NFPA Journal

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Historically, NFPA has produced an annual look at on-duty firefighter fatalities in the United States that focuses on deaths that occurred while the victims were on the job, either as the result of traumatic injuries or the onset of acute medical conditions. In truth, the firefighter fatality picture is far broader, as studies have shown that years spent in the fire service can take a toll on a firefighter’s health, both physical and emotional, and can also result in exposures to toxins that eventually result in job-related cancer. Unfortunately, a comprehensive study that enumerates all duty-related deaths in a year is not yet possible to accomplish.

In 2017, 60 firefighters died while on-duty in the U.S. as a result of injuries that occurred at specific events that year. This is the lowest total reported since NFPA began reporting on this set of firefighter fatalities more than 40 years ago, and it is the sixth time in the past seven years that the total has been below 70 deaths. In the late 1970s and early 1980s, by comparison, the number of such deaths averaged close to 150 per year.

Of these 60 firefighters, 32 were volunteer firefighters, 21 were career firefighters, three were employees of federal land management agencies, two were contractors with state and federal land management agencies, and two were prison inmates.

There was only one multiple-fatality incident in 2017, when a drunk driver struck and killed two firefighters and injured a third at the scene of downed power lines.

Fire ground deaths and other activities when fatal injuries occurred

The 17 deaths in 2017 at the scene of fires is the second-lowest number of fire ground deaths that we have observed since we began conducting this study in 1977, and the second consecutive year that the number has been below 20. In contrast, the number of fire ground deaths per year in the early 1970s averaged more than 80.

Nine of the 17 deaths in 2017 occurred at structure fires. Six of the structures were single-family dwellings, two were apartment buildings, and one fire started in a gym at a shopping center. One of the homes was vacant and abandoned at the time of the fire. None of the structures in which firefighters died was reported to have had an automatic fire suppression system.

The remaining eight firefighters died at wildland fire incidents: three were struck by falling trees, two were overrun by fire in separate incidents, one was fatally cut by a chainsaw, one crashed a vehicle while en route to refilling a water tank, and one suffered a sudden cardiac event. In 2017, no firefighters died at the scene of motor vehicle fires.

The Thomas Fire burns in California in December 2017. Eight firefighters were killed in wildland fire events int he U.S. in 2017. Photograph: Wally Skalij/Los Angeles Times via Getty Images

In most years, the second-largest share of on-duty firefighter deaths after fire ground fatalities occurs while firefighters are responding to or returning from emergency calls, but that was not the case in 2017.

Last year, the second-largest share, 11 deaths, occurred at the scene of non-fire emergencies: five were operating at motor vehicle crashes, three were at incidents with wires down, one was at the scene of a downed tree, one was investigating an odor in a structure, and one was checking on a possible flooding condition during a storm. Ten of the 11 were struck by passing vehicles and one suffered sudden cardiac death.

Ten deaths occurred during training activities, with sudden cardiac death claiming the lives of seven of the firefighters. Three of these seven firefighters were engaged in physical fitness training, two were involved in search-and-rescue training, one was training on vehicle extrication, and one was involved in hose training. Two of the other three training deaths resulted from traumatic injuries. One of these firefighters fell from an aerial ladder during above-ground fire training. Another was involved in a motor vehicle crash while traveling to an off-site drill. One firefighter died shortly after developing complications from a recent medical procedure while he was attending a classroom refresher class at the fire station.

Nine firefighters were killed responding to or returning from alarms. This is by far the lowest number of deaths in this category in the 41 years of this study. Five of these nine firefighters were killed in motor vehicle crashes, three suffered fatal cardiac events, and another suffered a stroke. All crashes and sudden cardiac deaths are discussed in more detail later in this report. The number of deaths that occurred while responding to or returning from calls has averaged 17 per year over the past 10 years and 13 per year over the past five years. During the first 10 years that NFPA conducted this study, 1977 through 1986, the average number of deaths per year while responding to or returning from alarms was 36. There has been a marked reduction in both crash deaths and cardiac-related deaths while responding to or returning from alarms over the past 40 years.

The remaining 13 firefighters died while involved in a variety of normal station or administrative activities. Eleven of these fatalities were due to sudden cardiac death and one to a stroke. One firefighter was killed in a crash while on fire department business.

Cause and nature of fatal injury or illness

Overexertion, stress, and medical issues accounted for more than half of the firefighter deaths in 2017. Of the 32 deaths in this category, 29 were classified as sudden cardiac deaths (usually heart attacks), two were due to strokes, and one was due to complications from a recent medical procedure that developed while the victim was at work.

Ten firefighters were struck by vehicles and eight others were killed in crashes. These vehicle-related deaths are discussed in more detail below.

Five firefighters were struck and killed by objects: three by trees that fell at separate wildland fires, one by a hose he had just wrapped around a fire hydrant, and one by a chainsaw when he lost his balance while cutting a fire line on a wildland fire.

Three firefighters were killed by rapid fire progress: two while operating on separate wildland fires and one at a structure fire.

