NIOSH Top 5 Causes of Firefighter Deaths: How to Prevent Them

Firefighting is a dangerous profession that requires courage, skill, and dedication. However, it also exposes firefighters to various hazards that can result in injuries or fatalities. According to the National Fire Protection Association (NFPA), 48 firefighters died in the line of duty in the United States in 2019. The causes and nature of these deaths vary, but some common factors can be identified and addressed to reduce the risk of future tragedies.

The National Institute for Occupational Safety and Health (NIOSH) has conducted investigations into firefighter fatalities and identified five key situations that contribute to most of them. These are:

  • Improper risk assessment
  • Lack of incident command
  • Lack of accountability
  • Inadequate communications
  • Lack of standard operating procedures or failure to follow established SOPs

These five factors, known as the NIOSH 5, repeatedly appear in the line-of-duty death (LODD) reports as the main contributing factors. In this article, we will discuss each of these factors and provide some recommendations on how to prevent them from causing firefighter deaths.

Improper Risk Assessment

Risk assessment is the process of evaluating the potential hazards and consequences of a fire incident and determining the appropriate actions to take. It involves gathering information, analyzing the situation, and making decisions based on the available resources and objectives. Risk assessment is not a one-time event, but a continuous process that requires constant monitoring and adjustment as the conditions change.

Improper risk assessment can lead to poor decisions, such as entering a building that is unstable or has signs of imminent collapse, engaging in offensive operations when defensive tactics are more suitable, or failing to recognize signs of flashover or backdraft. These decisions can expose firefighters to unnecessary dangers and result in injuries or deaths.

To prevent improper risk assessment, firefighters should:

  • Conduct a thorough size-up of the incident, including a full 360-degree walk-around of the building, if possible, or obtain an “eyes-on” report from another crew if not.
  • Use thermal imaging cameras (TICs) to identify hot spots, hidden fires, or potential victims.
  • Communicate with other firefighters, incident commanders, and witnesses to obtain relevant information and share situational awareness.
  • Be aware of their own limitations and capabilities, as well as those of their equipment and resources.
  • Be prepared to withdraw or change tactics if the situation becomes too dangerous or unpredictable.

Lack of Incident Command

Incident command is the system of organizing and managing an emergency response operation. It involves establishing a clear chain of command, assigning roles and responsibilities, setting objectives and strategies, coordinating resources and communications, and ensuring accountability and safety. Incident command is essential for ensuring an effective and efficient response that achieves the desired outcomes while minimizing risks.

Lack of incident command can lead to confusion, chaos, and conflict among firefighters, as well as duplication or omission of tasks, misallocation or waste of resources, loss of control or coordination, and increased exposure to hazards. Lack of incident command can occur when no one assumes or maintains command, when multiple or conflicting commands are given, when command is transferred without proper notification or briefing, or when command is overwhelmed or ineffective.

To prevent lack of incident command, firefighters should:

  • Follow the principles and practices of the Incident Command System (ICS), which is a standardized framework for managing emergency incidents that provides common terminology, structure, roles, functions, and procedures.
  • Establish command as soon as possible upon arrival at the scene and announce it clearly over the radio.
  • Maintain command until the incident is resolved or transferred to another qualified person.
  • Transfer command only when necessary and follow the proper protocol for doing so.
  • Use clear and concise communications that follow the standard radio etiquette and avoid jargon or slang.
  • Provide regular updates and feedback to subordinates and superiors.
  • Seek assistance or support from other agencies or units when needed.
  • Delegate tasks and authority appropriately and avoid micromanaging or overloading.
  • Monitor the progress and status of the incident and adjust plans and actions accordingly.

Lack of Accountability

Accountability is the process of keeping track of the location, assignment, and condition of all personnel involved in an emergency response operation. It involves identifying who is on scene, what they are doing, where they are located, how long they have been working, and how they are doing physically and mentally. Accountability is crucial for ensuring firefighter safety, as well as facilitating effective resource management, communication, coordination, and incident command.

