A summary of a NIOSH fire fighter fatality investigation August, 2014

Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

Executive Summary

2014

11

Fire Fighter Fatality Investigation Death in the line of duty... and Prevention Program

On February 1, 2014, a 57-year-old male 

volunteer fire fighter (“FF”) spotted a grass 

fire threatening a local residence and nearby 

barn. After notifying dispatch, he assisted 

the local fire department in extinguishing the 

fire. He pulled a 11⁄2-inch hoseline to the fire 

in two locations and to the top of the engine’s 

hosebed. While atop the engine hosebed, the 

FF was found unresponsive and not breathing 

(1341 hours). The incident commander of the 

responding fire department notified dispatch, 

then began cardiopulmonary resuscitation 

(CPR). The FF was placed into the bed of 

a pickup truck and driven to the ambulance 

station with CPR administered en route. 

Upon arrival, the ambulance paramedics 

began advanced life support including cardiac 

monitoring with defibrillations, intravenous 

cardiac resuscitation medications, and 

intubation. The ambulance transported the 

FF to the hospital’s emergency department 

(ED) where advanced life support continued 

an additional 12 minutes without a change 

in the FF’s clinical status. At 1424 hours the 

attending physician pronounced the FF dead, 

and resuscitation efforts were discontinued.

The death certificate, completed by the county 

coroner, listed “sudden cardiac death due 

to stress/overexertion at fire scene due to 

intentionally set fire due to hypertensive heart 

disease” as the cause of death. No autopsy was 

performed. Blood tests for carboxyhemoglobin 

were negative, suggesting the FF had minimal 

exposure to the carbon monoxide in fire 

smoke. National Institute for Occupational 

Safety and Health (NIOSH) investigators 

concluded that assisting with fire suppression 

activities probably triggered either a heart 

attack or a cardiac arrhythmia resulting in 

sudden cardiac death.

NIOSH investigators offer the following 

recommendations to reduce the risk of heart 

attacks and sudden cardiac arrest among fire 

fighters at this and other fire departments. 

Provide preplacement and annual 

medical evaluations to all fire fighters in 

accordance with NFPA 1582, Standard 

on Comprehensive Occupational Medical 

Program for Fire Departments, to identify 

fire fighters at increased risk for coronary 

heart disease (CHD).

Ensure exercise stress tests are performed on 

fire fighters at increased risk for CHD.

Ensure that fire fighters are cleared for 

return to duty by a physician knowledgeable 

about the physical demands of fire fighting, 

the personal protective equipment used by fire 

fighters, and the components of NFPA 1582.

Phase in a mandatory comprehensive 

wellness and fitness program for fire fighters.
A Summary of a NIOSH fire fighter fatality investigation Report #2014-11

Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

Page 2

The National Institute for Occupational Safety and Health (NIOSH), an institute within the Centers for Disease Control and Prevention (CDC), is the 

federal agency responsible for conducting research and making recommendations for the prevention of work-related injury and illness. In 1998, Congress 

appropriated funds to NIOSH to conduct a fire fighter initiative that resulted in the NIOSH “Fire Fighter Fatality Investigation and Prevention Program” 

which examines line-of-duty-deaths or on duty deaths of fire fighters to assist fire departments, fire fighters, the fire service and others to prevent similar 

fire fighter deaths in the future. The agency does not enforce compliance with State or Federal occupational safety and health standards and does not 

determine fault or assign blame. Participation of fire departments and individuals in NIOSH investigations is voluntary. Under its program, NIOSH 

investigators interview persons with knowledge of the incident who agree to be interviewed and review available records to develop a description of 

the conditions and circumstances leading to the death(s). Interviewees are not asked to sign sworn statements and interviews are not recorded. The 

agency’s reports do not name the victim, the fire department or those interviewed. The NIOSH report’s summary of the conditions and circumstances 

surrounding the fatality is intended to provide context to the agency’s recommendations and is not intended to be definitive for purposes of determining 

any claim or benefit. For further information, visit the program website at www.cdc.gov/niosh/fire or call toll free 1-800-CDC-INFO (1-800-232-4636).
A Summary of a NIOSH fire fighter fatality investigation Report #2014-11

Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

Page 3

Executive Summary (cont.)

Perform a candidate and member physical 

ability evaluation.

Provide fire fighters with medical clearance to wear 

a self-contained breathing apparatus (SCBA) as part 

of the fire department’s medical evaluation program.

