United States Firefighter Injuries 2016

Transcription

1 United States Firefighter Injuries 2016 October 2017 Hylton J. G. Haynes Joseph L. Molis October 2017 National Fire Protection Association

2 Abstract Based on data the NFPA received from fire departments responding to the 2016 National Fire Experience Survey, the NFPA estimates that 62,085 reported firefighter injuries occurred in the line of duty in An estimated 24,325 (39.2 percent) of all firefighter injuries occurred during fireground operations. An estimated 12,780 occurred at non-fire emergency incidents, while, 8,840 occurred during training and 5,200 occurred while responding to and returning from incidents and 11,300 occurred during other on duty activities. The leading type of injury received during fireground operations was strain, sprain or muscular pain (45.7 percent), followed by wound, cut, bleeding and bruise (14.2 percent). Regionally, the Midwest had the highest fireground injury rates. Keywords: fire statistics, firefighter injuries, exposures, injury rates, fireground, non-fire emergencies, type of duty, cause of injury, collisions, community size Acknowledgments NFPA is grateful to the many fire departments that responded to the 2016 National Fire Experience Survey for their continuing efforts to provide the data necessary to make national projections. The authors would also like to thank the members of NFPA staff who worked on this year s survey, including Stephen Belski, Frank Deely, and Jay Petrillo for editing the survey forms and making follow-up calls to fire departments, and Helen Columbo for processing the survey forms. To learn more about Research go to Copies of this analysis are available from: National Fire Protection Association NFPA Research, Data and Analytics Division 1 Batterymarch Park Quincy, MA research@nfpa.org Phone: NFPA No. FFI10 Copyright 2017, National Fire Protection Association, Quincy, MA

3 FACT SHEET» RESEARCH United States Firefighter Injuries ,085 firefighter injuries were reported in the United States during ffa decrease of 8.8% from ffone firefighter injury occurred every 8 minutes and 28 seconds. ff24,325 (39%) of all firefighter injuries occurred in fireground operations. ffthe leading cause of fireground injuries was overexertion or strain (27.1%). ff5,200 (8%) of all injuries occurred while responding to or returning from an incident. ff8,480 (13.7%) of all injuries occurred during training activities. ff12,780 (21%) of all injuries occurred during non-fire emergency incidents. ff11,300 (18.2%) of all injuries occurred during other onduty activities. ff19,050 (30.6%) of all firefighter injuries resulted in lost time in United States Firefighter Injuries by Type of Duty 2016 Non-fire emergency 21% Fireground 39% Training 14% Other on-duty activities 18% Responding to or returning from incidents 8% The Midwest region reported a higher number of fireground injuries per 100 fires than the rest of the country. There were 9,275 documented exposures to infectious diseases and 36,475 reported exposures to hazardous conditions. There were 15,425 collisions involving fire department emergency vehicles, with 700 firefighter injuries resulting from these collisions. Hylton J.G. Haynes and Joseph L. Molis, United States Firefighter Injuries 2016, October 2017, Quincy: National Fire Protection Association, Research, Data and Analytics Division. Source: NFPA Research: Contact information: or research@nfpa.org NATIONAL FIRE PROTECTION ASSOCIATION The leading information and knowledge resource on fire, electrical and related hazards This information is provided to help advance fire safety. It does not represent the official position of the NFPA or its Technical Committees. The NFPA disclaims liability for any personal injury, property, or other damages of any nature whatsoever resulting from the use of this information National Fire Protection Association / October 2017

4 Table of Contents Page Page Table of Contents i List of Tables and Figures ii Overview of 2016 United States Firefighter Injuries iii Background and Objectives 1 Methods 2 Results 3 Injuries by Type of Duty 3 Nature and Causes of Fireground Injuries 7 Fire Department Vehicle Collisions 14 Average Fires and Fireground Injuries per Department by Population Protected 16 Average Fires and Fireground Injuries by Population Protected and Region 18 Conclusions 21 NFPA Codes and Standards References 21 Definition of Terms 23 Selected Individual Incidents 24 United States Firefighter Injuries- 2016, 10/17 i NFPA Research, Quincy, MA

5 List of Tables and Figures Figure 1 Total Firefighter Injuries by Year ( ) 5 Page Table 1 Figure 2 Figure 3 Total Firefighter Injuries at the Fireground, and at Non-fire Emergencies, The Number of Injuries at the Fireground and the Fireground Injuries per 1,000 Fires 9 The Number of Injuries at Non-fire Emergencies and Injuries per 1,000 Non-fire Emergencies 10 Figure 4 Firefighter Injuries by Nature of Injury and Type of Duty, Table 2 Firefighter Injuries by Nature of Injury and Type of Duty, Figure 5 Fireground Injuries by Cause, Table 3 Table 4 Table 5 Figure 6 Fire Department Vehicle Collisions and Resulting Firefighter Injuries while Responding to or Returning from Incidents, Average Number of Fires, Fireground Injuries and Injury Rates by Population of Community Protected, Average Number of Fires and Fireground Injuries per Department and Injuries per 100 Fires, by Population of Community Protected, and Region, Fireground Injuries per 100 Fires for the Ten FEMA Regions in the United States 20 United States Firefighter Injuries- 2016, 10/17 ii NFPA Research, Quincy, MA

