NFPA Journal

REPORT SUMMARY
U.S. Firefighter Injuries in 2009
In 2009, firefighter injuries in the line of duty decreased
by 1.9 percent from the year before.

NFPA Journal®, November/December 2010 

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

 Download the full "U.S. Firefighter Injuries - 2009" report (PDF, 128 KB)
 Read the 2009 Firefighter Injury Narratives

Based on survey data reported by fire departments, NFPA estimates that 78,150 firefighter injuries occurred in the line of duty in 2009. This is a decrease of 1.9 percent from the year before. In recent years, the number of firefighter injuries has been considerably lower than it was in the 1980s and 1990s, but this is due in part to additional survey questions about exposures that allow us to place them in their own categories. Previously, some of these exposures might have been included in total injuries under other categories.

Download the full "U.S. Firefighter Injuries - 2009" report (PDF, 128 KB)  2009 Firefighter Injury Narratives RELATED NFPA REPORTS  Firefighter Injuries for 2008  Firefighter Injuries for 2007  Firefighter Injuries for 2004  (PDF, 332 KB) FIREFIGHTER INJURIES BY THE NUMBERS - 2009 78,150 firefighter injuries occurred in the line of duty in 2009, a decrease of 1.9 percent from the year before. 32,205, or 41.2 percent, of all firefighter injuries occurred during fireground operations. An estimated 15,455 occurred at nonfire emergencies, while 17,590 occurred during other on-duty activities. The Northeast reported a higher number of fireground injuries per 100 fires than other regions of the United States. The major types of injuries received during fireground operations were strains, sprains, and muscular pain, responsible for 48.2 percent; wounds, cuts, bleeding, and bruises, responsible for 13.2 percent; and smoke or gas inhalation, responsible for 6.2 percent. Strains, sprains, and muscular pain accounted for 58.9 percent of all nonfireground firefighter injuries. The leading causes of fireground injuries were overexertion and strains, responsible for 25.2 percent, and falls, slips, and jumps, responsible for 22.7 percent.

NFPA also estimates that there were 11,900 exposures to infectious diseases such as hepatitis, meningitis, and HIV in 2009. This amounts to 0.7 exposures per 1,000 emergency medical runs by fire departments in 2009.

In 2009, NFPA estimates that there were 23,000 exposures to hazardous conditions such as asbestos, radioactive materials, chemicals, and fumes. This amounts to 22.5 exposures per 1,000 hazardous condition runs.

An estimated 15,150 injuries, or 19.4 percent of all firefighter injuries, resulted in time lost from work in 2009.

These are some of the key findings in the U.S. Firefighter Injuries in 2009 report. Each year, using data collected during our annual Survey of Fire Departments for U.S. Fire Experience, NFPA studies firefighter injuries to provide national statistics on their frequency, extent, and characteristics. This year’s firefighter injury report includes an estimate of the total number of firefighter injuries in 2009, estimates of the number of injuries by type of duty, and an estimate of the number of exposures to infectious diseases. It also covers trends in firefighter injuries and rates, fireground injuries by cause, fire department vehicle accidents and resulting firefighter injuries, the average number of fires and fireground injuries per department by population of community protected, and descriptions of selected incidents that illustrate firefighter safety problems. In our 2009 Firefighter Fatality Report, which appeared in the July/August issue of NFPA Journal®, we reported that 82 firefighters died on duty in the United States in 2009.
 
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, non-fatal injuries, and illnesses occur can help identify corrective actions that could help minimize the inherent risks.

Injuries by type of duty
Type of duty is divided into five categories: responding to, or returning from, an incident, including fires and nonfire emergencies; participating in fireground operations, including structure fires, vehicle fires, and brush fires, from the moment of arrival at the scene to departure time, including setup, extinguishment, and overhaul; operating at nonfire emergencies, including rescue calls, hazardous materials calls such as spills, and natural disasters; training; and participating in other on-duty activities such as inspection or maintenance.

Not surprisingly, results by type of duty indicate that the largest share of injuries occurs during fireground operations. In 2009, 32,205, or 41.2 percent, of all firefighter injuries occurred during fireground operations. That number is the lowest recorded during the 1981-to-2009 period and represents a 53.3 percent drop in fireground operations injuries since 1981, which saw a high of 67,500 over that same period. The number of fires also declined steadily during that period, for an overall decrease of 52.3 percent. The rate of injuries per 1000 fires has not shown any consistent trend up or down for the period. These results suggest that even though the number of fires and fireground injuries declined similarly during the period, the injury rate did not, and when there is a fire, the fireground injury rate risk has not changed much for the period.

Overall for the 1981-to-2009 period, the number of injuries at nonfire emergencies increased from 9,600 in 1981 to 15,320 in 2009, for an overall increase of 66 percent. For the same period, the number of nonfire emergencies increased a substantial 220 percent, due in large part to an increase in the number of medical aid incidents. The injury rate per 1,000 nonfire emergencies declined during the period, from 1.24 in 1981 to 0.62 in 2009, because the number of nonfire emergencies increased at a higher rate than did the number of injuries at nonfire emergencies.

Nature and cause of fireground injuries
Estimates of 2009 firefighter injuries by nature of injury and type of duty indicate that the major types of injuries that occur during fireground operations are strains and sprains, which were responsible for 48.2 percent; wounds, cuts, bleeding, and bruises, responsible for 13.2 percent; smoke or gas inhalation, responsible for 6.2 percent; burns, 7.1 percent; and thermal stress, responsible for 5.8 percent.