Conduct annual respirator fit testing.

Perform an autopsy on all on-duty fire fighter fatalities.

Introduction & Methods

On February 1, 2014, a 57-year-old male volunteer fire fighter suffered sudden cardiac death while 

working at a grass fire. NIOSH was notified of the 

fatality by the U.S. Fire Administration on February 

4, 2014. NIOSH contacted the affected fire department on February 4, 2014, to gather additional information and on May 6, 2014, to initiate the investigation. On May 12, 2014, a safety and occupational 

health specialist from the NIOSH Fire Fighter Fatality Prevention and Investigation Program traveled to 

Mississippi to investigate the incident.

During the investigation, NIOSH personnel interviewed the following people:

● Incident commander of the responding fire department

● Fire chief of the FF’s fire department

● County emergency management director

NIOSH personnel reviewed the following documents:

● Fire department standard operating procedures

● Witness statements

● Sheriff’s report

● Fire department annual report for 2013

● Primary care physician records

● Emergency medical service (ambulance) report

● Hospital ED report

● Death certificate

Investigative Results

Incident. At noon on February 1, 2014, the FF left 

his home to run errands. While driving he noticed 

a grass fire threatening a local residence and a 

nearby barn. He notified dispatch, which alerted 

the local fire department and requested mutual aid 

from a neighboring fire department where the FF 

was a member (1249 hours). 

By the time the first fire engine arrived (1252 

hours), the fire had grown to about 11.5 acres. The 

FF assisted the engine crew by spraying water for 

about 20 minutes using a 11⁄2-inch hoseline. The 

crew disconnected the hoselines as the FF loaded 

the hoses atop the engine. The engine, crew, and 

FF then drove to a barn at risk of catching on fire. 

After extinguishing the grass fire in this area, the 

FF climbed atop the engine and assisted in loading 

the hoselines (about 1320 hours).

The engine crew then drove to another nearby 

location and began to stretch the hoselines but 

was told to relocate to another area. Again, the 

FF climbed atop the engine to reload the hose. 

After a few minutes, the incident commander 

noticed the hose was not being pulled. He 

climbed atop the engine to check on the FF 

and found him unresponsive and not breathing 

(1341 hours). The incident commander notified 

dispatch to request an ambulance (1342 hours). 

The incident commander also alerted the FF’s 

chief, who was also a paramedic, as he began 

CPR. With the help of the FF’s chief, the FF was 

moved into the bed of a pickup truck and driven 

to the ambulance station.

At 1352 hours, the pickup truck arrived at the 

ambulance station, and paramedics found the FF 

in cardiac arrest with CPR being performed. The 

FF was placed onto a long spine board, secured to 
A Summary of a NIOSH fire fighter fatality investigation Report #2014-11

Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

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Investigative Results (cont.)

a stretcher, and placed into the ambulance, which 

departed the scene en route to the ED. Advanced 

life support began; an intravenous line was placed, 

cardiac monitoring revealed ventricular fibrillation 

(a heart rhythm incompatible with life), and two 

shocks were administered. His heart rhythm 

reverted to asystole (no heart beat). Cardiac 

resuscitation medications were administered while 

the FF was intubated with tube placement verified 

by capnography [Neumar et al. 2010].

The ambulance arrived at the ED at 1412 hours. 

Inside the ED, CPR and advanced life support 

efforts continued for an additional 12 minutes 

including two additional shocks. At 1424 hours, 

the FF was pronounced dead by the attending 

physician, and resuscitation efforts were stopped.

Medical Findings. The death certificate, 

completed by the county coroner, listed “sudden 

cardiac death due to stress/overexertion at 

fire scene due to intentionally set fire due to 

hypertensive heart disease” as the cause of death. 

No autopsy was performed. Blood tests for 

carboxyhemoglobin were negative, suggesting the 

FF had minimal exposure to the carbon monoxide 

in fire smoke.

The FF’s risk factors for CHD included: age older 

than 45, male gender, and high blood pressure. 

In 1990, the FF was diagnosed with high blood 

pressure and was treated with beta-blocker 

medications, exercise, and a weight-loss diet. His 

most recent blood pressure was 133/83 millimeters 

of mercury (December 2013). The FF was 69 

inches tall and weighed 198 pounds, giving him 

a body mass index of 29.2 kilograms per meters 

squared [CDC 2014]. Prior to this incident the FF 

never complained of chest pain.