6 Overview of 2016 United States Firefighter Injuries 62,085 firefighter injuries occurred in the line of duty in 2016, a decrease of 8.8 percent from the previous year. In addition to injuries, there were 9,275 documented exposures to infectious diseases, and 36,475 exposures to hazardous conditions. 24,325 or 39.2 percent of all firefighter injuries occurred during fireground operations. An estimated 5,200 while responding to, or returning from an incident, 8,480 during training activities, 12,780 occurred at non-fire emergency incidents, and 11,300 occurred during other on duty activities. The Midwest region reported a higher number of fireground injuries per 100 fires than other regions of the country (excluding New York City from the analysis). The major types of injuries received during fireground operations were: strain, sprain, muscular pain (45.7 percent); wound, cut, bleeding, bruise (14.2 percent); burns (2.6 percent) smoke or gas inhalation (7.5 percent). Strains, sprains, and muscular pain accounted for 57.0 percent of all non fireground injuries. The leading cause of fireground injuries was overexertion or strain (27.1 percent). United States Firefighter Injuries- 2016, 10/17 iii NFPA Research, Quincy, MA

7 Background and Objectives Firefighters work in varied and complex environments that increase their risk of on-the-job death and injury. Each year, the NFPA studies firefighter deaths and injuries to provide national statistics on their frequency, extent, and characteristics. Earlier this year, the NFPA reported that there were 69 firefighter fatalities while on duty in 2016 (See, NFPA Journal July/August) 1 A better understanding of how these fatalities, nonfatal injuries, and illnesses occur can assist in identifying corrective actions which could help minimize the inherent risks of firefighter work. This report addresses 2016 firefighter injuries in the United States. The results are based on data collected during the NFPA Survey of Fire Departments for U.S. Fire Experience (2016). An earlier report, Fire Loss in the United States during 2016, 2 measured the national fire experience in terms of the number of fires that fire departments responded to and the resulting civilian deaths, civilian injuries, and property losses that occurred. This year's report includes among its results: An estimate of the total number of 2016 firefighter injuries. Estimates of the number of injuries by type of duty. An estimate of the number of exposures to infectious diseases. Trends in firefighter injuries and rates. Fireground injuries by cause. Fire department vehicle accidents and resulting firefighter injuries. The average number of fires and fireground injuries per department by population of community protected. Descriptions of selected incidents that illustrate firefighter safety problems. 1 Rita F. Fahy et al, Firefighter Fatalities in the United States 2016, June 2017, Quincy: National Fire Protection Association, Research, Data and Analytics Division. 2 Hylton J.G. Haynes, "Fire Loss in the United States during 2016", NFPA Journal, Vol. 111, No. 5 (September/October 2017). United States Firefighter Injuries- 2016, 10/17 1 NFPA Research, Quincy, MA

8 Methods NFPA annually surveys a sample of fire departments in the United States to make national projections of the fire problem. The sample is stratified by the size of the community protected by the fire department and includes all United States fire departments that protect communities with a population larger than 5,000. The 8,635 fire departments in the eight highest strata protect a population of 246 million or 76 percent of the United States population as of July The rest of the sample includes 11,855 randomly selected departments that protect populations under 5,000, for a total sample size of 20,490, or 69 percent of all known departments to NFPA in the United States. The estimation method used for the survey was ratio estimation with stratification by community size 3. For each firefighter injury statistic, a sample injury rate was computed for each stratum. This rate consisted of the total for that particular statistic from all departments reporting it, divided by the total population protected by the departments reporting the statistic. Note that this means the departments used in calculating each statistic could be different, reflecting differences in unreported statistics. The national projections are made by weighting the sample results according to the proportion of total United States population accounted for by communities of each size. Around any estimate based on a sample survey, there is a confidence interval that measures the statistical certainty or uncertainty of the estimate. We are confident that the actual number of total firefighter injuries falls within 5 percent of the estimate. A total of 2,769 departments responded to the 2016 fire experience survey. The results are based on injuries that occurred during incidents attended by public fire departments. No state or federal firefighting entities were included in this sample, and no adjustments were made for injuries that occurred during fires attended solely by private fire brigades, such as those at industrial or military installations. We enhanced the data collection for the selected incident summaries by sending the fire departments a form requesting information on the type of protective equipment worn, the ages and ranks of the firefighters injured, and a description of circumstances that led to injury. 3 William G. Cochran, Sampling Techniques, John Wiley, New York, NY 1977, pp United States Firefighter Injuries- 2016, 10/17 2 NFPA Research, Quincy, MA

