PATTERNS OF FIREFIGHTER FIREGROUND INJURIES

PATTERNS OF FIREFIGHTER FIREGROUND INJURIES Michael J. Karter, Jr. Fire Analysis & Research Division National Fire Protection Association 1 Batterymarch Park Quincy, MA 02169-7471 www.nfpa.org November 2003 Copyright, 2003, National Fire Protection Association, Quincy, MA 02169-7471

TABLE OF CONTENTS Table of Contents i Introduction 1 Nature of Injury 2 Type of Activity 6 Cause of Injury 11 Occupancy Type Where Injuries Occurred 16 Ages of Injured Firefighters 20 Time of Day Injuries Occurred 23 Methodology 26 Patterns of Firefighter Fireground Injuries, 11/03 i NFPA Fire Analysis and Research, Quincy, MA

Introduction An analysis of firefighter injury data from the Federal Emergency Management Agency s (FEMA) National Fire Incident Reporting System (NFIRS) was undertaken to examine factors that are beyond the scope of results based on the NFPA survey. Results were analyzed for the 1994-98 period. Earlier NFPA reports analyzed results for 1993-97, 1991-95, 1989-93, and 1987-88. National estimates of firefighter injuries for selected breakdowns are based on data from the NFPA survey used in conjunction with NFIRS. Because of the slightly different manner in which the two data bases collect firefighter injury data (see methodology section for details), results presented here are for firefighter fireground injuries only. According to NFPA 901 and NFIRS, there are four levels of injury severity: Minor The patient is not in danger of death or permanent disability. Immediate medical care is not necessary. Moderate There is little danger of death or permanent disability. Quick medical care is advisable. Severe The situation is potentially life threatening if the condition remains uncontrolled. Immediate medical care is necessary. Life Threatening Death is imminent; body processes and vital signs are not normal. Immediate medical care is necessary. Patterns of Firefighter Fireground Injuries, 11/03 1 NFPA Fire Analysis and Research, Quincy, MA

For the 1994-98 period, there were an estimated annual average of 46,650 firefighter fireground injuries in the U.S. Of these, an average of 29,780 were minor, 15,460 were moderate, 1,310 were severe, and 100 were life threatening. Analysis indicated a similar distribution of injuries for minor and moderate injuries by nature of injury, and so they are combined for the remainder of this report. Because of the small number of life threatening injuries, they are combined with the severe injuries. Thus for the 1994-98 period for firefighter fireground injuries, there were an annual average of 45,240 minor and moderate injuries, and 1,410 that were severe (including life threatening.) (Table 1). Nature of Injury For the 1994-98 period for minor and moderate firefighter fireground injuries, there was an annual average of 9,580 sprains and strains a year, or 21.2% of all minor and moderate injuries (Table 2). Other leading types of minor and moderate injuries were pain only, accounting for 6,780 injuries (15.0%); burns, accounting for 5,240 injuries (11.6%); laceration or cut, accounting for 3,615 injuries (8.0%); and asphyxiation, accounting for 2,560 injuries (5.7%). For the 1994-98 period for severe firefighter fireground injuries, there was an annual average of 244 asphyxiation injuries a year, or 17.3% of all severe injuries (Table 3). Other leading types of severe injuries were cardiac symptoms, accounting for 231 injuries (16.4%); dizziness or fainting, accounting for 120 injuries (8.5%); dehydration, accounting for 102 injuries (7.2%); pain only, accounting for 72 injuries (5.0%); and difficulty breathing, accounting for 81 injuries (5.7%). Patterns of Firefighter Fireground Injuries, 11/03 2 NFPA Fire Analysis and Research, Quincy, MA

Table 1 Firefighter Fireground Injuries by Severity, 1994-98 Minor and Year Moderate Severe* 1994 51,200 1,675 1995 48,960 1,680 1996 44,420 1,305 1997 39,780 1,140 1998 41,840 1,240 *Includes life threatening. Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 3 NFPA Fire Analysis and Research, Quincy, MA

