NIOSH report into Massachusetts, US, LODD reveals carbon monoxide toxicity and cardiac event
The National Institute for Occupational Safety and Health (NIOSH) has released a report on the findings around a line of duty death that occurred in Massachusetts, US, nearly two years ago. On 17 March 2017, at 10h20, a 54-year-old male career fire fighter responded to a structure fire in a 2½-storey single family home. The fire fighter coordinated interior attack operations, gave an in-person report to the incident commander, changed his air bottle and returned to the interior to assist with overhaul. At 10h41 hours, the fire fighter collapsed while performing overhaul. Fellow fire fighters immediately removed him from the fire room, transported him down stairs and lifted him onto a stretcher that was brought to the front of the house. Fire fighters initiated cardiopulmonary resuscitation (CPR) as the stretcher was wheeled to the ambulance. Paramedics provided advanced life support (ALS) protocols en route to the hospital, including cardiac medication and multiple defibrillations. The ambulance arrived at the hospital emergency department at 10h58 hours. Hospital emergency department personnel continued resuscitation efforts unsuccessfully for approximately 30 minutes. The fire fighter was pronounced dead on 17 March 2017, at 11h26 hours.
A witness on the scene of the incident said, “I’d just arrived home at my house on Arlington street and was puzzled by the smell of something burning until I noticed black smoke drifting over the back of my garage. I ran around the corner onto Merrifield Ave and saw smoke billowing out of the attic of a house at the end of the street. But no people were around. As I turned to run back to my house to get my phone to call 911, I saw a neighbour out of the corner of my eye running across to the house and the front door of the house opening. I heard someone yell, “Call 911!” I kept running and as I reached my house I heard the fire trucks. When I got back to the scene with my phone, flames were raging out of the attic windows.”
“The first fire truck pulled up less than a minute later and I saw a woman and elderly man coming out of the house and my neighbour helping them. The police and EMTs arrived shortly after. I heard one of the fire fighters call for a 2nd alarm and more fire trucks arrived quickly after. About 20-30+ minutes later the firemen brought out a man on a stretcher. I watched in agony as they wheeled him down the street, with one fire fighter performing clearly desperate and rapid chest compressions all the way. I later learned this was the fire fighter who was lost. Based on what I saw of the man on the stretcher and the pictures I’ve later seen of him, I believe I captured some of his last moments alive in the first 30 seconds of this video. I believe he is the fire fighter in the red shirt with the white hair making preparations at the rear of the L2 fire truck. Thank you for your sacrifice, sir and to all of the incredible fire fighters and police and EMT personnel I witnessed today. I am in awe of what you do for all of us.”
The Watertown community was mourning the loss of a 21-year veteran of the fire department. Joseph Toscano, aged 54, was identified as the fire fighter that died following a medical emergency as he battled a two alarm blaze on Merrifield Avenue. It seemed a day like any other day when fire fighters responded to the call, according to the Deputy Fire Chief Bob Quinn. “He left this morning to go to work like he did every day and to have this happen is pretty devastating,” Quinn said. In the midst of extinguishing the fire in a second floor room Toscano suddenly collapsed.
“Nothing prepares you for this,” said union president Rob Mannix. It was devastating as well for those who witnessed the scene. “I was worried, everyone was worried. We weren’t expecting it to happen,” said witness Osman Yageiou. Two residents of the home made it out but the grim faces of fire fighters at the scene told the rest of the story. “This puts the reality in it,” said Deputy Chief Quinn. “It gives you a punch in the face to see this happen.”
At fire headquarters where Toscano worked as a commander bunting was hung and the fire fighter memorial drew new attention for the married father of five. Toscano’s family said he “took immense pride” in being a husband and father. “You can see Joe’s warmth, kindness, curiosity for life and love of the outdoors reflected in his five extraordinary children,” Toscano’s family said in a statement. “Family was at the centre of Joe’s life and defined him.”
The Medical Examiner’s report and death certificate listed “carbon monoxide toxicity in a person with hypertensive and atherosclerotic cardiovascular disease” as the immediate cause of death. The National Institute for Occupational Safety and Health (NIOSH) concludes that the physical exertion associated with fire fighting and the elevated levels of carbon monoxide (CO) in the presence of severe underlying cardiovascular disease likely triggered an arrhythmia in this fire fighter.
In their key recommendations following the report, they highlighted the following:
Source: National Institute for Occupational Safety and Health