9 Results Based on data reported by fire departments responding to the 2016 National Fire Experience Survey, we estimate that 62,085 firefighter injuries 4 occurred in the line of duty in This is a decrease of 8.8 percent from the year before, and the lowest rate since NFPA began analyzing this data in 1981 (See Figure 1). In recent years, the number of reported firefighter injuries has been considerably lower than it was in the 1980s and 1990s, due in part to additional survey questions on exposures to hazardous conditions and infectious diseases, information that allows us to place them in their own categories. Previously, some of these exposures might have been included in total injuries under other categories. NFPA estimates that there were 9,275 exposures to infectious diseases such as hepatitis, meningitis, and HIV in This amounts to 0.4 exposures per 1,000 emergency medical service runs by fire departments in We also estimate there were 36,475 exposures to hazardous conditions such as asbestos, radioactive materials, chemicals, and fumes last year, which amounts to 32.9 exposures per 1,000 hazardous condition runs. This 34 percent increase in exposures from the year before, can in part be explained by the heightened awareness about cancer and other chronic illnesses in the fire service and the importance of documentation. This is a large increase from previous years and could be a result of improved reporting for such exposures. An estimated 19,050 injuries, or 30.6 percent of all firefighter injuries, resulted in lost time. Injuries by Type of Duty Estimates of firefighter injuries by type of duty are displayed in Table 2 and Figure 4. As in past reports, type of duty is divided into five categories: Responding to or returning from an incident (includes fire and non-fire emergencies). Fireground (includes structure fires, vehicle fires, brush fires, etc.); refers to all activities from the moment of arrival at the scene to departure time (e.g., setup, extinguishment, overhaul). 4 Around any estimate based on a sample survey, there is a confidence interval that measures the statistical certainty (or uncertainty) of the estimate. Based on data reported by fire departments responding to the NFPA Survey for U.S. Fire Experience (2016), the NFPA is very confident that the actual number of firefighter injuries falls within the range of 60,300 to 63,875. United States Firefighter Injuries- 2016, 10/17 3 NFPA Research, Quincy, MA

10 Non-fire emergency (includes rescue calls; hazardous calls, such as spills; and natural disaster calls). Training. Other on-duty activities (e.g., inspection or maintenance duties). United States Firefighter Injuries- 2016, 10/17 4 NFPA Research, Quincy, MA

11 Number of Firefighter Injuries 120, , ,340 80,000 62,085 60,000 40,000 20,000 0 Source: NFPA Survey of Fire Departments for U.S. Fire Experience ( ). Year Figure 1. Total Firefighter Injuries by Year, United States Firefighter Injuries /17 5 NFPA Research, Quincy, MA

12 Firefighters were more likely to be injured at fireground operations than at other types of duties. In 2016, 24,325, or 39.2 percent, of all firefighter injuries occurred at the fireground. This was a decrease of 8.8 percent from the previous year, which was the lowest number since 1981 (Table 1). Injuries at the fireground decreased from a high of 67,500 in 1981 to 24,325 in 2016, a drop of 64.0 percent. The number of fires also declined steadily, for an overall decrease of 53.6 percent, and the rate of injuries per 1,000 fires over the past 35 years has fluctuated between a high of 28.3 injuries per 1,000 fires in 1990 and a low of 18.1 injuries per 1,000 fires in These results suggest that even though the number of fires and fireground injuries declined during the period, the injury rate did not, meaning the fireground injury rate per fire risk has not changed much since 1981 (See Figure 2). Overall, the number of injuries at non-fire emergencies increased 33.1 percent between 1981 and 2016, from 9,600 to 12,780. During the same period, the number of non-fire emergencies also increased 340 percent, due in large part to an increase in the number of fire department responses to medical emergencies. The injury rate per 1,000 non-fire emergencies declined between 1981 and 2016, from 1.24 to 0.38 largely because the number of non-fire emergencies increased at a higher rate than the number of injuries at non-fire emergencies. In addition, 5,200 firefighter injuries occurred while responding to or returning from an incident in Another 8,480 firefighter injuries occurred during training activities, and 11,300 injuries occurred during other on-duty activities. United States Firefighter Injuries- 2016, 10/17 6 NFPA Research, Quincy, MA

13 Nature and Causes of Fireground Injuries The major types of injuries that occurred during fireground operations were strains and sprains, which accounted for 45.7 percent of the injuries; wounds, cuts, bleeding, and bruises, which accounted for 14.2 percent; smoke or gas inhalation, which accounted for 2.6 percent; and burns, which accounted for 7.5 percent. These results were fairly consistent during all non-fireground activities, with strains, sprains, and muscular pain accounting for 57.0 percent of all nonfireground injuries, and wounds, cuts, bleeding, and bruises accounting for 15.9 percent (Table 2). Because fireground injuries are of particular concern from an occupational hazard perspective, we examined their causes, defined here as the initial circumstance leading to the injury. Overexertion or strain, which accounted for 27.1 percent, was the leading cause of fireground injuries. Other major causes were falls, jumps, or slips, which accounted for 21.0 percent, and exposure to fire products, which accounted for 13.6 percent (Figure 5). United States Firefighter Injuries- 2016, 10/17 7 NFPA Research, Quincy, MA

14 Table 1 Total Firefighter Injuries at the Fireground, and at Non-fire Emergencies, Year Total Firefighter Injuries Firefighter Injuries at the Fireground Firefighter Injuries at Non-fire Emergencies Injuries per Injuries per Injuries 1,000 Fires Injuries 1,000 Incidents ,340 67, , ,150 61, , ,150 61, , ,300 62, , ,900 61, , ,540 55, , ,600 57, , ,900 61, , ,700 58, , ,300 57, , ,300 55, , ,700 52, , ,500 52, , ,400 52, , ,500 50, , ,150 45, , ,400 40, , ,500 43, , ,500 45, , ,550 43, , ,250 41, , ,800 37, , ,750 38, , ,840 36, , ,100 41, , ,400 44, , ,100 38, , ,700 36, , ,150 32, , ,875 32, , ,090 30, , ,400 31, , ,880 29, , ,350 27, , ,085 29, , ,085 24, , Source: NFPA Survey of Fire Departments for U.S. Fire Experience ( ). United States Firefighter Injuries- 2016, 10/17 8 NFPA Research, Quincy, MA

