FFFIPP Progress Report 1 May 4, 2011

NIOSH Fire Fighter Fatality Investigation and Prevention Program 

(FFFIPP) Progress Report and Proposed Future Directions – 2011 

The National Institute for Occupational Safety and Health (NIOSH) is committed to 

ensuring that the NIOSH Fire Fighter Fatality Investigation and Prevention Program 

(FFFIPP) is meeting the needs and expectations of the U.S. fire service. NIOSH has 

sought public input to help plan and direct the goals and objectives of the FFFIPP since 

the program was initiated in 1998. NIOSH received public comments on the FFFIPP in 

January 1998, March 2006, and November 2008.

Most recently, in November 2008, nineteen fire service representatives attended a 

FFFIPP public stakeholder meeting held in Chicago. The organizations represented 

included the International Association of Fire Chiefs (IAFC), the International 

Association of Fire Fighters (IAFF), the National Fire Protection Association (NFPA), 

the United States Fire Administration (USFA), the National Institute of Standards and 

Technology (NIST), the ISO, the International Safety Equipment Association (ISEA), 

and the National Fallen Firefighters Foundation (NFFF). Several of these groups made 

presentations and all contributed comments to the docket 

http://www.cdc.gov/niosh/docket/archive/docket063A.html.

The primary modifications made to the FFFIPP following the November 2008 

stakeholder meeting were to finalize the FFFIPP strategic plan

(http://www.cdc.gov/niosh/fire/strategicplan2009.html), add information on pending 

investigations to the FFFIPP website (http://www.cdc.gov/niosh/fire/PendingFire.html), 

modify the fatality investigation reports to create an executive summary and clearly 

identify contributing factors, and to continue to increase the depth of the investigations 

through expert consultation and increased attention to the identification of contributing 

factors such as fire growth. 

NIOSH is again seeking stakeholder input on the progress and future directions of the 

NIOSH FFFIPP to ensure that the program is meeting the needs and expectations of the 

U.S. fire service, and to identify ways in which the program can be improved to increase 

its impact on the safety and health of fire fighters across the United States

(http://www.cdc.gov/niosh/docket/review/docket063B/default.html).

Background

During fiscal year 1998, Congress recognized the need to address the continuing national 

problem of occupational fire fighter fatalities and funded NIOSH to implement a fire 

fighter safety initiative. Based on stakeholder input received in 1998 and since, the 

FFFIPP conducts independent investigations of fire fighter line-of-duty deaths (LODD) 

to formulate recommendations for preventing deaths and injuries. 
FFFIPP Progress Report 2 May 4, 2011

Since the FFFIPP was initiated in 1998, 1270 fire fighters have died in the line-of-duty 

through 2010 (not counting the 343 fire fighters who died on September 11, 2001). 

During this 13-year period, the FFFIPP has investigated 524 fire fighter LODDs or 41 

percent of the total (296 trauma LODDs and 228 medical LODDs). The FFFIPP has also 

conducted a small number of near-miss incidents in which fire fighters were injured. 

Investigation Priorities

Since NIOSH does not have the resources to conduct investigations of all fire fighter 

LODDs, each incident is prioritized using a decision logic that can be found on the 

NIOSH FFFIPP website at http://www.cdc.gov/niosh/fire/pdfs/FFFIP_DecisionChart.pdf. 

The current priorities for investigating traumatic LODDs include multiple fatality events, 

structure fires, motor vehicle incidents, and new or emerging hazards. The priorities for

investigating medical LODDs include hyper/hypothermia; seizures, diabetes, and drug 

overdose; physical fitness training; emergency responder training; and sudden cardiac 

death on the fireground. NIOSH welcomes comments on these priorities along with 

suggestions for replacing or modifying them. 

