ANALYSIS REPORT ON

FIREFIGHTER FATALITIES

Prepared by

Fire Analysis and Research Division

National Fire Protection Association

1 Batterymarch Park

PO Box 9101

Quincy, MA 02269-9101

Prepared for

Federal Emergency Management Agency

U.S. Fire Administration

Contract No. EMW-90-C-3332

August 1991

Any opinions, findings, conclusions or recommendations expressed in this

publication do not necessarily reflect the views of the Federal Emergency

Management Agency.
This document was scanned from hard copy to portable document format (PDF)

and edited to 99.5% accuracy. Some formatting errors not detected during the

optical character recognition process may appear.
Acknowledgement

This study was funded by the U.S. Fire Administration of the Federal

Emergency Management Agency (FEMA). It would not have been possible

without the cooperation and assistance of the U.S. fire service, the United States

Fire Administration, the Public Safety Officers’ Benefits Program of the

Department of Justice, the National Wildfire Coordinating Group, the Bureau of

Land Management of the Department of the Interior, the Bureau of Indian

Affairs, the U.S. Department of Energy and the U.S. military, all of whom

contributed data to this study.

The assistance of other NFPA staff members is also acknowledged: Dr.

John R. Hall, Jr., Assistant Vice President, Fire Analysis and Research; William

Neville, Assistant Vice President of External Affairs; Martin Henry, Assistant

Vice President, Public Fire Protection; Kenneth Tremblay, Alison Miller, Michael

Sullivan and Michael Karter, Fire Analysis and Research Division; and William

Baden, Jon Jones, Carl Peterson, Bruce Teele and Gary Tokle, Public Fire

Protection Division.

The authors also wish to acknowledge the assistance of USFA staff,

particularly John Ottoson, Project Officer, for their suggestions and support.

Special thanks go to Nancy Schwartz for typing the several drafts of this

report.

Rita F. Fahy

Arthur Washburn

Paul R. LeBlanc

Project Staff
Table of Contents

Page

I .

Table of Contents ...................................

List of Figures .....................................

List of Tables ......................................

Background .......................................

Introduction ......................................

A. Who Is a FireFighter?. ..........................

B. What Constitutes an On-Duty Fatality?. ..............

C. Sources of Initial Notification ......................

D. Procedure for Including a Fatality in the Study ........

E. Additional Data Collection Completed

for the Contract ...............................

II. 1990 Findings........................................

A. Type of Duty. ....................................

B. Cause and Nature of Fatal Injury or Illness. ..........

C. Ages of Fire Fighters .............................

D. Fire Ground Deaths. ............................

E. Time of Day.. ...................................

F. Month of the Year................................

i

ii

iv

V

1

1

2

4

5

6

6

10

14

14

19

G. State and Region ................................. 24

H. Analysis of Urban/Rural/Suburban Patterns

in Fire Fighter Fatalities . . . . . . . . . . . . . . . . . . . . . . . . . 24

III. Wildland Fire Fighter Fatalities 1981-1990. . . . . . . . . . . . . . . . 30

IV. Fatalities Resulting from Heart Attacks 1981-1990 . . . . . . . . . 42

V. Conclusions and Recommendations .................... 58

References. ......................................... 56

i
Figure

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9

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12

13

14

15

16

17

18

List of Figures

Title

On-Duty Fire Fighter Deaths 1981-1990

Fire Fighter Deaths 1990 by Type of Duty

Fire Fighter Deaths 1990 by Cause of Injury

Fire Fighter Deaths 1990 by Nature of Injury

Fire Fighter Deaths 1990 by Age and Cause

of Death

Average Death Rates per 10,000 Fire Fighters

1986-1990

Fire Ground Deaths in 1990 by Fixed Property Use

Fire. Fighter Fatalities 1990 by Time of Alarm

Fire Fighter Fatalities by Time of Alarm 1981-1990

Fire Fighter Fatalities 1990 by Month of Year

Fire Fighter Fatalities by Month of Year 1981-1990

Fire Fighter Fatalities 1990 by Region

Fire Fighter Fatalities in Wildland Fires 1981-1990

Fire Fighter Fatalities in Wildland Fires by

Jurisdiction 1981-1990

Fire Fighter Fatalities at Wildland Fires

by Region 1981-1990

Fire Fighter Fatalities on the Fireground at

Wildland Fires by Cause of Injury 1981-1990

Fire Fighter Fatalities Responding to or

Returning from Wildland Fires

by Cause of Injury 1981-1990

Fire Fighter Deaths Due to Heart

Attacks 1981-1990

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Page

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20 

21

22

2 3

27

31

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40

43
List of Figures (Continued)

Figure Title Page

19 Fire Fighter Deaths Due to Heart Attacks

by Physical Condition 1981-1990

20 Fire Fighter Deaths Due to Heart Attacks

by Type of Duty 1981-1990

21 Fire Fighter Deaths Due to Heart Attacks

by Age 1981-1990

22 Fire Fighter Deaths Due to Heart Attacks,

Career vs. Volunteer 1981-1990

23 Fire Fighter Deaths Due to Heart Attacks

by Rank 1981-1990

24 Comparison of Career and Volunteer

Experience 1977-1990

44

46

48

50

51

54

iii
Table

1

2

3

List of Tables 

Title Page

1990 On-Duty Fire Fighter Fatalities by State 25

Fire Fighter Death Rates by Region 1990 26

Wildland Fire Fighter Fatalities on the Fire

Ground by Nature of Fatal Injury 198l- 1990 37

iv
Background

For more than a decade, the National Fire Protection Association (NFPA)

has developed the most complete records on U.S. fire fighter fatalities - both in

breadth of coverage and depth of detail - of any organization. This data base has

been used to support the fire fighter fatality studies produced each year by NFPA

since 1974.

Over the past 10 years, NFPA also has worked with FEMA’s U.S. Fire

Administration (USFA) to provide, in a timely manner, lists of fire fighter

fatalities and their next of kin to support the National Fire Academy’s annual Fire

Fighter Memorial Service, analyses of each year’s fire fighter fatalities, and

briefings on the latest experience. Under the present contract, NFPA has provided

the USFA with lists, both hand lettered and typed, of 1990 fire fighter fatalities and

with lists of names and addresses of next of kin and of fire department chiefs for

use in the Memorial Service in October 1991.

