Preventing Sudden Cardiac Death Part 1: The Physiological Effects of Firefighting

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)


The reduction in firefighter deaths last year, is a tremendous step forward for the fire service.  Unfortunately, the majority of firefighter line of duty deaths are still being classified as sudden cardiac deaths.  It is critical that we take a closer look at health and wellness in the fire service.  This is the first of three articles in the “Preventing Sudden Cardiac Death” series from TACFIT Fire Fighter:


Dangers of Firefighting

Firefighting is a dangerous and physically demanding occupation.  The United States Fire Administration reports that approximately 100 firefighters die in the line of duty each year (USFA, 2009). The number of structure fires per year is decreasing, safety standards are higher and technology is better.  Why haven’t we seen a dramatic reduction in firefighter fatalities?

Let’s take a look at  some of the life-threatening situations that firefighters may face:

  • Flashover
  • Backdraft
  • Explosion
  • Entrapment
  • Building Collapse

Statistics show that these events do not cause the majority of firefighter deaths.  The majority of firefighters dying in the line of duty are succumbing to a sudden cardiac event. The USFA reports that in 2009 heart attacks and strokes account for nearly 60% of all firefighter deaths (USFA, 2009).

Smith, Liebig, Steward, and Fehling (2010) found that the acute physiological effects of firefighting such as adrenaline surge, increased core temperature and dehydration coupled with underlying cardiovascular disease may contribute to a sudden cardiac event (Smith, Liebig, Steward, & Fehling, 2010).


Physiological Effects of Firefighting

Picture yourself sound asleep at your fire station on a Tuesday night.  The tones go off for a residential structure fire with victims trapped.  What is your heart rate as you leap out of bed and run to the rig?  Your sympathetic nervous system has just been activated.  Siddle (1995) states, “The activation of this system increases heart rate, which in turn, has a crucial effect on motor performance, visual processing and cognitive reaction time” (Siddle, 1995, p.7).  You pull up on scene and it is time to get to work.  The initial adrenaline surge has already impacted your cognitive and motor function.  Now consider the physical, mental and emotional stress of the fire scene.  You are in full gear doing strenuous work in a super heated environment.  The physiological strain of this incident is enormous.

Smith et al. (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.

These stressors may help explain how firefighting may serve as a trigger for a sudden cardiac event in individuals with underlying cardiovascular disease. This “trigger effect” may be the root cause of many fire fighter deaths each year (Smith et al., 2010 pp. 3-10).

If we know what the physiological effects of fire fighting are, can’t we prepare our bodies and minds to better handle these stressors?


Survival Stress Management for Fire Fighters

Siddle (1995) states the three important perceptions that influence the level of survival stress:

1.  Level of threat perceived such as nature of the incident, potential victims, etc.

2.  Individual confidence in knowledge, skills and ability to control the threat.

3.  Past experience in dealing with the threat.


This provides the foundation for training goals and objectives:


Skill Confidence: Hands on training for the wide variety of skills required for firefighters such as hose and ladder evolutions, ventilation, etc.

Situational Confidence: Participation in regular scenario based training to prepare for the incidents that may be encountered such as residential structure fires, high rise drills, firefighter survival drills, etc.

Visualization: Use fire scene photos to generate conversation about strategy and tactics.  Discuss fire scenarios for buildings in the response area.

Breath Control:  Practicing slow controlled breathing when stress levels are increased can help control anxiety and re-focus on the task at hand (Siddle, 1995, pp. 91-107).

Physical Training: Firefighters are tactical athletes.  Sonnon (2010) states, “tactical athletes require a comprehensive physical training program which will foster the physical skills, attributes and energy reserves necessary for tactical response (Sonnon, 2010).  This training approach not only improves performance on the fire ground, but it will also help prepare your body for the physiological strain of firefighting.

Understanding the physiological effects of fire fighting and training frequently to minimize these effects is a vital first step to preventing a sudden cardiac event.