15 Number of Fireground Injuries Fireground Injuries per 1000 fires 80, ,000 67, , , , ,000 20,000 Number of Fireground Injuries 24, ,000 Fireground Injuries per 1000 Fires Figure 2. The Number of Injuries at the Fireground and Fireground Injuries per 1,000 Fires, Source: NFPA Survey of Fire Departments for U.S. Fire Experience ( ). Year United States Firefighter Injuries- 2016, 10/17 9 NFPA Research, Quincy, MA

16 Number of Nonfire Emergencies Injuries per 1000 Nonfire Emergencies 20, , ,000 14, , ,000 10,000 8,000 9, , , ,000 Nonfire Emergency Injuries 0.20 Injuries per 1000 Nonfire Incidents Year Figure 3. The Number of Injuries at Non-fire Emergencies and Injuries per 1,000 Non-fire Emergencies, Source: NFPA Survey of Fire Departments for U.S. Fire Experience, United States Firefighter Injuries- 2016, 10/17 10 NFPA Research, Quincy, MA

17 Number of Firefighter Injuries 30,000 25,000 24,325 20,000 15,000 12,780 11,300 10,000 8,480 5,000 5,200 0 Responding/Returning At Fireground At Non-Fire Emergencies Training Other On-Duty Type of Duty Figure 4. Firefighter Injuries by Nature of Injury and Type of Duty, 2016 Source: NFPA Survey of Fire Departments for U.S. Fire Experience, United States Firefighter Injuries- 2016, 10/17 11 NFPA Research, Quincy, MA

18 Table 2 Firefighter Injuries by Nature of Injury and Type of Duty, 2016 Responding to or Returning from an Incident Fire ground Non-fire Emergency Training Other on Duty Total Nature of Injury Number Percent Number Percent Number Percent Number Percent Number Percent Number Percent Burns (Fire or Chemical) 25 (0.5%) 1,425 (5.9%) 50 (0.4%) 225 (2.7%) 175 (1.5%) 1,900 (3.1%) Smoke or Gas Inhalation 325 (6.3%) 1,825 (7.5%) 150 (1.2%) 5 (0.1%) 50 (0.4%) 2,355 (3.8%) Other Respiratory Distress 100 (1.9%) 375 (1.5%) 50 (0.4%) 175 (2.1%) 100 (0.9%) 800 (1.3%) Burns and Smoke Inhalation 175 (3.4%) 625 (2.6%) 5 (0.0%) 50 (0.6%) 25 (0.2%) 880 (1.4%) Wound, Cut, Bleeding, Bruise 750 (14.4%) 3,450 (14.2%) 1,700 (13.3%) 1,700 (20.0%) 1,850 (16.4%) 9,450 (15.2%) Dislocation, Fracture 250 (4.8%) 600 (2.5%) 250 (2.0%) 325 (3.8%) 425 (3.8%) 1,850 (3.0%) Heart Attack or Stroke 25 (0.5%) 225 (0.9%) 75 (0.6%) 100 (1.2%) 150 (1.3%) 575 (0.9%) Strain, Sprain, Muscular Pain 2,925 (56.3%) 11,125 (45.7%) 7,700 (60.3%) 4,975 (58.7%) 5,925 (52.4%) 32,650 (52.6%) Thermal Stress (frostbite, heat exhaustion) 125 (2.4%) 1,750 (7.2%) 150 (1.2%) 325 (3.8%) 125 (1.1%) 2,475 (4.0%) Other 500 (9.6%) 2,925 (12.0%) 2,650 (20.7%) 600 (7.1%) 2,475 (21.9%) 9,150 (14.7%) Total 5,200 (100.0%) 24,325 (100.0%) 12,780 (100.0%) 8,480 (100.0%) 11,300 (100.0%) 62,085 (100.0%) Note: If a firefighter sustained multiple injuries, only the nature of the single most serious injury was tabulated and reported. Source: NFPA Survey of Fire Departments for U.S. Fire Experience, United States Firefighter Injuries- 2016, 10/17 12 NFPA Research, Quincy, MA

19 Exposure to chemicals or radiation, 3.7% Fall, jump, slip, 21.0% Exposure to Fire Products, 13.6% Other, 16.4% Overexertion, strain, 27.1% Contact with an object, 9.7% Extreme weather, 3.1% Struck by an object, 5.9% Source: NFPA Annual Survey of Fire Departments U.S. Fire Experience, Figure 5. Fireground Injuries by Cause, 2016 United States Firefighter Injuries- 2016, 10/17 13 NFPA Research, Quincy, MA

20 Fire Department Vehicle Collisions The NFPA reported earlier that 19 firefighters died in vehicle-related incidents in 2016, including 17 firefighters who died in vehicle crashes and two who were struck by vehicles. (See 2016 Firefighter Fatalities July/August NFPA Journal In 2016, an estimated 15,425 collisions involved fire department emergency vehicles responding to or returning from incidents. This is the seventh highest number of collisions since NFPA began collecting this information in To put this number in perspective, fire departments responded to more than 35.3 million incidents in 2016, meaning that the number of collisions represents 0.04 percent of total responses. However, these collisions resulted in 700 injuries, or 1.1 percent, of all firefighter injuries. Another 850 collisions involved firefighters personal vehicles, in which they were responding to or returning from incidents. These collisions resulted in an estimated 175 injuries, 5 injuries higher than the median estimate (170) since NFPA started collecting this statistic in 1990 (Table 3). United States Firefighter Injuries- 2016, 10/17 14 NFPA Research, Quincy, MA

