By Kevin Freier
Growing up, my two biggest heroes were firefighters. There was Grandpa Warren, a seven-year veteran of Racine (WI) Fire Department’s Engine 9, and Mr. Jim, my childhood neighbor and twenty-year veteran of Baltimore City’s Truck 30. Both were hardworking public servants that put their lives on the line for their communities day in and day out. But unfortunately it wasn’t just their diligence and selflessness that they shared, as both also died of service related cancer.
Now it is no secret that firefighting is a dangerous profession. Hell, most of our firehouses probably display some kind of tribute to the 343 who experienced this occupational danger firsthand on a crisp September morning back in 2001. But with all the talk these days surrounding cancer, responder suicide, line of duty deaths, and whatnot, it got me thinking: Just how dangerous is firefighting really?
According to the U.S. Department of Labor, firefighting is the ninth most dangerous job in the United States. Falling in line behind farmers, garbage collectors, and delivery drivers. In 2022, 96 firefighters died in the line of duty. For comparison 118 police officers and 1,009 active duty military members died in the line of duty that same year. But unlike cops and Marines we aren’t usually bracing gunfire and artillery on shift. So it begs the question, what is it that actually kills us?
The Culprits
A study conducted by the National Fire Prevention Association found that the three most prominent causes of “on duty” firefighter deaths are sudden cardiac arrest, vehicle accidents, and fire. Whereas the three most prominent causes of “off duty” firefighter deaths, including those of retired firefighters, are cancer, suicide, and heart disease.
Cardiac Arrest
Sudden cardiac arrests account for 51% of all on duty deaths. Usually caused by overexertion, the physical stress of certain high-intensity activities, such as fighting fires and physical training, can often aggravate underlying conditions and cause firefighters to suffer serious medical emergencies, such as myocardial infarctions or strokes, that often prove fatal in the form of sudden cardiac arrests.
In the past year alone 34 of the 49 line of duty deaths have been due to sudden cardiac arrest, including Lieutenant Jan Tchoryk of the Chicago Fire Department. While fighting a high-rise fire back in early April, Lieutenant Tchoryk suddenly collapsed and was pronounced dead shortly after. An autopsy later revealed that he died of sudden cardiac arrest due to aggravated hypertensive-arteriosclerotic cardiovascular disease.
Some best practices to avoid this faee include staying hydrated, eating a balanced diet, limiting tobacco and alcohol use, exercising daily, seeing your doctor regularly, getting adequate sleep, and lowering stress levels.
Vehicle accidents
Vehicle accidents account for 24% of all on duty deaths. They are usually caused by either a firefighter being struck by a passing vehicle while out working in the roadway or a fire apparatus being involved in an accident while responding to and or returning from a call.
A recent Federal Emergency Management Agency study found that 550 firefighters were injured and 15 were killed due to vehicle accidents alone in 2020. The vast majority of those deaths involved a firefighter being hit by a passing vehicle. In October of 2018, Hanover County (VA) Fire-EMS Lieutenant Brad Clark was hit and killed by a tractor trailer while working a motor vehicle accident on the side of the interstate. Witnesses say that moments before the truck plowed into Clark’s engine, he called for his crew to take shelter and in turn saved their lives.
Some best practices to avoid this fate include: slowing down, using proper blocking techniques, downgrading responses for lower acuity calls, and always maintaining situational awareness on the roadway.
Fire
Last but not least, fire accounts for 8% of all on duty deaths. Caused by either asphyxiation or burns, fire-based deaths are usually due to equipment failure (mask malfunctions), medical emergencies (passing out), loss of structural integrity (falling through the floor), human error (getting lost), and or rapidly changing fire conditions (flashover).
The US Fire Administration found that in 2021, 141 firefighters died while on duty, with 34 of those dying of fire related causes, including Frederick County (MD) Captain Joshua Laird. While fighting a McMansion fire in Ijamsville, Maryland back in early August of 2021, Captain Laird fell through the floor and quickly found himself trapped in the basement. Despite crew’s best efforts to rescue him, he ultimately succumbed to smoke inhalation induced asphyxia, but not before transmitting one last heartbreaking goodbye to his family.
Some best practices to avoid this fate include: proper personal protective equipment (PPE) application (that includes buckling chin straps and waist belts), sounding floors, paying attention to changing fire behavior, not freelancing, and establishing proper rapid intervention team procedures.
Cancer
A 2022 study conducted by the CDC found that cancer is the new leading cause of death among firefighters. This includes on-duty, off-duty, and retired personnel. 75% of the most recent 469 names added to the International Association Fire Fighter’s Fallen Firefighter Memorial have been due to cancer.
Statistically speaking firefighters are 9% more likely to contract cancer and 14% more likely to die from cancer than civilians. A recent NIOSH report found that the most common forms of service related cancer are: mesothelioma, testicular cancer, esophageal cancer, and leukemia. In terms of mortality, mesothelioma has a 10% five-year survival rate, testicular cancer has a 99% five-year survival rate, esophageal cancer has a 20% five-year survival rate, and leukemia has a 65% 5-year survival rate.
