Analyzing the 2016 LODD statistics

[jes82]

When arguing for changes in fireground tactics, I often hear people cite the number of Line of Duty Deaths. 'We're killing 100 firefighters a year with this stuff,' the argument goes. But the LODD statistics tell a different story.

In 2016, there were 89 Line of Duty Deaths. Of those 89 fallen firefighters, only 4 died at a structure fire, as a result of collapse, thermal injuries, or smoke inhalation. Only those 4 deaths, of 89, occurred as a result of incidents that could have been avoided by a change in tactics. The other 85 of 89 fatal incidents in 2016 had nothing to with interior vs. transitional attack, the use of vertical ventilation, or the timing of ventilation and search, and most of those incidents did not involve a working structure fire at all.

If you want to keep reading, I'll talk a little about how I came up with those numbers. But if not, just know that I believe that Line of Duty Deaths are tragic, and the fire service should continue making important culture changes in the name of life safety. However, the culture changes that will actually prevent firefighter deaths are related to nutrition, fitness, safe driving practices, and improved training, and have little to do with fireground tactics.

It's true, we are killing 100 firefighters a year. That's a tragedy, and we should do something about it. But changing our tactics will do little to reduce the number of Line of Duty Deaths per year.

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I got my numbers from pg. 17 of the FEMA and the National Fallen Firefighter Foundation 2016 LODD report, where they break down Line of Duty Deaths by cause of injury.
https://www.usfa.fema.gov/downloads/...s/ff_fat16.pdf

43 were caused by stress and overexertion, and resulted in heart attacks and strokes.
19 were caused by vehicle collisions.
8 were caused by objects striking a firefighter. This includes shootings, and a number of wildland firefighters killed by falling objects. One incident that I arguably could have included was a firefighter who died as a result of an explosion at a gas leak call. But because it was not a working fire, and because the firefighter was in the street when he was killed by debris from the explosion (not actually in the house), I didn't include this in my count of incidents that could be attributed to tactical decisions.
5 causes were listed as other, and all were due to medical emergencies.
1 was caused by a suicide while on duty.

The remaining 13 incidents were the result of falls, collapses, getting lost, running out of air, or exposure.

5 were caused by falls. The falls occurred during EMS and law enforcement assists, training exercises, and wildland operations. None of the falls occurred during working house fires, or had anything to do with tactical decision making.
2 were caused by exposure. One occurred in an industrial setting, and resulted from the use of pneumatic tools. One occurred as a result of a medical emergency during a training that did not include live fire.
1 was caused by running out of air. It occurred as a result of an air embolism during a dive operation.
1 was caused by becoming caught or trapped. This firefighter drowned, while assisted civilians in flood conditions.

Only 4 incidents occurred during working fires in structures.

3 were caused by collapse, all as a result of the same incident. During a rowhome fire with a report of trapped occupants, the first floor collapsed while firefighters were advancing a hoseline into the structure.
1 was caused by a firefighter becoming lost or disoriented, while searching a commercial structure during a working fire.

[Andy2802]

Good info, and so glad to see something new and non-political on this forum. Thanks!

[FyredUp]

While good information that should open some eyes, this information, with a VERY few limited exceptions over the past decades, has remained constant. The problem stems from a lack of annual physicals by the majority of Fire Departments, both paid and volunteer, and the lack of a physical fitness standard. I am not advocating that everyone be a weight lifting body builder type, or a marathon runner, but at least be in good enough shape to do the job and for more than 5 minutes.

Thanks for posting this. It is valuable information that more Chiefs need to pay attention to and more firefighters need to be held responsible to.

[johnsb]

Something seems to be missing. Where are the LODD deaths from cancer??? It doesn't happen on the scene or the next day, but it DOES happen. And what about illnesses contracted by contact with a patient?

[jes82]

I think that's a fair point. As you said, to be considered a line of duty death, it must have occurred on duty (or within 24 hours of duty, since the 2003 Hometown Heroes act). So long term, job related illnesses like cancer or exposure to disease usually don't meet that criteria, because most people who are that sick are already off work or have retired. But not counting those deaths underrepresents the risks of fire/ems as a career field.

Personally, I don't think those longer term deaths should be tracked as line of duty deaths, but they should still be just as carefully tracked and reported. Maybe a separate category for job related deaths, or something like that?