21 Table 3 Fire Department Vehicle Collisions and Resulting Firefighter Injuries While Responding to or Returning from Incidents, Involving Fire Department Emergency Vehicles Involving Firefighters Personal Vehicles Firefighter Firefighter Year Collisions Injuries Collisions Injuries ,325 1, ,125 1,075 1, ,500 1,050 1, , , ,755 1,035 1, , , , , ,950 1,350 1, ,650 1,050 1, , , , , , , ,550 1,040 1, , , , ,885 1,120 1, ,020 1,250 1, , , , , , , , , , , ,600 1, , Source: NFPA Survey of Fire Departments for U.S. Fire Experience ( ). United States Firefighter Injuries- 2016, 10/17 15 NFPA Research, Quincy, MA

22 Average Fires and Fireground Injuries per Department by Population Protected The number of fires a fire department responds to is directly related to the population protected, and the number of fireground injuries incurred by a department is directly related to the number of fires the department attends. The second point is clearly demonstrated when we examine the range of the average number of fireground injuries per year per fire department, which range from a high of for departments that protect communities of 1,000,000 or more, to a low of 0.1 for departments that protect communities that protect fewer than 2,500 people (Table 4). One way to understand the risk that firefighters face is to examine the number of fireground injuries that occur for every 100 fires they attend. This takes into account relative fire experience and allows more direct comparison between departments protecting communities of different sizes. In 2016, the overall range of rates varied from a high of 2.5 injuries per 100 fires for departments that protected communities with populations ranging from 1,000,000 to a low of 1.1 injuries per 100 fires for departments that protected communities with populations less than 2,500. The wide range in the average number of fireground injuries by population protected narrows when relative fire experience is taken into account. The overall injury rate for departments that protect communities of 50,000 or more was 1.8 injuries per 100 fires, which is 26 percent higher than the injury rate of 1.4 injuries per 100 fires for departments protecting communities under 50,000. Larger fire departments generally had the highest rates of fireground injuries; departments protecting communities of 1,000,000 or more had experienced 5.9 injuries per 100 firefighters. As the size of the community decreases, the rate of fireground injuries declines steadily, to a low of 0.6 for departments protecting fewer than 2,500 people. That is a difference in risk of injury of more than 10 to 1 between communities of 1,000,000 and communities of less than 2,500. One explanation for this difference is that, although departments protecting communities with populations of 1,000,000 have, on average, more than 85 times as many firefighters as departments protecting populations smaller than 2,500, larger departments attend more than 360 times as many fires as the smaller departments and incur considerably more fireground injuries. Different policies for documenting minor injuries and different levels of fire engagement could also explain some of this difference. United States Firefighter Injuries- 2016, 10/17 16 NFPA Research, Quincy, MA

23 Table 4 Average Number of Fires, Fireground Injuries and Injury Rates by Population of Community Protected, 2016 Population Average Average Number Number of Fire- Number of Fireof Community Number of of Fireground ground Injuries ground Injuries Protected Fires Injuries per 100 Fires per 100 Firefighters 1,000,000 or more* 4, ,000 to 999,999 2, ,000 to 499,999 1, ,000 to 249, ,000 to 99, ,000 to 49, ,000 to 24, ,000 to 9, ,500 to 4, Under 2, *Excludes New York City Source: NFPA Survey of Fire Departments for U.S. Fire Experience, United States Firefighter Injuries- 2016, 10/17 17 NFPA Research, Quincy, MA

24 Average Fires and Fireground Injuries by Population Protected and Region Table 5 displays the average number of fires and fireground injuries per department by population of community protected and region of the country. 5 As in the nationwide results in Table 4, the results of each region of the country indicate that the number of fires a fire department responds to is directly related to the population protected, and the number of fireground injuries incurred by a department is directly related to the number of fires attended. In 2016, the Midwest region of the United States reported a higher fireground injury rate at 2.1 fireground injuries per 100 fires. This observation is consistent with previous years, except in 2014 when the western region reported a higher rate for the first time (Table 5) 6. It is important to note that historically this analysis has excluded New York City because it is the largest fire department in the country and is treated as an outlier in the reporting of this statistic. If New York City is included in the analysis, then the Northeast region would have the highest number of fireground injuries per 100 fires. Using the ten FEMA regions, FEMA region 3 which is made up of the District of Columbia, Delaware, Maryland, Pennsylvania, Virginia and West Virginia reported the highest fireground injury rate at 3.7 fireground injuries per 100 fires (see Figure 6) 7. As these statistics attest, firefighting presents risk of personal injury to firefighters, and because of the type of work they perform and the fire scene hazards they face, it is unlikely that all firefighter injuries can be eliminated. However, a risk management system and the application of existing technology at the local level can offer options to reduce current injury levels. 5 The four regions as defined by the U.S. Census Bureau include the following 50 states and the District of Columbia: Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island and Vermont. Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota and Wisconsin. South: Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia and West Virginia. West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington and Wyoming. 6 Excludes New York City Fire Department. 7 Excludes New York City Fire Department. Departments from Puerto Rico, Virgin Islands, Guam, American Samoa, Trust Territories and the Commonwealth of the Northern Mariana Islands were not included in the statistical sample. United States Firefighter Injuries- 2016, 10/17 18 NFPA Research, Quincy, MA