In August, a briefing on the 1990 experience and two special analyses was

presented by NFPA staff to USFA staff in Emmitsburg, MD. Through the briefing

and analysis, this contract continued the trend toward more extensive analysis of

patterns and trends in specific parts of the fire fighter fatality problem. With over

a decade of experience now classified in a computer data base, NFPA is able to

provide increasingly detailed and focused examinations of the specific parts of the

problem addressable by particular strategies.

The deliverables under this contract are (a) this analysis report, (b) the

incident and casualty data on diskette in NFIRS Version 4.0 format, which is

being delivered separately, (c) the various lists described above, and (d) the briefing

provided in August.

V
I. Introduction

The purpose of this study is to analyze the circumstances surrounding fire

fighter fatalities in the United States in 1990 in an attempt to identify potential

means for reducing the number of deaths that occur each year. In addition to the

1990 findings, this study will also include special analyses of particular recurring

scenarios, using NFPA’s data base of fire fighter fatalities from 1981 through 1990.

A. Who Is a Fire Fighter?

For the purpose of this study, the term fire fighter covers all members of

organized fire departments, whether career, volunteer or mixed; full-time public

service officers acting as fire fighters; state and federal government fire service

personnel; temporary fire suppression personnel operating under official auspices

of one of the above; and privately employed fire fighters including trained members

of industrial or institutional fire brigades, whether full- or part-time.

Under this definition, the study includes not just municipal fire fighters but

also seasonal and full-time employees of the U.S. Forest Service and state wildland

agencies; prison inmates serving on state forest service crews; fire fighters for the

Bureau of Land Management, the Bureau of Indian Affairs, the Bureau of Fish

and Wildlife, the National Park Service, and the U.S. Department of Energy;

military personnel performing assigned fire suppression activities; civilian fire

fighters working at military installations; and members of industrial fire

brigades.

1
B. What Constitutes an On-Duty Fatality?

The term on-duty refers to being at the scene of an alarm, whether a fire or

non-fire incident; being en route while responding to or returning from an alarm;

performing other assigned duties such as training, maintenance, public

education, inspection, investigations, court testimony and fund raising; and being

on call, under orders or on stand-by duty other than at home or at the individual’s

place of business.

On-duty fatalities include any injury sustained while on duty that proves

fatal, any illness that was incurred as a result of actions while on duty that proves

fatal, and fatal mishaps involving occupational hazards that occur while on duty.

The types of injuries included in the first category are mainly those that occur on

the fire ground, in training, or in accidents while responding to or returning from

alarms. The most common examples of fatal illnesses incurred on duty are fatal

heart attacks. Another example is a fire fighter who contracted hepatitis when a

victim being transported by ambulance pulled out his intravenous needle and

stuck the fire fighter. A few examples of fatal occupational mishaps that have

occurred in the past include fire fighters who died of asphyxiation while working

on fire apparatus in closed garages, a fire fighter who fell through a slide pole

hole, a fire fighter electrocuted while raising a banner for a town event, a

volunteer fire fighter who was fatally injured when he fell down a flight of stairs in

his home while responding to an alarm, and a fire inspector who fell through a

skylight. In 1990, a fire fighter was killed when the aerial ladder he was strapped

to collapsed as he was hanging a banner.

Also included in the file are fire fighters who were murdered while on duty.

These include fire fighters shot by snipers while on the fire ground, fire fighters

shot in the station by off-duty or former fire fighters, one who was kidnapped and

2
shot after responding to a verbal request for assistance, and one in 1990 who was

killed when a pipe bomb planted in his car exploded as he left the station.

Fatal injuries and illnesses are included even in cases where death is

considerably delayed. When the onset of the condition and death occur in different

years, the incident is counted on the basis of the former. For example, a Michigan

fire fighter died in 1986 of a brain injury received in 1979 when he was struck by a

hose coupling, resulting in recurring seizures. Because his death was the direct

result of his injury, and the injury occurred in 1979, he is counted as a 1979

fatality.

The NFPA recognizes that these definitions should include chronic illnesses

(such as cancer) that prove fatal and that arise from occupational factors. In

practice, there is as yet no mechanism for identifying fatalities that are due to

illnesses that develop over long periods of time and that thereby present an

ambiguous picture on the issue of occupational versus other factors as causes.

This is recognized as a gap that cannot now be filled because of the limitations of

the state of the art in tracking and analysis.

C. Shot of Initial Notification

As an integral part of its ongoing program to collect and analyze fire data,

NFPA solicits information on fire fighter fatalities from the U.S. fire service and a

wide range of other sources. These include the U.S. Fire Administration and the

Public Safety Officers’ Benefits Program (PSOB). Both are organizations with

whom NFPA has maintained long-standing cooperative efforts in collecting and

analyzing fire fighter fatality data. Other contacts include federal agencies such

as the U.S. Forest Service of the Department of Agriculture, the Bureau of Indian

Affairs and the Bureau of Land Management of the Department of Interior, the

3
U.S. military, the Department of Energy, and the Occupational Safety and Health

Administration (OSHA). In recent years, significant assistance has been received

from the National Wildfire Coordinating Group, an organization made up of

representatives of state and federal wildland agencies.

The NFPA also receives notification from fire service organizations such as

the International Association of Fire Fighters, state fire associations, state

training organizations, state and local fire marshals, and fire service

publications. A network developed over the years of individuals interested in the

area of fire fighter fatalities also assists in identifying incidents, especially those

that occur outside of large urban areas or that involve non-fire-incident-related

fatalities. Among these individuals are fire fighters, photographers, fire buffs,

and members of the insurance industry.

Notification of fatal incidents also comes from NFPA members and staff and

through the use of a newspaper clipping service that reads all daily and weekly

newspapers in the country.

D. Procedure for Including a Fatality in the Study

After initial notification of a fatal incident is received, contact with the local

fire department is made by telephone to verify the incident, its location and the fire

department involved. Data collection forms for the fatality and the fire, if it was a

fire incident, are sent to the responsible local official identified during the

telephone follow-up. After the forms are returned to NFPA, a final decision is

made to include or exclude the fatality, based on the inclusion criteria described

previously. In order to make a final determination, additional information is

sometimes sought, either by contacting the fire department directly to clarify some

4
of the details or by obtaining data elsewhere, such as medical documentation

frequently available from PSOB.

