NO
EASY
FIX
THE FIRE SERVICE CONFRONTS
THE NATION’S OPIOID EPIDEMIC
NFPA.ORG/JOURNAL
JANUARY | FEBRUARY 2017
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Contents
JANUARY/FEBRUARY 2017 • Vol. 111 | No. 1
Features
Dispatches
page /
08
Oakland Aftermath In almost every way,
the warehouse-turned-living-space known
locally as the Ghost Ship was primed for a
disastrous fire. By Angelo Verzoni
Needs Assessment NFPA’s fourth
comprehensive fire service survey reveals
that behavioral health resources are sorely
lacking in most fire departments across the
United States. By Angelo Verzoni
Tennessee Wildfire The deadly blaze that
killed 14 serves as a reminder that wildfire is
not just a problem for the Western U.S.
By Angelo Verzoni
Briefs Energy storage training; assessing
page /
22
Cover Story
Chasing a Killer: On the Front Lines
of America’s Opiate Crisis
The nation’s fire service is confronting a
full-fledged public health emergency, and as
opiate-related deaths rise, some are asking if
there is a better way to address the problem.
42 | Health Care Facilities
Defining Risk
As the industry evolves, what health
care providers, facility designers, and
enforcers need to know about the riskbased approach of NFPA 99.
by Michael Crowley
48 | Health Care Facilities
The Air in There
Oxygen-rich hyperbaric chambers are
touted for their healing powers, but
their proliferation also raises concerns
over potential fire hazards.
by Stephanie Schorow
by Jesse Roman
72 | Occupational Health and Safety
‘We Drove Like We Were Crazy’
Thirty years after crafting NFPA 1500,
the fire service’s first standard for
health and safety, the architects of the
document reflect on how far the
profession has come.
by Jesse Roman
Perspectives
page /
34
Hospital Shooter More health care
facilities are now training staff on what to
do during an active shooter incident. Safety
Officer Michael Marturano, who leads these
preparation trainings, says hospitals are soft
targets, and weighs in on how to address the
threat. By Angelo Verzoni
04 | First Word By Jim Pauley
06 | Editor’s Note By Scott Sutherland
GETT Y IMAGES
72
the economic impact of burns; Texas adopts
Remembering When; and Firewise turns 15.
By Angelo Verzoni
2 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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NFPA JOURNAL
In Compliance
Columns
page /
18 |Outreach
30
NFPA 101 Classroom door locks need to let
children out and keep intruders at bay.
By Ron Coté
NFPA 70 + 70E Just because it works
doesn’t mean it’s safe. Grounding and bonding appliances is critical. By Jeffrey Sargent
NFPA 72 Smoke detectors and door release
requirements for smoke barriers.
By Wayne Moore
NFPA 13 Matching water supply with
sprinkler system demands seems obvious,
but can be overlooked. By Matt Klaus
Firewatch
page /
54
A collection of fire incidents in an assortment
of occupancies from across the United
States, compiled by NFPA’s Research Group.
NO
EASY
FIX
THE FIRE SERVICE CONFRONTS
THE NATION’S OPIOID EPIDEMIC
NFPA.ORG/JOURNAL
JANUARY | FEBRUARY 2017
ON THE COVER
The needle and how
the fire service is trying
to limit the damage
done. Cover image by
Thinkstock.
JOURNAL ONLINE
Safety Overseas
U.S. students travelling abroad need
to know the fire safety situation of their
host countries. By Lorraine Carli
20 |Washington, D.C.
Innovative Pairings
A new effort to match technology
startups to fire service needs.
By Gregory Cade
38 | International
Viva Los Voluntarios
Helping Latin America’s volunteer
fire service fulfill its lifesaving mission.
By Donald Bliss
40 | Research
A Solution and a Problem
Eliminating a greenhouse gas threat
means dealing with potentially hazardous alternatives. By Casey Grant
68 | First Responder
Defeating Cancer
The fire service is more engaged than
ever before in tackling its biggest killer.
By Ken Willette
70 | Wildfire
Seeing is Believing
Managing the global wildfire problem
means learning about local needs.
By Lucian Deaton
nfpa.org/opiates
Watch videos of first
responders saving
opiate overdose
victims.
Read a report from
the Centers for
Disease Control
about the increase
in U.S. opiate
overdoses.
nfpa.org/
making1500
Listen to an NFPA
Journal Podcast
about riding the
tailboard—the fun
and the danger—
and how NFPA 1500
helped virtually
eliminate the oncecommon issue of
firefighters falling
from trucks.
nfpa.org/
dispatches
Read the full U.S.
Fire Service Needs
Assessment.
Read the complete
NFPA Journal online
at nfpa.org/journal
88 |Looking Back
The Hartford Hospital Fire of 1961.
By Mary Elizabeth Woodruff
NFPA.ORG/JOURNALAPPS
Read NFPA Journal on your favorite device with apps for
Apple iOS and Android. These easy-to-navigate apps let
you read the complete NFPA Journal anywhere, anytime.
View videos, link to editorial and advertiser websites,
and share articles with colleagues. And they’re free.
DATA CONNECTIONS
DATA CONNECTIONS
HOW NFPA’S BOLD NEW DATA ANALYTICS EFFORT COULD TRANSFORM FIRE SAFETY
HOW NFPA’S BOLD NEW DATA ANALYTICS EFFORT COULD TRANSFORM FIRE SAFETY
NFPA.ORG/JOURNAL
NFPA.ORG/JOURNAL
NOVEMBER | DECEMBER 2016
NOVEMBER | DECEMBER 2016
Nov Dec 16 Cover.indd 2
Nov Dec 16 Cover.indd 2
11/4/16 2:27 PM
11/4/16 2:27 PM
NFPA.ORG/PODCAST
Each month listen to the NFPA Journal Podcast for takes
on timely topics, expert insight, and more. Subscribe on
iTunes or wherever you get your podcasts.
