U.S. Firefighter Injuries in 2017

An estimated 58,835 firefighter injuries occurred in the line of duty in 2017, a decrease of 5 percent from the year before and the lowest number since NFPA began analyzing this data in 1981 BY BEN EVARTS AND JOSEPH L. MOLIS • 10 MINUTE READ

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Firefighters work in varied and complex environments that increase their risk of on-the-job deaths and injuries. Each year, NFPA studies firefighter deaths and injuries to provide national statistics on their frequency, extent, and characteristics. Earlier this year, NFPA reported that there were 60 on-duty firefighter fatalities in 2017. A better understanding of how these fatalities, nonfatal injuries, and illnesses occur can assist in identifying corrective actions that could help minimize the inherent risks of firefighter work.

This summary report examines firefighter injuries in the United States in 2017. The results are based on data collected during the NFPA Survey of Fire Departments for U.S. Fire Experience (2017). Based on that data, we estimate that 58,835 firefighter injuries occurred in the line of duty in 2017. This is a decrease of 5 percent from the year before, and the lowest number since NFPA began analyzing this data in 1981. In recent years, the number of reported firefighter injuries has been considerably lower than it was in the 1980s and 1990s, due in part to additional survey questions on exposures to hazardous conditions and infectious diseases, information that allows us to place them in their own categories. Previously, some of these exposures might have been included in total injuries under other categories.

NFPA estimates that there were 7,345 exposures to infectious diseases such as hepatitis, meningitis, and HIV in 2017. This amounts to 0.3 exposures per 1,000 emergency medical service runs by fire departments in 2017.

We also estimate there were 44,530 exposures to hazardous conditions such as asbestos, radioactive materials, chemicals, and fumes last year. The increase in these types of exposures in recent years can in part be explained by the heightened awareness about cancer and other chronic illnesses in the fire service and the importance of documentation. This could be a result of improved reporting for such exposures.

An estimated 10,155 injuries, or 17 percent of all firefighter injuries, resulted in lost time.

This summary report includes among its results an estimate of the total number of U.S. firefighter injuries in 2017, estimates of the number of injuries by type of duty, an estimate of the number of exposures to infectious diseases, trends in firefighter injuries and rates, fireground injuries by cause, fire department vehicle accidents and resulting firefighter injuries, the average number of fires and fireground injuries per department by population of community protected, and descriptions of selected incidents that illustrate firefighter safety problems.

METHODS AND RESULTS

NFPA annually surveys a sample of fire departments in the U.S. to make national projections of the fire problem. The sample is stratified by the size of the community protected by the fire department and includes all U.S. fire departments that protect communities with a population larger than 5,000.

The 8,846 fire departments in the eight highest strata protect a population of 283 million, or 87 percent of the U.S. population, as of July 2017. The rest of the sample includes 12,642 randomly selected departments that protect populations under 5,000 for a total sample size of 21,488 departments, or 72 percent of all U.S. fire departments known to NFPA.

The method used for the survey was ratio estimation with stratification by community size. For each firefighter injury statistic, a sample injury rate was computed for each stratum. This rate consisted of the total for that particular statistic from all departments reporting it, divided by the total population protected by the departments reporting the statistic. This means the departments used in calculating each statistic could be different, reflecting differences in unreported statistics. The national projections are made by weighting the sample results according to the proportion of total U.S. population accounted for by communities of each size. Around any estimate based on a sample survey, there is a confidence interval that measures the statistical certainty or uncertainty of the estimate. We are confident that the actual number of total firefighter injuries falls within 5 percent of the estimate.

A total of 2,592 departments responded to the 2017 fire experience survey. The results are based on injuries that occurred during incidents attended by public fire departments. No state or federal firefighting entities were included in this sample, and no adjustments were made for injuries that occurred during fires attended solely by private fire brigades, such as those at industrial or military installations.

In Virginia, a firefighter was among, four people injured in a fire at a senior living complex. Photograph: AP/Wide World

In this summary report, “fire” refers to any instance of uncontrolled burning, excluding combustion explosions and fires out on arrival (whether authorized or not); overpressure rupture without combustion; mutual aid responses; smoke scares; and hazardous materials responses such as flammable gas, liquid, or chemical spills without fire. “Incident” refers to the movement of a piece or pieces of fire service apparatus or equipment in response to an alarm. “Injury” refers to physical damage suffered by a person that requires (or should require) treatment by a practitioner of medicine (physician, nurse, paramedic, or EMT) within one year of the incident, regardless of whether treatment was actually received, or that results in at least one day of restricted activity immediately following the incident.

INJURIES BY TYPE OF DUTY

As in past reports, type of duty is divided into five categories, including responding to or returning from an incident (including fire and non-fire emergencies); fireground (including structure fires, vehicle fires, brush fires, etc.), referring to all activities from the moment of arrival at the scene to departure time (e.g., setup, extinguishment, and overhaul); non-fire emergency (including rescue calls, hazardous calls such as spills, and natural disaster calls); training; and other on-duty activities (e.g., inspection or maintenance duties).

Firefighters were more likely to be injured at fireground operations than at other types of duties. In 2017, 24,495 injuries, or 42 percent of all reported firefighter injuries, occurred at the fireground. This was a slight increase over the previous year. Injuries at the fireground decreased from a high of 67,500 in 1981 to 24,495 in 2017, a drop of 64 percent. The number of fires also declined steadily, for an overall decrease of 54 percent. The rate of injuries per 1,000 fires over the past 35 years has fluctuated between a high of 28.3 injuries per 1,000 fires in 1990 and a low of 18.1 injuries per 1,000 fires in 2016.