25 Table 5 Average Number of Fires, Fireground Injuries and Injury Rates, by Population of Community Protected, 2016 Northeast Midwest South West Population of Community Protected Average Fires Average of Fireground Injuries Fireground Injuries per 100 Fires Average Fires Average of Fireground Injuries Fireground Injuries per 100 Fires Average Fires Average of Fireground Injuries Fireground Injuries per 100 Fires Average Fires Average of Fireground Injuries Fireground Injuries per100 Fires 250,000 or more 3, , , , ,000 to 249, ,000 to 99, ,000 to 49, ,000 to 24, ,000 to 9, ,500 to 4, Under 2, Overall Regional Rate Note that the results above do not include New York City. With New York the overall fireground injury rate for the Northeast would be 6.8. The Northeast region fireground injuries per 100 fires rate was slightly higher than the Southern region. Source: NFPA Survey of Fire Departments for U.S. Fire Experience, United States Firefighter Injuries- 2016, 10/17 19 NFPA Research, Quincy, MA

26 Figure 6. Fireground Injuries per 100 Fires for the Ten FEMA Regions in the United States in 2016 *Excludes New York City Fire Department. Fire departments from Puerto Rico and the Virgin Islands were not included in the sample. Note: Region 2 - Fire departments from Puerto Rico and the Virgin Islands were not included in the statistical sample. Region 10 - Fire departments from Guam, American Samoa, Trust Territories and the Commonwealth of Northern Mariana Islands were not included in the statistical sample. Source: NFPA Survey of Fire Departments for U.S. Fire Experience, United States Firefighter Injuries- 2016, 10/17 20 NFPA Research, Quincy, MA

27 Conclusions Since 1981 when firefighter injury data was first collected for this report, the overall trend is a decreasing number of firefighter injuries. For the first time, the Midwestern region reported the higher fireground injury rate per 100 fires relative to the rest of the United States. Historically, the Northeastern region has had the higher rate and it will be interesting to see if this observation is repeated in As the statistics in this report and previous reports attest, firefighting presents risks of personal injury to firefighters. Due to the kind of work performed and the hazards of the incident scene environment, it is unlikely that all firefighter injuries can be eliminated. A risk management system and the application of existing technology, however, can offer options to reduce present injury levels and bring about corresponding reductions that are recommended by NFPA that could be taken at the local level. NFPA Codes and Standards References Commitment on the part of top fire service management to reducing injuries NFPA 1500 Standard on Fire Department Occupational Safety and Health Program, Section 4.3. Establishment of a safety committee headed by a safety officer to recommend a safety policy and the means of implementing it NFPA 1500, Section 4.5. Develop and implement an investigation procedure that includes all accidents, near misses, injuries, fatalities, occupational illnesses, and exposures involving members. NFPA 1500, and Provision of appropriate protective equipment and a mandate to use it. NFPA 1500, Section 7.1 through 7.8. Development and enforcement of a program on the use and maintenance of SCBA NFPA 1500, Section 7.9 through Development and enforcement of policies on safe practices for drivers and passengers of fire apparatus NFPA 1500, Section 6.2 and 6.3 Development of procedures to ensure response of sufficient personnel for both fire fighting and overhaul duties. NFPA 1500, 4.1.2; NFPA 1710 Standard for the Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments; and NFPA 1720, Standard for the Organization and Deployment of Fire Suppression Operations, Emergency, Medical Operations, and Special Operations to the Public by Volunteer Fire Department). Implementation of regular medical examinations and a physical fitness program NFPA 1500, Section 10.1 through 10.3 NFPA1582, Standard on Comprehensive Occupational Medical Program for Fire Departments NFPA 1583, Standard on Health-Related Fitness Programs for Firefighters). Adoption and implementation of an incident management system. NFPA 1500, Standard on Fire Department Occupational Safety and Health Program, Section 8.1; and NFPA 1561, Standard on Emergency Services Incident Management System. United States Firefighter Injuries- 2016, 10/17 21 NFPA Research, Quincy, MA

28 Training and education for all members related to emergency operations NFPA 1500, Chapter 5. Implementation of programs for the installation of private fire protection systems, so that fires are discovered at an earlier stage, exposing the firefighter to a less hostile environment NFPA 1, Uniform Fire Code and NFPA 101, Life Safety Code, ; Increased efforts in the area of fire safety education programs, so that citizens are made aware of measures to prevent fires and of correct reactions to the fire situation NFPA 1201, Standard for Providing Emergency Services to the Public, Chapter 6. Other NFPA standards that may help in reducing firefighter injuries include: NFPA 1584, Standard on the Rehabilitation Process for members During Emergency Operations and Training Exercises, 2008 Edition, Chapter 4 Preparedness and Chapter 6 Incident Scene and Training Rehabilitation. NFPA 1002, Standard for Fire Apparatus Driver Operator Professional Qualification Risk Management, 2010 Edition, Section 4.8 The Risk Management process. NFPA 1620, Standard for Pre-Incident Planning, 2010 Edition, Chapter 4 Pre-Incident Planning Process, Chapter 5 Physical & Site Considerations, Chapter 7 Water supplies & Fire Protection Systems, Chapter 8 Special Hazards. Efforts need to be made to recognize that firefighter injuries can be reduced. By addressing the priorities listed above, Fire Service organizations can make significant strides towards reducing the number and impact of such injuries. United States Firefighter Injuries- 2016, 10/17 22 NFPA Research, Quincy, MA