Table 2 Minor and Moderate Firefighter Fireground Injuries, by Nature of Injury, 1994-1998 Annual Average Minor and Moderate Injuries Nature of Injury Number Percent Sprain or strain 9,580 21.2 Pain only 6,780 15.0 Burns 5,240 11.6 Laceration or cut 3,615 8.0 Contusion or bruise 2,560 5.7 Asphyxiation 2,210 4.9 Difficulty breathing 1,675 2.8 Puncture 1,470 3.3 Dizziness or fainting 1,285 2.8 Abrasion 1,055 2.3 Foreign body 840 1.9 Swelling 805 1.8 Dehydration 330 0.7 Fracture 605 1.3 Cardiac symptoms 330 0.7 Shock (electric) 250 0.6 Unconscious 50 0.1 Other 6,880 15.2 Total 45,240 100.0 Note: Totals may not equal sums due to rounding. The unknowns were allocated. Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 4 NFPA Fire Analysis and Research, Quincy, MA

Table 3 Severe* Firefighter Injuries, by Nature of Injury, 1994-98 Annual Average Severe Injuries* Number Percent Asphyxiation 244 17.3 Cardiac symptoms 231 16.4 Dizziness or fainting 120 8.5 Dehydration 102 7.2 Difficulty breathing 81 5.7 Pain only 72 5.0 Sprain or strain 62 4.4 Burns 69 4.9 Fracture 36 2.6 Shock (electric) 27 1.9 Laceration or cut 21 1.5 Unconscious 16 1.1 Puncture 13 0.9 Contusion/bruise 11 0.8 Swelling 5 0.4 Other 300 15.7 Total 1,410 100.0 *Includes life threatening injuries Note: Totals may not equal sums due to rounding. The unknowns were allocated. Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 5 NFPA Fire Analysis and Research, Quincy, MA

An estimated 37.3% of minor and moderate asphyxiation injuries occurred with no breathing apparatus used, and these injuries were examined further (Table 4). Activity and location at time of injury for 1994-98 data for these injuries were looked at. The 27.3% of minor and moderate injuries that occurred handling charged hose lines included 21.6% that occurred outside on ground level, and 2.9% that occurred inside the structure at grade level. About 43.2% of severe asphyxiation injuries occurred with no breathing apparatus used and a similar analysis was done (Table 5). The 45.7% of severe injuries that occurred handling charged hose lines included 27.6% that occurred outside on ground level, and 12.4% that occurred inside the structure at grade level. The large percentages of asphyxiation injuries occurring with no breathing apparatus used clearly indicate the need for using self-contained breathing apparatus (SCBA) during all phases of fireground operations and particularly during activities outside a structure. Type of Activity For the 1994-98 period for minor and moderate firefighter fireground injuries, an estimated annual average of 22,155, or 49.0%, occurred during activities related to extinguishing a fire (Table 6). Of these, 16,835 occurred while handling charged hose lines, and 2,895 while using hand tools. Suppression support activities, which include overhaul operations, ventilation, and forcible entry, accounted for an annual average of 11,975 injuries, or 26.5%. Miscellaneous incident scene activities, which include laying hose, moving tools or equipment, etc., accounted for 4,425 injuries. Also, for the 1994-98 period for severe firefighter fireground injuries, Patterns of Firefighter Fireground Injuries, 11/03 6 NFPA Fire Analysis and Research, Quincy, MA

Table 4 Minor and Moderate Firefighter Fireground Smoke Inhalation Injuries Where Breathing Apparatus Was Not Present Activity and Location at Time of Injury, 1994-98 Activity and location Number Percent Handling charged hose lines 228 27.3 Outside on ground level 179 21.6 Inside structure at grade level 24 2.9 Inside structure on second through fourth stories 3 0.3 On structure s roof 4 0.4 Outside above grade level 7 0.8 Other 13 1.6 Other extinguishing activities 96 11.5 Outside on ground level 20 2.4 Inside structure at grade level 20 2.4 Inside structure on second through fourth stories 10 1.2 Outside above grade level 2 0.2 On structure s roof 14 1.7 Other 30 3.6 Other suppression support 74 8.9 Outside on ground level 42 5.1 Inside structure on second through fourth stories 2 0.2 through structure at grade level 8 1.0 Other 22 2.7 Overhaul 55 6.6 Inside structure at grade level 17 2.0 Inside structure on second through fourth stories 8 1.0 Outside on ground level 8 1.0 Inside structure above seventh level 12 1.4 Other 10 1.2 Patterns of Firefighter Fireground Injuries, 11/03 7 NFPA Fire Analysis and Research, Quincy, MA

