NFPA Journal

New Jersey firefighters at the scene of a house fire that was started by a lightning strike. One firefighter and several others were injured. (Photograph: AP/Wide World/Mel Evans)

U.S. Firefighter Injuries in 2010
Last year, 71,875 firefighter injuries occurred in the line of duty

NFPA Journal®, November/December 2011

By Michael J. Karter, Jr. and Joseph L. Molis

 Download the full "U.S Firefighter Injuries - 2010" report (PDF, 128 KB)
 Read the 2010 Firefighter Injury Narratives

Firefighters work in varied and complex environments that increase their risk of on-the-job death and injury. A better understanding of how these fatalities, nonfatal injuries, and illnesses occur can help identify corrective actions that could help minimize the inherent risks. 

Each year, NFPA studies firefighter deaths and injuries in the United States to provide national statistics on their frequency, extent, and characteristics. In the July/August issue of NFPA Journal, we reported that 72 firefighters died on duty last year. This article addresses 2010 firefighter injuries, based on data collected for the NFPA’s Survey of Fire Departments for U.S. Fire Experience (2010).

Among the survey’s results are an estimate of the total number of 2010 firefighter injuries, estimates of the number of injuries by type of duty, and an estimate of the number of exposures to infectious diseases. The survey also collected data on trends in firefighter injuries and rates; fire ground injuries by cause; fire department vehicle accidents and resulting firefighter injuries; the average number of fires and fire ground injuries per department by population of community protected; and descriptions of selected incidents that illustrate firefighter safety problems.

Overall Results
NFPA estimates that 71,875 firefighter injuries occurred in the line of duty in 2010. This is a decrease of 8 percent from 2009 and the lowest it’s been for the 1981–2010 period. In recent years, the number of firefighter injuries have been much lower than they were in the 1980s and 1990s, but this is due in part to additional survey questions on exposures that allow us to place them in their own categories. Some of these exposures may previously have been included in total injuries under other categories.

NFPA estimates that there were 11,200 exposures to infectious diseases, such as hepatitis, meningitis, and HIV, in 2010. This amounts to 0.6 exposures per 1,000 emergency medical runs by fire departments in 2010.

NFPA also estimates that there were 25,700 exposures to hazardous conditions, such as asbestos, radioactive materials, chemicals, and fumes, in 2010. This amounts to 24.2 exposures per 1,000 hazardous condition runs last year.

An estimated 15,000 injuries, or 20.8 percent of all firefighter injuries, resulted in lost time from work in 2010.

Injuries by Type of Duty
Estimates of firefighter injuries by type of duty were examined. As in the past, type of duty is divided into five categories: responding to, or returning from, an incident, including fire and non-fire emergencies; fire ground, including structure fires, vehicle fires, and brush fires, and refering to all activities from the moment of arrival at the scene to departure time, such as setup, extinguishment, and overhaul; non-fire emergencies, which include rescue calls, hazardous calls (such as spills), and natural disaster calls; training; and other on-duty activities, such as inspections or maintenance.

Not surprisingly, the largest share of these injuries occurs during fire ground operations. In 2010, 32,675, or 45.4 percent, of all firefighter injuries occurred during such operations, a slight increase of 1.4 percent from the year before. We also looked at firefighter injuries at the fire ground and injury rates for the 1981–2010 period. Injuries at the fire ground decreased from their high of 67,500 in 1981 to 32,675 in 2010, for a drop of 51.6 percent. The number of fires also declined steadily for an overall decrease of 54 percent. The rate of injuries per 1,000 fires has not shown any consistent trend up or down for the period, which suggests that, even though the number of fires and fire ground injuries declined similarly during the period, the injury rate did not. When there is a fire, the fire ground injury rate risk did not change much for the period.

Overall, the number of injuries at non-fire emergencies for the 1981 to 2010 period increased from 9,600 in 1981 to 13,355 in 2010, for an overall increase of 39 percent. For the same period, the number of non-fire emergencies increased a substantial 247 percent, due in large part to an increase in the number of medical aid incidents. When we examine the injury rate per 1,000 non-fire emergencies during the period, we can see that the rate declined from 1.24 in 1981 to 0.5 in 2010 because the number of non-fire emergencies increased at a higher rate than the number of injuries at non-fire emergencies.

Also in 2010, 4,380 firefighter injuries occurred while responding to, or returning from, an incident; 7,275 occurred during training activities; and 14,190 occurred during other on-duty activities.