Firefighters at the scene of a house fire in Michigan. A nine-year-old girl and three firefighters who rushed into the burning home to rescue her were among those injured. Photograph: AP/Wide World

Overall, the number of injuries at non-fire emergencies increased 28 percent between 1981 and 2017, from 9,600 to 12,240. During the same period, the number of non-fire emergencies also increased 332 percent, due in large part to an increase in the number of fire department responses to medical emergencies. The injury rate per 1,000 non-fire emergencies declined between 1981 and 2017, from 1.2 to 0.4, largely because the number of non-fire emergencies increased at a higher rate than the number of injuries at non-fire responses.

In addition, 4,555 firefighter injuries occurred in 2017 while responding to or returning from an incident. Another 8,380 firefighter injuries occurred during training activities, and 9,165 injuries occurred during other on-duty activities.

NATURE AND CAUSE OF FIREGROUND INJURIES

The major types of injuries that occurred during fireground operations were strains and sprains, which accounted for 48 percent of the injuries; wounds, cuts, bleeding, and bruises, which accounted for 15 percent; smoke or gas inhalation, which accounted for 7 percent; and thermal stress (frostbite or heat exhaustion), which accounted for 5 percent. Except smoke or gas inhalation, these results were fairly consistent during all non-fireground activities, with strains, sprains, and muscular pain accounting for 56 percent of all non-fireground injuries, and wounds, cuts, bleeding, and bruises accounting for 17 percent.

Because fireground injuries are of particular concern from an occupational hazard perspective, we examined their causes, defined here as the initial circumstance leading to the injury. Overexertion or strain, which accounted for 29 percent, was the leading cause of fireground injuries. Other major causes were falls, jumps, or slips, which accounted for 20 percent, and exposure to fire products, which accounted for 11 percent.

FIRE DEPARTMENT VEHICLE COLLISIONS

NFPA reported previously that 18 firefighters died in vehicle-related incidents in 2017, including 10 who were struck by vehicles and eight who died in vehicle crashes. Ten is an unusually high number for firefighters struck by vehicles, as the average for the previous 30 years is four per year.

In 2017, an estimated 15,430 collisions involved fire department emergency vehicles responding to or returning from incidents. This is similar to the number in 2016. To put this number in perspective, fire departments responded to 34.7 million incidents in 2017, meaning that the number of collisions represents 0.04 percent of total responses. However, these collisions resulted in 1,005 injuries, or 2 percent of all firefighter injuries.

Another 795 collisions involved firefighters’ personal vehicles, in which they were responding to or returning from incidents. These collisions resulted in an estimated 75 injuries.

AVERAGE NUMBER OF FIRES AND FIREGROUND INJURIES PER DEPARTMENT BY POPULATION PROTECTED

The number of fires a fire department responds to is correlated with the population protected. The number of fireground injuries incurred by a department is also correlated with the number of fires the department attends. The second point is clearly demonstrated when we examine the range of the average number of fireground injuries per year per fire department, which ranges from a high of 107.1 for departments that protect communities of 1,000,000 or more to a low of 0.2 for departments that protect communities of fewer than 5,000 people.

One way to understand the risk that firefighters face is to examine the number of fireground injuries that occur for every 100 fires they attend. This takes into account relative fire experience and allows more direct comparison between departments protecting communities of different sizes. In 2017, the overall range of rates varied from a high of 2.2 injuries per 100 fires, for departments that protect communities with populations ranging from 100,000 to 249,999, to a low of 0.7 injuries per 100 fires, for departments that protect communities with populations between 2,500 and 4,999.

An injured California firefighter is assisted at the scene of a fire at a chemical manufacturing plant. Photograph: AP/Wide World

Large fire departments generally had the highest rates of fireground injuries per firefighter. Departments protecting communities of 1,000,000 or more experienced 5.6 injuries per 100 firefighters. As the size of the community decreases, the rate of fireground injuries generally declines, to a low of 0.7 for departments protecting between 2,500 and 4,999 people (the rate moves up slightly, to 1.1, for the smallest communities). That is a difference in risk of injury per firefighter of 8 to 1 between communities of 1,000,000 or more and communities of between 2,500 and 4,999.

One explanation for this difference is that, although departments protecting communities with populations of 1,000,000 have, on average, more than 96 times as many firefighters as departments protecting populations smaller than 2,500, larger departments attend 572 times as many fires as the smaller departments and incur considerably more fireground injuries. Different policies for documenting minor injuries and different levels of fire engagement could also explain some of this difference.

AVERAGE NUMBER OF FIRES AND FIREGROUND INJURIES BY POPULATION PROTECTED AND REGION

As with the nationwide results, regional results indicate that the number of fires a fire department responds to is correlated with the population protected, and the number of fireground injuries incurred by a department is correlated with the number of fires attended.

In 2017, the Northeast region of the United States reported a higher fireground injury rate of 2.0 injuries per 100 fires. This observation is consistent with previous years, except in 2014, when the Western region reported a higher rate for the first time. It is important to note that historically this analysis has excluded New York City because it is the largest fire department in the country and is treated as an outlier in the reporting of this statistic.

CONCLUSION

Since 1981, when firefighter injury data was first collected for this report, the overall trend is a decreasing number of firefighter injuries. The most common place for these injuries is at the fireground, but many firefighters are injured at other types of incidents.

As the statistics in this report and previous reports attest, firefighting presents risks of personal injury to firefighters. Due to the kind of work performed and the hazards of the incident scene environment, it is unlikely that all firefighter injuries can be eliminated. A risk management system and the application of existing technology, however, can offer options to reduce present injury levels and bring about corresponding reductions that are recommended by NFPA that could be taken at the local level.

BEN EVARTS is data collection and research manager at NFPA and JOSEPH MOLIS is a fire data assistant at NFPA and a lieutenant with the fire department in Providence, Rhode Island. Top Photograph: Jim Marabello