[tree68]

While we still need to reduce that number of deaths, your analysis nonetheless confirms my impression that we are not, indeed, killing firefighters at fires.

Something requiring much deeper analysis/research would be a look at how each category of firefighter deaths has trended over time.

Perhaps we have a point of pride there - before we started including some of the categories, we were still killing 100+ firefighters a year. Have we actually progressed from 100 fireground deaths per year to just 4?

We're starting to get the idea with the concept that full PPE/SCBA are necessary well after the fire itself is out, a look at statistics over time with that in mind could be productive. F'rinstance, I'm convinced that more than a few of the firefighter "cardiac" deaths that occur back at the station, or at home, following a fire event are actually cyanide poisoning.

The other categories need similar study. Are motor vehicle deaths up, down, or constant? The list goes on.

[Too_Old]

Perhaps we have a point of pride there - before we started including some of the categories, we were still killing 100+ firefighters a year. Have we actually progressed from 100 fireground deaths per year to just 4?

Not sure we ever had 100 fireground (or rather 'in building') deaths. People used to fall off trucks, got crushed by unchocked engines and hit by tools in the past just as they are today.

We're starting to get the idea with the concept that full PPE/SCBA are necessary well after the fire itself is out, a look at statistics over time with that in mind could be productive. F'rinstance, I'm convinced that more than a few of the firefighter "cardiac" deaths that occur back at the station, or at home, following a fire event are actually cyanide poisoning.

With the now common distribution of medical/accident vs. 'true fire' calls, many of these 'back at the station' deaths don't occure after an actual fire. At times they even happen after training events or even with the FF working out in the stations gym. If a body goes to the ME office, part of the standard toxicology is to look for cyanide, so if that was a significant cause I would think it had shown up at some autopsies. Also, cyanide poisoning kills you dead right then and there, not 6 hrs later.

[tree68]

Also, cyanide poisoning kills you dead right then and there, not 6 hrs later.

A misconception on my part, then, borne partly of the European practice of routinely giving smoke inhalation victims a Cyanokit, and the fact that the symptoms of cyanide poisoning can mimic a heart attack. And I've recently seen more interest in the concept from other quarters.

OTOH, death is not necessarily instantaneous - it depends on the dose and route.

I would hope that a toxicology screens would be run, but if someone passes after the incident (at home, at the station), the ME may not put two and two together.

[Mr Pita]

There are more and more cases of throat, skin and brain cancers popping up. The findings are starting to reveal the lack of proper gear cleaning.
We boiled our hoods in a pot one evening after a fairly long job to see what the water would look like. It looked like somebody dumped a pot of coffee in there. Most cancers are presumptive now, and a death from cancers that fall in those categories are considered LODD.

I was reading an article recently that a fire captain somewhere was finally classified as an OJI after contracting AIDS from a needle stick some years back. Unfortunately he is now a LODD, he was awarded this posthumously. This can only serve to help any future cases like this.

[slackjawedyokel]

There are more and more cases of throat, skin and brain cancers popping up. The findings are starting to reveal the lack of proper gear cleaning.
We boiled our hoods in a pot one evening after a fairly long job to see what the water would look like. It looked like somebody dumped a pot of coffee in there. Most cancers are presumptive now, and a death from cancers that fall in those categories are considered LODD.

I was reading an article recently that a fire captain somewhere was finally classified as an OJI after contracting AIDS from a needle stick some years back. Unfortunately he is now a LODD, he was awarded this posthumously. This can only serve to help any future cases like this.

It amazes me that there is pushback on granting a LODD on something like an aids or a cancer death (especially the more "exotic" types) and then award it to some overweight 50 year old with 3 years in a slow vfd , that dies of a heart attack.

[Too_Old]

It amazes me that there is pushback on granting a LODD on something like an aids or a cancer death (especially the more "exotic" types) and then award it to some overweight 50 year old with 3 years in a slow vfd , that dies of a heart attack.

Given what we know now, I have to shake my head any time I see firefighters smoking or dipping in front of a fire station.

[tree68]

Given what we know now, I have to shake my head any time I see firefighters smoking or dipping in front of a fire station.

Heck, it amazes me to see anyone smoking or dipping, yet they do.

But I have a certain amount of understanding of the habit. Never smoked myself, but my father did, right up to his first heart attack in 1962. Eight years later, another heart attack killed him (bypass surgery, stents, etc were still in the future then). After he died, I found in one of his jackets a roll of Life Savers candy - the final manifestation of the oral habit he never lost. Lemon drops, gum, Life Savers, all served to replace the cigarettes he had to give up.

