What is killing over 50% of our firefighters who die in the line of duty each year?

Hey guys, Ryan here:

We know that our job as firefighters is one of the most dangerous and physically demanding occupations in the world.  Let’s take a look at a few of the many life-threatening situations that firefighters may face in the line of duty:

  • Flashover
  • Backdraft
  • Explosion
  • Entrapment
  • Building Collapse

We train constantly to prepare ourselves to recognize and avoid these dangerous fire ground events.  We watch videos, we read books, we study and work hard to become the best firefighters we can be to perform at a high level and return home safely.

Let’s consider the following facts:


  • We are training hard to hone our skills as firefighters.
  • We are responding to fewer fires.
  • Safety standards are higher and technology is better than ever.


Why are so may firefighters dying in the line of duty?


What are we missing? 


Sudden Cardiac Death is the Number One Killer of Firefighters!

Statistics show that the majority of firefighters dying in the line of duty are not being killed by flashover, backdraft, explosion, entrapment, building collapse or any other fire ground event.  Firefighters are dying in the line of duty from sudden cardiac death.



Let’s take a look at the stats:


  • Over 50% of firefighter line of duty deaths are being attributed to a sudden cardiac event.  The number of line of duty deaths in the fire service has been on the decline over the past few years, but the percentage of firefighters dying from sudden cardiac death is fairly consistent year in and year out.  The following is the abstract from the 2010 firefighter fatalities report from the NFPA:

“In 2010, a total of 72 on-duty firefighter deaths occurred in the U.S.     This is another sharp drop from the 105 on-duty deaths in 2008 and 82 in 2009, and the lowest annual total since NFPA began conducting this annual study in 1977.  Stress, exertion, and other medical-related issues, which usually result in heart attacks or other sudden cardiac events, continued to account for           the largest number of fatalities.  More than half of the deaths resulted from overexertion, stress and related medical issues.  Of the 39 deaths in this category, 34 were classified as sudden cardiac deaths (usually heart attacks) and five were due to strokes or brain aneurysm.” (NFPA, 2010).


Recent studies have found that the underlying cause of sudden cardiac death in firefighters is the physiological effects of firefighting combined with underlying cardiovascular disease.

In order to reduce the number of firefighter deaths caused by sudden cardiac death, we must first understand the physiological effects of firefighting and cardiovascular disease in our population.



Physiological Effects of Firefighting

Smith, Liebig, Steward, and Fehling (2010) detail research findings on the effect firefighting has on the major systems of the body:


  • Cardiovascular:  Heart rate and blood pressure are increased.  Firefighters may be working near maximum heart rate for the duration of their air bottle depending on the circumstances.
  • Thermoregulatory: The superheated environment coupled with the layers of protective clothing causes a significant increase in core body temperature.  The physical work and heat conditions can quickly lead to dehydration.
  • Respiratory and Metabolic: The mental, emotional and physical stress causes increased respiratory rate, oxygen consumption and lactate fatigue.
  • Nervous: The sympathetic nervous system is activated and large amounts of adrenaline are being released to help manage the perceived threat.
  • Muscular: The physical nature of the work leads to increased oxygen consumption, heat production and fatigue.


 Cardiovascular Disease in Firefighters

Firefighters are at greater risk for cardiovascular disease compared to the general population.  It is critical that we make good lifestyle choices to offset the risk we face due to the nature of our work.  We each need to examine the choices we make each day.  What are we doing to reduce our risk?



Let’s take a look at a few more statistics:


  • A large percentage of people who die from coronary artery disease are over age 65.  The risk for firefighters increases over age 45.  In 2009, 34 of the 47 fire fighters to die from heart attack or stroke were between the ages of 35 and 60 (USFA, 2009).  It is estimated that firefighters have a 300% increased risk for cardiac disease compared to other segments of the population.  Dr. H. Robert Superko conducted a FEMA sponsored study of firefighters in Gwinnett County, Georgia.  The study was prompted by the sudden death of a 53 year-old firefighter who suffered a cardiac arrest while fighting a house fire.  Superko (2011) found that the stress and psychological pressures related to the job, poor nutrition, lack of exercise, and inherent personality traits, combined with a genetic predisposition to heart disease may have a tremendous impact on the risk of sudden cardiac death in firefighters (Superko, 2011).


  •  Smith et al. (2010) describe cardiovascular disease as a pathological condition that affects the heart, blood vessels, or the clotting potential of blood.  Although cardiovascular disease is a chronic condition that progresses over the course of many years, it may transition into an acute life-threatening event in which death occurs quickly.  The physiological strain of firefighting coupled with underlying cardiovascular disease may be the lethal combination causing a sudden cardiac event in firefighters.