Program Accomplishments 

Since the last Public Stakeholder Meeting in November 2008, the FFFIPP has recorded 

the following accomplishments:

• Completed – 30 medical and 50 traumatic investigations

• Published – NIOSH ALERT: Preventing Deaths and Injuries of Fire Fighters 

using Risk Management Principles at Structure Fires. Publication no. 2010-153

• Published – NIOSH Workplace Solutions: Preventing Deaths and Injuries of Fire 

Fighters Operating Modified Excess/Surplus Vehicles. Publication no. 2010-125

• Published – NIOSH Safety Advisory - Manual Adjustment of Automatic Slack 

Adjusters May Contribute to Unexpected Brake Failure on Automotive Fire 

Apparatus. Publication no. 2010-102 

• Published – NIOSH Workplace Solutions: Preventing Deaths and Injuries of Fire 

Fighters Working Above Fire-Damaged Floors. Publication no. 2009-114

• Published – Fire Fighter Fatality Investigation and Prevention Program: Leading 

Recommendations for Preventing Fire Fighter Fatalities, 1998-2005. Publication 

no. 2009-100
FFFIPP Progress Report 3 May 4, 2011

• Provided information and data from several recent LODD investigations 

regarding the thermal degradation of SCBA facepiece lenses to the NFPA 

Technical Committee on Respiratory Protective Equipment

• Provided information and data from several recent CVD investigations associated 

with left ventricular hypertrophy to the NFPA Technical Committee on Fire 

Service Occupational Safety and Health

• Provided information and data from a recent training investigation involving an 

elevated aerial platform to the NFPA Technical Committee on Automotive Fire 

Apparatus.

• Disseminated findings from NIOSH investigations via presentations at fire service 

and medical conferences.

In addition, the FFFIPP continues to receive examples of others using program findings 

and recommendations to improve fire fighter safety. For example: 

• During 2009 and 2010 there were approximately 453,600 visits to the FFFIPP 

webpage.

• Fire departments regularly report using FFFIPP investigation reports and 

publications to support fire fighter training.

• The 2012 International Residential Code will require the application of a drywall 

or structural wood membrane to the underside of floor systems in non-sprinklered 

residential dwellings. The IAFF proposed this code modification based in part on 

findings from NIOSH LODD investigations and recommendations that 

lightweight construction systems be protected with a fire-resistant barrier.

• Fire service articles and publications frequently reference and encourage the use 

of NIOSH fatality investigations and recommendations to improve fire fighter 

safety.

Strategic Plan

Since 2009 the Strategic Plan for the NIOSH Fire Fighter Fatality Investigation and 

Prevention Program has been used to guide the research and continued implementation of 

the FFFIPP, http://www.cdc.gov/niosh/fire/strategicplan2009.html. Developmental

sources for the plan include fire service stakeholder comments submitted to the NIOSH 

docket and during public meetings; a 2007 report to NIOSH from the IAFC Fire Fighter 

Fatality Investigation and Prevention Program Task Force; results of a Fire Fighter 

Fatality Investigation and Prevention Program Evaluation conducted by RTI 

International; and recommendations from a 2007 program review by the Health and 

Human Services Office of Inspector General.
FFFIPP Progress Report 4 May 4, 2011

The Strategic Plan addresses the mission of the FFFIPP, strategic goals to improve fire 

fighter health and safety, program activity/output goals, and performance measures by 

which the NIOSH FFFIPP can be evaluated. 

Progress Toward Goal Achievement

While FFFIPP activities since November 2008 have been closely linked with the 

activity/output goals and performance measures of the Strategic Plan, staffing and 

funding resources have hindered the program from achieving some of its goals. The 

FFFIPP budget has been stable since the program’s initiation in 1998; however, staffing 

and operating costs have increased. It is anticipated that this situation will not improve 

and may further deteriorate over the next few years. Given current efforts to reduce the 

federal deficit, there is the potential for FFFIPP funding to be reduced. 

The following table summarizes the FFFIPP implementation progress since November 

2008 related to individual activity/output goals and performance measures in the 

Strategic Plan and identifies areas which NIOSH proposes to scale back should staffing 

and funding resources be further constrained.

FFFIPP Progress

Activity/Output Goals

Performance Measures

Progress November 2008

to January 2011

Comments

Goal A: Conduct fatality 

investigations as the principal 

activity of the FFFIPP

80 fatality investigations 

completed, 30 medical and 

50 traumatic injury

Budget reductions 

would negatively 

impact this activity;

however, NIOSH 

proposes that LODD 

investigations remain 

the highest FFFIPP 

priority

A.1: Investigations will be 

finalized each year at a minimum

of 3 investigations per fulltime 

investigator.