I've read that one way to beat smoking is to break the habits. Light up a cigarette as soon as you're sitting on the edge of the bed in the morning? Start by giving that one up. Then lose the one you smoke with your breakfast, etc and so on.

Back in the day of one phone in the house, on a table in the hallway, it was not unusual to find a pack of cigarettes and matches. When the phone rang and it was going to be a long chat - light one up!

Many people struggle with breaking the habit - they quit numerous times, but still go back to lighting up. Clearly, they know better, but...

[L-Webb]

A misconception on my part, then, borne partly of the European practice of routinely giving smoke inhalation victims a Cyanokit, and the fact that the symptoms of cyanide poisoning can mimic a heart attack. And I've recently seen more interest in the concept from other quarters.

OTOH, death is not necessarily instantaneous - it depends on the dose and route.

I would hope that a toxicology screens would be run, but if someone passes after the incident (at home, at the station), the ME may not put two and two together.

Its a good bet that if you had cyanide poisoning of any level and you acquired it from smoke at a fire then you would have other toxins as well, i.e carbon monoxide will absolutely cause an ischemic heart. Couple that with an older person **or someone with bad genetics** that has just exerted themselves to the max and you have the recipe for sudden cardiac death.

I would be lying if I said that it didn't worry me some when I'm laying down after we have had a fire or a hard day.

[Too_Old]

Its a good bet that if you had cyanide poisoning of any level and you acquired it from smoke at a fire then you would have other toxins as well, i.e carbon monoxide will absolutely cause an ischemic heart. Couple that with an older person **or someone with bad genetics** that has just exerted themselves to the max and you have the recipe for sudden cardiac death.

I would be lying if I said that it didn't worry me some when I'm laying down after we have had a fire or a hard day.

Interestingly, there have been smoke inhalation fatalities where victims had high cyanide levels and low carbon monoxide levels. Nobody is certain how that is. There are plastics that off-gas cyanide when heated below the level of flaming combustion which would be one potential explanation.

The actual cyanide has a half life of an hour in a living human being. Most of the cases of CN poisoning in firefighters became symptomatic on the fireground or in the station. There is some older data that suggests that cardiac effects from cyanide poisoning can be detectable for hours after the exposure.

I do believe that monitoring for CN levels in air during operations and checking blood levels after fires would be a good idea and offer insights on that particular poison. There are issues with both air cyanide level testing and blood cyanide testing that make any such study quite a challenge. Otoh, a Honeywell Gas-Alert HCN is $420, may be worth for the dept to buy one and stick it in the officers pocket to see what we get for readings.

[jes82]

My original post contained the 2016 statistics. Now that the year is over, I will add that only ONE of the 93 Line of Duty Deaths in 2017 occurred inside a burning structure. That incident occurred in San Antonio, in May, when a firefighter was searching a commercial structure for victims, became trapped while attempting to exit, and ultimately was killed when the structure collapsed.
https://apps.usfa.fema.gov/firefight...deathYear=2017

The Line of Duty Death statistics do not support the idea that our fireground tactics are recklessly or needlessly risky, and need to be re-evaluated. In the last two years, the 5 firefighters who have died in burning structures have all been searching for victims in tenable conditions. The use of "progressive" fire tactics (like a transitional attack) would not have saved these men. Also, at this point, it has literally been years since a firefighter has died while performing vertical ventilation.

Of course tactics should be determined based on information available to an IC at size up, and based on an assessment of risk. But getting personnel inside is the only way you're going to discover victims. Getting personnel inside (with a hoseline) is the only way to protect means of egress like hallways and stairwells, so that victims can exit the structure, and firefighters can safely conduct a search. Getting personnel inside (with a hoseline) is the only way to discover fire in void spaces, like attics, knee walls, and cocklofts in row homes, and stop the extension that turns a small fire into a fire that destroys an entire structure.

And these "aggressive" tactics aren't nearly as risky people claim. In the last two years, only 3% Line of Duty Deaths (5 of 190) have occurred inside a burning structure. I'm sure we'll keep debating tactics, and there are some good reasons to choose transitional attack as a tactical choice in some circumstances. But the likelihood of a Line of Duty Death is not one of those reasons. Because it's not very likely at all.