As most of us are probably aware, service related cancer is usually contracted through contact with carcinogens like polycyclic aromatic hydrocarbons (PAH). These deadly carcinogens can be found in smoke, exhaust fumes, Class B foam, and even our bunker gear. Meaning that we are more or less constantly surrounded by cancer causing chemicals while on shift.
So it is no surprise that both Grandpa Warren and Mr. Jim contracted cancer after a collective almost-30 years in the fire service. Especially since they fought the majority of their fire back in the days of rudimentary air packs and salty gear. But regardless of the PPE and cancer prevention advances we have made since then, the threat still remains as construction materials become more and more toxic and chemicals become more and more advanced. Grandpa Warren died of leukemia on June 3, 2003 and Mr. Jim died of esophageal cancer on January 22, 1999.
Some best practices to avoid this fate include: properly decontaminating gear/tools, showering after fires, getting regular ultrasounds checkups, keeping gear stored outside of living quarters, and staying on air in environments that are immediately dangerous to health or life.
Suicide
A study conducted by the Firefighter Behavioral Health Alliance found that 80 firefighters died by suicide in 2022. That is only 16 fewer than the total number of line of duty deaths that year and likely only accounts for a fraction of the real amount considering there is no national database that officially tracks firefighter suicides.
Trauma, depression, post traumatic stress disorder, alcohol/drug addiction, and a lack of adequate mental health resources are some of the main reasons why firefighters are three times more likely to commit suicide than civilians. Tim Casey, a Firefighter/Paramedic with the Colorado Springs (CO) Fire Department, documented his struggles with mental health and suicidal ideations on his Youtube channel @DrunkenFireman. Featured in the powerful Al Jazerra documentary, “The Final Call: Why Firefighters Commit Suicide,” he spoke about the horrible things we see daily and the mental toll that they take on us. Despite his and others best efforts, though, he died by suicide on July 31, 2015.
Some best practices to avoid this fate include: asking for help, forming peer support groups, seeing a therapist or counselor, looking out for each other, developing healthy coping mechanisms, and avoiding drugs/alcohol.
Heart Disease
Heart disease accounts for 45% of all firefighter deaths. Different from the above mentioned cardiac arrests, heart disease refers to more chronic cardiac conditions like congestive heart failure and atrial fibrillation. Conditions that develop over time and are spurred by things like stress, unhealthy eating habits, and genetics.
Similar to cardiac arrests though, stress plays a vital role when it comes to heart disease and firefighters. Only this kind of stress isn’t physical. Cortisol, a hormone that is released in our bodies during stressful events, has been directly linked to heart health. Studies show that people with higher levels of cortisol tend to be at higher risk for heart disease as increases in cortisol tend to increase things like blood pressures, triglycerides, cholesterol, and blood sugars. So people who regularly work in high stress environments tend to have a much higher risk of developing heart disease.
Firefighter Matthias Wirtz of the North Haven (CT) Fire Department is one such example of the toll heart disease can take on firefighters. A 22-year veteran of the fire service, Firefighter Wirtz was pumping two-alarm fire back in late December of 2022 when he experienced a medical emergency on scene. He was quickly transported to a local hospital where he later died of complications associated with hypertensive-arteriosclerotic cardiovascular disease.
Similar to cardiac arrests, some best practices to avoid this fate include: eating well, exercising regularly, sleeping (can’t stress this one enough), taking care of your mental health, lowering personal stress levels, and seeing your doctor regularly.
Dangerous or not?
As I previously mentioned there is no doubt that firefighting is a dangerous job. I mean we literally run into burning buildings, but when it comes down to brass tacks the actual act of fighting fire is not as dangerous as it is often portrayed. Sure, accidents happen, but if anything I think the real dangers are the ones that lurk in the shadows. The carcinogens, the trauma, the cholesterol, and all the other indirect killers are what hurt most of us, not fire or structural collapse.
So the question remains: Just how dangerous is firefighting really? Like anything else in life, if you do not take the necessary precautions, firefighting is incredibly dangerous. But if you decontaminate your PPE, exercise regularly, get some sleep, slow down, see a shrink, and keep your head on a swivel, firefighting is a lot less dangerous. So put down the bacon cheeseburger and go wash your gear because when it comes to things like cancer, suicide, and heart disease, we are the only ones that can save ourselves.
Bio
Kevin Freier is a 28-year-old firefighter/EMT that works full time at Albemarle County Fire Rescue in Albemarle County, Virginia. He is also a member of the Barboursville Volunteer Fire Company in Barboursville, Virginia. He has been a firefighter/EMT for roughly four years now and is currently working on obtaining his Paramedic certification. Alongside riding an ambulance and engine, Kevin is also a member of Albemarle’s Hazmat team and Peer Support Group.
He received a BA from the University of Dayton in Dayton, Ohio in 2017. Here he studied Political Science with an emphasis in Eastern European studies.
Outside of fire rescue Kevin is a passionate reader and writer. He has been writing for pleasure for nearly a decade now and has several pieces of published work. When he isn’t too busy writing articles and or studying cardiac rhythms, Kevin enjoys working on his novel. A somewhat autobiographical account of life as a rookie firefighter. He lives in Barboursville, Virginia with his cat, Sweet Pea.