N F PA . O R G / J O U R N A L • NFPA JOURNAL
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NFPA BOARD OF DIRECTORS
First Word
by Jim Pauley
NFPA President
A Year of Transformation
f I had to use one word to
describe 2016 for NFPA, it
would be “transformational.”
The core of that transformation is our continued
journey from a codes and standards developer to a comprehensive information and
knowledge organization. To help us chart
that path, we have spent a great deal of time
interacting and talking with many of you
in order to better understand your current
needs and future expectations. This effort
is essential for all of you who rely on us to
do your jobs effectively, and why supplying
you with key information and knowledge—
through publications, training, blogs, and
more—is critical to advance our mission.
A number of accomplishments from 2016
contribute to that mission. We created segment directors and technical lead roles to
advance our commitment to better stakeholder engagement. We established our
enforcer advisory committee and held our
first Enforcers Forum, part of our commitment to enhancing effective enforcement.
We introduced a new edition of the National
Electrical Code® and created a new subscription-based online NEC® that includes access
to the last three editions, making it easier
for users to compare editions. We used your
feedback to redesign nfpa.org, creating a
website that is easier to navigate and connects users with the information they need
quickly; in 2017 we will further refine it to
give users more of the content they need. In
cooperation with the Boston Fire Department, we developed a hot works training
I
program to educate construction-trades
workers on hot-work safety. Xchange, our
online community, grew to more than 25,000
members and has become a valuable way for
members and others to connect with peers
and NFPA technical staff.
We were also very involved with the fire
service. We completed our fourth comprehensive needs assessment survey of the U.S.
fire service. We held a social media summit to
bring together organizations that can amplify
“We have spent a great deal
of time talking with you
to better understand your
needs and expectations.”
the important messages being shared. We held
our second Responder Forum for emerging
leaders in the field, as well as a successful fire
prevention summit in Alabama that we will
replicate in other states in 2017. We received
a fire grant to study the nation’s fire data
systems to see if we can develop a more comprehensive roadmap toward modernizing the
collection of accurate fire-related data.
That’s just a sample of what we accomplished with our stakeholder community
in 2016—no wonder so many of you tell me
NFPA is now much more than a codes and
standards publisher. The coming year promises even greater interaction and advancement
of electrical, fire, and life safety.
Officers
Randolph W. Tucker
Chair
Tucker Consulting Associates
Houston, Texas
Keith E. Williams
First Vice-Chair
Underwriters Laboratories Inc.
Northbrook, Illinois
Amy R. Acton
Second Vice-Chair
The Phoenix Society
Grand Rapids, Michigan
Donald R. Cook
Secretary
Shelby County Department of
Development Services
Pelham, Alabama
Thomas Lawson
Treasurer
FM Global
Johnston, Rhode Island
James Pauley
President
President and CEO, NFPA
*Bruce H. Mullen
Staff Officer
Executive VP and CFO, NFPA
*Dennis J. Berry
Assistant Secretary
Secretary of the Corporation, NFPA
Directors
Ernest J. Grant, Ph.D.
Immediate Past Chair
North Carolina Jaycee Burn Center
Chapel Hill, North Carolina
Terms Expire in 2017
Kwame Cooper
Los Angeles Fire Department
Los Angeles, California
Russell Leavitt
Telgian Corp.
Phoenix, Arizona
Julie A. Rochman
IBHS
Tampa, Florida
Eric Rosenbaum
JENSEN HUGHES
Baltimore, Maryland
Terms Expire in 2018
John Bonney
Alendi Consulting
Ropley, United Kingdom
R. David Paulison
Global Emergency Solutions
Davie, Florida
Harold A. Schaitberger
International Assoc. of Fire Fighters
Washington, D.C.
William A. Stewart
Toronto Fire Services (retired)
Toronto, Ontario, Canada
Michael Wallace
United Technologies
Farmington, Connecticut
Peter J. Gore Willse
XL GAPS
Hartford, Connecticut
Terms Expire in 2019
Tonya Hoover
Fire Marshal
Sacramento, California
Hatem Kheir
Kheir Group
Cairo, Egypt
Teresa L. Deloach Reed
Oakland Fire Department
Oakland, California
Stacy N. Welch
Marriott International
Bethesda, Maryland
*Not a Board member
4 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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Editor’s Note by Scott Sutherland
Executive Editor, NFPA Journal
EXECUTIVE EDITOR
Scott Sutherland
ssutherland@nfpa.org
The Oakland Lesson
A
detail that stuck with me from the
coverage of the Ghost Ship fire
in Oakland came from a former
tenant of the building, who told
the Los Angeles Times that he used to sleep
with a fire extinguisher next to his bed. That
suggests at least two things: The potential
danger was enormous, and not everyone
who called the Ghost Ship home was blind
to that danger. The potential became reality
on December 2, when a fire tore through the
building during an unpermitted electronic
music concert, killing 36 people and becoming the deadliest structure fire in the United
States in more than a decade.
Hazards aside, properties like the Ghost
Ship and other warehouse-turned-artistlive-work-spaces around the country hold
a lot of appeal for a certain segment of
the populace. With their funky, DIY-fueled
sense of community and rents that can be
a fraction of market rate, such spaces present themselves as live-work refuges where
artists, musicians, dreamers, and fellow
travelers band together, more or less, and
pursue their alt-vision of modern urban life.
