Firefighter Life Safety Initiatives

Culture is generally defined as the behaviors, attitudes, values, and beliefs that are shared within a group or organization. It reflects the collective perception of right and wrong, good and bad, or desirable and undesirable actions and characteristics. The safety culture within a fire department is reflected through its members’ behaviors, attitudes and actions in and out of the station as well as on the fire ground. The 1st Initiative asks us to explore the characteristics of our departments to bring about a higher commitment to safety. Nationwide, the firefighter’s personal protective ensemble, apparatus and equipment technology, available training and safety resources, and safety standards are at the highest, safest levels ever experienced in fire service history. However, United States Fire Administration statistics reveal a ten-year plateau of more than 100 firefighter line-of-duty deaths and approximately 10,000 serious line-of-duty injuries each year. To worsen matters, firefighters are being injured and killed on incidents at rates close to those of 20 years ago. Case analyses show that most of these line-of-duty deaths and injuries are preventable. Within the context of Everyone Goes Home® and the 16 Firefighter Life Safety Initiatives, no advocacy point carries more importance and potential than the need to change the culture of safety from within. Clearly, the fire service must change its attitudes, beliefs, and behaviors toward safety if reductions in firefighter injuries and fatalities are going to be reduced.

All too often fire service health and safety initiatives fall short of their intended goals, in part due to accountability by the organization or the individual firefighter. Often this lack of accountability comes from an attitude that one must possess bravado to be perceived as a good firefighter. The 2nd Initiative asks us to make a personal commitment to accountability regarding health and safety issues at all times and at all levels of our fire service. The fire service can address this attitude head-on by implementing strategies for both the organization and the individual to accept responsibility and ensure that accountability is an integral component to creditable health and safety programs. Turning a blind eye to unsafe behaviors should never be an acceptable action. Above all else, the Firefighter Life Safety Initiative proposes that every member of a department must accept personal responsibility for his or her actions, as well as be “accounted for” and held accountable by the organization.

This initiative incorporates a range of components that relate to our ability to safely conduct emergency operations in a high-risk environment. There is no question that firefighters are expected to work in environments that are inherently dangerous, however most risks and most of the specific dangers are well known.” The 3rd Initiative asks us to function safely in high-risk environments by implementing risk management controls wherever they can help reduce injuries and line-of-duty deaths. Too many lives are lost in situations where the risks were not justified. The fire service understands risks, yet the same accidents, injuries and fatalities keep happening. Incidents must be managed with a constant awareness and balance between risks and desired outcomes. High risk is only acceptable when there is a real possibility of saving a life. Fire command must carefully measure and control risks to save valuable property that can be saved. It is not an acceptable risk to attempt to save lives or properties that are already lost. The fire service should remember that if something bad happens it miscalculated, and that we should never use “that’s the way it’s always been done” to ever except a line-of-duty injury or death.

While this may appear to be a challenging or even controversial statement, it simply means that every organization should provide an environment that allows its members to speak up regarding personal and organizational safety; without negative consequences for doing so (within a prescribed context), and without decentralizing the authority of the formal leader. The resources needed for all fire service organizations to institute Initiative #4, regardless of type or size, are already at our disposal, and the best part is that they are free. The goal is to have every member fully engaged during an emergency incident with a focus on doing the work in a proficient manner and looking out for one-another to avoid injuries and potential line of duty death.

A great deal of training and education occurs in the fire service on a daily basis throughout the United States. How fire departments and training agencies measure, compare, and quantify this training is important to the profession and the safety of the individuals providing the service. If the training is accomplished in accordance with national standards, and the results are certified by an independent body or organization, then the system has substantial credibility. There must be a system to ensure this and provide standards that are recognized as being professional in terms of safety, competency, and responsibility. It is very disturbing that between 2005 and 2013, an average of 10.5 firefighters a year died in training-related incidents. Reported training-related injuries totaled more than 7,400 in 2012. Given those statistics, it’s no surprise the U.S. Fire Administration (USFA) identifies firefighter recruits, firefighters participating in training and firefighters conducting training as especially vulnerable to death and injury. Fire Service training programs that have been designed and conducted in concert with the appropriate NFPA Professional Qualification Standards will reduce these needless deaths and injuries. The 5th Initiative of the Firefighter Life Safety Initiatives is an attempt to tie training to a reduction in firefighter injuries and line-of-duty fatalities.