Table 4 (continued) Minor and Moderate Firefighter Fireground Smoke Inhalation Injuries Where Breathing Apparatus Was Not Present Activity and Location at Time of Injury, 1994-98 Activity and location Number Percent Rescue 81 9.8 Inside structure at grade level 34 4.1 Inside structure on second through fourth stories 24 2.9 Outside on ground level 5 0.6 Other 18 2.2 Miscellaneous incident scene 42 5.1 Outside on ground level 25 3.0 One story below grade level 8 1.0 Other 9 1.1 Ventilation with hand tools 42 5.1 On structure roof 19 2.2 Outside on ground level 8 1.0 Inside structure at grade level 7 0.8 Other 8 1.0 Other 212 25.5 Outside on ground level 76 9.2 Inside structure at grade level 41 4.9 Inside structure second through stories 20 2.4 Other 75 9.0 Total 830 100.0 Note: Totals may not equal sums due to rounding. The unknowns were allocated. Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 8 NFPA Fire Analysis and Research, Quincy, MA

Table 5 Severe* Firefighter Fireground Smoke Inhalation Injuries Where Breathing Apparatus Was Not Present Activity and Location at Time of Injury, 1994-98 Activity and location Number Percent Handling charged hose lines 48 45.7 Outside on ground level 29 27.6 Inside structure at grade level 13 12.4 Inside structure on second through fourth stories 3 2.8 Outside above grade level 2 1.9 Other 1 1.0 Other extinguishing activities 8 7.6 Outside on ground level 1 1.0 Inside structure at grade level 3 2.8 Other 4 3.8 Overhaul 6 5.7 Inside structure at grade level 3 2.8 Inside structure on second through fourth stories 2 1.9 Other 1 1.0 Rescue 5 4.8 Inside structure at grade level 5 4.8 Miscellaneous incident scene 3 2.8 Outside on ground level 3 2.8 Patterns of Firefighter Fireground Injuries, 11/03 9 NFPA Fire Analysis and Research, Quincy, MA

Table 5 (continued) Severe* Firefighter Fireground Smoke Inhalation Injuries Where Breathing Apparatus Was Not Present Activity and Location at Time of Injury, 1994-98 Activity and location Number Percent Other Suppression Support 10 9.5 Inside structure at grade level 2 1.9 One storyf below grade level 5 4.8 Other 3 2.8 Other 25 23.8 Outside on ground level 11 10.5 Inside structure at grade level 8 7.6 Other 6 5.7 Total 105 100.0 Note: Totals may not equal sums due to rounding. The unknowns were allocated. Source: National estimates based on NFIRS and NFPA survey. *Includes life threatening injuries. Patterns of Firefighter Fireground Injuries, 11/03 10 NFPA Fire Analysis and Research, Quincy, MA

an estimated annual average of 784, or 55.6%, occurred during activities related to extinguishing a fire (Table 7). Of these, 611 occurred while handling charged hose lines. An annual average of 293 occurred during suppression support activities, an average of 114 occurred during miscellaneous incident scene activities, and an average of 62 occurred during rescue activities. Cause of Injury Minor and moderate firefighter fireground injuries were examined by cause for the 1994-98 period. (Table 8). Overall, an estimated annual average of 15,095, or one of every three minor and moderate injuries, were the result of contact with or exposure to something. Other major causes of minor and moderate injuries were overexertion or strain, accounting for an annual average of 10,255 injuries (22.7%); falling or slipping, accounting for an average of 8,585; and being struck by an object, accounting for an average of 6,865 (15.2%). Patterns of Firefighter Fireground Injuries, 11/03 11 NFPA Fire Analysis and Research, Quincy, MA