Some of the material that might be received to document an incident

includes casualty forms, both NFPA fire fighter fatality study reporting forms and

NFIRS-type forms; NFPA’s Fire Incident Data Organization (FIDO) major-fire

report form or the department’s own incident reporting form, if a fire incident was

involved in the fatality; medical data such as death certificates or autopsy reports;

special investigation reports from other agencies; police and motor vehicle

accident reports, if applicable; photographs and diagrams; and additional

newspaper accounts. Incidents to be included in the study are then coded into

NFPA’s FIDO system, which includes both incident and casualty information. By

mutual agreement of the USFA and NFPA project staff, the same inclusion

criteria were used for the USFA study as are used in the NFPA study.

Work described to this point was done as part of NFPA’s ongoing program of

data collection and analysis in the area of fire fighter fatalities and was completed

at no cost to FEMA.

E. Additional Data collection Completed for the Contract

To meet FEMLA’s request for a list of the next-of-kin of the 1990 fatalities and

the names and addresses of the fire chiefs, a follow-up mailing was sent to all

departments asking them to verify the victims’ names and dates of fatal injury, the

names and addresses of the departments and chiefs, and the names and

relationships of the next of kin. Telephone calls were made to non-responding fire

departments to obtain the information.

5
II. 1990 Findings

One hundred five fire fighters died in the line of duty in 1990, the lowest total

in the 14 years that NFPA has done this study. As shown in Figure 1, this is a

decrease of 10.3 percent from the year before, and a 22.2 percent decrease from

1988.* With this second consecutive sharp drop in fire fighter deaths, we can begin

to be encouraged that the efforts made to improve fire fighter health and safety are

beginning to take effect; however, efforts to further reduce the death toll need to

continue. This study will report some of the most frequently occurring scenarios

and will present some conclusions and recommendations to address the problem.

A. Type of Duty

The distribution of deaths by type of duty being performed is shown in Figure

2. The largest proportion of deaths occurred during fire ground operations (43.8

percent).

Of the 46 fire ground deaths, 16 were due to heart attacks, 14 to asphyxiation,

seven to internal trauma, five to burns, two to stroke (CVA) and one each to

crushing injuries and heat stroke. Thirteen of the victims were career fire

fighters and 33 were volunteers.

The second largest category involved responding to and returning from

alarms, which accounted for almost a quarter of the deaths -- a result consistent

with the findings in previous years. Eight of these 24 deaths were due to heart

attacks, one to a fall from the jumpseat of an apparatus, one to a fall from the back

* The totals for some earlier years have been adjusted to reflect new information received since

the earlier studies.

6
Figure 1

On-Duty Fire Fighter Deaths

1977 - 1990

Number of Deaths
Figure 2

Fire Fighter Deaths 1990

by Type of Duty
of a pickup truck, one to a drowning in a bridge collapse and the remaining 13 to

collisions. Four were career fire fighters and 20 were volunteers. Three were

killed while responding to or returning from false calls -- two were responding to

an accidental alarm and one was returning from a system malfunction.

There were 15 deaths while working at non-fire incidents. These included

four fire fighters who suffered heart attacks while working at motor vehicle

accidents, four fire fighters struck by passing vehicles while working at motor

vehicle accidents, three deaths due to carbon monoxide poisoning while pumping

out a well, two drowned at an ice rescue, one drowned at a water rescue and one

who fell while attempting to rescue a rock climber.

There were 8 deaths related to training activities. All of the deaths were due

to heart attacks -- two during physical fitness training and one each during live

fire training, a smoke drill, a disaster drill., a simulated aircraft engine fire (using

halon), a company drill and a muster.

The remaining 12 deaths occurred while performing other duties -- four fire

fighters who suffered fatal heart attacks during normal station and

administrative duties, two killed in a plane crash while returning from a visit to

another fire department, two overcome by carbon dioxide while recharging the

carbon dioxide system after a fire, one killed when his tractor overturned while he

was working on the fire station’s grounds, one whose aerial ladder collapsed while

he hung a banner, one who was electrocuted and fell while attempting to retrieve a

cat, and one killed when a pipe bomb exploded in his vehicle as he was leaving the

station.

9
B. Cause and Nature of Fatal Injury or Illness

As used in this study, the term cause refers to the action, lack of action, or

circumstances that directly resulted in the fatal injury, while the term nature

refers to the medical nature of the fatal injury or illness, or what is often referred

to as the cause of death. Often, the fatal injury is the result of a chain of events, the

first of which is recorded as the cause. For example, if a fire fighter is struck by a

collapsing wall, becomes trapped by the debris, runs out of air before being

rescued, and dies of asphyxiation, the cause of fatal injury recorded is “struck by

collapsing wall” and the nature of fatal injury is “asphyxiation.”

Figure 3 shows the distribution of deaths by cause of fatal injury or illness.

As found in most previous years, the largest proportion of deaths were due to

stress or overexertion. Three of these 41 deaths were specifically attributed to

strenuous physical activities. Stress deaths usually result in heart attacks or

strokes.

The next major category was struck by or contact with objects. These 27

deaths included 24 motor vehicle accidents, and one each struck by a collapsing

wall, a hose coupling and a falling tree limb.

Twenty-two fire fighters were caught or trapped -- 13 by rapid fire progress;

three by being lost inside buildings; three underwater, where they drowned; two in

explosions (one involving a pipe bomb and the other involving the ignition of vapors

leaking from a propane gas transmission pipe); and one who was strapped to an

aerial ladder that collapsed.

Nine fire fighters died of various types of exposure. Of the nine, three were

exposed to carbon monoxide while pumping out a well, three were exposed to

carbon dioxide, one was exposed to hot weather and suffered heat stroke, one was

10
Figure 3

Fire Fighter Deaths 1990

by Cause of Injury
exposed to smoke and had a heart attack, and one was exposed to electricity and

fell.

Six fire fighters were killed as a result of falls -- one from a jumpseat, one

from the tailgate of a pickup truck, one at a quarry, one from a stair landing inside

a structure, one into a well, and one down a hillside.

Figure 4 shows the distribution of deaths by the medical nature of the fatal

injury or illness. The largest proportion of deaths were due to heart attacks. Of

these 40 deaths, medical documentation indicated that 17 of the victims had prior

heart problems, either previous heart attacks or bypass surgery; and six others

had severe arteriosclerotic heart disease (defined for this study as arterial

occlusion of at least 50 percent but usually found to be in excess of 70 percent). Two

other victims suffered from hypertension and one had suffered a viral infection

that had damaged his heart and lungs. Medical documentation was not available

for the other 14 heart attack victims.

