Health-Related Near-Miss Reports

A few departments have long used well-developed and funded programs to monitor their responders’ wellness from recruit school through retirement. Others are moving from annual medical exams to full-fledged wellness centers. Some departments have contracts with third-party health agencies, while others have wellness plans on the drawing board. And sadly, some departments have not yet embraced the concept of firefighter wellness and the value of an NFPA 1582 medical exam.

A quick search of the near-miss database produces many reports that can prove the benefits of comprehensive medical exams.

Near-Miss Report #10-030
“In my department, all members must complete their annual physical by the end of the calendar year. [If they don’t,] that person’s turnout gear is secured and they cannot work, respond on emergency calls or attend any training until their annual physical is complete. I scheduled my annual physical for mid-December. My physical went well up to the point of my stress test. The doctor conducting the stress test was not happy with the results and prohibited me from responding until I had consulted with a cardiologist. I consulted with a cardiologist that evening and two days later was in the hospital where I underwent a cardiac catheterization.”

Report #09-1144
“I was diagnosed with cancer, and through aggressive surgical intervention, I am able to report this as a near miss. Early diagnosis and detection through a routine department physical was the key. In my opinion, exposure to carcinogens during a 19-year career contributed to the event. PPE and SCBA are essential protection from exposure. Maintain physical fitness and participate in regular checkups and health screenings.”
Several other reports that discuss health issues are worth reviewing. Reports 06-285 and 06-255 are featured in the 2011 Near-Miss Calendar, and reports 08-247, 09-617 and 09-924 all describe acute-onset events that nearly cost firefighters their lives.

The message is clear: Comprehensive health screenings that are tailored to the lifestyle and job requirements of the emergency responder are paramount to longevity. The sooner we adopt a mindset geared toward achieving overall health and wellness, the sooner we’ll begin to see declines in our cardiac death rates and higher-than-normal cancer death rates. This equates to everyone going home long after they’ve hung up their helmet.


  1. Work with your funding agency to begin offering comprehensive physical exams.
  2. Seek out grant opportunities through sources like AFG or your healthcare provider, health insurance underwriter or area research/teaching hospital to fund the health screening program. Be prepared to educate the health industry on the unique aspects of firefighting and other emergency work so they can develop a program that’s better suited to you.    
  3. Take ownership of your health and wellness. If your department doesn’t offer one, get a physical every year from your personal physician. Educate your primary care doctor about your job. A resting EKG, for instance, is not as valuable a diagnostic tool as a cardiac stress test when it comes to screening firefighters for abnormalities.
  4. Take heed of warning signs. Seek medical attention early if you notice unusual changes in your body. Don’t ignore signs, such as chest pain.

In Closing
It’s essential that we remain fit to do our jobs. The front-end investment in a comprehensive medical exam program more than offsets the emotional and fiscal loss related to the loss of a member of the department. So take full advantage of (or strive to implement) job-related health-screening programs–it’s one of the essential components in stopping health-related firefighter deaths.

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