Table 6 Minor and Moderate Firefighter Fireground Injuries by Type of Activity, 1994-98 Annual Average Activity Number Percent Extinguishing fire 22,155 49.0 Handling charged hose line 16,835 37.2 Using hand tools in extinguishment 2,895 6.4 activity Using hand extinguisher 390 0.9 Operating master stream device 300 0.7 Shutting off utilities, gas lines, etc. 120 0.3 Other 1,615 3.6 Suppression support 11,975 26.5 Overhaul 5,595 12.4 Ventilation with hand tools 2,320 5.1 Forcible entry 1,175 2.6 Ventilation with power tools 745 1.6 Salvage 530 1.2 Other 1,610 3.6 Rescue 1,715 3.8 Searching for fire victim 970 2.1 Rescue of fire victim 535 1.2 Other 210 0.5 Miscellaneous incident scene 4,425 9.7 Laying hose 1,045 2.3 Moving tools or equipment 985 2.2 Picking up tools or equipment 925 2.0 Connecting to hydrant 415 0.9 Other 1,055 2.3 Other 4,970 11.0 Total 45,240 100.0 Note: Totals may not equal sums due to rounding. The unknowns were allocated. Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 12 NFPA Fire Analysis and Research, Quincy, MA

Table 7 Severe * Firefighter Injuries by Type of Activity, 1994-98 Annual Average Activity Number Percent Extinguishing Fire 784 55.6 Handling charged hose lines 611 43.3 Using hand tools in extinguishment 72 5.1 activity Shutting off utilities, gas lines, etc. 51 3.6 Using hand extinguishers 7 0.5 Operating master stream device 8 0.5 Other 35 2.5 Suppression support 293 20.7 Overhaul 109 7.7 Ventilation with hand tools 62 4.4 Ventilation with power tools 28 2.0 Forcible entry 18 1.3 Salvage 18 1.3 Other 58 4.1 Rescue 62 4.4 Searching for fire victim 41 2.9 Rescue of fire victims 16 1.1 Other 5 0.3 Miscellaneous incident scene 114 8.1 Laying hose 32 2.3 Picking up tools, or equipment 26 1.8 Moving tools, or equipment 4 0.3 Connecting to hydrant 9 0.6 Other 43 3.0 Other 157 11.0 Total 1,410 100.0 *Includes life threatening injuries. Note: Totals may not equal sums due to rounding. The unknowns were allocated. Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 13 NFPA Fire Analysis and Research, Quincy, MA

Table 8 Minor and Moderate Firefighter Fireground Injuries* by Cause, 1994-98 Annual Average Cause Number Percent Contact with or exposure to 15,095 33.4 Smoke or toxic fire products 3,405 7.5 Heat 3,380 7.5 Embers 1,235 2.7 Nails 1,200 2.7 Glass 895 2.0 Stream 745 1.6 Chemicals 585 1.3 Fire 550 1.2 Hot metal 465 1.0 Extreme weather 355 0.9 Electricity 315 0.7 Unusual fumes or gases 290 0.6 Hot tar 220 0.5 Other 1,455 3.2 Overexertion or strain 10,255 22.7 While pulling hose 2,520 5.6 While lifting hose 1,420 3.1 While pulling hand tool or saw 720 1.6 While carrying hose 615 1.4 While lifting hand tool or saw 555 1.2 While pulling property or contents 380 0.8 While lifting property or contents 345 0.8 While lifting other object 295 0.7 While lifting ladder 235 0.5 Other 3,170 7.0 Fell or slipped 8,585 19.0 Over object 1,490 3.3 On icy surface 1,510 3.3 On steps or stairs 1,305 2.9 On wet surface 885 2.0 In hole or outside structure 710 1.6 From ladder 385 0.9 Patterns of Firefighter Fireground Injuries, 11/03 14 NFPA Fire Analysis and Research, Quincy, MA

