On March 12, 2018, at approximately 0700 hours a 44-year-old female career firefighter (FF) completed a physical ability test (PAT) at the beginning of her 24-hour shift and then reported to the station and was assigned as the driver of the rescue unit. The FF and her crew responded to a full cardiac arrest late in the morning and then to a motor vehicle accident (MVA) shortly thereafter.
Around 1200 hours, the crew returned to the station. Within 5 minutes of returning to the station, the FF complained of burning in her throat and grasped her shirt. As fellow fire department members were assessing the FF, she went into cardiac arrest. Paramedics in the station initiated cardiopulmonary resuscitation (CPR) and delivered two manual shocks. The transport ambulance arrived on scene at 1215 hours and participated in advanced cardiac life support (ACLS). The FF was loaded into the ambulance and resuscitation efforts were continued en route to the hospital emergency department (ED). Hospital ED personnel continued resuscitation efforts unsuccessfully for approximately 20 minutes. The FF was pronounced dead at 1306 hours.
The death certificate and the Medical Examiner’s report listed the FF’s cause of death as “occlusive coronary artery disease” due to “atherosclerotic cardiovascular disease”. The autopsy found complete occlusion of the proximal left anterior descending (LAD) coronary artery. National Institute for Occupational Safety and Health (NIOSH) investigators concluded that the physical exertion of the PAT and emergency responses triggered a myocardial infarction in an individual with underyling cardiovascular disease.
The FF was a non-smoker and was very physically active. She had hypercholesterolemia (highcholesterol) and had begun medication for this within the past 3 months.
NIOSH offers the following recommendations to reduce the risk of heart attacks and sudden cardiac arrest among firefighters at this and other fire departments across the country.
- Ensure that all firefighters receive an annual medical evaluation consistent with National Fire Protection Association (NFPA) 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments
- Ensure firefighters are cleared for duty by a physician knowledgeable about the physical demands of firefighting, the personal protective equipment used by firefighters, and the various components of NFPA 1582
- Phase in a mandatory comprehensive wellness and fitness program for firefighters Continue to perform annual physical performance (physical ability) evaluations.