The fact that these repurposed buildings can
exist largely off the radar of official inspectional services only underscores the outlaw
nature of the enterprises.
Published reports on the Ghost Ship since
the fire paint a frightening picture. Safety
ART DIRECTOR
Doug Sternberg
dsternberg@nfpa.org
measures designed to protect tenants and visitors apparently did not exist. The building’s
last permitted use was as a warehouse, and
it was not intended for use as a residence or
a performance space. It was not sprinklered,
did not include working smoke alarms,
lacked proper exits, and featured twisting
egress paths that were challenging even in
the best of circumstances. That change in
use—the focus of our Ghost Ship story on
page eight—without corresponding upgrades
to the life safety features of the building
provided all of the conditions necessary for a
disaster. Once the fire took hold, no amount
of communal spirit or resourcefulness could
ensure that everyone got out alive.
Experts have pointed out that the fire
could have happened in any one of scores
of communities across the country where
repurposed buildings house people on society’s margins, spaces with a Ghost Ship-style
disregard for even the most rudimentary
trappings of life safety. Some cities, citing
safety concerns, have already ordered the
evacuation of these buildings. What we
know is that the codes intended to create
and preserve life safety work. How we proceed from here depends to a great degree on
the willingness of all stakeholders—owners,
managers, tenants, and cities—to understand
and recognize their life-safety obligations
that the codes are designed to support.
THE NFPA JOURNAL MISSION It is the mission of NFPA Journal to provide
NFPA members and other stakeholders with important information on fire,
electrical, and life safety topics and on issues related to NFPA’s codes and
standards development, education initiatives, and advocacy efforts. We will
do this by identifying stories that are relevant and timely for our readers; upholding the highest journalistic standards of thoroughness and accuracy; and
conveying that information in an attractive, well-designed publication across
all platforms. The content of NFPA Journal solely reflects the personal opinions
of the contributors and does not necessarily represent the official position of
NFPA; the meaning and intent of NFPA codes and standards can be obtained
only through NFPA’s published procedures for requesting formal interpretations. The contents of this magazine may not be reprinted without the written
permission of NFPA. NFPA Journal is a registered trademark of NFPA.
NFPA JOURNAL
An award-winning
member of Association
Media & Publishing
ASSOCIATE EDITOR
Jesse Roman
jroman@nfpa.org
STAFF WRITER
Angelo Verzoni
averzoni@nfpa.org
PRODUCTION MANAGER
Adrienne M. Albrecht
PROOFREADER
Nancy Wirtes
DIRECTOR OF SALES
Bill Mello
wmello@nfpa.org
ADVERTISING OPERATIONS
MANAGER
Dorinda Fergason
dfergason@nfpa.org
ADVERTISING SYSTEMS MANAGER
Susan Richard
ONLINE ADVERTISING
Lynne Grant
lygrant@nfpa.org
MARKETING/PERIODICALS
CIRCULATION MANAGER
Michael Carinci
VICE-PRESIDENT
OUTREACH AND ADVOCACY
Lorraine Carli
COPYRIGHT © 2017 NFPA. All rights reserved.
PRINTED IN USA. NFPA Journal (ISSN 1054-8793) is a
membership magazine published bimonthly by NFPA,
One Batterymarch Park, Quincy, Massachusetts 021697471. NFPA annual dues are $175, which include a $45
subscription to NFPA Journal. Periodicals postage rates
paid at Boston, Massachusetts, and at additional mailing
offices. POSTMASTER: Send address changes to NFPA
Journal, National Fire Protection Association, P.O. Box
9101, Quincy, Massachusetts 02269-9101. All issues of
NFPA Journal are available in microfilm from University
Microfilms, International, 300 North Zeeb Road, Ann
Arbor, Michigan 48106.
6 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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Dispatches
THE OAKL AND GHOST SHIP FIRE
UNDER
THE RADAR
HOW THE UNDOCUMENTED REPURPOSING OF
BUILDINGS IS ONE OF THE BIGGEST CHALLENGES
FACED BY THE ENFORCEMENT COMMUNITY
By Angelo Verzoni
rom the outside, the building
looked like a run-of-the-mill disused
warehouse. Sitting on a crowded
block in Oakland’s Fruitvale neighborhood, adjacent to an auto body
shop, the structure’s cracked concrete walls and
wide windows were emblazoned with graffiti.
Inside, however, the building told a different story.
The warehouse, known locally as the Ghost
Ship, had been converted into an unpermitted
residence and performance space for artists.
Makeshift interior walls divided a warren of
living, working, and performance areas; a staircase made partially of wooden pallets connected
the two floors of the 10,000-square-foot space.
Musical instruments, artwork, antique furniture, and other collectibles were amassed in
hoarder-like fashion, creating a claustrophobic,
mazelike atmosphere. In addition to the clutter
and makeshift nature of the building’s interior,
there were no sprinklers or smoke alarms and no
proper exits or signage. In nearly every way, the
Ghost Ship was primed for a disastrous fire.
On December 2, 36 people died in a latenight fire there while attending an unpermitted
electronic music performance and dance party.
AFTER
Reports indicated
that the former
warehouse known
as the Ghost Ship
had not been
inspected in 30
years.
Investigators are still looking into the cause of the
fire, and city officials have said criminal charges
are possible. The Ghost Ship fire is the deadliest
blaze in the United States since 100 people died in
the Station nightclub fire in West Warwick, Rhode
Island, in 2003, and the deadliest ever in Oakland.