Description of the Fire Department

At the time of the NIOSH investigation, the fire 

department consisted of one fire station with 

10 volunteer uniformed personnel. The fire 

department served 1,000 residents in a geographic 

area of 100 square miles. In 2013, the fire 

department responded to 21 fire/rescue calls.

Membership and Training. The fire department 

requires volunteer fire fighter applicants to 

be 18 years of age, have a valid state driver’s 

license, pass a background check, and pass a 

membership vote. The member is on probation for 

6 months prior to becoming a full member. The 

fire department sponsors two state fire schools 

to train fire fighters. The FF was trained as a first 

responder, in various fire fighting skills, and in the 

incident command system. He had 5 years of fire 

fighting experience.

Preplacement and Annual Medical Evaluations. 

Preplacement and annual medical evaluations 

are not required by the fire department. The fire 

department does not have a requirement for return 

to duty medical clearance for members injured 

on duty, medical clearance to wear a respirator, 

or an annual self-contained breathing apparatus 

facepiece fit test.

Health and Wellness Programs. The fire 

department does not have a wellness/fitness 

program, and exercise equipment is not 

available in the fire station. An annual job 

performance physical ability test is not required 

for members. The FF did not participate in 

physical fitness activities.
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Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

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Discussion

Atherosclerotic CHD. In the United States, 

atherosclerotic CHD is the most common risk 

factor for cardiac arrest and sudden cardiac death 

[Meyerburg and Castellanos 2008]. Risk factors 

for its development include age older than 45, 

male gender, family history of coronary artery 

disease and five modifiable risk factors: smoking, 

high blood pressure, high blood cholesterol, 

obesity/physical inactivity, and diabetes [NHLBI 

2012; AHA 2014]. The FF had two modifiable 

CHD risk factors: high blood pressure and 

physical inactivity.

The narrowing of the coronary arteries by 

atherosclerotic plaques occurs over many years, 

typically decades [Libby 2013]. However, the 

growth of these plaques probably occurs in a 

nonlinear, often abrupt fashion. Heart attacks 

(myocardial infarctions) typically occur with 

the sudden development of complete blockage 

(occlusion) in one or more coronary arteries that 

have not developed a collateral blood supply. This 

sudden blockage is primarily due to blood clots 

(thrombosis) forming on top of atherosclerotic 

plaques [Libby 2013].

Establishing a recent (acute) heart attack 

requires any of the following: characteristic 

electrocardiogram (EKG) changes, elevated 

cardiac enzymes, or coronary artery thrombus. 

In this case, the FF did not have a heart rhythm 

to obtain an EKG, cardiac enzymes were not 

tested because of his rapid demise (< 1 hour), 

and no autopsy was performed to find a coronary 

artery thrombus. Thus, while it is possible the FF 

suffered a heart attack, this diagnosis is less likely 

because the FF did not report angina at the fire 

scene [Davies 1992; Farb et al. 1995]. The FF’s 

sudden cardiac death may have been caused by 

primary cardiac arrhythmia, possibly related to his 

history of hypertension.

Occupational Trigger. Heavy physical exertion 

has been linked to heart attacks and sudden 

cardiac death [Willich et al. 1993; Albert et al. 

2000]. Among fire fighters, sudden cardiac events 

have been associated with alarm response, fire 

suppression, and heavy exertion during training 

(including physical fitness training) [Kales et 

al. 2003; Kales et al. 2007; NIOSH 2007]. The 

FF’s activities at the fire scene would have 

expended about 8 metabolic equivalents, which 

is considered moderate physical activity [Gledhill 

and Jamnik 1992; Ainsworth et al. 2011].

In summary, NIOSH investigators conclude the 

FF’s sudden cardiac death was probably due to a 

heart attack or an arrhythmia, possibly triggered 

by the physical exertion associated with fire 

ground activities. 