9 investigators, 8 fulltime

and 1 half-time averaged 

over 4 completed

investigations annually.

A.2: 90% of investigations 

through 2010 will involve CVD, 

structure fires, and MVA

incidents.

81% of all cases involved 

CVD, structure fires, and 

MVA incidents.

A.3: Initial site visits will be 

conducted within 3 weeks of the 

fatality in 80% of fatal traumatic 

injury incidents.

Site visits were conducted 

for 79% of traumatic injury 

incidents within 3 weeks. 

Site visits are often 

delayed in deference 

to funeral and 

memorial services
FFFIPP Progress Report 5 May 4, 2011

FFFIPP Progress

Activity/Output Goals

Performance Measures

Progress November 2008

to January 2011

Comments

A.4: Input will be obtained to 

improve the design and format of 

fatality investigation reports by 

Fiscal Year 2010.

Report format revisions 

were implemented during 

2009 and 2010. Stakeholder 

input is being sought 

through the 2011 docket.

NIOSH health 

communication 

experts collected 

comments from fire 

fighters during fire 

service conferences 

A.5: Investigation priorities will 

be revisited and input sought for 

proposed changes by 2010. 

Stakeholder input is being 

sought through the 2011 

docket.

G oal B: I ndividual fatality 

r epor ts will be gener ated for 

each investigation and 

investigation findings will be 

r epor ted and summar ized in 

additional publications. 

B.1: 50% of investigation reports

will be completed within 6 months 

of the site visit, 95% will be within 

12 months.

41% of the investigation

reports were completed 

within 6 months and 48% 

were completed within 12 

months. 55% of cases 

initiated in 2009 were 

completed in 6 mos. and 

81% were completed within 

12 mos.

The FFFIPP will 

continue its efforts to 

reduce the 

completion time for 

investigations.

B.2: One document (other than a 

fatality report) will be published 

annually 

1 NIOSH Alert, 1 Safety 

Advisory, 2 Workplace 

Solutions and 1 Technical 

Report were published.

G oal C : Seek peer and 

stakeholder input to impr ove the 

quality of pr oducts and the 

impact of the pr ogr am.

C.1: 75% of traumatic fatality

reports will be reviewed by 

external experts and 100% of 

publications will be reviewed by 

peers and/or stakeholders

100% of traumatic LODD 

reports were reviewed by 

external experts.

All publications were 

reviewed by peers and 

stakeholders.
FFFIPP Progress Report 6 May 4, 2011

FFFIPP Progress

Activity/Output Goals

Performance Measures

Progress November 2008

to January 2011

Comments

C.2.: Expert consultation and/or 

testing will be sought on all 

investigations suggestive of 

personal protective technology 

malfunctions or failures. 

Expert consultation was 

sought for 4 cases involving 

the possibility of equipment 

malfunctions. 

If there are budget 

reductions, NIOSH 

proposes scaling back 

on expert 

consultations 

requiring funding.

C.3: Stakeholder input will be 

sought at least every two years 

through a public meeting and/or 

docket.

NIOSH is seeking input

through the 2011 docket. 

A public meeting is 

not being held 

because of budget 

uncertainties.

G oal D: I ncr ease fir e ser vice 

exper tise of F F F I PP per sonnel

D.1: Each trauma investigator will 

take at least one fire-service 

training course or attend a fire 

service conference specifically for 

training annually.

Each investigator attended 

one or more fire service 

training sessions yearly.

If there are budget 

reductions, NIOSH 

proposes scaling back 

on training with 

vendor and /or travel 

costs.

D.2: Announcements for

investigator positions will require 

fire service and occupational 

safety and health experience.

3 investigators with fire 

service experience have 

joined the FFFIPP team 

since January 2008

Under the current 

budget, no additional 

investigators will be 

hired. 

G oal E : E nsur e F F F I PP 

r ecommendations and pr oducts 

ar e used to impr ove fir e fighter 

safety and health

E.1: The program will be involved 

in at least 2 outreach activities 

annually.