The fire also sheds light on an issue fire safety
officials have recognized as a problem for some
time: the undocumented repurposing of buildings,
such as the conversion of old warehouses into
residential or assembly occupancies. But it’s a
problem that can be hard to contain, NFPA President Jim Pauley explained in an interview with
NFPA Journal.
GETT Y IMAGES
F
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NEWS FROM NFPA
AND BEYOND
“It can fly under the radar of enforcement,” Pauley said
of undocumented changes in building uses. “Folks in the
enforcement community will tell you that this is one of the
biggest concerns they have in front of them.”
The problem is complex, Pauley said, because there are
many reasons building owners or managers might change
the use of a space without taking the proper steps to ensure
it’s safe. One owner might do it intentionally, he said, to
avoid paying the costs associated with the code requirements
for a new use, such as the addition of sprinklers, while
another owner might do it without knowing any better.
Whatever the reason, changing a building’s use without
addressing life safety issues can put lives in danger, and the
more people are aware of this—from owners and managers
of buildings to the people who live in, work in, or visit
them—the better, because code enforcement and compliance
is a group effort, said Pauley. “The enforcer is only one component of the enforcement and compliance system,” he said.
“The compliance system works best when all of the stakeholders recognize their obligation to notify the city of the
change of use of an occupancy. It’s about the obligation to
pull the required permits in the interest of life safety.”
OFFICIAL DESIGNATION, UNOFFICIAL USE
The building had not been inspected in 30 years, reports
show, and Oakland Fire Chief Teresa Deloach Reed, an
NFPA board member, said her department has no records of
N F PA . O R G / J O U R N A L • NFPA JOURNAL
Dispatches_01.17 SJS EDIT JP.indd 9
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Dispatches
complaints about the building, according to the San Francisco Chronicle.
The building was not listed in the fire
department’s database of properties
requiring state-mandated fire inspections because, as far as the department
knew, it was nothing but an empty
warehouse, according to Deloach Reed.
A central characteristic of these
properties, though, is the discrepancy
that can exist between their official
designation and their unofficial use.
The fire department’s assessment of the
building “struck some people as odd,
given that the Ghost Ship’s Fruitvale
district neighbors were well aware that
people were coming and going from the
building and that parties were a regular thing,” the San Francisco Chronicle
reported. “It seemed even more odd
that such activity went unnoticed by
the fire station that’s located just a
block away.”
Laws governing code inspections further complicate the issue. In California,
for example, an inspector cannot enter
a property unless admitted by an owner
or resident. Just days after the fire, several former Ghost Ship tenants told The
New York Times that when the building’s owner would stop by, the building’s
managers would tell tenants to pack
away their bedding and cooking supplies
to make it look like no one lived there.
Oakland city officials have asked
NFPA to assist them in examining
enforcement and related topics that
could help the city prevent this kind
of fire from
happening in
the future. Ray
Bizal, senior
regional director
for NFPA, was one of a trio of NFPA
staff members who spent three days
touring the Ghost Ship site and meeting with city officials following the fire.
Bizal said he is confident fire officials
nationwide will be watching to see
what comes of the partnership. “There
is acknowledgement that undocumented change of use in occupancies
is widespread,” he said. “People in the
fire service want to get their heads
around what might be going on in their
jurisdictions.”
In a more general sense, the Ghost
Ship fire serves as a reminder that the
public must not become complacent
about the danger of fire. “We’ve done a
great job over the decades of reducing
the number of fires and fire deaths,
and it can be easy for people to simply
believe that a fire won’t happen,” Pauley
said. “But as we see all too often, when
fires do occur they can be deadly and
disastrous.”
BEFORE
Images of the Ghost
Ship interior prior to
the fire showing the
dense construction
and accumulation of
objects. The building
had no sprinklers or
smoke alarms.
10 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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C U LT U R E
TOWER LEGACY
50 YEARS LATER, A NEW FILM LOOKS AT
THE COUNTRY’S FIRST MASS SCHOOL
SHOOTING OF THE MODERN ERA
By Angelo Verzoni
KEITH MAITLAND
O
N AUGUST 1, 1966, Charles Whitman, a 25-yearold ex-Marine sharpshooter and architectural
engineering student at the University of Texas at
Austin, unleashed what the Associated Press would describe
as a “deadly storm of bullets” from the observation deck of
the 307-foot-tall campus clock tower. Armed with a scoped
rifle and other guns, Whitman killed 16 and injured dozens
more from his perch before he
was shot dead by police; armed
students and other civilians who
fired back at Whitman were
also credited with stemming the
carnage. The terror lasted an
agonizing 96 minutes.
An acclaimed new documentary film, “Tower,” details the
event and examines its immeDirector Keith Maitland.
diate aftermath as well as its
Top, a still from “Tower.”
legacy as America’s first mass
school shooting. “Tower” combines archival footage with animation to tell the stories of two students who were shot; two
civilians who aided victims and police; a radio reporter who
live-broadcasted the event; and the police officers who eventually shot and killed Whitman. “Tower” is being screened
in selected locations across the country and will be aired on
PBS’s “Independent Lens” series on February 14.
While mass shootings in schools and on campuses have
become more common in the decades since, the University
of Texas shooting shocked the country, a point driven home
in “Tower.” “You get a sense of just how brutal and absolutely
foreign that violence must once have seemed,” The New York
Times said in its review of the movie. Variety wrote that
“the film remarkably conveys not only the panic but also the
sheer bewilderment that gripped those on the ground as the
events were unfolding—a confusion that would be unthinkable now, given how sadly commonplace school shootings
and other acts of mass murder have become.”
