rate for firefighters is four times greater than that of the general working population, and there has been little improvement in the past 25 years. In this presentation, we summarize results from an analysis of firefighter fatalities (N = 127) investigated by NIOSH between 2004 and 2007. As part of the Firefighter Fatality Investigation and Prevention Program (FFFIPP), NIOSH conducts onsite investigations of firefighter line-of-duty deaths to define the characteristics of line-of-duty deaths, develop recommendations for prevention, and disseminate prevention strategies to the fire service. NIOSH disseminates findings from individual investigations, and our purpose was to collate findings from three years of investigations and to identify common causes, event sequences, and priority recommendations. Since NIOSH uses a decision algorithm to select cases for investigation, we compared NIOSH investigations against all firefighter fatalities using US Fire Administration data. NIOSH cases were generally representative of all fatalities in term of demographics, work activities, and cause of death. Between 2004 and 2007, NIOSH investigated 69 fatalities involving medical conditions and 58 cases involving traumatic injury. These investigations produced a total of 685 recommendations for corrective action. The most frequent recommendations for medical cases involved pre-placement/periodic medical examinations, wellness/fitness, and clearance for duty. Trauma cases produced a wider array of recommendations, but recommendations involving pre-incident planning, incident command, communications, emergency equipment and motor vehicle safety (seatbelts, traffic laws, etc.) were especially frequent. Root cause analysis points to a subset of organizational vulnerabilities (or “hotspots”) shared by many firefighting organizations.