Lack of accountability can lead to firefighters becoming lost, trapped, injured, or killed, as well as missing or delayed rescue opportunities, inefficient or ineffective operations, and increased liability and litigation. Lack of accountability can occur when firefighters fail to report their arrival, assignment, location, or status, when accountability systems are not implemented or followed, when personnel tags or devices are not used or updated, or when personnel accountability reports (PARs) are not conducted or verified.

To prevent lack of accountability, firefighters should:

  • Use a reliable and consistent accountability system that is compatible with the ICS and the local policies and procedures.
  • Wear or carry identification tags or devices that indicate their name, rank, unit, and assignment.
  • Report their arrival, assignment, location, and status to the incident commander or their supervisor at regular intervals or whenever they change.
  • Maintain crew integrity and avoid freelancing or wandering off.
  • Request and receive permission before entering or exiting a hazard zone.
  • Conduct PARs at predetermined times or events, such as every 10 minutes, after a change in strategy, after a mayday call, or after an evacuation signal.
  • Acknowledge and confirm PARs and report any missing or unaccounted for personnel.
  • Use the buddy system and look out for each other.

Inadequate Communications

Communications is the process of exchanging information and instructions among firefighters, incident commanders, dispatchers, and other emergency responders. It involves using verbal and non-verbal methods, such as radios, phones, hand signals, whistles, horns, or sirens. Communications is vital for ensuring firefighter safety, as well as achieving situational awareness, coordination, cooperation, and command.

Inadequate communications can lead to firefighters becoming isolated, misinformed, misunderstood, or ignored, as well as missing or conflicting orders, delayed or incorrect actions, duplication or omission of tasks, loss of control or coordination, and increased exposure to hazards. Inadequate communications can occur when radios are not available, functional, compatible, or monitored, when radio traffic is too high or low, when messages are not clear, concise, complete, or confirmed, when background noise or interference is too loud or distracting, or when communication protocols or etiquette are not followed.

To prevent inadequate communications, firefighters should:

  • Use radios that are compatible with the local frequency plan and have sufficient battery life and volume.
  • Carry a spare radio battery and a personal alert safety system (PASS) device.
  • Monitor the radio at all times and acknowledge all messages directed to them.
  • Use clear and concise language that follows the standard format of who you are calling, who you are, what you want to say, and over.
  • Avoid using jargon, slang, codes, abbreviations, or acronyms that may not be understood by others.
  • Repeat back or paraphrase any orders or instructions to confirm understanding and agreement.
  • Ask for clarification or confirmation if unsure or unclear about any message.
  • Use plain English and avoid using 10-codes or signals that may vary by jurisdiction or agency.
  • Use the emergency traffic or mayday channel only for urgent or life-threatening situations and follow the proper protocol for doing so.
  • Use non-verbal methods of communication as backup or supplement to radios when necessary.

Lack of Standard Operating Procedures or Failure to Follow Established SOPs

Standard operating procedures (SOPs) are written guidelines that describe the expected actions and behaviors of firefighters in various situations. They provide a common framework for performing tasks safely and efficiently. They also reflect the best practices and lessons learned from previous incidents and training. SOPs are developed by fire departments based on their needs, resources, capabilities, and objectives.

Lack of SOPs or failure to follow established SOPs can lead to firefighters acting inconsistently, ineffectively, or unsafely, as well as violating policies, laws, or regulations, increasing liability and litigation, and compromising performance and reputation. Lack of SOPs or failure to follow established SOPs can occur when SOPs are not available, accessible, updated, or enforced, when firefighters are not aware, trained, or proficient in SOPs, when firefighters disregard, deviate, or improvise from SOPs, or when firefighters are influenced by peer pressure, groupthink, or complacency.

To prevent lack of SOPs or failure to follow established SOPs, firefighters should:

  • Have access to current and relevant SOPs that cover all aspects of fire department operations and activities.
  • Read and review SOPs regularly and keep them handy for reference.
  • Participate in developing and revising SOPs based on feedback and experience.
  • Follow SOPs strictly and consistently unless there is a valid reason to deviate from them.
  • Seek approval or justification for any deviation from SOPs and document it accordingly.
  • Train and drill on SOPs frequently and
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