Directed by Keith Maitland, “Tower” is partly based on
“96 Minutes,” a 2006 Texas Monthly article that included
biographical information and quotes from dozens of people
who survived the shooting. The accolades for “Tower” include
the 2016 Critics’ Choice Award for Most Innovative Documentary and the 2016 South by Southwest Film Festival Audience
and Grand Jury awards. It has been short-listed for an Oscar.
The UT shooting catalyzed the creation of special weapons
and tactics (SWAT) teams across the country. Later mass
shootings, such as those at Columbine High School in Colorado in 1999 (13 killed) and Virginia Tech in 2007 (32 killed),
prompted further changes to law enforcement response to
active shooter incidents and launched a discussion among life
safety experts on the role of codes and standards in addressing
such events. An NFPA standard pertaining to active shooter
incident response and preparedness is currently in development. Public comments on the proposal will be accepted until
January 17. For more information or to submit a comment, go
to nfpa.org/activeshooterresponse.
“TOWER” is being screened in selected locations across the
country and airs on PBS on February 14 at 10 p.m. EST. For more
information on the film, visit towerdocumentary.com.
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Dispatches
u
EVEN HERE
A resident of Gatlinburg, Tennessee,
surveys the site
of her home that
was destroyed
by wildfire in late
November. Wildfire
is not uncommon in
the hills of Eastern
Tennessee, but
residents said they
were surprised by
the size and speed
of the fire, which
killed 14 people and
injured hundreds.
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WILDFIRE
Comin’ Down
the Mountain
It can happen anywhere, any time. That’s the
message fire officials are stressing in the wake
of a deadly wildfire that began in Great Smoky
Mountains National Park in eastern Tennessee in
late November and roared into Gatlinburg, Pigeon
Forge, and other communities in Sevier County.
The fire was still burning in mid-December but
was mostly contained.
The wildfire killed 14 people, injured hundreds,
torched over 17,000 acres of land, and destroyed
or damaged upwards of 2,400 structures in
an area that’s a popular destination for nature
enthusiasts and country music fans alike; Great
Smoky Mountains is the most-visited national
park in the United States, and Pigeon Forge is
home to country music legend Dolly Parton’s
Dollywood. Two juveniles have been charged with
aggravated arson in connection with the blaze.
The Sevier County event is further evidence
that wildfire isn’t limited to the western U.S. “This
is a wildfire that could have just as easily happened in New England,” said Michele Steinberg,
who heads NFPA’s Wildfire Division. Tony Watson,
fire chief in Pigeon Forge, agreed. “I don’t think
anyone ever expected wildfires to be this bad
east of the Mississippi,” he told NFPA Journal. “I
want everyone in the country to learn from this.”
On the night of November 28, in the hours before the fire spread from the Great Smoky Mountains north into Gatlinburg and Pigeon Forge,
smoke shrouded the mountains, preventing local
firefighters from assessing the size of the threat,
Watson said. “Little did we know that we had this
huge fire raging above us,” he said. Soon, though,
they were dealing with a situation they had
never experienced before. At 5 p.m. that night,
no structures were threatened by fire; an hour
later, nearly two dozen had been damaged. In the
end, Gatlinburg sustained the most damage, and
Pigeon Forge experienced significant losses.
Watson said he plans to rebuild Pigeon Forge
with a focus on protecting structures from wildfires. Watson said he is considering implementing
NFPA 1144, Reducing Structure Ignition Hazards
from Wildland Fire. “As fire professionals, we owe
it to our citizens and the 12 million visitors that
come here each year to improve the system,” he
said, “and a component of that is codes and code
enforcement.” —Angelo Verzoni
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AP/WIDE WORLD
A deadly late-season wildfire sends
shock waves through Tennessee
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Dispatches
REAL NEEDS
BEHAVIORAL HEALTH EMERGES AS A KEY
CONCERN IN NFPA’S MOST RECENT NEEDS
ASSESSMENT SURVEY OF THE U.S. FIRE SERVICE
By Angelo Verzoni
JOB STRESS
The Needs Assessment Survey
conducted in 2015
and published in
November found
that 80 percent of
U.S. fire departments do not
provide behavioral
health programs for
firefighters.
n the summer of 2015, city officials
in Biddeford, Maine, a small, coastal
city 20 miles south of Portland,
sought benefit cuts for public safety
workers, citing the need to lessen
the burden on taxpayers. Labor unions representing Biddeford’s firefighters, police officers, and
public works employees fiercely opposed the proposals and urged people to protest them.
In an interview with the Journal Tribune, Biddeford firefighter and union president Tim Sevigny
I
said the proposal to cut health care benefits
for retired firefighters specifically irked him, as
many active and retired firefighters suffer from
post-traumatic stress disorder (PTSD) and need
behavioral health care. “The dead people we see
[on the job] are not like the dead people you see
at a funeral,” Sevigny told the newspaper, adding
that the most difficult part of the job is “seeing
people who’ve shot themselves in the face, hanged
themselves, or overdosed.” Sevigny’s concern
illustrates a problem facing fire departments
nationwide: the need for behavioral health care
for firefighters to treat PTSD, substance abuse,
and other conditions brought on by the stressful
and at times traumatic nature of the job.