29 Definition of Terms Fire: Any instance of uncontrolled burning. Excludes combustion explosions and fires out on arrival (whether authorized or not), overpressure rupture without combustion; mutual aid responses, smoke scares, and hazardous materials responses, e.g., flammable gas, liquid, or chemical spills without fire. Incident: The movement of a piece or pieces of fire service apparatus or equipment in response to an alarm. Injury: Physical damage suffered by a person that requires (or should require) treatment by a practitioner of medicine (physician, nurse, paramedic, EMT) within one year of the incident (regardless of whether treatment was actually received), or that results in at least one day of restricted activity immediately following the incident. United States Firefighter Injuries- 2016, 10/17 23 NFPA Research, Quincy, MA

30 Selected Individual Incidents (These incidents were selected to illustrate typical firefighter safety problems) Wind-Driven Structure Fire The fire department received several phone calls for a multiple-family home on fire. Firefighters arrived on scene within three minutes and encountered a four story, wood, balloon-frame constructed building in flames. The wind-driven fire was spreading rapidly from the secondfloor porch throughout the 3 rd floor and through the roof and quickly extended to adjacent buildings to the left and right, and ignited a very large brush fire in the rear of the structures that threatened several garages. The first-arriving fire companies immediately requested multiple alarms. Twenty-eight minutes after the first units arrived, a general alarm was called by the fire chief, bringing nearly 92 firefighters to the scene. The fire was brought under control in approximately 90 minutes. A total of fourteen firefighters were injured battling the multiple alarm fire. Two of those firefighters suffered life threatening injuries. Several other firefighters suffered significant injuries including a fractured hand, shoulder injury, and an eye injury. A firefighter experienced a cardiac event and was hospitalized after overexerting himself at the fire scene. The 25-year veteran was assigned to an engine company that responded on the general alarm. He performed several tasks including establishing a water supply by laying 1,000 ft. (304.8) of 5 in. (12.7 cm.) hose, connecting hose and appliances and turning on a fire hydrant. He briskly walked to the fire building after collecting his SCBA and equipment. He was then ordered to advance a hoseline to the 4 th floor of the exposure building where the injured captain was operating. He moved up and down the four stories numerous times to ensure the hoseline was adequately stretched while wearing 60 lbs. (27.2 kg.) of gear and equipment. After the fire was knocked down, he informed his company officer that he needed a break and promptly reported to the rehabilitation area outside the building. He removed his protective ensemble and entered rehabilitation. After 20 minutes of rest, his vital signs had not returned to normal and he was placed on a cardiac monitor. The commanding officer of the EMS unit decided that the firefighter needed to be transported due to a cardiac event. The 52-year-old male was diagnosed with demand ischemia, a cardiac event where the heart needs more oxygen than is available in the body s supply and occurs in patients with United States Firefighter Injuries- 2016, 10/17 24 NFPA Research, Quincy, MA

31 tachyarrhythmia (abnormally fast heart rates). He was hospitalized for a few days and cleared to return to firefighting duties several weeks after the incident. An engine company staffed with a captain and two firefighters were tasked with advancing a hose line into an exposure building on the right side of the original fire building. The wood-frame building was similar to the original fire building in terms of construction type and occupancy. All the fire in the apartment and walls on the third floor was extinguished, and the building was overhauled and thoroughly ventilated. The wind was blowing into the front of the building towards the back with sustained winds at mph (35-56 kph) with gusts recorded at 46 mph (74 kph). The officer and the firefighters, along with another engine and ladder company, were ordered to advance a hoseline up the rear stairs to extinguish fire on the fourth floor. Conditions on the third floor were clear, with strong swirling winds blowing through the apartment. Firefighters used the third floor as an area of refuge to conserve their air and removed their SCBA facepieces while cycling in and out of the rear stairs and fourth floor, believing the atmosphere was clear. The fire captain with 31 years of firefighting experience fell down the stairs and twisted his knee while exiting the building after a strenuous work cycle. He was transported to the emergency room from the scene by ambulance. During his treatment at the emergency room for his knee injury, he began having difficulty breathing, eventually going into respiratory arrest. He was intubated and ultimately treated for cyanide poisoning and hospitalized in critical condition. The department reached out to members who experienced symptoms of cyanide toxicity and directed them to the emergency room for treatment. Three firefighters were immediately treated for cyanide poisoning in addition to the captain. The following morning another 6 firefighters sought treatment at the emergency room. A total of 10 firefighters received treatment for cyanide poisoning. Seven of those 10 firefighters treated operated inside or near the same exposure building. The captain never returned to fire duty and still has respiratory issues. United States Firefighter Injuries- 2016, 10/17 25 NFPA Research, Quincy, MA