 – The initial report of the first Firefighter Life Safety Initiatives Summit, and subsequently the Everyone Goes Home® program, identified the need for national medical and physical fitness standards for all firefighters. Summit participants acknowledged the importance of increasing the emphasis on health, wellness and fitness within the fire service and reported that “…the most significant reductions in line-of-duty deaths are likely to be achieved through increased medical surveillance and physical fitness programs.” To demonstrate the scope of the physical fitness issue, the United States Fire Administration estimates that “737,000 firefighters serve in fire departments with no program to maintain basic health, most of them volunteers with less than 5,000 population 2006.” The 6th Initiative seeks to increase awareness of the need for medical and physical wellness programs for every firefighter. In 2016, the National Fallen Firefighters Foundation created the First Responder Center for Excellence for Reducing Occupational, Illness, Injuries, and Deaths, Inc. to provide increased awareness, training, and research to ensure that first responders have the correct tools and information to build and maintain a healthy foundation to reduce injuries and fatalities related to behavioral health, cardiac, cancer prevention as well as overall improved health and wellness.

 In response to the need to improve firefighter safety, The National Fallen Firefighters Foundation has hosted two research agenda symposiums, one in 2005 and 2011. The National Fire Service Research Agenda is an effort to identify particular areas in which research is needed to contribute to the mission of supporting the Firefighter Life Safety Initiatives of the Everyone Goes Home Program® (NFFF). The resulting document is intended to assist the many different organizations and individuals that have a role in conducting, supporting and encouraging research projects to focus their efforts and resources on the areas that have been identified as important and significant by a group that represents the diverse interests and priorities of the fire service—all with the overarching goal of eliminating preventable firefighter line-of-duty-injuries and fatalities. Communication with all fire departments in clear and concise ways is critical to improving the safety of firefighters. Acknowledging the need for research and data was an important step for the fire service to take in 2004. Now it is critical that the identified research be conducted, the results be transferred and implemented at the local levels. This is the only way that research will impact the life safety of firefighters and the communities they serve.

A major study conducted in 2006 by the United States Fire Administration and the National Fire Protection Association focused on the needs of U.S. fire departments. Where technology is concerned, the fire service is certainly gaining ground, but lags in important indicators. For instance, 24% of fire departments lack internet access, which means they lack access to information about emerging technology and actual web-based technologies. An estimated 60% of fire departments do not have enough self-contained breathing apparatus to equip all firefighters on a shift. Three-fifths (60%) of fire departments have at least some SCBA units that are least 10 years old. An estimated half (48%) of fire departments do not have enough personal alert system (PASS) devices to equip all their firefighters. These are basics, second nature to many of us, and yet we forget that tens of thousands of firefighters are responding everyday dangerously lacking basic levels of safety (USFA, Four Years Later—A Second Needs Assessment of the U.S. Fire Service, 2006). Regarding new and emerging technology, the USFA/NFPA study found the following: A majority (55%) of fire departments now own thermal imaging cameras, and another one-fourth have plans to acquire them. A previous survey (2001) reported that 24% of departments had such cameras, and the majority of those without them had no plans to acquire one. Only one department in 17 had mobile data terminals (6% of departments, up 4% from 2001), though the majority of fire departments protecting at least 100,000 population have them. Most departments with without mobile data terminals (69% overall) still have no plans to acquire them. Only one department in 31 has advanced personnel location equipment, though one-fourth of the fire departments protecting communities of at least 500,000 population have them. Only one department in 18 has equipment to collect chemical or biological samples for remote analysis, though most of the fire departments protecting communities of at least 100,000 population have such equipment.

How many firefighters are killed in the U.S. each year? Nearly 100. And in 2012, the National Fire Protection Association estimated that more than 69,000 firefighters were injured on the job. The NFPA believes that their estimate is accurate to +/- 6.5%. This is a projection, not an actual number – we’re really not sure how many firefighters were injured in 2012. We don’t truly know how many actual injuries there were, and we certainly have no idea how many near-miss (or near-hit) incidents occurred. Initiative #9 asks us to learn from our mistakes—the only way to do this is to thoroughly investigate every near-miss, significant injury or fatality.

