The memorial plaque to honor fallen heroes of the U.S. fire service for 2019 has yet to be unveiled at the National Fallen Firefighters Memorial in Emmitsburg, Maryland. COVID-19 forced the cancellation of the annual memorial weekend that normally occurs in October.
But if you were to imagine the bronze plaque, mounted on the circular wall surrounding the monument and eternal flame, you might take notice that there would be fewer names on it than in years past – a remarkable trend worthy of further discussion, and one we’ll explore here.
But how will COVID-19 impact the 2020 numbers? Is the downward trend all but erased? There are several factors to consider.
Counting COVID-19 deaths
COVID-19 has rocked the first responder community, with more than 100 fire and EMS personnel falling victim to the virus – and there will likely be more fatalities before the end of the year. This is in addition to the illness and disruption that many firefighters and their families have faced.
The total number of fire and EMS personnel deaths reported as of this date has surpassed the number of fallen firefighters that were to be honored this past October in Emmitsburg – the 2019 fallen. It is anticipated that the 2021 memorial service may have as many as 250 fallen heroes to be honored.
How do we reach these numbers? There are many variables at play. Some are in need of additional documentation, some need Public Safety Officers’ Benefits (PSOB) review, and some are just in the beginning stages of application.
As background, early in the pandemic, the Department of Justice acknowledged that certain COVID-19 deaths would be classified as LODDs, noting that, “Under the current PSOB Act and its implementing regulations, conditions caused by infectious diseases, viruses, and bacteria may be found to be an injury sustained in the line of duty.”
The DOJ update explained that in order to establish eligibility for a public safety officer’s death or disability due to COVID-19, the PSOB Act and regulations require that the evidence show that it is more likely than not that the virus resulted from the first responder’s exposure while performing a line-of-duty activity or action. It pointed out that while some states have laws that presume a public safety officer’s infectious disease resulted from their employment, eliminating the need for evidence of when the transmission of a disease or infection occurred, the PSOB Program has no such presumption.
In August, Congress passed and the president signed legislation that provided a streamlined consideration process for PSOB that has resulted in a clearer path to approval for these deaths.
These unique factors play an important role in tracking LODDs but can also create some confusion. So, let’s break down the statistics and how they are tracked to better understand the impact of COVID-19 LODDs and what that means for tracking fire fatality trends.
3 agencies, 3 LODD tallies
By any measure, line-of-duty deaths (LODDs) in the U.S. fire service have been decreasing. This is confirmed by all three major indices that track such statistics – the National Fallen Firefighters Foundation (NFFF), the NFPA and the U.S. Fire Administration (USFA). Each group uses different criteria when determining an LODD.
NFFF: The NFFF defines an LODD as a firefighter fatality that involves any activity or action which a firefighter is obligated or authorized by statute, rule, regulation, condition of employment or service, official mutual-aid agreement, or other law, or for which he or she is compensated to perform under the auspices of the fire service protection agency he or she serves, and that such agency legally recognizes that the activity or action to have been obligated or authorized at the time performed. Beginning in 2019, the NFFF is recognizing some occupational cancer deaths, while the NFPA and USFA counts do not include such deaths.
NFPA: The NFPA’s defines an LODD as a firefighter fatality that occurs at the scene of an alarm, whether it is a fire or non-fire incident (including EMS calls); responding to or returning from an alarm; participating in other fire department duties; or being on call or standby for assignment at a location other than at the firefighter’s home or place of business.
USFA: For the USFA, an on-duty fatality includes any injury or illness that was sustained while on duty and proves fatal. The term “on duty” refers to being involved in operations at the scene of an emergency, whether it is a fire or non-fire incident, responding to or returning from an incident; performing other officially assigned duties, such as training, maintenance, public education, inspection, investigations, court testimony or fundraising; and being on call, under orders or on standby duty (except at the individual’s home or place of business).
The NFFF reported 82 LODDs in the U.S. fire service in 2019, while the USFA tallied 62. The NFPA, with its more conservative criteria, recorded 48 deaths in 2019.
One of the significant reasons that the numbers differ is that the NFFF includes cancer deaths, as well as 9/11-related illness deaths as LODDs. Additionally, the NFFF and the USFA recognize federal and military firefighters while the NFPA does not.
In 2021, the NFFF will also record the deaths of fire service members from COVID-19 resulting from incidents in 2020. Those members will be honored with the other 2020 LODDs at the NFFF’s annual memorial weekend in October 2021.