Fire fighter deaths over the past 10 years that resulted from heart attacks

are discussed in more detail in a separate section of this report.

The other categories of nature of fatal injury were internal trauma (25

deaths), asphyxiation (20 deaths), crushing (7 deaths), bums (5 deaths), drowning

(5 deaths), strokes (2 deaths), and heat stroke (1 death). The 20 asphyxiation

deaths included seven at wildland fires, four in wells, three while recharging CO2

systems, three disoriented inside buildings until their air supplies were depleted,

two trapped by rapid fire progress in a building and one trapped in an overturned

tanker.
Figure 4

Fire Fighter Deaths 1990

by Nature of Injury
C. Ages of Fire Fighters

The ages of fire fighters who died in 1990 ranged from 18 to 77 years with a

median age of 41 years.

The distribution of fire fighter deaths by age and cause of death is displayed

in Figure 5. Over half of the fire fighters over age 40 who died were killed by heart

attacks. Of the three youngest heart attack victims (those age 25 and younger), two

had congenital heart problems and the third had suffered a viral infection that

damaged his heart and lungs.

Figure 6 shows the death rates by age categories using estimates of the

number of fire fighters in each age group from NFPA’s 1988 profile of fire

departments and the fatality data from 1986 through 19901. As the graph shows,

the death rate is lowest for fire fighters aged 20 to 39, slightly above the average

rate for those aged 40 to 49, and much higher than average for fire fighters aged 50

and over. This is a reflection of the fact that although only 14 percent of all fire

fighters are over age 50, that age group accounted for over a third of the deaths

from 1986 through 1990, including over half of all heart attack deaths. When the

rates are calculated for non-heart-attack deaths, fire fighters aged 60 and over

have a rate more than 2 1/2 times the average.

D. Fire Ground Deaths

The distribution of the 46 fire ground deaths by fixed property use is shown

in Figure 7. For only the second time since 1977, when NFPA began doing these

annual studies of fire fighter fatalities, the largest proportion of fire ground deaths

did not occur at residential structure fires. By far the largest proportion of deaths

14
Number of Deaths

Figure 5

Fire Fighter Deaths 1990

by Age and Cause of Death
Figure 6

Average Death Rates per 10,000 Fire Fighters

1986 - 1990

Note: These figures combine career and volunteer

fire fighters. The two groups may have very different

age distributions, which are not reflected here.
Figure 7

Fire Ground Deaths in 1990

by Fixed Property Use
(41.3 percent) occurred at wildland fires. These 19 deaths include the single worst

incident in 1990: six deaths occurred in June on the Tonto National Forest in

Arizona when five members of an inmate crew and their supervisor suffered fatal

smoke inhalation and burns when they were overrun by rapid fire progress.

Because of the high number of deaths in wildland fires in 1990, a lo-year analysis

of deaths related to wildland fires was completed and can be found, along with a

discussion of the 1990 wildland deaths, in a separate section of this report.

The next largest share of fire ground deaths (15.2 percent) occurred at

residential structure fires. These seven deaths all involved single-family

dwellings. This is the lowest number of deaths reported at residential fires since

1977 when NFPA began doing this study. The previous low number was 12 deaths

in 1987. Annually, there has been an average of 22 such deaths.

The other deaths occurred in a range of other property types. There were

five deaths in storage properties -- one of which was a dwelling garage. Four

deaths occurred in unoccupied buildings including two in vacant buildings and

one each in a building under renovation and a building under construction. There

were three deaths in fires involving public assembly buildings -- two at a fitness

center and one at a restaurant. Two fire fighters suffered fatal heart attacks at

motor vehicle fires. There was one death each at a college classroom building, an

office building, a laboratory, a manufacturing plant and a gas pipeline. One fire

fighter suffered a fatal heart attack while fighting a fire on a vacant lot.

Eleven fire fighters were killed at the scene of incendiary or suspicious fires.

Nine of these deaths were at structure fires and two were at wildland fires. (Three

other fire fighters died while responding to incendiary or suspicious fires.)

To put the hazards of fire fighting in various types of occupancies into

perspective, the number of deaths per 100,000 structure fires was examined by

fixed property use. The rates were calculated using the estimates of fire

18
experience from NFPA’s 1990 fire loss study2

. There were 1.5 fire fighter deaths 

per 100,000 residential structure fires, compared to 10.2 deaths per 100,000

nonresidential structure fires. Although almost three times as many fires

occurred in residential structures, the size, complexity and special hazards often

associated with nonresidential structures result in a much greater risk at such

fires.

E. Time of Alarm

The distributions of 1990 fire ground deaths and total deaths by time of

alarm are shown in Figure 8. The highest number of deaths occurred for alarms

between 11 am and 3 pm. This time period includes the six deaths on the Tonto

National Forest in June, The distributions of deaths by time of alarm over a tenyear period are shown in Figure 9: Thenumber of deaths in both categories was at

the highest level for alarms between 1:00 and 9:00 pm and dropped to the lowest

level in the early morning hours.

F. Month of the Year

Figure 10 shows the distribution of 1990 fire fighter deaths by month. The

same information for 1981 through 1990 is shown in Figure 11. The ten-year

analysis shows that fire ground deaths are higher in the winter months and in

midsummer.

19
Number of Deaths

Figure 8

Fire Fighter Fatalities 1990

by Time of Alarm

Based on 45 fire ground fatalities and

66 total fatalities for which alarm

time was reported.
Figure 9

Fire Fighter Fatalities by Time of Alarm

1981 - 1990

Number of Deaths

Based on the 554 fire ground fatalities and

1001 total fatalities for which alarm

time was reported.
Number of Deaths

Figure 10

Fire Fighter Fatalities 1990

by Month of Year

Based on 46 fire ground fatalities and

105 total fatalities.
Figure. 11

Fire Fighter Fatalities by Month of Year

 1981 - 1990

Number of Deaths

Based on 589 fire ground fatalities and

1221 total fatalities.
G. State and Region

The distribution of fire fighter deaths by state is shown in Table 1. Thirtyfive states are represented on the list, led by New York with 11 deaths. The

experience by region3 is displayed in Table 2 and Figure 12. The South lost the

largest number of fire fighters (38), followed by the Northeast (28), the West (23)

and the Northcentral region (16). Only the West had a higher than average fire

ground death rate, due to the high number of wildland fire deaths in 1990.