 While it is difficult to measure the exact impact of grant money relative to increased safety, a positive relationship certainly exists. Without such assistance, fire departments with limited local or public funding would find it very difficult to meet safety training mandates and standards. While it will take more than grants to change the culture of the fire service, grant money can go far in helping departments implement safe practices. Reasonable efforts should be made to ensure that grants reinforce safety whenever practical. The 10th Initiative asks us to examine the grant process and look for opportunities to make improvements in safety. Because grants intersect as so many areas within the fire service, we must also remember that in order to change how grants are allocated, we must also focus on the important areas of culture, technology, and safety-related training.

Many in the fire service have long argued the need for uniform response standards as a means to increase fire service operational effectiveness, and to give credibility to the observation that the fire service is a bona fide profession in the sense of education, credentialing, training, and execution. Success has been limited at best due to competing opinions from fire service organizations categorized as volunteer, combination, or career. Unification in the fire service has also been difficult due to geographic demands which drive local priorities and response policies. Unlike many other fire service systems internationally which are organized, trained, and funded at the national level, the U.S. fire service has developed into over 30,000 idiosyncratic and separate systems. Undoubtedly, this is the source of much pride, but it also has led to massive system inadequacies. The 11th Initiative calls for a minimum set of activities that are universally recognized and understood to assure life safety at every fire—regardless of organizational composition, or geographic location. Common standards provide the added benefit of allowing multiple responding agencies to operate with similar strategic and tactical considerations, regardless of the complexity of the event.

From the beginning of America’s fire service, firefighters have been responding to incidents that were the result of, or caused by, an act of violence. Fire departments respond to a wide range of events from the simple Saturday night altercation at the corner bar, to the events like: Watts, Columbine, Oklahoma City, 9/11, Webster, NY, or Gwinnett County, GA. On most occasions, the fire department responds, renders service, and returns to quarters. Unfortunately, over our history, not every member has been able to return home due to factors associated with violence. In March 2006, former Peoria (AZ) Fire Department Fire Inspector Howard M. Munding produced a thesis titled “Violence Against Firefighter: Angels of Mercy Under Attack.” In the thesis, he quotes the stunning statistic that an estimated 700,000 assaults occur on paramedics and emergency medical technicians (EMTs) annually. Additionally, according to a 2008 National Fire Protection Association (NFPA) Firefighter Fatality Report, 32 firefighters died from assaults while on duty in the report’s 32-year history. At the end of 2010, that number grew to 34, or one firefighter per year. In order to ensure that we meet our mission, to make sure everyone goes home, we offer the following strategies designed to reduce the likelihood of injury or death from responding to incidents of violence.

• Improved understanding and application of Dynamic Risk Management
• Initiate or improve communication with the local law enforcement component.
• Define and expand role of dispatchers in reducing risk
• Prohibit single (person) resource response to violent incidents
• Require use of an Incident Management System
• Communicate directly with Law Enforcement component prior to operating at an incident of violence.
• De-commit personnel and equipment and leave if violence commences or reoccurs during fire department operations
• Obtain stakeholder understanding and buy-in of response and deployment policies including non-response and non-engagement at incidents of violence
• Implementing these strategies will help reduce the likelihood of fire service members being injured or killed during a response to a violent incident. The 12th Initiative expands our understanding of how and where firefighters can be injured and demonstrates the need for the development of national protocols regarding violent incidents.