And then, there are those deaths considered to be “traditional” or “legacy” LODDs, the ones the public most commonly associates with the death of a firefighter on the job. It is in this area where improvement has been noticeable in recent years – the area that accounts for the downward trend.
‘Legacy’ LODDs on the decline
Pre-COVID-19, all three organizations’ numbers show a decline in fire service LODDs in 2019, continuing a mostly downward trend seen in recent years. So, what’s happening here?
“Let me start with the obvious: Firefighting is a dangerous endeavor,” says Pittsburgh Bureau of Fire Chief Darryl Jones. “There has been great debate over the past several years between those who advocate safety and those who advocate mission and purpose. One side was saying be safe at all costs, and the other was saying forget safety, full speed ahead, our job is to assume all risks. I disagree with both sides.”
Jones says that when we review how and where firefighters are being killed and injured, the majority of LODDs do not occur on the fireground: “We are not being killed by thermal injuries, structural collapse or the by-products of combustion. In order to reduce our risks we must identify and understand the risks we face. This comes through classical research and formal education.”
Certainly, it’s widely accepted across the U.S. fire service that training at the department, company and individual level plays a significant role in the reduction of injuries and LODDs. We learn from our tragedies and our mistakes. Firefighters today are confronted with increasing challenges on the job thanks to evolving technology, construction techniques, the fire load that we put into buildings and other concerns. Training itself is evolving as well, with new approaches designed to keep members ahead of the curve. It employs the same focus on new technology and thought.
Chief Jones cites an example: “Research conducted by NIST and UL among others develop theories such as flow path. Placing the theories developed through research and formal education into practice is done through development of courses that are delivered at the local level. Practicing research-based strategies and tactics is what I believe is reducing the number of LODDs today.”
In addition to practical training, however, one has to acknowledge that, along with the evolution of physical things, there has also been an evolution in thinking in the fire service, both corporately and individually, that is helping to reduce line-of-duty injuries and fatalities. Risk management and the risk/benefit ratio of every fireground action is on the minds of firefighters today.
In 2004, the NFFF hosted a meeting of some of America’s greatest fire service leaders who came together with a singular goal to reduce preventable LODDs. Today, that commitment is beginning to be realized in concrete measurable ways.
“By any objective measure, fewer firefighters are dying today than were dying in 2004 as a result of the singular focus on taking action to prevent deaths through leadership, accountability and action,” says Harrisonburg (Virginia) Fire Chief Matthew Tobia
Perhaps the area of greatest challenge remains in reducing the percentage of firefighter deaths due to cardiac-related events. As a segment of the whole, these deaths remain a significant issue. However, progress is being made.
“While overall LODD numbers are dropping, we still see about one-third of our firefighter LODDs related to cardiovascular related concerns,” says FireRescue1 Executive Editor and Highlands County (Florida) Fire Chief Marc Bashoor, also the former chief of the Prince Georges County (Maryland) Fire Department. “It’s maddening to me that we can directly and indirectly control 1/3 of our deaths, but many within our ranks fail to take diet and fitness seriously.”
Bashoor adds: “National programs, which we implemented in Prince George’s County, for peer fitness programs and adoption of the candidate physical ability test (CPAT), help to build our mentor programs, collective consciousness and establish baselines to build on.”
Bashoor says the focus on strength and conditioning should be more about overall strength rather than size. “Not that all bulk is bad,” Bashoor says. “However, too many times, we see firefighters substitute bulk and bravado, where it would be much more important to consider strength, agility and general health.”
But when it comes to fitness, prevention is the key for Tobia, and that means proactive behavior by firefighters: “Today, more firefighters than ever are getting an annual medical evaluation, many in accordance with NFPA 1582. In addition, FEMA-funded research through the AFG program is supporting key scientists like Dr. Denise Smith of Skidmore College, who has led the charge in identifying the causes of cardiac-related deaths among firefighters, tying heat stress and prolonged elevated core body temperature to sudden death in this group of responders.”
Tobia adds that Smith’s research, coupled with other seminal efforts by NIOSH, Dr. Sara Jahnke, Dr. Stefanos Kales, Dr. Gavin Horn, and numerous other leaders “has not only identified the underlying causes but also led to more concerted efforts to integrate technology into real-time biometric monitoring.” In total, Tobia believes, these efforts have saved firefighter’s lives and contributed to the reduction in LODDs.
So, while positive steps on the training, education and fitness fronts continue to bear fruit, there will still be 82 names on the 2019 NFFF memorial plaque when it is finally dedicated next year. Too many, still, for Tobia’s liking: “More work remains.”
