commentary FossilMedic on 06 May 2008 09:46 am
Parking Your Firefighters
FossilMedic throws the switch:
THIRTY-FIVE LESS LINE OF DUTY DEATHS IN 2009
I was one of the 200 that developed the 16 initiatives that came out of the National Fallen Firefighter Foundation (NFF) Life Safety Summit in Tampa four years ago. http://www.firehero.org/index1.aspx?BD=26803. We committed to reduce firefighter line-of-duty deaths by 25% in five years.
Since the Life Safety Summit, the industry has witnessed excellent work by many to raise the awareness and change some processes. Unfortunately, it appears we will not meet our commitment by January 2010. Here is my proposal to meet our original commitment.
NO COMBAT FIREFIGHTING PAST THE AGE OF 50
The NFFF tasked Gordon Routley to analyze twenty years of line-of-duty death reports. The only statistically significant item was the rate of cardiac-related deaths in firefighters over the age of 50.
This factoid* is used by every person selling automatic external defibrillators (AED). Fire company AEDs is one of the reasons why the number of firefighters dying of sudden cardiac arrest have declined, from an average of 65 deaths a year in the 1970s to an average of 41 deaths a year in this decade.
One LODD example was a seventy-something fire-police member. Fire-police are elderly firefighters who control traffic at an emergency scene. He suffered a cardiac arrest while operating at a fire. The AED that resuscitated him a year earlier could not repeat the task.
This prohibition is a draconian concept, penalizing about a quarter million firefighters that are over the age of 50. Of that group, about 80,000 have a cardiac condition, whether known or unknown, that may lead to a fireground line-of-duty death. So, lets refine this concept to …
MANDATORY PHYSICAL, STRESS TEST AND WORK PERFORMANCE AT AGE 49, 56 & 63
When a firefighter reaches the age of 49, 56 and 63 the department should require a comprehensive occupational physical exam designed to assess the ability to perform firefighting tasks. This will include a cardiac stress test and comprehensive analysis of blood work.
A mandatory work performance test will be required when firefighter passes the physical and stress test. This is to confirm that the firefighter can continue to participate in structural firefighting.
This applies to all ranks: from firefighter to command officer. If you are on the fireground you must be physically capable of performing required tasks within this demanding environment. Those familiar with retirement plans and pension regulations will recognize that these three ages represent decision points for many municipal employees.
There are dozens of fire departments that do more. Check with your IAFF or IAFC representative to get contact information from the departments that participate in the Wellness-Fitness task force: http://www.iaff.org/HS/Well/index.htm
I appreciate that this recommendation is fraught with fit-for-duty, disability, retirement, rehabilitation, and labor-management concerns. Maybe this option is too expensive or politically difficult. How about this:
NO FIREFIGHTING AFTER CARDIAC SURGERY OR A SIGNIFICANT CARDIAC EPISODE
The majority of the 41 firefighters who have a cardiac line-of-duty death each year had a known condition, cardiac surgery or a “sentinel” event days, weeks or months before their death. I am concerned when reading about cardiac arrest survivors and multiple bypass recipients who return to full firefighting duty. They have an exponentially higher chance of suffering another cardiac event that will cripple or kill them.
This option also raises significant labor-management and worker compensation issues. We have many examples of fire departments that “look-the-other-way” to allowing our heart-damaged brethren to stay on the job in frontline assignments.
One LODD example was a company officer assigned to office duty. The results of his cardiovascular stress test never got to his boss, the officer hid the report in his desk. He died of a cardiac arrest when assisting on a greater alarm fire.
We need to show tough love and move these dedicated sister and brother firefighters off the front line before they become a statistic or assisted living resident. This affects about 5,000 of the 80,000 firefighters with a cardiac condition. This third option can result in 35 less LODDs in 2009.
* * *
*Factoid: NFPA analyzed post mortem information or known medical history on 713 of the 1,117 sudden cardiac arrest deaths that occurred in a twenty-five year period. 84.6% had suffered prior heart attacks, had severe arteriosclerotic heart disease, had undergone bypass surgery or angioplasty/stent placement or were diabetic.
Source:
Fahy, LeBlanc and Molis (June 2007) Firefighter Fatalities in the United States - 2006.