The program actively 

supports the National Seat 

Belt Pledge and the June 

IAFC Safety, Health, and 

Survival Week

E.2: FFFIPP investigators will 

meet annually with the National 

Personal Protective Technology 

Laboratory (NPPTL) staff to 

discuss investigation findings 

related to personal protective 

technology.

3 meetings were held to 

discuss findings related to 

personal protective 

equipment (PPE). FFFIPP 

and NPPTL routinely 

collaborate on PPE 

evaluations related to fire 

fighter LODDs.
FFFIPP Progress Report 7 May 4, 2011

FFFIPP Progress

Activity/Output Goals

Performance Measures

Progress November 2008

to January 2011

Comments

E.3: Investigation findings will be 

communicated to the National Fire 

Protection Association (NFPA) 

and other standards setting 

agencies annually 

FFFIPP and NIOSH staff

members participate on 5 

NFPA committees. NIOSH 

documented issues of SCBA 

face piece degradation to 

NFPA by letter in 2010. 

NIOSH proposes

continued 

participation on 

NFPA committees, 

but proposes limiting 

participation 

requiring travel if 

there are budget 

reductions

E.4: Relevant investigation 

findings will be communicated to 

manufacturer groups as needed, 

and at least every two years.

Findings related to thermal 

degradation of SCBA lenses

was provided to NFPA.

Manufacturers of fire 

service equipment, 

including all SCBA 

manufacturers, are 

represented on NFPA 

committees.

E.5: Implement improved 

communications strategy to reach 

small and volunteer departments

by 2011.

The FFFIPP will work with 

the NIOSH Office of Health 

Communications to improve 

communications strategy

and is seeking stakeholder 

input through the 2011 

docket.

FFFIPP team 

members and the 

National Volunteer 

Fire Council have 

recently discussed 

ideas for improving 

outreach to volunteer 

departments.

E.6: Implement input from a web 

publishing consultant to improve 

the FFFIPP Web site by 2011.

The FFFIPP will work with 

the NIOSH Office of Health 

Communications to improve 

the FFFIPP website and is 

seeking input through the 

2011 docket.

Budget concerns will 

preclude acquisition 

of consultant services 

for this effort.

E.7: Develop a survey that would 

be provided to all departments 

following a NIOSH fatality 

investigation that would provide 

feedback on the investigation and 

departmental changes made as a 

result of the investigation will be 

developed by Fiscal Year 2011 

and implemented by 2013. 

A pilot survey was 

developed and is currently 

being pilot tested by the 

medical investigation team. 

E.8: Seek funding to conduct a 

study assessing the FFFIPP impact

on fire department training, 

policies and practices by Fiscal 

Year 2012.

It is anticipated that 

budgetary restrictions 

may hinder this 

effort.
FFFIPP Progress Report 8 May 4, 2011

Proposed Future Directions

One key area in which NIOSH is seeking comment involves the uncertainties with the 

federal budget. In the event that the FFFIPP budget is reduced, the FFFIPP proposes to 

devote all available resources to the independent investigation of fire fighter line-of-duty 

deaths. The FFFIPP proposes to reduce or eliminate attendance at conferences, 

workshops, training and fire service stakeholder meetings. This will impact NIOSH 

participation on standard-setting committees such as NFPA technical committees. 

Reports and publications will continue to be available through the NIOSH and FFFIPP 

web pages. However, printed reports and publications may also be eliminated. NIOSH 

welcomes comments on proposed priorities for the FFFIPP in the event of reduced 

funding.

Specific Topics for Stakeholder Input 

The NIOSH FFFIPP welcomes comments on any aspect of the FFFIPP. Specific 

comments are being solicited on the following key topics:

• FFFIPP priorities for conducting investigations

• changes to the format of FFFIPP investigation reports

• changes to the FFFIPP website

• suggestions for program improvements to increase the impact on fire fighter safety and 

health

• examples of how FFFIPP investigation reports and products are used by fire service 

organizations, fire departments and fire fighters, and fire service safety and health 

researchers

• ways in which the FFFIPP can document its impact on fire fighter safety and 

health.