Table 8 (continued) Minor and Moderate Firefighter Fireground Injuries by Cause, 1994-98 Annual Average Cause Number Percent Falling or slipping In unguarded opening in floor 270 0.6 On flat surface 310 0.7 From structure 145 0.3 In or onto emergency apparatus 120 0.3 Other 1,455 3.2 Struck by 6,865 15.2 Dirt particles 700 1.6 Hand tools or equipment 740 1.6 Collapsing ceiling 670 1.5 Falling object 560 1.2 Glass broken by self 445 1.0 Ceiling pulled by self 425 0.9 Hose 390 0.9 Coupling 375 0.8 Flying glass 310 0.7 Pieces of wall 270 0.6 Glass broken by others 195 0.4 Water stream or handline 200 0.4 Other 1,585 3.5 Caught or trapped by 2,130 4.7 Collapsing roof, wall, floor or ceiling 695 1.5 Fire progress 320 0.7 Backdraft or explosion 335 0.7 Other 785 1.7 Other 2,310 5.1 Total 45,240 100.0 Note: Totals may not equal sums due to rounding. The unknowns were allocated. Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 15 NFPA Fire Analysis and Research, Quincy, MA

The 31.8% of minor and moderate injuries that were the result of contact with or exposure to something for the 1994-98 period included 7.5% that occurred due to exposure to smoke and/or toxic fire products, 7.5% due to exposure to heat, 2.7% due to contact with nails, and 2.7% due to exposure to embers. The 22.7% of minor and moderate injuries that were the result of overexertion included 5.6% that occurred while pulling hose, and 3.1% while lifting hose. The 19.0% that were the result of falling or slipping included 3.3% that occurred on an icy surface, 3.3% over an object, 2.9% on steps or stairs, and 2.0% on a wet surface. Severe firefighter fireground injuries were also examined by cause for the 1994-98 period (Table 9). Overall, an estimated annual average of 578, or about 2 out of 5 of severe injuries, were the result of contact with or exposure to something. Other major causes of severe injuries were overexertion or strain, accounting for an annual average of 448 (31.8%); and falling or slipping, accounting for an average of 133 (9.4%). The 41.0% of severe injuries that were the result of contact with or exposure to something included 18.5% that occurred due to exposure to smoke and/or toxic fire products, and 8.4% due to exposure to heat. The 31.8% of severe injuries that were the result of overexertion included 6.7% that occurred while pulling hose, and 3.6% while lifting hose. Occupancy Type Where Injuries Occurred In 1994-98, fires in residential structures accounted for about seven out of ten firefighter fireground injuries in structures (Table 10). This was in large part due to the large portion of all structure fires that are residential fires. When differences in fire occurrence by occupancy are taken into account, results are quite different. The highest firefighter fireground injury rates per 100 fires by occupancy occurred in industry, utility, defense, and manufacturing facilities (4.1); special properties (4.0); and stores and Patterns of Firefighter Fireground Injuries, 11/03 16 NFPA Fire Analysis and Research, Quincy, MA

Table 9 Severe * Firefighter Fireground Injuries by Cause, 1994-98 Annual Average Cause Number Percent Contact with or exposure to 578 41.0 Smoke or toxic fire products 261 18.5 Heat 118 8.4 Extreme weather 39 2.8 Electricity 38 2.6 Unusual fumes or gases 10 0.7 Fire 16 1.1 Nails 10 0.7 Chemicals 7 0.5 Glass 6 0.4 Embers 4 0.3 Stream 4 0.3 Other 65 4.6 Overexertion or strain 448 31.8 While pulling hose 94 6.3 While lifting hose 50 3.5 While carrying hose 33 2.4 While lifting hand tool or saw 18 1.3 While pulling hand tool or saw 17 1.2 While pulling property or contents 11 0.8 While lifting property or contents 5 0.3 While lifting ladder 6 0.4 While lifting other item 4 0.3 Other 210 14.9 Falling or slipping 133 9.4 On icy surface 25 1.8 In unguarded opening in floor 18 1.3 On wet surface 15 1.1 On steps or stairs 14 1.0 In hole, outside structure 11 0.7 Over object 10 0.7 From structure 9 0.6 Patterns of Firefighter Fireground Injuries, 11/03 17 NFPA Fire Analysis and Research, Quincy, MA

