Health and Safety Guidelines for Firefighter Training

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Health and Safety Guidelines for Firefighter
Training
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OVERVIEW

• Introduction/Scope of Problem
• Project Goals
• Research Design and Execution
• Health and Safety Guidelines

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FIREFIGHTER FATALITIES

• ?
• year number
• 2005 99
• 2004 108
• 2003 111
• 2002 100
• 2001 106
• 2000 105
• 1999 113
• 1998 93

(Plus 343 on 9/11)
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TRAINING FATALITIES

• ?
• year number
• 2005 14
• 2004 13
• 2003 12
• 2002 11
• 2001 14
• 2000 13
• 1999 3
• 1998 12

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FIREFIGHTER FATALITIES Type of Duty-2005
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SUDDEN CARDIAC DEATH1995-2004
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LEADING TYPES of TRAINING ACTIVITIES ASSOCIATED
with FATALITIES (1990-2000)
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• Physical Fitness
• Equipment/Apparatus Drill
• Live Fire
• Underwater/Dive
• SCBA
• Class/Seminar
• Driver Training
• Enroute/Returning

25.9
17.2
8.6
6.9
5.2
3.4
1.7
0 5 10 15 20 25 30
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Source USFA 2002
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TRAINING INJURIES-2003

• Category Burns Smoke Other Burns Smoke
  Wound, Cut Subtotal
• Inhalation Respiratory Inhalation
  Bleeding, Bruise
• N 330 25 85 35 1185 1660
• 4.7 0.4 1.2 0.5 16.7 23.0
• Category Dislocation, Heart Attack Strain,
  Thermal Stress Other Total
• Fracture or Stroke Sprain
• N 340 70 4130 325 575 7,100
• 4.8 1.0 58.2 4.6 8.1 100

NFPA 2004
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PHYSICAL DEMANDS OF FIREFIGHTING

• Cardiac Failure
• Thermal Stress
• Inhalation of Contaminants
• Disorientation and Panic

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CARDIAC FAILURE

• Most likely cause of firefighter fatalities is
  cardiac arrest
• Severe exertion stresses the heart and requires
  it to deliver more blood to working muscles

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PROJECT GOALS

• Provide a tool to assist the fire service on a
  national level with reducing the number and
  seriousness of training-related injuries and
  deaths
• Develop standardized guidelines for health
  management of firefighters during training
  activities

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CENTER for FIREFIGHTER SAFETY RESEARCH and
DEVELOPMENT PARTNERSHIP

• Maryland Fire and Rescue Institute
• Fire Protection Engineering Department
• Small Smart Systems Center
• VivoMetrics Government Services
• Project funded by Assistance to Firefighters
  Grant Program by DHS

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THE LIFESHIRT SYSTEM

• Ambulatory Monitoring
• Objective Physiologic Data
• Peripheral Diagnostic Devices

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THE LIFESHIRT SYSTEM
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VivoMetrics LifeShirt DATA

• Pulmonary Function
• Respiratory rate
• Tidal Volume
• Minute Ventilation
• Electrocardiogram (ECG)
• Accelerometer
• Blood Oxygen Saturation
• Skin Surface Temperature
• Core Body Temperature

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RESEARCH PROTOCOL

• Harvard Step Test
• Training Evolutions
• Maze
• First Floor Burn
• Third Floor Burn
• RIT
• Obtained data from actual firefighting activity

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HARVARD STEP TEST

• Validated test to estimate aerobic capacity based
  on fitness index
• Subjects step to a 30-step cadence on and off a
  20 cm box for five minutes

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MAZE EVOLUTION

• Three story obstacle course
• Participants in full PPE and SCBA
• Traverse at own pace

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BURN EVOLUTIONS

• First Floor
• Third Floor
• RIT Team

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INSTRUMENTATION

• Temperature Sensors
• Average ceiling temperature of 725 F
• Range of temperature from 714 F to 1,285 F
• Temperature above 930 F not recommended

o
o
o
o
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THE PARTICIPANTS

• Over 200 firefighters

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AGE AND MORPHOMETRY
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GENERAL FINDINGS

• Maze and Burn Evolutions
• Fitness Level
• Hydration Status

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FITNESS LEVEL vs PERFORMANCE

• Lower heart rates and levels of minute
  ventilation, breathing frequency and inspired and
  expired air flow were observed in the most fit
  individuals compared to all other fitness groups.

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HYDRATION vs PERFORMACE

• The most hydrated participants had a
  significantly lower relative heart rate response
  compared to all other hydration groups.