Fire Analysis and Research Division
National Fire Protection Association
on 06 May 2008 at 5:45 pm 1.Mike said …
I think that once you reach the age of 50 in firefighting, you should be removed from active participation into something less demanding such as training the recruits. I know it’s hard to admit that the older we get the tougher the job becomes, but in reality firefighting is a young mans job these days. I spent 32 years in the fire service all of it in active houses and when I retired a few years back, it was the hardest decision I ever made, but I am hoping to be able to enjoy my retirement for many years to come. Stay safe out there.
on 06 May 2008 at 6:52 pm 2.Rich R. said …
I strongly disagree with establishing an arbitrary age (like 50) after which an individual is automatically deemed unfit for “combat (Is there any other kind?) firefighting” regardless of their physical condition. That is blatant discrimination.
The real issue is physical fitness; it is a fact that there are firefighters in their 50’s and even 60’s who, through diet and exercise, are in better shape than some firefighters in their 30’s and yes, even 20’s. The Firefighter Combat Challenge has a category for over 50 and over 60. In fact the best time for a male firefighter over 50 is better than the best time for a female firefighter — should females automatically be deemed unfit for firefighting?
What there should be is a requirement for annual physical exams for all “combat firefighters” to include a body fat assessment and treadmill EKG stress test to determine cardiovascular health.
on 06 May 2008 at 7:31 pm 3.Mark Akins said …
I whole hearted agree with Rich R.,
Statistics can be geared to say what you want them too,there are far too many factors involved to make a broad statement and say “No more firefighting after 50″.
Ibelieve that the mandatory physical assessments and medical exam for ALL firefighters is the best choice.
The truth is a lot of the cardiac deaths in the fire service would be stopped if there were a truly MANDATORY physical fitness initiative.
on 08 May 2008 at 12:24 am 4.NJSteve said …
Yes unfortunatately, not a chance to hit your fatality numbers this year.
Rich R and Mark states correctly what should be done. I don’t like your 1st suggestion but I think the author favors his second suggestion anyway. 2nd suggestion is good but I don’t like the years choosen. 49 is good but then I think no latter than 54 and then every 3 years after that for testing and even these year suggestions are maybe too conservative. Yes and mandatory work performance test should be required when firefighter passes the physical and stress test. Your 3rd suggestion, I lean towards supporting, but I’d have to see more data and specific cardiac problems need to be described not just a blanket cardiac episode.
I believe that probably early detection and correction through stress tests probably is the largest reason for decreasing cardiac mortality, and probably even more than AEDs.
on 08 May 2008 at 7:36 am 5.fossilmedic said …
I retired from a large department with an excellent occupational health center. Annual physicals and stress tests, work performance tests avery two/three years for all. Physicians with certification in occupational medicine.
With most departments having fewer resources, suggestion 2 is floated as one way to approach the issue … I agree with NJSteve that there needs to be a more frequent assessment.
Suggestion 1 was poised as an attention getter.
What I REALLY want is to have our brother/sisters who survived a cardiac arrest, cardiac surgery (bypass, stent ) or significant cardiovascular event (myocardial infarction) removed from operating on the fireground.
From both the IDLH environment and the cold zone. Including those operating the pumpers and commanding the incident. Regardless of age.
If we do this, the number of sudden cardiac arrests that are classified as LODDs will fall from the 41 we average every year to a handful.
To reinforce this I shared the NFPA retrospective data from a quarter century of LODD data. ALMOST ALL of those that died of cardiac arrest had a pre-existing cardiac condition.
on 08 May 2008 at 9:27 pm 6.Martha said …
Honestly, some people are just getting started at 50! It isn’t about age as much as the willingness to keep your parts in working order. Look at the over 50 group that competes in the Firefighter Combat Challenge. They aren’t super human, just willing to get off their butts and work. Don’t get sucked up into the numbers game. Get annual performance testing incorporated into all fitness and wellness programs and you’ll see a marked improvement in performance in the over 50, 40, 30 and 20 age groups. Why on earth would you want to put your seasoned veterans out to pasture when they should be more than capable of contributing to the combat effort on so many different levels. JUST KEEP THEM IN SHAPE, TEACH THEM HOW TO EAT, GET THEM OFF THE CIGARETTES, PERFORM ANNUAL HEALTH SCREENINGS, AND STAND BACK AND WATCH WHAT HAPPENS!