Two firefighters fell from ladders: one while climbing an aerial ladder during a high-rise fire training exercise and another from the basket of an aerial while fighting a structure fire.

Sudden cardiac deaths

The 29 sudden cardiac deaths in 2017 with onset while the victim was on duty is the fourth time in the last six years that the toll has been below 30, but still accounts for almost half of the deaths while on-duty. These are cases in which the onset of symptoms occurred while the victim was on duty and death occurred immediately or shortly thereafter.

Cardiac-related events have accounted for 43 percent of the on-duty firefighter deaths over the past 10 years. Though it usually accounts for the largest share of deaths in any given year, this compares to the earliest years of the study when an average of 60 firefighters each year suffered sudden cardiac deaths while on duty. In addition, the U.S. Fire Administration (USFA) is following up on the deaths of more than 20 other firefighters who reportedly died within 24 hours of non-routine strenuous and stressful physical activity, potentially qualifying them for Federal benefits.

Vehicle-related deaths

In 2017, 10 firefighters were struck by vehicles and eight died in vehicle crashes. This is very different from what we typically observe; the 10 deaths of firefighters struck by vehicles is far higher than the average of four deaths a year over the previous 30 years. Only twice before has the total been 10 or higher. In contrast, crash fatalities, which used to consistently account for the highest share of traumatic deaths annually, are below 10 for the fourth time in the past seven years.

Five of the firefighters who were struck by vehicles were at the scene of motor vehicle crashes. A firefighter directing traffic on a dark road at the scene of a motor vehicle crash was struck by a driver who did not see him until it was too late to avoid him. A firefighter guiding an engine that was backing along the road at the scene of a crash was struck by the engine; it was not clear if he tripped or fell beneath the vehicle. A firefighter who was returning to his vehicle after operating at a crash scene was killed by a vehicle that lost control while traveling at a high rate of speed on a dark, wet, slippery road. A firefighter reportedly walking down the middle of the road after finishing up at a scene was struck by a passing vehicle; the driver was not cited. And a firefighter retrieving his gear from his vehicle was struck by another responding firefighter who was intoxicated.

Three firefighters were struck by vehicles at two incidents involving downed wires. In one incident, two firefighters were killed when they and another firefighter were standing off the road but were struck by a vehicle that veered off the main road; the driver was intoxicated. In the other incident involving downed wires, the victim was standing in front of a parked fire department vehicle that was struck in a chain reaction crash when a driver failed to stop for another vehicle that had slowed at the scene.

In the remaining two incidents, a firefighter who was conducting a pre-dawn check of flooding conditions was struck and killed by a passing driver traveling at a high rate of speed. At the scene of a downed tree, a firefighter was killed when a driver struck his vehicle, which then struck a brush truck that pinned the firefighter underneath; all emergency vehicles at the scene had lights operating and the victim was wearing appropriate reflective clothing. The driver was cited for impaired and reckless driving.

Four of the eight firefighters who died in road crashes were killed while responding to fires and one was killed while returning from a fire. One was driving to a training event, one was on official fire department business, and one was operating at the scene of a wildland fire.

Of the firefighters who died in crashes, one was using a seatbelt, three were not using seatbelts, and no details on seatbelt use were reported for four victims. Three of the victims were ejected from the vehicles and another was partially ejected.

Other findings from 2017 firefighter fatalities

Last year, one firefighter was killed and two others were injured as a result of one intentionally set fire that occurred in a gym at a shopping center. The victim and his partner were pulling ceiling tiles to gain access to the fire in the attic when they were overcome by rapidly developing fire. Another firefighter was injured while searching for the downed firefighters. From 2008 through 2017, 41 firefighters (5.5 percent of all on-duty deaths) died in connection with intentionally set fires, either at the fire or while responding to or returning from the fire.

In 2017, no deaths resulted during a false call. Over the past 10 years, six firefighter deaths have resulted from false calls, including malicious false alarms and alarm malfunctions.

Emergency personnel work the scene of a fire in Texas in 2017. The blaze, which was intentionally set, killed one firefighter and seriously injured two more. Photograph: Jacob Beltran/San Antonio Express-News/Zuma Wire

The firefighters who died in 2017 ranged in age from 19 to 83, with a median age of 51.5 years. The lowest death rates were for firefighters between the ages of 20 and 39, whose death rate was less than half the all-age average. The rate for firefighters aged 60 and over was two and one-half times the average. Firefighters aged 50 and over accounted for about half of all firefighter deaths over the five-year period, although they represent only one-quarter of all career and volunteer firefighters in the U.S.

The 21 deaths of career firefighters while on-duty in 2017 is a slight increase over the 19 reported in 2016, which was the lowest total ever reported in this study. In the earliest years of this study, the annual average number of deaths of career firefighters while on duty was 57. The 31 deaths of volunteer firefighters is the second lowest total in all the years of this study, and brings the average number of deaths in the most recent 10-year period to fewer than 40 deaths per year, far lower than the average of 67 deaths per year in the earliest years of this study.

