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Technology &
Development Center
Wildland Firefighter Health and Safety
Recommendations of the April 1999 Conference

Illness, Injuries, and Fatalities Among Wildland Firefighters

Richard J. Mangan
USDA Forest Service
Missoula Technology & Development Center

Wildland fire activities, whether they involve prescribed burning or wildfire suppression, take place in a high-risk environment. Persons involved in these activities, are at risk from illness and disease, injuries, and even death. In the years 1990 to 1998, 133 individuals died in activities associated with wildland fire.

This paper will discuss the environment that fire personnel work in, the kinds of hazards they are exposed to, and the types of illnesses, injuries, and fatalities that occur in the work force. In addition, workshop participants will be challenged to identify ways to reduce or eliminate adverse events that cause these illnesses, injuries, and fatalities.

The Work Environment

A wide variety of environmental and geographic conditions exist within the world of wildland fire. The wildland firefighter works in a wide variety of areas: from the Florida Everglades to the Alaskan tundra; from the high peaks of Glacier National Park to the Pine Barrens of New Jersey; from the Australian Bush to the West Texas hills. Environmental conditions in these areas include steep, uneven ground; high ambient air temperatures; elevations ranging from sea level to over 8,000 feet; and above-average levels of smoke and dust. All these conditions have the potential to affect the performance of the wildland firefighter and may result in illness, injury, or death. These factors, especially for individuals not acclimated to them, can have a cumulative effect on a firefighter’s ability to resist them.

The Firefighter Work Force

The individuals that participate in wildland fire operations are as varied as the terrain and fuel types that they work in: they include females and males of all racial backgrounds; they must be at least 18 years old but often are in their 50’s; and 60’s; sometimes they weigh less than 100 pounds or more than 250 pounds; they may be from under 5 feet tall to over 6 feet 6 inches tall. Although they must meet the physical fitness requirements of their agencies, they often come to the wildland fire environment with the same physical conditions as the general population: allergies to smoke and dust, bad backs, and trick knees. They may be out of shape and have other preexisting conditions that may surface on the fireline.

Photo of firefighters.

The Firefighting Job

In addition to the environmental and human factors already described, the other critical factor that contributes to wildland firefighter illnesses, injuries, and deaths is the job itself. Long hours of arduous work under difficult physical conditions, coupled with reduced sleep and dietary changes, plus exposure to a new group of individuals who may have the potential to spread infections, all during a period of reduced immunity: these are prime conditions for illness or injury to strike the firefighter, especially on a prolonged fire assignment.

Firefighter Illnesses

The illnesses reported by wildland firefighters are not very different from those suffered by other large groups of individuals thrown together in a close environment for extended periods of time–such as sailors at sea, or teachers and students in a classroom. The introduction of endemic levels of infection and disease in any one individual has the potential to cause visible signs of illness among other individuals who have not had previous exposures and the opportunity to develop an immune response. Wildfires not only bring a large group of people together, they complicate the equation by requiring long hours of hard work, coupled with a change in diet and sleep patterns. These factors, and the exposure to smoke and dust, result in a variety of illnesses, especially as the duration of a fire assignment progresses beyond the first week.

The effects of long-term exposure to high levels of environmental smoke from wildfires was most apparent in the 1987 and 1988 fire seasons. In those years, smoke inversions plagued not only the immediate fire area, but also the incident base camps and surrounding communities for days on end. For firefighters spending multiple 21-day assignments under those conditions, the incidence of upper respiratory tract infections was widespread and lasted for as long as 3 to 4 months after the fire operations were over. As a result, the Health Hazards of Smoke project sponsored by the National Wildfire Coordinating Group (NWCG) was undertaken at the Missoula Technology and Development Center (MTDC). The 6-year project culminated in 1997 with a Consensus Conference in Missoula, Montana, that summarized the research findings and developed mitigation measures to reduce exposure to smoke during on-the-ground fire operations.

