Examining critical fire service health concerns such as Cardiovascular and chemical risks faced by firefighters - led by IFSI in partnership with FSRI and NIOSH.

Assessing the Cardiovascular and Chemical Risks Faced by Firefighters

Examining critical fire service health concerns - led by IFSI in partnership with FSRI and NIOSH.
Assessing the Cardiovascular Health and Chemical Risks Faced by Firefighters
  • Overview
  • Findings
  • Updates
  • Resources


The Cardiovascular and Chemical Risks faced by Firefighters Study led by IFSI in collaboration with FSRI and NIOSH rigorously processes, analyzes and synthesizes existing data on fireground exposures, recovery timelines and the effectiveness of on-scene personal protective equipment (PPE) and skin decontamination techniques.

In addition, the project team investigates cardiovascular and carcinogenic exposure during training fire scenarios. A specific area of focus is the fuels used in firefighter training, such as Oriented Strand Board (OSB) and theatrical smoke, to ensure that instructors and students aren’t being needlessly exposed to unacceptable risks.

To obtain the most meaningful results, the team re-creates realistic conditions. For the component of the study that focuses on the modern fire environment, researchers construct a fully-realistic modern structure—accurate down to the interior finishes, fuel loads and features. Twelve-member crews fight fires in the structure. Safety systems and hardened construction techniques are incorporated to ensure participant safety.

The team also re-creates several realistic firefighter safety training scenarios, including pallets and straw in a concrete building, pallets and OSB in a steel container system, and theatrical smoke and simulated fire in a training prop. Four-member crews participate in three different evolutions and five-member instructor cadres participate in six evolutions.

During this fire safety study, the team measures:

  • The production and transfer of thermal energy as well as the magnitude and composition of gasses and particles in the fire environment
  • Contamination of firefighters’ personal protective equipment and skin
  • Absorption of that contamination into the firefighters’ bodies
  • How these variables are influenced by tactical decisions (interior only vs. transitional attack) and operating locations (interior fire suppression exterior operations vs. interior overhaul)

Researchers also examine cardiovascular responses to firefighting and to specific firefighting tactics and operating location by assessing ECG responses, blood chemistry and coagulatory measures, and vascular responses during and up to 12 hours following firefighting.


Cardiovascular and chemical risks faced by firefighters are among the most pressing health concerns in the fire service such as sudden cardiac events and firefighting-related cancers. However, relatively little fire safety information exists on the cumulative exposures firefighters face while working on the modern fireground and participating in firefighter training exercises.

“This is the first time that we have had the opportunity to assess—in a comprehensive, efficient, yet safe manner—the thermal insult, chemical exposures and cardiovascular risks that firefighters face when responding to a residential structure fire in the 21st century. We studied the impact of firefighting tactics and fireground job function on exposure, but also the ability for skin cleaning and PPE decon to impact these risks. As we further examine research results, we will continue to lead the national discussion on ‘putting the firefighter back in service’”.

— Dr. Gavin Horn, FSRI Research Engineer (Formerly Director for IFSI Research)

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This research project provided a better understanding of how operating in an environment typical of today’s fireground impacts cardiovascular events and chemical exposures related to carcinogenic risk.

The results have been translated into ten key considerations for the fire service. The key considerations are broken into three categories: Tactical Considerations Related to Occupant Exposure, Exposure Considerations for Outside and Overhaul Operations, and Cleaning and Decontamination Considerations after the Fire. 


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Published: May 25, 2022