Journal Article

22 Firefighter Fatalities: Crude Mortality Rates and Risk Factors for Line of Duty Injury and Death

S Kahn and C Siordia

in Journal of Burn Care & Research

Volume 39, issue suppl_1, pages S15-S16
Published in print April 2018 | ISSN: 1559-047X
Published online April 2018 | e-ISSN: 1559-0488 | DOI:
22 Firefighter Fatalities: Crude Mortality Rates and Risk Factors for Line of Duty Injury and Death

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  • Medicine and Health
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Firefighter (FF) fatalities are frequently investigated by public health researchers. Trauma and cardiovascular disease related fatalities have been identified as important target areas for prevention. The United States Fire Administration (USFA) provides a high-standard data source for FF fatalities. The specific aim of this analysis was to explore the 1990–2016 temporal trends of FF fatalities to determine high risk groups and targets for safety education, outreach, training, and interventions.


Publicly available USFA information on FFs and number of deaths per yr published by the National Vital Statistics System was used to compute crude-rates per million deaths by year and categories for the following attributes: age; work status; cause and nature of death. All FF fatalities from 1990–2016 (27 years) were used in the analysis except for 2001 (excluded due to the 341 deaths during 9/11). An SAS MACRO was created by the authors and used for extracting FF information from a text file containing information from the USFA PDF booklet. Crude rates were compared from the 1990–2009 (early period) and 2010–2016 (recent period). Multinomial logistic regression was used to determine predictors of death in firefighters by age group (≤45 yrs old and >45) and by work status (career vs volunteer).


During the study period, 3159 FF fatalities were extracted and analyzed. Total FF crude-rate mortalities decreased between 1990–2009 and 2010–2016 (47.4 vs 35 FF deaths/million, p<0.0001). FFs ≤45 yrs old were less likely to die in the 2010’s than in the 1990s-2000’s, (13.7 vs 24.7 FF deaths/million, p=0.0002). Trauma related deaths also decreased between the periods (13.1 vs 8.1, p=0.0003) while CV-related deaths remained constant (19.4 vs 19.5, p=0.24). Regression analysis showed that volunteer FFs were more likely to die from burns (OR 1.7, CI:1.2–2.4, P<0.0001) and trauma (OR 1.8, CI:1.5–2.2, p<0.0001) than career firefighters. Younger FFs were also more likely to die from burns (OR 10.4, CI 6.9–15.6, P<0.0001) and trauma (OR 6.5, CI:5.4–7.8, p<0.0001).


Although overall and trauma related firefighter fatalities are on the decline after 2010, younger firefighters and volunteer firefighters are at higher risk to suffer mortality from burns and trauma. Cardiovascular disease related fatalities have remained constant throughout the entire 27-year study period and represent an important target for prevention, screening, and treatment. Future research should continue to make use of high-standard data sources to enumerate details of FF fatalities and measure changes induced by interventions.

Applicability of Research to Practice

Burn providers should understand risks for FF burn injury and are suited to participate in a multidisciplinary approach to prevention.

Journal Article.  0 words. 

Subjects: Medicine and Health ; Acute Medicine ; Emergency Medicine ; Critical Care ; Surgery

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