In summary

There were 60 on-duty firefighter deaths in 2017, the lowest number we’ve reported since NFPA began producing this study in 1977. Sudden cardiac death accounted for more than half of the fatalities.

The number of firefighters who were fatally struck by vehicles was unusually high in 2017, while the number of crash deaths continued to occur at a rate far lower than what we’ve seen in past decades.

The number of deaths at the scene of fires continued to be far lower than usual: 17 deaths in 2017, two more than reported in 2016, with nine at structure fires and eight at wildland fires.

Deaths among career and volunteer firefighters also continued to be low, with both at the second-lowest total occurring in 2017.

While the hazardous nature of firefighting cannot be fully captured in a study that focuses only on deaths that occur while firefighters are on the job, it is not possible to accurately assess the total number of deaths and injuries that have resulted annually due to long-term exposures to carcinogens and physical and emotional stress and strain. A complete picture of duty-related fatalities would also include deaths resulting from cancer, cardiac issues, and stress, as well as other fatalities that were caused by exposures to toxins or the emotional toll of responses.

Other sources can offer perspective on aspects of the overall firefighter fatality problem. On its website, the International Association of Fire Fighters lists more than 120 firefighter cancer deaths that were reported to the organization in 2017. According to the Firefighter Behavioral Health Alliance, 91 firefighters and 17 EMTs and paramedics died by suicide in 2017. Over the past several years, in its annual report on U.S. firefighter deaths, the U.S. Fire Administration has included an average of 15 firefighters a year who qualified for Hometown Hero benefits, which cover firefighters who suffer a heart attack or stroke within 24 hours after engaging in non-routine stressful or strenuous activity on duty. As mentioned above, the USFA is following up on more than 20 such fatalities in 2017.

Research by the National Institute for Occupational Safety and Health on firefighter cancer estimates that firefighters are nine percent more likely to have a cancer diagnosis than the general population and 14 percent more likely to die of cancer. The agency’s first study identified a link between firefighting and solid cancers, and a second study showed a relationship between firefighting and lung cancer and leukemia.

NFPA’s Fire Protection Research Foundation is currently involved in three studies related to firefighter health and safety: a 30-year cohort study to track exposures and effects, a study to validate procedures for the optimal removal of several types of contaminants from firefighting gear, and a study to develop prototypes for a real-time particulate and toxic gas sensor to alert firefighters to hazards in the air. The Foundation recently released a report on the development and implementation of a Fire Service Contaminant Control campaign. The findings from these studies will inform relevant NFPA standards for the fire service as well as educational and training programs aimed at reducing firefighter exposures.

There has been increased focus on first responder behavioral health issues and the importance of prevention programs and peer support for firefighters. Data collected by the Firefighter Behavioral Health Alliance has shown that, as with heart disease and cancer, this is a problem that follows firefighters after their careers end, whether in retirement or some other form of separation from the fire service. In 2012, the National Volunteer Fire Council, with support from USFA, published a report produced by FBHA on behavioral health and suicide prevention. Training programs and resources are also available from the National Fallen Firefighters Foundation and the NVFC. The NVFC program, “Share the Load”, points firefighters, EMTs, and their families to resources and support for mental well-being. The IAFF offers a peer-support training course for its members.

Heart disease, of course, has long been recognized as a significant factor in firefighter on-duty deaths, as sudden cardiac death consistently accounts for approximately half of the on-duty fatalities. Several NFPA standards focus on health risks to firefighters. NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments, outlines for fire departments the medical requirements that must be met by candidate firefighters and incumbent fire department members. NFPA 1500, Fire Department Occupational Safety, Health, and Wellness Program, calls for fire departments to establish a firefighter health and fitness program that meets NFPA 1583, Health-Related Fitness Programs for Fire Department Members, and requires that firefighters meet the medical requirements of NFPA 1582. Information on developing a wellness-fitness program is available from other organizations, including the NVFC’s Heart-Healthy Firefighter Program, launched in 2003 to address heart attack prevention for firefighters and EMS personnel through fitness, nutrition, and health awareness; and the Fire Service Joint Labor-Management Wellness-Fitness Initiative, a cooperative effort by the IAFF and the International Association of Fire Chiefs that’s available at online.

Acknowledgements

This study is made possible by the cooperation and assistance of the United States fire service, NIOSH, the USFA, the Forest Service of the U.S. Department of Agriculture, and the Bureau of Indian Affairs and the Bureau of Land Management of the U.S. Department of the Interior. The authors would also like to thank Carl E. Peterson, retired from NFPA’s Public Fire Protection Division, for his assistance on the study.

RITA FAHY is manager of fire database and systems in NFPA's Fire Analysis and Research Division. PAUL LeBLANC is a fire data assistant at NFPA and a retired lieutenant with the Boston Fire Department. JOSEPH MOLIS is a fire data assistant at NFPA and a lieutenant with the Providence, Rhode Island, Fire Department. Top Photograph: Rick Loomis/Los Angeles Times via Getty Images