Occupational Medical Standards for Structural 

Fire Fighters. To reduce the risk of sudden 

cardiac arrest or other incapacitating medical 

conditions among fire fighters, the National Fire 

Protection Association (NFPA) developed NFPA 

1582, Standard on Comprehensive Occupational 

Medical Program for Fire Departments [NFPA 

2013a]. This voluntary industry standard provides 

the components of a preplacement and annual 

medical evaluation and medical fitness for 

duty criteria. The FF’s risk for CHD was not 

identified until this incident. On the basis of the 

FF’s age and history of high blood pressure, the 

NFPA and the American College of Cardiology/

American Heart Association (ACC/AHA) would 

have recommended a symptom limiting exercise 

stress test (EST) to screen for CHD. However, 
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Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

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Discussion (cont.)

recommendations for ESTs on asymptomatic 

individuals without known heart disease are 

varied. The following paragraphs summarize the 

positions of widely recognized organizations on 

this topic.

NFPA 1582, a voluntary industry standard, 

recommends an EST performed “as clinically 

indicated by history or symptoms” and refers the 

reader to Appendix A [NFPA 2013a]. Items in 

Appendix A are not standard requirements, but 

are provided for “informational purposes only.” 

Appendix A recommends using submaximal 

(85% of predicted heart rate) EST as a screening 

tool to evaluate a fire fighter’s aerobic capacity. 

Maximal (i.e., symptom-limiting) EST with 

imaging should be used for fire fighters with the 

following conditions:

● abnormal screening submaximal tests

● cardiac symptoms

● known coronary artery disease (CAD)

● one or more risk factors for CAD (in men older 

than 45 and women older than 55) 

Risk factors are defined as hypercholesterolemia 

(total cholesterol greater than 240 milligrams per 

deciliter), hypertension (diastolic blood pressure 

greater than 90 mm of mercury), smoking, 

diabetes mellitus, or family history of premature 

CAD (heart attack or sudden cardiac death in a 

first-degree relative less than 60 years old). 

The ACC/AHA has also published exercise testing 

guidelines [Gibbons et al. 2002]. The ACC/AHA 

guideline states that the evidence to conduct stress 

tests in asymptomatic individuals is “less well 

established” (Class IIb) for the following groups: 

● persons with multiple risk factors (defined 

similarly to those listed by the NFPA)

● asymptomatic men older than 45 years and 

women older than 55 years:

○ who are sedentary and plan to start 

vigorous exercise

○ who are involved in occupations in which 

impairment might jeopardize public safety 

(e.g., fire fighters)

○ who are at high risk for coronary artery 

disease due to other diseases (e.g., 

peripheral vascular disease and chronic 

renal failure)

The U.S. Department of Transportation provides 

guidance for those seeking medical certification 

for a commercial driver’s license. An expert 

medical panel recommended exercise tolerance 

tests (stress tests) for asymptomatic “high risk” 

drivers [Blumenthal et al. 2007]. The panel 

defines high risk drivers as those with any of the 

following:

● diabetes mellitus

● peripheral vascular disease

● age 45 and above with multiple risk factors for 

coronary heart disease

● Framingham risk score predicting a 20% coronary heart disease event risk over the next 10 

years. The FF’s Framingham risk score was 10%.

The U.S. Preventive Services Task Force does 

not recommend stress tests for asymptomatic 

individuals at low risk for coronary heart disease 

events. For individuals at increased risk for 

coronary heart disease events, the Task Force 

found “insufficient evidence to recommend for 

or against routine screening with EKG, exercise 

tolerance test, or electron beam computerized 

tomography scanning....” Rather, they recommend 

the diagnosis and treatment of modifiable risk 

factors (hypertension, high cholesterol, smoking, 
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Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

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and diabetes) [USPSTF 2004]. The Task Force does 

note that “For people in certain occupations, such 

as pilots, and heavy equipment operators (for whom 

sudden incapacitation or sudden death may endanger 

the safety of others), consideration other than the 

health benefit to the individual patient may influence 

the decision to screen for coronary heart disease.”

Had an EST been performed as recommended 

by NFPA and AHA/ACC, perhaps the FF’s CHD 

could have been identified, leading to further 

evaluation and treatment.

Discussion (cont.)

Recommendations

NIOSH investigators offer the following recommendations to reduce the risk of heart attacks and 

sudden cardiac arrest among fire fighters at this 

and other fire departments. 

Recommendation #1: Provide preplacement and 

annual medical evaluations to all fire fighters 

in accordance with NFPA 1582, Standard on 

Comprehensive Occupational Medical Program 

for Fire Departments, to identify fire fighters at 

increased risk for coronary heart disease (CHD).