According to the fourth and most recent Needs
Assessment Survey of the U.S. Fire Service,
conducted by NFPA in 2015 and published in
November, it’s a need that the majority of departments is not addressing internally, with only
NEWSCOM
U. S. F I R E S E RV I C E
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one-fifth of fire departments reporting that they
offer behavioral health programs. The same question was not asked in the previous three Needs
Assessments, which include data from 2001, 2005,
and 2010.
The 2015 Needs Assessment Survey was
sent out electronically and by mail to 26,322
departments across the country. In total, 5,106
departments responded to the survey, and their
answers were used to paint a picture of fire service needs in the U.S. and highlight areas that
could use more funding.
One of the report’s authors, Hylton Haynes, a
senior research analyst in NFPA’s Research Division, told NFPA Journal he was surprised by the
behavioral health figures. “It’s an extremely stressful job, and only 20 percent of departments have a
program,” he said.
The lack of implementation of behavioral
health programs by departments comes at a time
of increased calls to action. In September, for
example, urban fire service leaders attending
the annual Urban Fire Forum at NFPA’s Massachusetts headquarters endorsed a position
paper that pointed to the “patchwork of ineffective services” most departments offer when
it comes to behavioral health and the need for
improvements. “Fire chiefs have an important
opportunity to demonstrate leadership and
implement a new, more effective framework for
responding to their employees’ behavioral health
needs,” the paper reads.
Similarly, an NFPA report published in November, which examines results from various research
studies on suicide and behavioral health in the
fire service, concludes that “it’s no longer a matter
of ‘Suck it up and deal with it!’ It’s time to deliver
firefighter suicide, behavioral health, and mental
well-being awareness and prevention programs at
the firefighter level.”
THE RURAL FACTOR
Behavioral health isn’t the only health care
area where departments have room to improve,
according to the assessment, which also found
deficiencies in basic firefighter fitness and
health programs that departments are required
to maintain by NFPA 1500, Fire Department
Occupational Safety and Health Program. Overall, only 27 percent of departments have such
programs, the assessment shows. This is down
from the 30 percent that reported having them in
2010. The 2015 figure translates to an estimated
716,000 firefighters currently working in departments without a program to maintain basic
fitness and health.
OVERVIEW OF
FOURTH NEEDS
ASSESSMENT
OF THE U.S. FIRE
SERVICE
37%
of the U.S. population is protected
by all or mostly
volunteer fire
departments
73%
of departments
do not provide a
program to maintain basic firefighter
fitness and health
80%
of departments
do not provide a
behavioral health
program
72%
of departments
have PPE that is at
least 10 years old
69%
of departments
have SCBA equipment that is at least
10 years old
20%
of departments do
not have anyone
conducting fire
code inspections
In both behavioral health as well as general
health and fitness, rural communities are driving
averages down. Only 10 percent of departments
in communities of fewer than 2,500 people have
behavioral health programs, according to the
assessment, whereas such programs exist in 76
percent of departments serving cities of 500,000
or more. Similarly, only 15 percent of rural departments said they had programs to maintain basic
firefighter fitness and health, compared to 89 percent of departments in large cities.
In an interview with NFPA Journal, Mark Light,
CEO and executive director of the International
Association of Fire Chiefs, speculated that while
departments might want to seek funding for
health-related programs, they can’t because they
still struggle to fund the more tangible, day-today needs like acquiring new personal protective
equipment (PPE). For example, even though the
largest share of federal Assistance to Firefighter
Grant (AFG) program funding from 2011-14 was
distributed for PPE, 72 percent of departments
reported in the assessment that they had PPE that
was at least 10 years old, up from 63 percent in
2010. In contrast, health and wellness programs
were awarded approximately 1 percent of total
AFG funds in those four years.
Kevin Quinn, chairman of the National Volunteer Fire Council, had a slightly different take on
why rural departments in particular aren’t seeking
funding for health programs and other resources:
A pattern of denied grants has left them feeling
NEEDS ASSESSMENT
INFORMATION ONLINE
NFPA is providing a number of resources to
complement the fourth Needs Assessment of the
U.S. Fire Service, including infographics and factsheets on national statistics and special topics
such as behavioral health, general health and
wellness, and community risk reduction. There
will also be an online graphical user interface and
factsheets to allow fire officials at the state level
to examine their area’s specific needs and use
this information for decision making and budgetary requests. A webinar on the national report
will be held January 18; to sign up, visit catalog.
nfpa.org/Fourth-Needs-Assessment-of-the-USFire-Service-Webinar-P17194.aspx
discouraged, thereby leading fewer departments
to even apply for grants. When rural departments
do apply for grants, Quinn said, applications are
often poorly written or are filed improperly.
“You read some of these grants and you’ll know
the department needs this money, but they’re not
following directions or not writing it clearly and
concisely enough, and so they don’t score well,”
he said. “They aren’t funded.” Quinn said the
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NVFC is determined to combat this
issue through a continued push for
federal funding for rural departments
and education efforts to improve rural
department heads’ grant-writing skills.
Asked about behavioral health programs specifically, Light pointed to a
number of other challenges preventing
the implementation of effective programs, such as a lack of data pertaining
to firefighter suicide attempts and
suicide mortality rates. “There has to
be some way of dealing with that issue
and tracking that issue and not creating an environment that puts a stigma
on a firefighter who admits they’ve
RECOVERY REFUGE
The IAFF partners to open a landmark facility
to treat firefighter behavioral health issues
The International Association of Fire Fighters will soon
open the first-ever in-patient
treatment facility catering
exclusively to firefighters
suffering from post-traumatic
stress disorder (PTSD),
substance abuse, and other
behavioral health conditions.