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BURN ROOM TEMPERATURES
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TURNOUT GEAR PERFORMANCE
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DECISION TREE

• Based on multiple regression analysis and
  derivitive equations
• Serve to predict the range of values expected
  based on age and fitness level

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GUIDELINES
INSTRUCTORS

• Instructors are expected to comply with the
  standards in NFPA 1041, Fire Service
• Instructor Professional Qualifications (2002)

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GUIDELINES
TRAINING FACILITIES

• Facilities used for live fire training are
  expected to comply with NFPA 1403, Standard on
  Live Fire Training Evolutions
• (2002)

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GUIDELINES
SAFETY PLAN

• Before the beginning of any training evolution,
  and especially for live fire training
• evolutions, a safety plan must be developed.

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GUIDELINES
PPE

• Full personal protective equipment will be
  available and required for all students
• participating in practical training evolutions.

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GUIDELINES
SAFETY OFFICER

• During any live fire training evolutions
  qualified, experienced safety officer will be
  appointed and must remain through the duration of
  the evolutions.

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GUIDELINES
ENVIRONMENTAL CONDITIONS

• Training facilities and instructors should
  monitor weather conditions and adjust or cancel
  related activities as conditions warrant.

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GUIDELINES
MEDICAL EVALUATION

• Medical evaluations in accordance with NFPA
  1582, Comprehensive Occupational Medical Program
  for Fire Departments (2003) should be conducted
  as a baseline for surveillance and annually
  thereafter on all individuals engaged in
  firefighter emergency functions.

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NFPA Study of United States Fire Service (2001)

• 73 percent of firefighters worked in fire
  departments that did not have a program to
  maintain basic firefighter fitness and health as
  required in NFPA 1500
• In rural communities, (population under 2,500),
  88 percent of firefighters did not have a
  firefighter fitness and health program

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U.S. Firefighter Fatalities Due to Sudden Cardiac
Death, 1995-2004 (NFPA 2005)

• During the study there were 1,006 on-duty
  firefighter fatalities of which 440 (43.7) fell
  into the category of sudden cardiac death.
• Autopsies or post mortem information was reported
  for 308 of the 440 victims of sudden cardiac
  death
• Of the 308 firefighters, 134 (43.5) had prior
  known heart-related conditions. These included
  previous heart attack, bypass surgery or
  angioplasty/stent placement
• An additional 97 firefighters had atherosclerotic
  heart disease defined as arterial occlusion of at
  least 50 percent

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GUIDELINES
MEDICAL SCREENING

• The seven question PAR-Q should be used by fire
  training academies as a means to
• screen students prior to participation in
  firefighter emergency training evolutions.

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PAR-Q YOU
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GUIDELINES
FITNESS EVALUATION

• Fitness evaluations in accordance with NFPA
  1582, Comprehensive Occupational Medical Program
  for Fire Departments (2003) should be conducted
  as a baseline for surveillance and annually
  thereafter on all individuals engaged in
  firefighter emergency functions.

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GUIDELINES
FITNESS SCREENING

• Fire training academies should conduct a
  two-fold fitness screening on all individuals
  prior to participation in firefighter emergency
  training.

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BODY MASS INDEX

• BMI Weight (lb)/height (in)2
• 703
• BMI Weight Status
• Below 18.5 Underweight
• 18.5 24.9 Normal
• 25.0 29.9 Overweight
• 30.0 and Above Obese

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FITNESS INDEX

• Harvard Step Test
• FI (100 test duration in seconds)/(2 THB
  in recovery)
• Fitness Level Fitness Index
• Excellent gt90
• Good   80-89
• High Average      65-79
• Low Average       55-64
• Poor  lt 55

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GUIDELINES
HYDRATION

• The training academy should provide instructions
  to participants to and during firefighter
  emergency training to encourage proper hydration

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GUIDELINES
MEDICAL MONITORING

• Training academies should adhere to NFPA 1584,
  Recommended Practice on the Rehabilitation of
  Members Operating at Incident Scene Operations
  and Training Exercises.

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GUIDELINES
FUEL LOAD AND EXPOSURE

• In all cases, only fuels with known burning
  characteristics that are controllable are to be
  used and only in quantities needed to create the
  desired fire size.

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Call to Action

• Our duty now is to learn from the effort, but
  most importantly to implement the recommended
  firefighter training guidelines in each and every
  fire department throughout the United States.

Thank you for your participation!
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