Guidance regarding the content and frequency of 

these medical evaluations can be found in NFPA 

1582 and in the International Association of Fire 

Fighters (IAFF)/International Association of Fire 

Chiefs (IAFC) Fire Service Joint Labor Management Wellness/Fitness Initiative [IAFF, IAFC 2008; 

NFPA 2013a]. These evaluations are performed to 

determine fire fighters’ medical ability to perform 

duties without presenting a significant risk to the 

safety and health of themselves or others. Following this recommendation will require significant resources and may be particularly difficult for smaller 

fire departments to implement. The fire department 

is not legally required to follow the NFPA standard 

or the IAFF/IAFC guideline.

To overcome the financial obstacle of medical 

evaluations, the fire department could urge current 

members to get annual medical clearances from 

their private physicians. Another option is having 

the annual medical evaluations completed by paramedics and emergency medical technicians from 

the local ambulance service (vital signs, height, 

weight, visual acuity, and EKG). This information 

could then be provided to a community physician 

(perhaps volunteering his or her time), who could 

review the data and provide medical clearance (or 

further evaluation, if needed). The more extensive 

portions of the medical evaluations (e.g., EST) 

could be performed by a private physician at the 

fire fighter’s expense (personal or through insurance), provided by a physician volunteer, or paid 

for by the fire department, city, or state. Sharing 

the financial responsibility for these evaluations 

between fire fighters, the fire department, the city, 

the state, and physician volunteers may reduce the 

negative financial impact on recruiting and retaining needed fire fighters.

Recommendation #2: Ensure exercise stress tests 

are performed on fire fighters at increased risk 

for CHD.

NFPA 1582, the IAFF/IAFC Fire Service Joint 

Labor Management Wellness/Fitness Initiative, 

and the ACC/AHA recommend an exercise stress 

test for male fire fighters older than 45 with one or 

more coronary artery disease risk factors [IAFF, 

IAFC 2008; Gibbons et al. 2002; NFPA 2013a]. 

The FF was over the age of 45 and had persistent 

high blood pressure. A symptom-limiting EST 
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Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

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Recommendations (cont.)

may have identified his CHD, possibly leading to 

further evaluation and treatment.

Recommendation #3: Ensure that fire fighters 

are cleared for return to duty by a physician 

knowledgeable about the physical demands of 

fire fighting, the personal protective equipment 

used by fire fighters, and the components of 

NFPA 1582.

Guidance regarding medical evaluations and examinations for structural fire fighters can be found 

in NFPA 1582 and in the IAFF/IAFC Fire Service 

Joint Labor Management Wellness/Fitness Initiative [IAFF, IAFC 2008; NFPA 2013a]. According 

to these guidelines, the fire department should 

have an officially designated physician who is 

responsible for guiding, directing, and advising 

the members with regard to their health, fitness, 

and suitability for duty. The physician should 

review job descriptions and essential job tasks 

required for all fire department positions and ranks 

to understand the physiological and psychological demands of fire fighters and the environmental 

conditions under which they must perform, as well 

as the personal protective equipment they must 

wear during various types of emergency operations. It is unclear if this FF’s personal physician 

was aware of NFPA 1582.

Recommendation #4: Phase in a mandatory 

comprehensive wellness and fitness program for 

fire fighters.

Guidance for fire department wellness/fitness programs to reduce risk factors for cardiovascular disease and improve cardiovascular capacity is found 

in NFPA 1583, Standard on Health-Related Fitness 

Programs for Fire Fighters, the IAFF/IAFC Fire 

Service Joint Labor Management Wellness/Fitness Initiative, the National Volunteer Fire Council Health and Wellness Guide, and in Firefighter 

Fitness: A Health and Wellness Guide [IAFF, 

IAFC 2008; NFPA 2008; USFA 2009; Schneider 

2010]. Worksite health promotion programs have 

been shown to be cost effective by increasing 

productivity, reducing absenteeism, and reducing the number of work-related injuries and lost 

work days [Pelletier 2009; Baicker et al. 2010]. 

Fire service health promotion programs have been 

shown to reduce CAD risk factors and improve 

fitness levels, with mandatory programs showing 

the most benefit [Dempsey et al. 2002; Womack et 

al. 2005; Blevins et al. 2006; Poston et al. 2013]. 