Table 9 (continued) Severe* Firefighter Fireground Injuries by Cause, 1994-98 Annual Average Cause Number Percent On flat surface 7 0.5 From ladder 5 0.4 Other 19 1.3 Struck by 93 6.6 Collapsing ceiling 7 0.5 Water stream from handline 5 0.3 Hose 4 0.3 Falling object 4 0.3 Dirt particles 3 0.2 Glass broken by others 3 0.2 Hand tools or equipment 2 0.2 Other 65 4.6 Caught or trapped by 51 3.6 Collapsing roof, wall, floor or ceiling 30 2.1 Fire progress 7 0.5 Backdraft or explosion 14 1.0 Other 107 7.6 Total 1,410 100.0 *Includes life threatening injuries. Note: Totals may not equal sums due to rounding. The unknowns were allocated. Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 18 NFPA Fire Analysis and Research, Quincy, MA

Table 10 Firefighter Fireground Injuries in Structure Fires, by Occupancy in Structure Fires, 1994-98 Occupancy Percentage Percentage of Total Fireground of Structure Fireground Injuries per Fires Injuries 100 Fires Public assembly 3.3 3.1 2.3 Educational 1.5 0.6 1.1 Health care and correctional 1.9 0.6 0.7 Residential 74.6 71.3 2.4 Store and office 4.7 6.4 3.4 Industry, utility 3.2 5.3 4.1 defense, and manufacturing Storage 7.2 6.9 2.4 Special* 3.6 5.9 4.0 Total structures 100.0 100.0 2.5 *Includes vacant buildings, and buildings under construction Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 19 NFPA Fire Analysis and Research, Quincy, MA

offices (3.4). The rate for residential structures (2.4) was now low in comparison to those occupancies, but higher than for educational properties and for health care and correctional properties. The percent of firefighter fireground injuries that occurred in incendiary or suspicious fires was also examined by occupancy for the 1994-98 period (Table 11). The highest percentage was in special structures, where 81% of all fireground injuries occurred in incendiary or suspicious fires. The majority of these injuries (54%) occurred in vacant buildings. Other occupancies with a high percentage of fireground injuries in incendiary or suspicious fires were educational properties (45%), health care and correctional properties (35%), and storage properties (34%). These are mostly properties in which a substantial proportion of reported fires are incendiary or suspicious 59% for special structures, 52% for educational facilities, 23% for health care and correctional facilities (including 64% for correctional), and 28% for storage facilities. 1 Ages of Injured Firefighters For the 1994-98 period, younger firefighters accounted for the major portion of all firefighter fireground injuries, a result that is very similar to the distribution of firefighters in the U.S. (Figure 1). In all, 55% of firefighters in the U.S. are in the under 40 group, and they accounted for 64% of firefighter fireground injuries. 1 John R. Hall, Jr., U.S. Arson Trends and Patterns; National Fire Protection Association, Quincy, MA, January 2000, Table 8. Patterns of Firefighter Fireground Injuries, 11/03 20 NFPA Fire Analysis and Research, Quincy, MA

Table 11 Percent of Firefighter Fireground Injuries Occurring in Incendiary or Suspicious Fires, by Occupancy, 1994-98 Occupancy Percent of Fireground Injuries That Occurred In Incendiary Or Suspicious Fires Public assembly 26 Educational 45 Health care and correctional 35 Residential 24 Store and office 30 Industry, utility, defense, and manufacturing 14 Storage 34 Special* 81 Total structures 28 *Includes vacant buildings and buildings under construction Source: National estimates based on NFIRS and NFPA survey. Patterns of Firefighter Fireground Injuries, 11/03 21 NFPA Fire Analysis and Research, Quincy, MA