Next week we will take a closer look at the risk factors for cardiovascular disease.




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.


Siddle, B. K.  (1995). Sharpening the Warrior’s Edge: The Psychology and Science of Training. Millstadt, IL: PPCT Research Publications.


Sonnon, S.  (2010). TACFIT: First In – Last Standing.  Atlanta, GA:  RMAX International.


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


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





Check out the Sledbarrow for firefighter fitness!



Our friends over at Sledbarrow have put together a workout to help you prepare for the Fire Fighter Combat Challenge.  You can learn more about the Sledbarrow and it’s versatility by visiting:

Please use the link below if you are interested in pricing and availability:


Clubbell Full Body Workout

Clubbbell Full Body Workout:

4 Rounds:

  • Front Swing x 20 Repetitions
  • Gamma Cast Squat x 10 Repetitions
  • Clean to Order Squat x 5 Repetitions (Right and Left)
  • Torch Press x 5 Repetitions
  • Shoulder Cast x 5 Repetitions (Right and Left).
  • Flag Press x 5 Repetitions

The goal is to complete 4 rounds in under 20 minutes.

This Clubbell Full Body Workout is one of my favorites for several reasons:

  • It requires one piece of equipment.
  • It requires very little space.
  • It is a full body, multi-joint, multi-planar workout.
  • It combines strength training and metabolic conditioning (at high intensity).
  • It is a lot of fun!

Tempo and Clubbell weight determine the intensity of this workout.  A slower tempo with a lighter Clubbell will enable you to train at moderate intensity.  Step up the tempo with a heavier Clubbell, and you will have no problem getting into your high intensity heart rate zone.


Check out the video:

Clubbell Training for Firefighters

Clubbells are the Ultimate Fitness Tool

Strength, power, endurance, mobility, and injury prevention are just a few of the benefits awarded from Circular Strength Training with Clubbells.


The Clubbell can be found in all of our TACFIT programs due to it’s superior training effect.  Unlike any other training apparatus, the Clubbell’s design and use accelerates strength and athletic development.  The Clubbell also offers a more comprehensive training platform due to it’s Circular Strength Training ability as opposed to Linear Strength Training.  Not only does the Clubbell offer incredible, full body development but it is also the Number 1 Choice to use for a health first approach.


Clubbell Equipment


The simple design of the Clubbell offers a displaced center of mass which significantly increases the challenge of controlling and deploying with proper technique.  The more challenging, the more development for you.  The Clubbell does not offer the luxury of being balanced in the user’s hand, such as a dumbell or barbell.  The result is not only significant gains in grip and core strength, but an incredible full body workout.


The simple act of swinging a Clubbell creates tension on the body as opposed to the compressive forces found with conventional weight training.  Tension decompresses your joint capsules, strengthens muscle and connective tissue, improves elasticity and breaks down adhesions which hinder mobility.  Conventional weight training offers the reverse effect;  applying compressive forces, damaging joints, creating soft tissue trauma, focused development on fascia without proper attention/training for connective tissue.  As you can see, the Clubbell offers the most important benefit of all, a health first training tool.  The Clubbell has been referred to as the Fountain of Youth after training has alleviated pain, restored mobility, and increased strength and endurance.


Not only is the Clubbell important for firefighters, but anyone who wants to accelerate strength and athletic development with a health first approach.  Firefighters need to possess the ability to move through all ranges of motion with expressible strength to perform their job safely and efficiently.  Firefighters also need to take care of themselves and maximize career longevity and prevent injury.  A firefighter’s training program should also be functional and enhance their skill set as firefighters, not detract from them.  The Clubbell’s design and versatility make it a “must have” piece of training equipment for the firefighter.


The Clubbell is not only fun and challenging but it also provides all of the benefits required not only for an occupational athlete such as a firefighter, but anyone who is interested in being stronger and moving better.  Please enjoy the video  where you can view samples of Clubbell exercises and be sure to visit THE ORIGINAL CLUBBELL to learn more.

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