Health and Safety Guidelines for Firefighter Training

1. Health and Safety Guidelines for Firefighter Training

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

4. 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)

5. TRAINING FATALITIES  year number 2005 14 2004 13 2003 12 2002 11 2001 14 2000 13 1999 3 1998 12

6. FIREFIGHTER FATALITIES Type of Duty-2005

7. SUDDEN CARDIAC DEATH1995-2004

8. LEADING TYPES of TRAINING ACTIVITIES ASSOCIATED with FATALITIES (1990-2000) Physical Fitness Equipment/Apparatus Drill Live Fire Underwater/Dive SCBA Class/Seminar Driver Training Enroute/Returning 31 25.9 17.2 8.6 6.9 5.2 3.4 1.7 0 5 10 15 20 25 30 35 Source: USFA 2002

9. 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

10. PHYSICAL DEMANDS OF FIREFIGHTING • Cardiac Failure • Thermal Stress • Inhalation of Contaminants • Disorientation and Panic

11. 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

12. 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

13. 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

14. THE LIFESHIRT SYSTEM • Ambulatory Monitoring • Objective Physiologic Data • Peripheral Diagnostic Devices

15. THE LIFESHIRT SYSTEM

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

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

18. 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

19. MAZE EVOLUTION • Three story obstacle course • Participants in full PPE and SCBA • Traverse at own pace

20. BURN EVOLUTIONS • First Floor • Third Floor • RIT Team

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

22. THE PARTICIPANTS • Over 200 firefighters

23. AGE AND MORPHOMETRY

24. GENERAL FINDINGS • Maze and Burn Evolutions • Fitness Level • Hydration Status

25. 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.

26. HYDRATION vs PERFORMACE The most hydrated participants had a significantly lower relative heart rate response compared to all other hydration groups.

27. BURN ROOM TEMPERATURES

28. TURNOUT GEAR PERFORMANCE

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

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

31. GUIDELINES TRAINING FACILITIES Facilities used for live fire training are expected to comply with NFPA 1403, Standard on Live Fire Training Evolutions (2002)

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

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

34. 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.

35. GUIDELINES ENVIRONMENTAL CONDITIONS Training facilities and instructors should monitor weather conditions and adjust or cancel related activities as conditions warrant.

36. 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.

37. 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

38. 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

39. 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.

40. PAR-Q & YOU

41. 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.

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

43. 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

44. FITNESS INDEX Harvard Step Test FI = (100 * test duration in seconds)/(2 * THB in recovery) Fitness Level Fitness Index Excellent >90 Good   80-89 High Average      65-79 Low Average       55-64 Poor  < 55

45. GUIDELINES HYDRATION The training academy should provide instructions to participants to and during firefighter emergency training to encourage proper hydration

46. 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.

47. 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.

48. 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!