Figure 1 Firefighters and Firefighter Injuries in the U.S. by Age Group, 1994-98 45 39.2 40 35 31.1 30 27.2 27.3 25 20.3 22.7 20 15 13.3 10 8.2 5 3.4 4.7 1.7 1.0 0 16-19 20-29 30-39 40-49 50-59 60 & over Age Sources: 1994-98 NFIRS, NFPA Survey Percent Percent of Firefighters Percent of Firefighter Injuries Patterns of Firefighter Fireground Injuries, 11/03 22 NFPA Fire Analysis and Research, Quincy, MA

Time of Day Injuries Occurred The peak periods for structure fires attended by fire departments were noon to 6:00 p.m. (32.4%) and 6:00 p.m. to midnight (30.2%). The smallest share of fires occurred in the early morning hours of midnight to 6:00 a.m. (16.4%) (Figure 2). Firefighter fireground injuries, as one might expect, occurred very often during the peak fire frequency periods of noon to 6:00 p.m. (26.0%) and 6:00 p.m. to midnight (27.6%), but the real surprise was the high occurrence of fireground injuries in the midnight to 6:00 a.m. slot (25.7%), compared to the 16.4% of fires occurring in this time period. This point is made even more clear when firefighter fireground injuries per 100 structure fires are examined (Figure 3). The highest injury rates per 100 fires occurred in the midnight to 6:00 a.m. time frame, when about 3.9 injuries occurred per 100 structure fires attended. Among the factors that may contribute to the high injury rates during the night time hours are lack of visibility, cold temperatures, and lower alertness of firefighters. Patterns of Firefighter Fireground Injuries, 11/03 23 NFPA Fire Analysis and Research, Quincy, MA

Figure 2 Fire and Firefighter Injuries by Time of Day, 1994-98 35 32.4 30.2 30 25.7 26.0 27.6 25 21.1 20.7 Percent 20 15 16.4 Percent of fires Percent of Firefighter Injuries 10 5 0 Midnight to 6 am 6 am to noon Noon to 6 pm 6 pm to midnight Time of Day Source: 1994-98 NFIRS Patterns of Firefighter Fireground Injuries, 11/03 24 NFPA Fire Analysis and Research, Quincy, MA

Figure 3 Firefighter Fireground Injuries per 100 Structure Fires by Time of Day, 1994-98 4.5 4.0 4 3.9 3.5 3.8 3 2.5 2 1.5 1 0.5 0 2.8 2.8 2.5 2.3 2.3 2.3 2.1 1.9 1.9 Fireground Injuries per 100 Structure Fires Midnight to 2 am 2 to 4 am 4 to 6 am 6 to 8 am 8 to 10 am 10 to noon Noon to 2 pm 2 to 4 pm 4 to 6 pm 6 to 8 pm 8 to 10 pm 10 pm to Midnight Source: 1994-98 NFIRS Time of Day Patterns of Firefighter Fireground Injuries, 11/03 25 NFPA Fire Analysis and Research, Quincy, MA

Data Sources and Methodology The primary data source in this study was the National Fire Incident Reporting System (NFIRS) of the Federal Emergency Management Agency's U.S. Fire Administration. When national estimates of firefighter injuries are presented, the results are weighted by year using total fireground injuries from the NFPA annual survey of fire departments. Because of the slightly different manner in which the two data bases collect firefighter injury data, results presented in this report are for firefighter fireground injuries only. The NFIRS casualty file is by definition limited to injuries that occurred at fire incidents only; this includes injuries that occurred as a result of responding to or returning from fires. The NFPA survey collects among its data elements the number of fireground injuries and the number of injuries responding to or returning from all incidents (includes fire as well as non-fire incidents). Because of the difference in the manner in which responding to or returning injuries are collected for the two sources, they were excluded from the analysis. This update for 1994-98 included injuries that occurred at fires (incident type 10-19), and where injury occurred (codes 21-69) in NFIRS. In this report, where data for a factor was unknown, it was assumed to have the same proportional distribution as the distribution where the data was known and reported. The Other category includes cases specifically coded as other and cases coded in specific categories but with very low frequency. Patterns of Firefighter Fireground Injuries, 11/03 26 NFPA Fire Analysis and Research, Quincy, MA