The IAFF Center of Excellence
for Behavioral Health Treatment and Recovery is slated
to open its doors in March on
a 15-acre property in Prince
George’s County, Maryland,
just outside of Washington,
D.C. The center is a collaborative effort between the IAFF
and Advanced Recovery Systems (ARS), a Florida-based
behavioral health care management company.
The new facility addresses
a growing need in the fire
service, according to Pat Morrison, assistant to the general
president for health, safety,
and medicine at the IAFF. The
rates of PTSD and suicide
among firefighters have been
increasing for the last decade
or so, Morrison told NFPA
Journal, and when an article
on the issue appeared in the
winter 2016 edition of the
IAFF Fire Fighter Quarterly, the
response from readers illustrated just how rampant the
problem is.
“Our phones rang off the
hook,” Morrison said. “We had
people calling us who said
they had issues they didn’t
realize they had until reading
[the story]. Now they knew
they needed to get help. They
needed to talk to somebody
about the feelings they had
suppressed throughout their
career. It was crippling them.”
The reaction to the article,
titled “Bringing PTSD Out of
the Shadows,” came at a time
when IAFF General President
Harold Schaitberger had been
hearing a lot about the behavioral health problems facing
firefighters as he visited with
them throughout the United
States and Canada. “As I travel
across our two great countries, I hear firsthand about
the struggles some of us face
with post-traumatic stress,”
Schaitberger said in a statement posted on IAFF.org. “It’s
a condition that affects our
members at double the rate
of the general population. But
there have been few programs
to address it.”
Over the summer, IAFF and
ARS met for the first time to
begin planning the center,
which will include 56 beds and
be staffed by a combination of
behavioral health professionals and firefighting peers from
the IAFF and ARS, Morrison
said. The IAFF hopes the
center, which is available only
to IAFF members, will flourish
into a large-scale program
with multiple locations.
nfpa.org/dispatches
Watch a video produced by
IAFF about the problem of
post-traumatic stress
disorder in firefighters.
thought about suicide,” he said.
Volunteer firefighting presents a special challenge to quantifying this issue,
according to Light. “What happens
when you get someone who’s an electrician who’s also a volunteer firefighter
who commits suicide?” Light said.
“How do you then make sure that triggers someone to realize he was also a
volunteer firefighter? I think that’s very
difficult to do when you have people
from all walks of life serving as volunteer firefighters.”
On a positive note, Quinn said he
believes the percentages reported in the
Needs Assessment do not reflect the
number of rural departments that do
provide their firefighters with behavioral health care or other resources.
For example, he said, if firefighters in a
rural department have seen something
horrific, the chief would likely connect
them with community resources to
handle the effects of such a situation—
an informal process that isn’t typically
documented. Quinn also contends that
in some ways, rural departments have
an advantage over urban departments
when it comes to behavioral health
care because of the tightknit nature
of small communities, which he said
can provide emotional support to
those suffering from behavioral health
conditions.
Outside of health care–related topics,
Haynes said he was surprised the assessment showed a lack of community risk
reduction activities. For example, 89
percent of departments said they did
not conduct a wildfire safety program,
and 88 percent said they did not conduct an older adult fire safety program.
In these areas, the differences between
urban and rural communities were
less pronounced; less than one-third of
departments in communities of 500,000
or more reported conducting wildfire
safety programs and only about half
reported conducting older adult fire
safety programs.
Overall, the 2015 Needs Assessment
contains nearly 40 percent more information than the last three assessments
conducted by NFPA. This is due in part
to an extended question set to address
emerging concerns, such as fire service
response to active shooters.
INTERNATIONAL ASSOCIATION OF FIRE FIGHTERS
Dispatches
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In
Brief
THINKSTOCK
NFPA Takes
Action on ESS
NFPA has taken a
number of steps to
teach the fire service
how to prepare for
the hazards associated with energy
storage systems
(ESS), an emerging
technology that
captures and stores
energy for later use.
ESS is increasingly
being used in everything from high-rise
buildings to vehicles
in the United States
and is already presenting a challenge
for the fire service. In
2011, for example, fire
erupted in the battery energy storage
system (BESS) building of a wind farm in
Hawaii and burned
for several days; in
August, more than 20
fire departments in
Wisconsin responded
to a BESS fire that
broke out in a shipping container.
NFPA recently
released the firstever online ESS
training program for
fire service personnel, which includes
an instructor-led
course, an educational video series,
and a reference
guide focusing on
areas such as basic
electrical theory and
emergency response
procedures. In October, NFPA partnered
with other ESS
experts to conduct
the first-ever ESS first
responder training at
the Energy Storage
North American Conference in San Diego,
and this year NFPA
plans to conduct
at least four more
in-person training
sessions. Additionally, NPFA is working
on an ESS standard—
NFPA 855, Installation
of Stationary Energy
Storage Systems—to
address the design,
construction,
installation, and commissioning of ESS
facilities, as well as
related fire suppression issues.
More information
about the online ESS
training program
can be found at nfpa.
org/esstraining. Fire
service organizations
interested in hosting
one of NFPA’s halfday ESS classroom
trainings should contact Michael Gorin
at NFPA at mgorin@
nfpa.org.
“The vast majority
of people were not
killed by burns, but
rather by smoke
inhalation, which
drives home the
importance of
having working
smoke detectors in
every home,” said
Joanne Banfield,
lead researcher
resources needed to
educate their local
senior populations
on fire and fall safety.
The program centers
around 16 key safety
messages—eight
related to fire prevention and eight to
fall prevention.