Results were fairly consistent during all nonfireground activities, with strains, sprains, and muscular pain accounting for 58.9 percent of all nonfireground injuries, and wounds, cuts, bleeding, and bruises accounting for 16.2 percent.

“Cause” here refers to the initial circumstance leading to the fireground injury. The leading causes of fireground injuries were overexertion and strains, which were responsible for 25.2 percent, and falls, jumps, slips, which were responsible for 22.7 percent. Other major causes were contact with object, responsible for 11.4 percent, and exposure to fire products, responsible for 12.9 percent.

Vehicle collisions
In our firefighter fatality report, we noted that 14 firefighters died in motor vehicle collisions in 2009. Last year, an estimated 15,100 collisions involved fire department emergency vehicles responding to, or returning from, incidents. To put this number in perspective, fire departments responded to more than 26.2 million incidents in 2009, meaning that the number of collisions represents about one-tenth of 1 percent of total responses. However, these collisions resulted in 820 firefighter injuries, or 1 percent of all injuries.

In addition, there were 870 collisions involving firefighters’ personal vehicles responding to, or returning from, incidents in 2009. These collisions resulted in an estimated 100 injuries.

Fireground injuries per department by population and region
We also examined the average number of fires and fireground injuries er department by population of community protected in 2009. These tabulations show that the number of fires a fire department responds to is directly related to the size of the population protected and that the number of fireground injuries incurred by a department is directly related to its exposure to fire—that is, the number of fires the department attends. The second point is clearly demonstrated when we examine the range of the statistic: they run from an average high of 83.9 fireground injuries 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 to obtain a reading on the relative risk that departments face is to examine the number of fireground injuries that occur for every 100 fires attended. This takes into account relative fire experience and allows more direct comparison between departments protecting communities of different sizes.

The overall range of rates varied from a high of 3.3 for departments that protect communities 250,000 to 499,999 to a low of 1.3 for departments that protect communities of 5,000 to 9,999. Thus, the wide range noted in average fireground injuries by the size of the population protected narrows when relative fire experience is taken into account. The overall injury rate for departments protecting communities with a population of 50,000 or more was 2.7 injuries per 100 fires, or 40 percent higher than the injury rate for departments protecting communities with populations under 50,000.

We also examined the risk of fireground injury per 100 firefighters by size of community protected. Larger departments generally had the highest rates, with departments protecting communities of 250,000 to 499,999 having the highest rate of 7.8 injuries per 100 firefighters. As community size decreases, the rate drops steadily to a low of 0.8 for departments protecting fewer than 2,500 people. That is a more-than-nine-to-one difference in risk of injury between communities of 250,000 to 499,999 and the smallest communities of less than 2,500.

An explanation for this difference is that, although a department protecting a community with a population of 250,000 to 499,999 has, on average, more than 24 times as many firefighters as a department protecting a population of less than 2,500, the larger department attends more than 95 times as many fires and, as a result, incurs considerably more fireground injuries.

An evaluation by region of the country shows that the Northeast reported a higher number of fireground injuries per 100 fires for most community sizes where all departments reported sufficient data.

Improving firefighter safety
As the statistics in this and previous reports 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.

A number of steps can be taken at the local level. Top fire service management must commit to reducing injuries and establish a safety committee headed by a safety officer to recommend a safety policy and the means of implementing it. An investigation procedure that includes all accidents, near misses, injuries, fatalities, occupational illnesses, and exposures involving fire department members should be developed and implemented. Firefighters should be provided with appropriate protective equipment and its use should be mandated, and regular medical examinations and a physical fitness program should be implemented.

A program for the use and maintenance of self-contained breathing apparatus should be developed and enforced, as should policies on safe practices for drivers and passengers of fire apparatus. Procedures should also be developed to ensure that enough personnel respond for both firefighting and overhaul duties. In addition, an incident management system should be adopted and implemented, and all fire department members should be trained and educated for emergency operations.

Programs for the installation of private fire protection systems should be implemented, so that fires are discovered at an earlier stage, exposing firefighters to a less hostile environment. Efforts in the area of fire safety education programs should be increased, so that citizens are made aware of measures to prevent fires and of correct reactions to a fire.

By addressing these priorities, fire service organizations can make significant strides towards reducing the number and impact of firefighter injuries. NFPA standards that apply to these priorities can be seen in the full firefighter injury report, which is available at nfpa.org/firefighterinjuries2009.

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 with a large share of the total population protected. For departments that protect communities with populations under 50,000, stratifying the sample by community size permits greater precision in the estimates. A total of 2,730 departments responded to the 2009 fire experience survey.

The national projections are made by weighting sample results according to the proportion of total U.S. population accounted for by communities of each size. Around any estimate based on a sample survey, there is a confidence interval that measures the statistical certainty or uncertainty of the estimate.

Based on data reported by fire departments responding to the NFPA Survey for U.S. Fire Experience 2009, NFPA is confident that the actual number of firefighter injuries falls within the range of 73,150 to 83,150.

The results in this report 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 sent to departments requesting information. The form included questions about the type of protective equipment worn, the age and rank of firefighters injured, and a description of the circumstances that led to the injury.

Acknowledgements
NFPA would like to thank the many fire departments that responded to the NFPA Survey for U.S. Fire Experience 2009 for their continuing efforts in providing in a timely manner the data so necessary to make national projections of firefighter injuries.

The authors would also like to 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, as well as Norma Candeloro for processing of survey forms and keyed in this report.