Nature and Cause of Fire Ground Injuries
Next, we examined estimates of 2010 firefighter injuries by the nature of the injury and the type of duty. The major types of injuries that occur during fire ground operations were strains and sprains, which accounted for 52.8 percent of the injuries; wounds, cuts, bleeding, and bruises, which accounted for 14.2 percent; thermal stress, which accounted for 7.2 percent; and burns, which accounted for 5.9 percent.

The injuries were fairly consistent during all non-fire ground activities, with strains, sprains, and muscular pain accounting for 59 percent of all non-fire ground injuries, and wounds, cuts, bleeding, and bruises accounting for 16.5 percent.

Because fire ground injuries are of particular concern, we examined their causes. The definition of cause here refers to the initial circumstance that led to the injury. Overexertion and strains, which accounted for 25.7 percent of the injuries, and falls, jumps, and slips, which accounted for 22.5 percent, were the leading causes of fire ground injuries. Other major causes were contact with an object, accounting for 12.4 percent, and exposure to fire products, accounting for 9 percent.

Fire Department Vehicle Collisions
In 2010, there were an estimated 14,200 collisions involving fire department emergency vehicles responding to, or returning from, incidents. To put this number in perspective, fire departments responded to more than 28.2 million incidents last year, so the number of collisions represents about one-tenth of 1 percent of the total number of responses. However, these collisions resulted in 775 firefighter injuries or 1 percent of all firefighter injuries.

In addition, there were 1,000 collisions involving firefighters’ personal vehicles while driving to, or returning from, incidents in 2010. These collisions resulted in an estimated 75 injuries.

Average Fires and Fire Ground Injuries per Department by Population Protected
The average number of fires and fire ground injuries per department by the size of the population of community protected in 2010 were examined. These tabulations show that the number of fires a fire department responds to is directly related to the size of the population it protects and that the number of fire ground injuries incurred by a department is directly related to its exposure to fire — that is, by the number of fires the department attends. The second point is clearly demonstrated when we examine the range of the statistic, which runs from a high of 81 for departments that protect communities of 500,000 to 999,999 to a low of 0.2 for departments that protect communities of less than 2,500.

A useful way to look at firefighter injury experience and obtain a reading on the relative risk that departments face is to examine the number of fire ground injuries that occur for every 100 fires they attend. This takes into account relative fire experience and allows more direct comparison among departments protecting communities of different sizes. When we examined the number of fire ground injuries per 100 fires, we found that the overall range of rates varied less, from a high of 3.1 for departments that protect communities of 500,000 to 999,999 to a low of 1.4 for those that protect communities of 2,500 to 4,999. Thus, the wide range noted in average fire ground injuries by population protected narrows when relative fire experience is taken into account. The overall injury rate for departments protecting communities of 50,000 or more was 2.3 injuries per 100 fires, which is 44 percent higher than the injury rate for departments protecting communities of less than 50,000.

The risk of fire ground injury per 100 firefighters by size of community protected was also calculated and examined. Larger departments generally had the highest rates with departments protecting communities of 500,000 to 999,999 having the highest rate with 7.2 injuries per 100 firefighters. As community size decreases, the rate drops quite steadily to a low of 0.9 for departments protecting less than 2,500 people. That is a more than an eight-to-one difference in risk of injury between communities of 500,000 to 999,999 and the smallest communities (less than 2,500).

An explanation for this difference is that, although a department protecting a community with a population of 500,000 to 999,999 has on average more than 55 times as many firefighters than a department protecting a population of less than 2,500, the larger department attends more than 240 times as many fires. As a result, it incurs considerably more fire ground injuries.
 
Average Fires and Fire Ground Injuries by Population Protected and Region
When we further examined the average number of fires and fire ground injuries per department by the population of community it protects and the region of the country in which it is located, we found that, for each region of the country, the number of fires a fire department responds to is directly related to the size of the population it protects and that the number of fire ground injuries the department incurs is directly related to the number of fires it attends. The Northeast reported a higher number of fire ground injuries per 100 fires for most community sizes where all departments reported sufficient data.

Improving Firefighter Safety
As these statistics attest, firefighting presents great risks of personal injury to firefighters. Moreover, because of the kind of work performed and the hazards of the incident scene environment, it is unlikely that all firefighter injuries can be eliminated. However, a risk management system and the application of existing technology can offer options to reduce current injury levels.

Top fire service management should commit to reducing injuries, in part by following the requirements presented in Section 4.3 of NFPA 1500, Fire Department Occupational Safety and Health Program, and establish a safety committee headed by a safety officer to recommend a policy and the means of implementing it, based on requirements in Section 4.5 of NFPA 1500.

Fire service management should also develop and implement an investigation procedure that includes all accidents, near misses, injuries, fatalities, occupational illnesses, and exposures involving members. Information to help set up such procedures can be found in Sections 4.4.4 and 4.4.5 of NFPA 1500.