Initiative 13 means that firefighters and EMS professionals and their families must have the resources to deal with the various complications that their jobs can bring to their lives, especially issues regarding emotional and psychological stress. They must also have help available to deal with the problems in living that all of us sometimes face, regardless of the work we do, especially regarding family, finances or even drug and alcohol issues. Health and safety standards (like the NFPA 1500 Standard on Firefighter Health and Safety) require that assistance programs be made available to ensure that such services are there when needed. But what form those services should take has become a serious question. Research has raised significant concerns about intervention and treatment approaches that have been and are to this day commonly used with fire service personnel. Ensuring that care is available whenever needed-and that the care delivered represents the best practices currently available-is the objective of Initiative 13: Firefighters and their families must have access to counseling and psychological support. A Consensus Approach – In order to find the best material upon which to build a new model, the National Fallen Firefighters Foundation (NFFF) adopted a consensus approach much like that used in developing standards in medicine or even operational firefighting. Fire chiefs and even those in our communities who routinely provide behavioral services to firefighters and EMTs often don’t have the best information available to them, nor the time to read medical journals, technical reports and other sources from around the world. To identify potential resources, the NFFF made a commitment to scour the literature, talk to experts in many fields to find new and better approaches to firefighter behavioral health treatments. Preparing fire service organizations to make good decisions about occupational behavioral health care for their personnel required deliberate efforts to bring scientists and our end-users (the fire service) together. This effort began by recruiting carefully selected researchers whose research programs deal with areas important to occupational behavioral health needs of the fire service. Those experts then worked with representatives from key organizations and standards bodies including the International Association of Fire Fighters, the International Association of Fire Chiefs, the National Volunteer Fire Council, the National Fire Protection Association, the National Association of Emergency Medical Services Physicians and the North American Fire Training Directors to develop practical ways to deliver state of the art assistance to fire and EMS providers. In addition, representatives from military medicine, private EAP provider organizations, and major research institutions contributed to the knowledge base for this effort. Creating Resources for Firefighters and their Families – The first meeting took place in Baltimore, Maryland, in December 2008. Researchers whose work centered on prevention and early intervention related to traumatic stress joined with fire service health and safety representatives to recommend effective strategies to assist personnel exposed to potentially traumatic events. A second meeting was held in April 2009 to examine standards and recommendations regarding comprehensive behavioral health assistance programs for firefighters and their families. A third session explored the role of peer support systems in promoting health, wellness and safety, and in developing innovative approaches to behavioral health resources. The outcome of these meetings and additional research points led to the development of a new model or way of thinking about firefighter behavioral health and attendant resources. Since 2011, segments of the model have been presented and critiqued at regional and national fire service conferences and articles have been published. These opportunities, added to the advice of leaders in military and community mental health, have allowed us to develop a wide range of new approaches, courses and suggestions to support Initiative 13.

Fire and life safety education is an effective means for establishing fire safe behavior among people of all ages and abilities. It also promotes understanding and acceptance of regulations and technologies that can improve safety within the homes, businesses, and institutions. Furthermore, educating the public about how to prevent fires can contribute significantly to reducing firefighter deaths. If evacuation plans are in place and practiced by residents of a home or occupants of an office building, responding firefighters will not as frequently face the personal risk associated with rescuing trapped citizens. Moreover, fighting extremely dangerous fires will become a less frequent necessity as individuals assume personal responsibility for maintenance of smoke alarms and as they adopt early suppression technologies such as fire sprinklers. The 14th Initiative asks us to rethink our priorities in the fire service—to recognize the central and enduring value of public education, and to raise fire prevention to the level of other department operations.

The term “fire prevention,” as used here, means preventing accidental fires from starting and, when they do start, minimizing their growth or extinguish them prior to human intervention. A successful effort in fire prevention will mean fewer fire responses by firefighters because of a reduction in fires, and less dangerous working conditions on the fire ground as a result of smaller, contained fires. With fewer fire responses and smaller, contained fires, and a better protected public, it is clear that there will be fewer firefighter injuries and fatalities – which is the goal of our overall efforts. The 15th Initiative asks us to advocate for stronger codes and laws which will decrease the number and severity of structural and residential fires to keep our firefighters out of harm’s way.

Today’s fire service leaders whether they are fire chiefs, other chief fire officers, equipment committees, or equipment manufacturers have a vested interest and a legal responsibility to provide for the safety of firefighters. Yet, each day these groups struggle with the issue of preventable firefighter injuries and deaths, and the need to incorporate safety as a primary consideration in the design of fire service apparatus and equipment. New technologies and innovations are available that can significantly reduce the potential for injury and deaths related to fire service apparatus and equipment failures or shortcomings. It is important to understand, and explore the technologies and innovations available today. We must also consider the best practices that can be implemented to improve fire fighter safety, thereby reducing the potential for injury and death. The 16th Initiative ratifies the belief that no firefighter should die in the line-of-duty due to apparatus or equipment-related issues.