The long fire season in northern Idaho and western Montana during 1994 offered another opportunity to look at the incidence of illness among firefighters on large fire incidents managed by fire overhead teams. An informal review of medical records conducted by Mark Vore from the Idaho Panhandle National Forests showed that nearly 40% of the visits to the Incident Medical Units were documented as respiratory problems. These findings are consistent with the problems that surfaced in 1987 and 1988. Respiratory problems could arise in future fire seasons, given the mountainous terrain and inversion potential that exist on many large wildfires and prescribed burns in the Western United States.

Another illness that appears to be more common during wildfire operations is heat stress. Under conditions of both high ambient air temperatures and high radiant heat flux, the firefighter can easily become dehydrated and even become a heat stress casualty if positive preventative measures are not implemented daily. A recently completed Australian study on work productivity among bushfire fighters indicated that personal protective clothing was a key factor in reducing heat stress. Project “Aquarius” noted that two-thirds of the firefighter’s heat load was generated internally, with only one-third coming from the radiant heat of the fire. They recommended that the design of protective clothing should be to “let heat out, not keep heat out.” Additionally, they recommend that wildland firefighters working in high temperatures with a heavy workload consume as much as 1 liter of fluids per hour. The logistics of supporting this level of fluid replacement during a 12-hour operational period can be challenging, but the fluids are essential to prevent heat stress illness. Dehydration and heat stress illness can be the result of a progressive deterioration that occurs over several days of reduced fluid intake, and can be compounded by other factors such as other illnesses or medications.

Firefighter Injuries

Injuries are one of the major perils wildland firefighters are subject to. Although no documented records show trends of firefighter injuries, on-the-ground observations by experienced personnel show several major areas where injuries occur:

Several of these injury areas can be related to the casual factors of fitness level and fatigue. As firefighters become more fatigued from long hours of arduous work, they become less attentive to the small things that prevent injuries under different circumstances:

Better documentation showing the rate of occurrence of these accidents on fire operations will more clearly define the problems and lead to practices that can mitigate the causes of these accidents and reduce their occurrence. The MTDC publication, “Fitness and Work Capacity” (9751-2814-MTDC), documents many of the conditioning techniques that can reduce firefighter fatigue by increasing work stamina.

Firefighter Fatalities

Two major wildfire fatality events occurred in the United States during the early 1990’s: the Dude Fire in 1990 killed 6 firefighters; 14 firefighters died on the South Canyon Fire in 1994. Although these tragic events were reminders of the risks inherent with wildfire suppression activities, they represent just a portion of the total deaths that occurred from 1990 to 1998. During those years, 133 firefighters and others involved in wildfire operations died from a variety of causes. A recent MTDC Technical Report, “Wildland Fire Fatalities in the United States” (9951-2808-MTDC), documents those causes, including aircraft accidents (30 deaths), heart attacks (28 deaths), and vehicle accidents (25 deaths).

Numerous opportunities exist to reduce firefighter fatalities off the immediate fire ground, through many of the same actions that will reduce illness and injuries. Reducing deaths from heart attacks offers the best opportunity to cut the number of firefighter fatalities. A major lifestyle change will be required to reduce the risk of heart attack for many firefighters.

Challenges to the Conference

As we begin this conference on the Health and Safety of Wildland Firefighters, we have the opportunity to help set the course of action for studying these issues during the upcoming 5-year period of work. The following items would be desirable outputs from this conference:

This conference offers the wildfire community, in the United States and around the world, an opportunity to make significant gains in the safety and well-being of our firefighters. The challenge is yours to use all of your collective wisdom and experience to not only better define the problems but to offer innovative and far-reaching solutions for the twenty-first century.


Budd, Grahame, and others. 1996. Safe and Productive Bushfire Fighting with Handtools. Australian Govt. Publishing Service, Canberra, ACT, Australia.

Mangan, Richard J. 1999. Wildland Fire Fatalities in the United States: 1990–1998. MTDC, Missoula, MT.

Sharkey, Brian, ed. 1997. Health Hazards of Smoke: Recommendations of the April 1997 Consensus Conference. MTDC, Missoula, MT.

Sharkey, Brian. 1997. Fitness and Work Capacity, second edition. MTDC, Missoula, MT.

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