H. Analysis of Urban/Rural/Suburban Patterns in Fire Fighter Fatalities

The U.S. Bureau of the Census defines urban as a place having at least 2,500

population or lying within a designated urbanized area. Rural is defined as any

community that is not urban. Suburban is not a Census term but may be taken to

refer to any place, urban or rural, that lies within a metropolitan area defined by

the Census but is not one of the designated central cities of that metropolitan area.

Fire department coverage areas do not always conform to the boundaries of

Census places. For example, fire departments defined by counties or special fire

protection districts may have both urban and rural sections, and there are

Federal, state, and private fire fighters. In such cases, it may not be possible to

characterize the entire coverage area of a fire department as rural or urban, and

one must assign a fire fighter death as urban or rural based on the particular

community in which the fatal injury occurred.

24
State State

Alabama

Arizona

California

Table 1

1990 On-Duty

Fire Fighter Fatalities

Connecticut

Delaware

Florida

Georgia

Illinois

Indiana

Iowa

Kansas

Kentucky

Maine

Maryland

Massachusetts

Michigan

Minnesota

Mississippi

Number of Deaths

2

6

8

3

1

5

3

3

3

2

Missouri

Nebraska

New Jersey

New York

North Carolina

Ohio

Oklahoma

Oregon

1

3

1

3

2

2

1

2

Pennsylvania

South Carolina

Tennessee

Texas

Utah

Virginia

Washington

West Virginia

Wisconsin

Number of Deaths

1

1

1

11

2

1

2

2

10

2

1

5

2

4

5

3

1

TOTAL: 105

25
Table 2

Fire Fighter Death Rates by Region

1990

Fire Ground

Death Rate

Region per 100,000 Fires

Northeast

Northcentral

South

West

Number of Number of Fire

Fatalities Ground Deaths

28 5

16 9

38 14

23 18

Nationwide 105 46

1.19

2.02

1.72

5.32

2.28

 26
Figure 12

Fire Fighter Fatalities 1990

by Region
Based on these rules, the following patterns were found and are shown with

available patterns for the general population and for the population of fire fighters

specifically in local fire departments:

Urban* Rural Total

Total 1990 fire fighter fatalities 52 (50%) 53 (50%) 105 (100%)

Suburban location 19 l6 35

Local fire department only** 48 (57%) 36 (43%) 84 (100%)

U.S. population (1980)

U.S. fire fighters (1989), total***

U.S. fire fighters (1989), career***

U.S. fire fighters (1989), volun.***

74% 26% 100%

60% 40% 100%

97% 100%

48% 52% 100%

In 1987, we reported that the distribution of fire fighter fatalities from local

fire departments was closer to the distribution of the whole U.S. population than to

the distribution of fire fighters from local fire departments; suggesting that urban

fire fighters faced a greater risk of dying than rural fire fighters. In 1988, we

reported that the distribution of local fire fighter fatalities was closer to the

distribution of local fire fighters, suggesting a similar risk of dying for urban and

rural fire fighters. In 1989, the distribution of local fire fighter fatalities fell

* Note that the classification of fire fighters into urban and rural is based strictly on the

population protected by the fire department and not on other community boundaries.

However, if fire fighter fatalities were similarly classified, the distribution would shift by

at most two percentage points, so the points here are not affected.

** Excludes one fire fighter in the military killed in an urban location, three members of

industrial fire brigades killed in urban locations and 17 federal, state and inmate fire

fighters killed in rural locations.

*** U.S. Fire Department Profile Through 1989, Quincy, Massachusetts: National Fire

Protection Association, Fire Analysis and Research Division, November 1990. All

percentages are for fire fighters in ‘local fire departments.

2 8
exactly between the two other distributions. The 1990 results were most similar to

those reported for 1988.

Since the results fluctuate back and forth each year, it is not advisable to

read too much into them. It will be necessary to collect several years of data and do

a multi-year analysis before any firm conclusions can be drawn.
III. Wildland Fire Fighter Fatalities, 1981 - 1990

Of the 1221 fire fighters who died while on duty from 1981 through 1990,162

(or 13.3 percent) died as a result of wildland fires. (For this analysis, the term

wildland is used to include forest, brush and grass fires.) As shown in Figure 13,

the number of deaths was generally between 15 and 22 per year with the exception

of six deaths in 1982 and 12 in 1983. Over the period, 20 percent of all fire ground

deaths occurred at wildland fires. This reexamination of wildland fire deaths

was prompted by the fact that in 1990 the majority of fire ground deaths occurred

at wildland fires for only the second year since 1977. A similar analysis was first

done in 1988, using data from 1978 through 1987.

This analysis includes members of municipal fire departments who

responded to grass, brush and forest fires within their jurisdictions as well as

career, seasonal and contract employees of state and federal wildland agencies

who were involved in assigned fire fighter activities at the time they were fatally

injured. The federal wildland agencies include the U.S. Forest Service, the

Bureau of Indian Affairs, the Bureau of Land Management, the Fish and Wildlife

Service, the National Park Service and the military. Figure 14 compares the

experience of wildland fire fighters and municipal fire fighters each year. A

distribution of these 162 deaths by region is shown in Figure 15.

For the 92 wildland fires for which cause of the fire was reported, 34 were of

incendiary or suspicious origin, 23 were due to misuse of heat (18 due to

inadequate control of open fire, two due to children playing, two due to abandoned

smoking materials and one due to a misfired teargas cannister), 19 were ,due to

lightning and the rest were due to various other factors.

30
Number of Deaths

Figure 13

Fire Fighter Fatalities in Wildland Fires

1981 - 1990
Number of Deaths

Figure 14

Fire Fighter Fatalities in Wildland Fires

by Jurisdiction 1981 - 1990
Figure 15

Fire Fighter Fatalities at Wildland Fires

by Region 1981 - 1990
The 162 victims included 11 chief officers, 16 company officers and 135 fire

fighters. They ranged in age from 17 to 71, with a median age of 40 years. Seven

of the victims were women.

Almost 75 percent of all wildland fire deaths (117) occurred during fire

suppression activities. The remaining 45 deaths occurred when fire fighters were

responding to or returning from such fires.

Deaths on the Fire Ground

The breakdown of causes of fatal injuries on the fire ground is shown in

Figure 16. The largest proportion of deaths during fire suppression activities

were due to stress. These 35 deaths included 12 attributed to physical exertion on

the fire ground.