32 Firefighter Struck By Apparatus A firefighter was severely injured when he was pinned between the firehouse wall and a backing fire apparatus. Upon returning to the firehouse, an engine company with a company officer, and two firefighters pulled onto the apron parallel to the fire station. The officer and the firefighter got off the truck. The driver was under the supervision of the company officer and currently in driver s training and had already completed 17 hours of documented driver s training. He pulled the apparatus to the right in order to align the truck with the bay and began backing in. The officer and another firefighter (the victim) acted as spotters to aid the driver in backing into the station. The firefighter, positioned to the rear of the backing fire truck on the driver s side, moved just inside the garage door and the driver lost sight of him due to the darkness of the garage bay and the sun glare outside. The officer kept giving the driver the backup signal. The firefighter noticed that the truck was off course and not directly in line with the bay and tried to squeeze between the door frame of the apparatus bay and the backing apparatus. The driver, who was looking at the officer in the passenger's side mirror, continued backing and did not see the firefighter. The truck pinned the firefighter between the apparatus and fire station wall. The officer immediately signaled the driver to pull forward and he immediately moved the truck forward and parked the truck. The 61-year-old firefighter suffered head trauma and was hospitalized for several days. He was cleared to resume firefighting nearly five months after the incident. After being involved in the fire service for 22 years, he decided not to return to active duty. Apparatus Crash Three firefighters suffered injuries in a crash while returning to the firehouse after apparatus maintenance. A company officer, driver, and firefighter were riding on the tiller truck at the time of the crash. A passenger vehicle with an adult and two young children drove through a red traffic light, striking the rear wheels of the tractor, causing the tiller to jackknife around the vehicle. All three firefighters were wearing seatbelts and were slightly injured. The firefighters immediately treated the victims in the sedan where a six-year-old girl suffered severe injuries. All the firefighters returned to firefighting activities soon after the incident. United States Firefighter Injuries- 2016, 10/17 26 NFPA Research, Quincy, MA

33 Training A firefighter fell from a second-floor window during mandatory bailout training. The victim was given the OK to begin the training evolution after instructors deemed he was wearing his class 3 harness and was attached properly to the belay line. After a quick check that all safety systems were in place and ready, the victim began his evolution. He attempted to perform the maneuver quickly in a real time fashion, contrary to the instructors direction to conduct the maneuver in a controlled manner. He placed his tool on the left side of the window frame and began his bailout maneuver, rolling out the window to his right. Unfortunately, the tool slipped off the window sill causing the firefighter to freefall. The belay line, which was equipped with a self-braking industrial descender, activated but did not stop his descent before his SCBA valve struck the ground. Investigators found that the industrial descender worked properly; however, the belay line rope was incorrectly placed over the tension line while in use, which was contributing factor in the fall. Also, the victim s quick movements likely contributed to increased and unwanted slack in the belay line. The department did not report specific information on the firefighter's injuries. Apparatus Mishap Members of a local fire department were at the high school gymnasium preparing for the funeral of a former firefighter when a call for a brush fire came in. The driver and a lieutenant were ordered to return to the station with the engine truck with lights and siren to get the department s brush truck and then proceed to the fire. The truck pulled onto the apron and pulled forward into the street to back into the firehouse. In accordance with department protocol, the lieutenant disembarked the truck to act as a spotter but did so before the truck came to a complete stop. Once on the ground, he was in direct line with the front tire as it slowly moved forward and to the right. The fire truck moved forward another 24 in. (61 cm.), running over his foot and leg and knocking him to the ground. The driver, looking in his rearview mirror did not realize he had just struck the spotter. The driver stated he was looking in his rearview mirror but did hear the lieutenant undo his seatbelt or the click of the door. When he looked to his right, the passenger door was open. He immediately placed the truck in park to close the door. At this time, he heard the victim United States Firefighter Injuries- 2016, 10/17 27 NFPA Research, Quincy, MA

34 screaming that he was pinned under the tire. The driver put the truck in reverse, freeing the victim s foot and leg. The 42-year-old lieutenant was able to return to the fire service nearly six months after his injury. Technical Rescue A firefighter was seriously injured during a technical rescue incident. The 32-year-old firefighter was attempting to evacuate a hiker needing medical attention. Firefighters requested a helicopter evacuation. A helicopter arrived on scene approximately 45 minutes after the call for help was received. One firefighter and the patient were being lifted off the trail in a rescue basket when it became snared on a utility pole and the basket tipped. The firefighter, who was not secured into the basket, fell approximately 30 feet (9.1 meters) to the ground. The victim remained inside the basket and was transported to safety and cared for by other firefighters. The seven-year veteran suffered electrical burns and multiple fractures from the fall. He was able to return to firefighting activities nearly six months after the incident. Cardiac Event In the early morning hours, the fire department received calls reporting a barn on fire. The department responded with four apparatus and approximately 15 firefighters on scene. Upon the department s arrival, a 22 ft. x 28 ft. (6.7 by 8.5 meters) barn was fully engulfed in flames. An engine company stopped at a fire hydrant and began establishing a water supply. A 34-year-old firefighter pulled a supply line from the truck and wrapped it around the hydrant. As the truck pulled away, a second member went to the truck to grab a hydrant wrench. When he came back to the fire hydrant, the other firefighter was laying on the ground, unresponsive. A mayday was called immediately as the firefighter collected the rescue bag and the automatic external defibrillator (AED). Other firefighters quickly came over to help, performing cardiopulmonary resuscitation (CPR) and ventilation for the firefighter in sudden cardiac arrest. One shock with the AED was delivered and CPR continued. During the next pulse check, the AED advised no shock and a pulse was detected. The victim began breathing and regained consciousness. He was transported to the emergency room. United States Firefighter Injuries- 2016, 10/17 28 NFPA Research, Quincy, MA