Firefighter Survival

Discussions about firefighter survival often include topics such as RIT, Mayday and building construction.  How often do we discuss physical fitness and nutrition as part of firefighter survival?  The fire service as a whole, each fire department, and individual firefighter should be placing a very high priority on improving firefighter health and wellness.  Studies show that there is a direct link between the physiological effects of firefighting, underlying cardiovascular disease and sudden cardiac death for firefighters.  These statistics are fairly consistent year in and year out, yet many modern day fire departments do not have a formal health and wellness program.  Many departments still do not have dedicated exercise facilities, fitness testing procedures, or peer fitness trainers.  According to NIOSH, less than half of the departments who experience a LODD had an established fitness and wellness program, and only 10% of those that  required participation.


Why don’t conventional fitness programs meet our needs as firefighters?


There are a lot of good fitness programs out there.  I know that I have tinkered with a lot of different programs over the years.  I started lifting weights with my dad in the garage as a young teenager. I really embraced the body building approach to fitness.  There was no question that I got bigger and stronger through my training, but was I fit?

I thought I was fit because I worked out all the time.  The sad fact is that my approach to fitness was far from comprehensive.  I was actually damaging my joints and destroying my mobility.  By the time I was in my early 30s, I had undergone 5 surgeries, been diagnosed with arthritis in my hips and suffered from chronic back pain. I was beginning to worry about my longevity as a firefighter.

So the question remains:  Why don’t conventional fitness programs meet our needs as firefighters?  Unfortunately, most fitness programs do not meet our needs because they were not designed to develop the wide array of physical attributes that firefighters must possess.  A comprehensive firefighter fitness program will develop strength, power, metabolic conditioning, dynamic body movement and mobility while placing a high priority on recovery and injury prevention.  Most conventional fitness programs fall short of these demands.

Let’s take a look at a few conventional fitness programs:


Body Building:  Body building training protocols are designed to increase the size and strength of individual muscle groups.  This training approach focuses on single plane movements and often places undue stress on individual joint complexes. Physical strength and power are critical attributes for firefighters, but they must be expressed through multiple planes of movement through a full range of motion.


Endurance Training: Endurance training protocols are typically designed to improve performance at low to moderate intensity for longer periods of time, often up to an hour or more.  This training protocol is appropriate for tri-athletes, endurance cyclists or marathon runners.  Most firefighters will not operate for longer than 20 minutes while utilizing their Self Contained Breathing Apparatus.  Conditioning of energy systems for firefighters should be more specific to this time period.



Cross Training:  Many firefighters are utilizing random high intensity training protocols to develop a broad range of exercise skills to improve general fitness and athletic performance.  In many cases there is little emphasis on comprehensive training through varied intensity and adequate recovery.  Firefighters must be response ready at all times, and we cannot afford to be broken down all the time.  Furthermore, the movement patterns and physical attributes required of firefighters to perform at the highest level are very specific. Specific training adaptations require specific training protocols.


 Home Exercise Programs:  There are several home workout programs that are gaining popularity.  Many of these are good programs for the general population, but are not ideal for firefighters.  In most cases the exercises selected and the energy system development provided are meant for the widest demographic possible.  Firefighters have very specific needs.  Some of these programs require over an hour to complete.  Most firefighters would benefit from a more efficient and more effective training protocol.


There is not one “right” way to train, or one physical training program that is the end all, be all for everyone.  Ultimately, some form of exercise is better than no exercise at all.

The best physical training program for any individual is the one that they will follow consistently.


It is time to take action!


Does your fire department have a health and wellness program?

Are you dedicated to optimizing your health and firefighter fitness?

 Are you ready to take a look at comprehensive and specific fitness training for firefighters?


In 10 days, you will have the opportunity to take your firefighter fitness to the next level.  Mark your calendar for March 2nd, because TACFIT Fire Fighter First Alarm will be available at 30% off for the first 3 days of the launch period.

Be sure to let us know how your training is going with the firefighter challenge.

Train hard, train smart and stay safe!



Heart Scan Services. (2011, May 16).  Landmark FEMA study:  Heart disease is an epidemic for firefighters.  Retrieved from http://heartscanservices.com/police.php

National Fire Protection Association (NFPA) Fire Analysis and Research. (2010). Firefighter fatalities in the United States in 2010. Quincy, MA.

Smith, D., Liebig, J., Steward, N., & Fehling, P.  (2010).  Sudden Cardiac Events in the Fire Service: Understanding the Cause and Mitigating the Risk.  Skidmore College.

United States Fire Administration (USFA). (2009).  Firefighter fatalities in the United States in 2009. Emitsburg, MD