Firefighter Autopsy Protocol - US Fire Administration - Federal ...

■ Firefighter Autopsy Protocol
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I: Background ■
■ In Los Angeles, cancer mortality among surviving firefighters is elevated for all lung and circulatory
system cancers. 20
■ A study of firefighter mortality as compared to police officers in three northwestern U.S. cities showed
excesses of brain tumors, and lymphatic and hematopoietic cancers. 21
■ A detailed mortality study in Toronto showed firefighters to have statistically significant excesses of
brain, central nervous system, and other cancers. 22
A more recent study has documented the risk of increased rates of multiple myeloma, non-Hodgkin
lymphoma, and testicular cancer for firefighters based on a review of 32 different studies related to firefighter
cancer risks. 23
It can be very difficult to directly attribute a non-line-of-duty death to a line-of-duty exposure, especially
if the exposure occurred years before the death. Comprehensive autopsies of firefighters whose death
may have been caused by a line-of-duty exposure could help establish a better understanding of the
relationship between exposures and premature deaths; however, this will require much better data be
obtained and maintained than is currently the norm.
Many fire departments have mandated physical requirements and medical examinations for firefighters.
Regular medical exams and physical testing can track a firefighter’s physical and medical status from hire
to retirement, and can serve as a baseline against which to compare, especially after an incident or series of
incidents where a firefighter may be concerned that an exposure has jeopardized his or her health.
Records of exposures to particular toxins should be kept by the fire department along with the medical
records. Such documentation would be valuable in determining whether an exposure led to medical
problems, or whether a non-line-of-duty death is related to firefighting or other emergency or
occupational activities.
The firefighter autopsy protocol is primarily intended to be applicable to line-of-duty deaths; however,
it would also be appropriate for non-line-of-duty deaths where an occupational factor is suspected to be
involved in the cause of death. For most firefighter deaths that are not duty-related or that involve former
firefighters, existing clinical autopsy procedures consistent with the individual’s medical history should
be appropriate. The USFA Firefighter Autopsy Protocol has been designed to uncover pertinent forensic
information consistent with the distinct occupational aspects of firefighting.
III.9 Firefighter Health
Several studies have looked at the frequency of premature death rates among active and retired firefighters.
Rubin has described the relationships between the hazards of fire suppression and the risk of premature
20
lewis, S.S., h.R. Bierman, and M.R. faith. “Cancer Mortality Among los Angeles City fire fighters.” Published Report
Submitted to the los Angeles fire Department, Dec., 1982.
21
Demers, Paul A., nicholas J. heyer, and linda Rosenstock. “Mortality Among firefighters from three northwestern united
States Cities.” British Journal of Medicine, 1992, 49: 664-670.
22
l’Abbe, Kristan A. and george A. tomlinson. “fire fighters in Metropolitan toronto: Summary of the Mortality Study.” Industrial
Standards Panel, toronto, Ontario, Canada, 1994.
23
leMasters, grace K. et al. “Cancer Risk Among firefighters: A Review and Meta-Analysis of 32 Studies.” Journal of Environmental
Medicine, vol. 48, no. 11, november 2006, pp. 1189-1202.