The next major category was caught or trapped - 26 by fire progress and one

by falling objects. Seventeen of the 26 fire fighters overrun by fire died as a result

of bums; the other nine died of asphyxiation.

There were 17 deaths as the result of exposure or contact with an object.

These deaths include six exposed to smoke, six exposed to electricity, three

overcome by hot weather and two struck by lightning. Two of the fire fighters

exposed to electricity came into contact with downed power lines, two touched guy

wires that had been energized from contact with power lines, one touched a wire

that had been flung over a power line and one made contact with his vehicle

which had been energized.

Twenty fire fighters were killed in fire department apparatus accidents

during fire suppression activities, including 16 in aircraft crashes. Fourteen of

those 16 victims were contract pilots working for state and federal wildland

agencies. The other two pilots were employees of a state and federal agency,

34
Figure 16

Fire Fighter Fatalities on the Fire Ground

at Wildland Fires, by Cause of Injury

1981 - 1990
respectively. Three of the-victims were killed in one accident that was due to the

structural failure of the plane. Pilot error was a factor in most of the other

accidents.

Fifteen fire fighters were struck by vehicles or falling objects. The

remaining three fire fighters fell -- one into a hole, one from a fire department

vehicle and one down a hillside.

The next breakdown of wildland fire deaths is by nature of fatal injury,

more commonly referred to as medical cause of death. State and federal wildland

officials believe that their rigorous fitness requirements lower the risk of heart

attack death among fire fighters under their jurisdiction. For this analysis, then,

the fire ground deaths were broken down by type of department - municipal

(career or volunteer) or wildland agencies. A profile of the 117 fire ground victims

shows that 55 were members of municipal fire departments (48 belonged to

volunteer departments and 7 to career departments). Another 59 fire fighters

were career, seasonal or contract employees of state and federal wildland

agencies. (The remaining three fire fighters were employees of paper companies

and members of their companies’ fire brigades. They are not included in this

analysis. Two of them died of bums and one of a heart attack.)

As shown in Table 3, heart attacks accounted for over half of the deaths of

municipal fire fighters during fire suppression activities, while most of the

deaths to state and federal employees were due to internal trauma, bums and

asphyxiation.

Of the 20 municipal heart attack victims for whom medical documentation

was available, 12 had had prior heart attacks or bypass surgery, four had severe

arteriosclerotic heart disease, two had diabetes and one had hypertension. No

medical problems were reported for one fire fighter. The municipal volunteer fire

fighters who suffered heart attacks ranged in age from 27 to 71, with a median

36
Table 3

Wildland Fire Fighter Fatalities on the

Fire Ground by Nature of Fatal Injury

1981 - 1990

Heart attack

Internal trauma

Bums

Asphyxiation

Electric shock

Crushing

Heat stroke

Amputation

Stroke

Bleeding

Drowning

Fracture

Aneurysm

Federal and State Municipal

Wildland Agencies Volunteer Career

3

2l

13

9

3

5

0

2

2

29

5

1

1

5

3

1

0

0

Total

2

0

1

1

0

0

2

0

0

34

26

15

11

8

8

3

2

2

2

1

1

1

0 2 0

0 1 0

1 0 0

0 0 1

Total 59 48 7 114

Note: Another three deaths involved members of fire brigades of paper companies

two died from burns and one suffered a heart attack.

37
age of 56 years. The two career municipal fire fighters were aged 56 and 61. Of

the three wildland fire fighters who died of heart attacks, one had severe

arteriosclerotic heart disease, one had hypertension and no medical

documentation was available on the other victim. The three men were aged 38, 44

and 55 years.

The lower proportion of heart attacks among wildland agency fire fighters

may be a result of stricter fitness requirements, but it could also be a function of

age. Older fire fighters are more likely to suffer heart attacks and if the wildland

agencies employ a significantly lower percentage of older fire fighters, their

experience would reflect this. Looking at all fire ground deaths, municipal vs.

wildland agencies, the ages of wildland fire fighters who died ranged from 18 to

64, with a median age of 35 years, while volunteer municipal fire fighters ranged

in age from 17 to 71,with a median age of 52, and career municipal fire fighters

ranged in age from 24 to 61, with a median age of 50 years. Other factors besides

age and fitness requirements that may impact the incidence of heart attack

deaths at wildland fires include the equipment provided. In many of the incidents

handled by municipal fire fighters, those involved in fighting the fire did so in full

protective clothing designed for structural fire fighting, while wildland fire

fighters wear clothing, helmets and boots more appropriate to outdoor work.

As far as the other types of injuries suffered on the fire ground are

concerned, increased use of fire shelters could result in a reduction in fatal burns

and smoke inhalation deaths and safer handling of aircraft could reduce the

number of deaths due to aircraft crashes during suppression activities.

38
Deaths While Responding to or Returning from Alarms

Of the 45 fire fighters who died while responding to or returning from

wildland fires, 37 of the victims were responding to fires and 8 were either en

route from fires or back at the station or base camp when they died. The

breakdown of deaths while responding to or returning from alarms is shown in

Figure 17.

Thirty of the victims were involved in motor vehicle accidents while driving

or riding on fire department apparatus, including eight in aircraft crashes.

Three of the eight were killed in two aircraft crashes that resulted from

mechanical failure; four were killed in one helicopter that crashed after striking

a high tension wire; and the cause of the remaining crash was not reported. Ten

fire fighters died as a result of stress, two fell from fire department apparatus,

one was struck by a vehicle, one was caught or trapped by a falling object, and one

was caught and trapped underwater and drowned.

The 45 injuries while responding to or returning from wildland fires

resulted in 27 deaths due to internal trauma, 10 heart attacks, five deaths due to

crushing injuries, and one death each due to fracture, bums and drowning.

Experience in 1990

As mentioned earlier in this report, 1990 was only the second year since

NFPA began doing comprehensive studies of fire fighter deaths that the largest

proportion of fire ground deaths occurred in wildland fires. (1987 was the first

year that that happened.) In addition to those 19 deaths, two others, both

volunteers, died while responding to or returning from such fires.
Figure 17

Fire Fighter Fatalities Responding to or

Returning from Wildland Fires by Cause of Injury

1981 - 1990
The most serious incident in 1990 resulted in the deaths of six fire fighters ---

five inmates and their supervisor. They all suffered smoke inhalation and burns

when they were overrun by the fire. Ironically, the next day in a neighboring

state, a similar scenario resulted in the deaths of two more inmates. Later in the

summer, two fire fighters cutting a fire line with a bulldozer also were overrun by

fire and fatally burned.