A study conducted by the Oregon Health and Science University reported a savings of more than 

$1 million for each of four large fire departments 

implementing the IAFF/IAFC wellness/fitness 

program compared to four large fire departments 

not implementing a program. These savings were 

primarily due to a reduction of occupational injury/illness claims with additional savings expected 

from reduced future nonoccupational healthcare 

costs [Kuehl 2013].The fire department currently 

does not have a wellness/fitness program, and exercise equipment is not available in the fire station. 

Given the fire department’s structure, the National 

Volunteer Fire Council program would be applicable [USFA 2009], but NIOSH recommends 

a formal, mandatory wellness/fitness program to 

ensure all members receive the benefits of a health 

promotion program.

Recommendation #5: Perform a candidate and 

member physical ability evaluation.

NFPA 1500, Standard on Fire Department Occupational Safety and Health Program, requires the 
A Summary of a NIOSH fire fighter fatality investigation Report #2014-11

Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

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Recommendations (cont.)

fire department to develop physical performance 

requirements for candidates and members who 

engage in emergency operations [NFPA 2013b]. 

Members who engage in emergency operations 

must be annually qualified (physical ability test) as 

meeting these physical performance standards for 

structural fire fighters [NFPA 2013b]. This could 

be incorporated into the annual task-level training 

program.

Recommendation #6: Provide fire fighters with 

medical clearance to wear SCBA as part of the 

fire department’s medical evaluation program.

The Occupational Safety and Health Administration (OSHA) Revised Respiratory Protection Standard requires employers to provide medical evaluations and clearance for employees using respiratory protection [29 CFR 1910.134]. These clearance evaluations are required for private industry 

employees and public employees in states operating OSHA-approved state plans. Mississippi does 

not operate an OSHA-approved state plan; therefore the fire department is not required to ensure 

all members have been medically cleared to wear 

an SCBA [OSHA 2013]. However, we recommend 

voluntary compliance with this recommendation 

to improve fire fighter health and safety.

Recommendation #7: Conduct annual respirator 

fit testing. 

The OSHA respiratory protection standard requires employers whose employees are required to 

use a respirator (e.g., an SCBA) to have a formal 

respiratory protection program, including annual 

fit testing [29 CFR 1910.134]. Therefore, each 

member should have their own SCBA facepiece or 

the fire department would have to ensure enough 

facepieces of each size were made available on 

each fire apparatus. As mentioned previously, 

Mississippi does not operate an OSHA-approved 

state plan; therefore, the fire department is not 

required to follow OSHA standards [OSHA 2013]. 

Nevertheless, NIOSH investigators recommend 

voluntary compliance with this standard to ensure 

proper fitting personal protective equipment.

Recommendation #8: Perform an autopsy on all 

on-duty fire fighter fatalities.

In 2008, the USFA published the Firefighter 

Autopsy Protocol [USFA 2008]. With this publication, the USFA hopes to provide “a more thorough 

documentation of the causes of firefighter deaths 

for three purposes: 

1. to advance the analysis of the causes of firefighter deaths to aid in the development of improved firefighter health and safety equipment, 

procedures, and standards;

2. to help determine eligibility for death benefits 

under the Federal government’s Public Safety 

Officer Benefits Program, as well as state and 

local programs; and

3. to address an increasing interest in the study 

of deaths that could be related to occupational illnesses among firefighters, both active 

and retired.”
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Grass Fire – Mississippi

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A Summary of a NIOSH fire fighter fatality investigation Report #2014-11

Fire Fighter Suffers Sudden Cardiac Death While Working at a 

Grass Fire – Mississippi

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References (cont.)

This incident was investigated by the 

NIOSH Fire Fighter Fatality Investigation 

and Prevention Program, Cardiovascular 

Disease Component in Cincinnati, Ohio. Mr. 

Tommy Baldwin (MS) led the investigation 

and co-authored the report. Mr. Baldwin is a 

Safety and Occupational Health Specialist, 

a National Association of Fire Investigators 

(NAFI) Certified Fire and Explosion 

Investigator, an International Fire Service 

Accreditation Congress (IFSAC) Certified 

Fire Officer I, and a former Fire Chief and 

Emergency Medical Technician. Dr. Thomas 

Hales (MD, MPH) provided medical 

consultation and co-authored the report. Dr. 

Hales is a member of the NFPA Technical 

Committee on Occupational Safety and 

Heath, and Vice-Chair of the Public Safety 

Medicine Section of the American College 

of Occupational and Environmental 

Medicine (ACOEM).

Investigator Information