Injuries can also be reduced by providing and mandating the use of appropriate protective equipment, which is detailed in Sections 7.1 through 7.8 of NFPA 1500, and by developing and enforcing a program on the use and maintenance of SCBA, detailed in Sections 7.9 through 7.14 of NFPA 1500. Developing and enforcing policies on safe practices for the drivers and passengers of fire apparatus will also help reduce injuries. Sections 6.2 and 6.3 of NFPA 1500 provide the needed information.

Procedures to ensure response of sufficient personnel for both firefighting and overhaul duties can be developed using Section 4.1.2 of NFPA 1500; NFPA 1710, Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Career Fire Departments; and NFPA 1720, Organization and Deployment of Fire Suppression Operations, Emergency Medical Operations, and Special Operations to the Public by Volunteer Fire Departments.

Information on implementing regular medical examinations and a physical fitness program can be found in Sections 10.1 through 10.3 of NFPA 1500; NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments; and NFPA 1583, Standard on Health-Related Fitness Programs for Fire Department Members.

Requirements for adopting and implementing an incident management system can also be found in NFPA 1500, Section 8.1, and in NFPA 1561, Emergency Services Incident Management System, while information on training and education for all members related to emergency operations can be found in Chapter 5 of NFPA 1500.

For information on implementing installation programs for private fire protection systems, so that fires are discovered at an earlier stage, exposing the firefighter to a less hostile environment, consult NFPA 1, Fire Code; NFPA 101, Life Safety Code®; and NFPA 5000, Building Construction and Safety Code®. To increase efforts in the area of fire safety education programs in order to make citizens aware of measures they can take to prevent fires and correct their reactions to a fire, consult Chapter 6 of NFPA 1201, Providing Fire and Emergency Services to the Public.

Other NFPA standards that may help in reducing firefighter injuries include the 2008 edition of  NFPA 1584, The Rehabilitation Process for Members During Emergency Operations and Training Exercises, particularly Chapter 4, “Preparedness,” and Chapter 6, “Incident Scene and Training Rehabilitation”; the 2009 edition of NFPA 1002, Fire Apparatus Driver/Operator Professional Qualifications, particularly Section 4.8, “The Risk Management Process”; and NFPA 1620, Pre-Incident Planning, particularly Chapter 4, “Pre-Incident Planning Process,” Chapter 5, “Physical and Site Considerations,” Chapter 7, “Water Supplies and Fire Protection Systems,” and Chapter 8, “Special Hazards.”

Firefighter injuries can be reduced, but it will require effort. By addressing these priorities, fire service organizations can make significant strides towards reducing the number and impact of such injuries.
 
Description of NFPA Survey and Data Collection Method
NFPA annually surveys a sample of departments in the United States to make national projections of the fire problem. The sample is stratified by the size of the community the fire department protects. All U.S. fire departments that protect communities of 50,000 or more are included in the sample because they constitute a small number of departments that protect a large share of the total population. For departments that protect less than 50,000, stratifying the sample by community size permits greater precision in the estimates. A total of 2,650 departments responded to our 2010 fire experience survey.

We make the national projections by weighting the sample results according to the proportion of the total U.S. population accounted for by communities of each size. There is a “confidence interval” around any estimate based on a sample survey that measures the statistical certainty or uncertainty of the estimate. We are very confident that the actual number of total firefighter injuries falls within 5 percent of the estimate.

Our results are based on injuries that occurred during incidents attended by public fire departments. No adjustments were made for injuries that occurred during fires attended solely by private fire brigades, such as those at industrial or military installations.

Data collection for the selected incident summaries was enhanced by a form we sent to departments requesting information. The form included questions about the type of protective equipment worn, the ages and ranks of the firefighters injured, and a description of the circumstances that led to the injury.

Acknowledgments
NFPA thanks all the fire departments and state fire authorities that participate in the National Fire Incident Reporting System (NFIRS) and the annual NFPA fire experience survey. These firefighters are the original sources of the detailed data that make this analysis possible. Their contributions allow us to estimate the size of the fire problem. We are also grateful to the U.S. Fire Administration for its work in developing, coordinating, and maintaining NFIRS.

The authors thank the many NFPA staff members who worked on this year’s survey, including Frank Deely, John Baldi, and John Conlon for editing and keying the survey forms and their follow-up calls to fire departments, and Norma Candeloro for processing survey forms and typing this report.

Michael J. Karter, Jr., is senior statistician with NFPA’s Fire Analysis and Research Division. Joseph L. Molis is a fire data assistant and a lieutenant with the Providence, Rhode Island, Fire Department.