Two U.S. Forest Service contractors died when their plane crashed as they

 were dropping retardant on a fire. One fire fighter was killed when his helicopter

crashed as he was dropping water on a fire.

One fire fighter died of a heart attack while operating at a grass fire. One

fire fighter operating at a large fire involving brush and several dwellings fell

down a steep hillside and hit a tree stump; the resulting pulmonary embolism led

to his death. A fire fighter who was caught in a flare-up was fatally burned.

Another was struck on the head. by a burning snag. One fire fighter suffered a

stroke while attending a morning briefing before going on the fire line. And

finally, a fire fighter working at a grass fire died of heat stroke.

Of the two fire fighters who were killed while responding to wildland fires,

one died of a heart attack and the other was killed in a head-on collision while en

route to the station.

41
IV. Fatalities Resulting from Heart Attacks, 1981 - 1990

NFPA’s first special study on fire fighter fatalities as a result of heart

attacks, strokes and aneurysms was done in 1987 and covered the period from

1977 through 1986. Since heart attack continues to be the leading cause of U.S. fire

fighter deaths, that analysis is updated here to cover the period from 1981 through

1990.

The 1987 analysis included cardiac arrest, stroke (CVA) and aneurysm,

because all involve the cardiovascular system. This analysis will concentrate on

cardiac arrest, or heart attack, only. Of the 1221 fire fighter fatalities over the 10-

year period, 560 (45.9 percent) fell into this category. (Over the same period, there

were also 19 strokes and 5 aneurysms.) The aspects of the problems examined in

this study include the physical condition of the victims prior to their deaths, the

types of duty and activities they were engaged-in and their ranks and ages.

Over the lo-year period, the number of deaths annually has ranged from a

high of 71 in 1981 to its lowest level of 40 in 1984 and 1990. As shown in Figure 18,

however, there has not been a steady decrease over the period. Looked at another

way, the proportion of total deaths each year that these deaths account for has

varied from a high of 53.8 percent in 1989 to a low of 33.6 percent in 1984.

Physical Condition

Information on physical condition prior to fatal injury was available for 263

of the 560 heart attack victims. This information was obtained from medical

documentation that accompanied fatality reports.* As shown in Figure 19, of

* Medical documentation used to evaluate the physical conditions of heart attack victims was in

the form of death certificates and autopsy reports. Fire fighters who experienced prior heart

problems may or may not have been aware of their physical conditions prior to the fatal heart

attack.

42
Figure 18

Fire Fighter Deaths Due to Heart Attacks

1981 - 1990

Number of Deaths

80

70

60

50

40

30

20

10

1981 1982 1983 1984 1985 1986 1987 1988 1989 1990

Year
Figure 19

Fire Fighter Deaths Due to Heart Attacks

by Physical Condition

1981 - 1990
these 263 fire fighters, 128 (48.7 percent) had had some prior heart-related

conditions, such as previous heart attacks or coronary bypass surgery. Another

93 of tlhe victims (35.4 percent) had severe arteriosclerotic heart disease (defined

for this study as medically documented arterial occlusion of at least 50 percent but

usually found to be in excess of 70 percent). Taken together, then, almost 85

percent of the heart attack victims for whom medical documents were available

had known or detectable heart problems and were still active in the fire service.

Hypertension - another easily diagnosed, serious condition - was indicated

in an additional 20 (7.6 percent) of the victims, and 12 others (4.6 percent) had

diabetes. One fire fighter had recently had an operation to remove the lower part

of his left lung. One was taking medication for blood clotting. And one had

recently suffered a viral infection that had resulted in inflammation of his heart.

Only 7 of the 263 victims reportedly had no previous health problems.

Available reports on the other 297 heart attack victims did not contain

enough medical documentation to determine whether previous, related problems

existed.

Type of Duty

Figure 20 shows the distribution of types of duty the 560 fire fighters were

engaged in when they suffered their fatal heart attacks. The largest proportion,

258 deaths (46.1 percent), occurred during fire ground activities. Of these, 233

were attributed to stress or overexertion (89 were reportedly during strenuous

physical activity), 23 were due to exposure to smoke and two were due to hot

weather. Four of the 23 smoke-exposure heart attack deaths occurred at wildland

45
Figure 20

Fire Fighter Deaths Due to Heart Attacks

by Type of Duty

1981 - 1990
fires, where fire fighters do not use breathing apparatus. Two others were at

vehicle fires and the remaining 17 deaths were at structure fires. In 13 of those 17

cases and 31 of the 47 stress-related deaths that occurred inside structures, the

fire fighters were not using self-contained breathing apparatus (SCBA). Of the

remaining four smoke exposure deaths, three had their SCBA off and on during

the fire and one removed his SCBA as he left the building. All 23 victims of smoke

exposure heart attacks reportedly had pre-existing heart conditions.

The next largest proportion involved fire fighters responding to or

returning from alarms (144 deaths or 25.7 percent). Of these 144 fire fighters, 75

were responding to incidents at the time they suffered the fatal heart attack. The

other 69 were returning or had returned from the alarm when they were stricken.

Most of the alarms that resulted in these deaths involved actual emergencies, but

there were 10 false calls involved -- five of them malicious false alarms.

The other major categories included 58 deaths during admimistrative and

normal station duties (10.4 percent), 47 deaths during training (8.4 percent) and

33 deaths while working at non-fire incidents such as emergency medical and

rescue calls (5.9 percent). The other 20 deaths (3.6 percent) occurred during other

on-duty activities such as fire prevention, inspection, maintenance, etc. Of the 47

fire figlhters who died during training activities, 17 were engaged in physical

fitness activities, such as jogging, playing basketball or undergoing stress tests.

Ages of Fire Fighters

The distribution of ages of the heart attack victims is displayed in Figure 21.

The ages range from 16 to 81 years, with a median age of 52 years. Five of the six

fire fighters aged 25 and under had congenital heart problems. The sixth fire

fighter had had a viral infection that damaged his heart and lungs. Eleven of the

47
Figure 21

Fire Fighter Deaths Due to Heart Attacks

by Age 1981 - 1990
26 fire fighters aged 26 to 35 had prior heart problems (heart attacks or bypass

surgery) and five others had severe arteriosclerotic heart disease. As can be seen

from the breakdown by career and volunteer fire fighters (232 career fire fighters

vs. 328 volunteer fire fighters) over 40 percent of the victims were career fire

fighters, although it is estimated that only 25 percent of the nation’s fire fighters

are career. Therefore, career fire fighters suffer proportionally more heart attack

deaths than volunteer fire fighters. (Career fire fighters in fact suffer

proportionally more deaths of all types than volunteers, possibly because of the

higher number of hours and calls per year per person for career fire fighters.)

Figure 21 also shows that the victims over age 60 were mostly volunteer, possibly

due to the tendency of volunteer fire fighters to remain active well beyond the

retirement ages of career fire fighters. Figure 22 compares the experience of

career and volunteer fire fighters over the lo-year period.

Ranks of Fire Fighters

Figure 23 shows the ranks held by the fire service personnel who suffered

fatal heart attacks and whose ranks were known. The largest proportion (333 or

59.4 percent) were fire fighters. Company officers made up 23.4 percent (131

deaths) of the total and the remaining 17.2 percent were chief officers (96 deaths).

These statistics indicate that, for every 2.5 fire fighters stricken with a fatal heart

attack, one company officer is stricken. Based on typical complements of three or

four personnel to each fire company (one officer and two or three fire fighters) this

suggest’s a roughly equal risk of heart attack for company officers and fire

fighters. However, for every 3.5 fire fighters stricken, one chief officer died,

showing a much higher risk for chiefs (although the ratio of chief officers to fire

fighters; is not known). These patterns, taken together, show that fire service

49
Figure 22

Fire Fighter Deaths Due to Heart Attacks

Career vs. Volunteer 1981 - 1990

Number of Deaths

45

40

35

30

25

20

15

1 0

5

1981 1982 1983 1984 1985 1986 1987 1988 1989 1990

Year
Figure 23

Fire Fighter Deaths Due to Heart Attacks

by Rank

1981 - 1990
personnel at all ranks face increased risk of heart attack, and so prevention

programs should not focus on, or exclude, any one rank.

Summary

From 1981 through 1990, 560 fire fighters, or almost half of the total number

of fire fighters who died in the line of duty, died as the result of heart attacks, and

over 80 percent of those with medically documented prior conditions had known or

detectable heart problems. (Nearly all had some serious prior health problems.)

Heart attacks among fire service personnel are serious, all-too-common

occurrences. Steps to reduce the risk of heart attacks among fire fighters, along

with more detailed medical evaluations, should be taken. Further study in the

areas of physical fitness and dietary requirements for fire fighters is

recommended.

Above all, attention must be focused on the significant problem of fire

service personnel who have heart problems, yet are allowed to remain active in

fire fighting.

52
V. Conclusions and Recommendations

For the second consecutive year, there was a sharp drop in the number of

fire fighter deaths in the U.S. Last year we reported that most of the decrease in

1989 was accounted for in the experience for volunteer fire fighters, after two

years of increases for them. In 1990, the experience for volunteers held fairly

steady and the decrease occurred in the experience of career fire fighters. The

trends since 1977 are shown for both groups in Figure 24.

As shown in Figure 1, the annual number of fire fighter fatalities had

reached a plateau throughout the 1980s. We may be seeing the beginning of a

major downward trend in fire fighter deaths. Clearly, there is a major downward

trend for career fire fighters, but volunteer fire fighter deaths were higher in 1990

than they were at the beginning of the decade,

Two of the areas of major concern in 1990 were highlighted id special 10-

year analyses -- wildland fire deaths and heart attack deaths. The first analysis

was prompted by the very high proportion of fire ground deaths at wildland fires

in 1990. The second analysis addresses a chronic problem observed each year.

The analysis of wildland fires showed that almost a third of the deaths

resulted in heart attacks -- mainly affecting members of municipal fire

departments and that motor vehicle accidents, particularly those involving

aircraft, and rapid fire progress remain significant problems. Rigorous fitness

requirements for wildland fire fighters, the use of fire shelters and appropriate

protective clothing and safer operation of vehicles including aircraft show real

potentials in reducing losses in wildland fires. The special risks associated with

operations at wildland fires warrant continued attention to command, control and

communications issues.

53
Figure 24

Number of Deaths

Comparison of Career and Volunteer Experience

1977 - 1990
As described in the 10-year analysis of heart attack deaths, heart attacks

continue to account for the largest share of fire fighter deaths annually. For over

80 percent of the cases where medical documentation was available, the victims

had suffered prior heart attacks, had had bypass surgery or had severe

arteriosclerotic heart disease. Others had serious health problems such as

hypertension or diabetes. Detailed medical evaluations throughout the course of a

fire fighter’s career, as well as studies into the areas of physical fitness and

dietary requirements for fire fighters, are among the steps that must be taken to

reduce the incidence of heart attacks among fire fighters.

Heart attacks and wildland fires accounted for 59 of the 105 fire fighter

deaths in 1990. Other serious health and safety issues continue to account for a

sizeable share of the annual death toll and must also be addressed. These include

motor vehicle collisions, accidents at rescue scenes, plane crashes and carbon

monoxide and carbon dioxide poisoning, for example.

Basic guidelines for sound health and safety practices need to be

implemented throughout the fire service. One example is NFPA 1500, Standard

on Fire Department Occupational Safety and Health Program, which provides the

framework and objectives for a comprehensive program to reduce and eliminate

fire fighter deaths and injuries. Another is proposed NFPA 1582, Standard on

Medical Requirements for Fire Fighters, which will specify minimum medical

requirements for candidate and current fire fighters, including full-time or parttime employees and paid or unpaid volunteers.

Further reductions in fire fighter deaths can be accomplished if changes

are made in operating procedures and attitudes.

55
References

1. Michael J. Karter, Jr., U.S. Fire Department Profile through 1989; Quincy,

MA: National Fire Protection Association, Fire Analysis and Research

Division, November 1990.

2 . Michael J. Karter, Jr., “U.S. Fire Loss in 1990,” NFPA Journal, Vol. 85,

No. 5, (September 1991).

3 . The four regions defined by the U.S. Census Bureau are as follows:

Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New

Jersey, New York, Pennsylvania, Rhode Island, and Vermont.

Northcentral: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota,

Missouri, Nebraska, North Dakota, Ohio, South Dakota, and Wisconsin.

South: Alabama, Arkansas, Delaware, District of Columbia, Florida,

Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina,

Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West

Virginia.

West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana,

Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.

5 6