As part of the
state’s endorsement
munities throughout
the country, teaches
communities at risk
for brush, grass,
and forest fires how
to best prepare for
those types of incidents. Firewise is
cosponsored by the
USDA Forest Service,
the U.S. Department
of the Interior, and
for the study and
manager of Trauma
Injury Prevention at
Sunnybrook.
To read more
about the study,
visit sunnybrook.
ca/media/item.
asp?page=38&i=1491.
of Remembering
When, NFPA, along
with Karen BerardReed, senior project
manager of public
education at NFPA,
were officially recognized by the State
Firefighters’ and Fire
Marshals’ Association of Texas and the
Texas Fire Marshals’
Association.
More information
about the program,
as well as program
materials, can be
found at nfpa.org/
rememberingwhen.
the National Association of State
Foresters.
The nine communities who reached
15 years of Firewise
participation include
Timber Ridge,
Prescott, Arizona;
Perry Park, Larkspur,
Colorado; Genesee Foundation,
Golden, Colorado;
Wedgefield, Orlando,
Florida; Wilderness
Ranch, Boise, Idaho;
Greater Eastern
Jemez WUI Corridor,
Jemez Springs, New
Mexico; Emigration Canyon, Salt
Lake City, Utah;
Sundance, Provo
Canyon, Utah; and
River Bluff Ranch,
Spokane, Washington. Over the last 15
years, the communities have collectively
contributed more
than $5.9 million in
wildfire risk-reduction activities.
More information
about the Firewise
program is available
at firewise.org.
Study Finds High
Economic Impact
of Burns in Home
Fires
A new study led by
a Canadian research
institute found that
lives shortened
or lost in home
fires over a 14-year
period have cost the
Canadian economy
billions of dollars.
The study,
conducted by Sunnybrook Health
Sciences Centre
in Toronto, found
fires caused a loss
of approximately
24,000 years of life
between 1998 and
2012; resulted in
an average cost of
nearly $85,000 to
treat a burn patient;
and totaled $5.8
billion (CAD$7.6
billion) in the cost of
potential years of life
lost due to residential fires.
Researchers
arrived at the figures
by reviewing coroner investigation
statements and
autopsy reports of
about 1,200 adults
who died in homes
without fire sprinklers between 1998
and 2012.
Texas Adopts
Remembering
When
Texas has adopted
Remembering
When™: A Fire and
Fall Prevention
Program for Older
Adults as a statewide
standard.
Remembering
When is a program
developed by NFPA
and the Centers for
Disease Control and
Prevention that is
designed to help
seniors live safely at
home for as long as
possible. Remembering When equips
fire departments and
other organizations,
such as churches
and retirement
homes, with the
Firewise
Communities
Mark 15 Years
Nine of the original
12 participants in
NFPA’s Firewise
Communities
Program recently
celebrated 15 years
of participation.
The program,
which started in
2002 and has since
grown to include
more than 1,300
participating com-
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Outreach by Lorraine Carli
ADVOCACY,
LEGISLATION,
AND PUBLIC
EDUCATION
Fire Safety Abroad
HOW COLLEGE STUDENTS STUDYING OVERSEAS
CAN STAY FIRE SAFE
n 2010, my daughter
lives ahead of them, or the horror experiheaded off to study abroad
enced by their parents and relatives who
in Barcelona. Since I work
probably expected a certain level of safety
in fire safety, I’m sure I
for these children.
told her to be careful and
While we have not solved the fire probto always look for a way out every time
lem in and around colleges here in the
she entered a building. However, back
U.S., there are a few factors that make
then I don’t think I fully grasped the
the situation here different than in other
differences between the United States
countries in terms of fire safety. For one,
and other countries when it came to fire
the U.S. maintains a strong commitment
safety and public education. I do now.
to education and code enforcement that
This fall, I attended the Center for
contributes to a safer environment for
Campus Fire Safety’s Annual Campus Fire
students. We are also able to build on
Forum and listened to representatives
public education efforts targeting U.S.
“Many residences
from the Jasmine Jahanshahi Fire Safety
kids from early ages, as well as requirein Europe are not
Foundation. The foundation is devoted to
ments for smoke alarms in all occupancies
required to have
making studying abroad more fire safe for
and fire sprinklers in many college dorms
smoke alarms. Many
the approximately 300,000 U.S. students
and other residences. These factors don’t
residential buildings
studying in other countries as part of
exist everywhere. Many residences in
are old, constructed
their college experience. The foundation
Europe, for instance, are not required to
of wood, and often
provides critical resources that include
have smoke alarms. Similar to Jasmine’s
without fire protection
discounted access to fire safety equipapartment, many residential buildings
or adequate exits.”
ment such as smoke alarms and escape
are old, constructed of wood, and often
ladders. It has also compiled a list of
without fire protection or adequate exits.
the emergency numbers for many of the
Jasmine’s story, while painful, is also
most popular destinations for exchange
a reminder that simple actions can save
students and other safety information, all
lives. We need to do all we can to share
available at firesafetyfoundation.org.
these safety tips with students travelling abroad. My favorite
The foundation was founded in 2011 by the family and friends three tips: take a couple of battery-operated smoke alarms with
of Jasmine Jahanshahi. Jasmine was among a group of students you and place them in the apartment; try to live on a low floor
studying abroad in Paris in 2011 when she and three friends so you can be reached by a fire truck ladder; and choose a
died when they jumped out of windows as a fast-moving fire residence made of brick or stone rather than wood and with
swept through the building where they lived. One other person unobstructed windows.
died in the building and dozens of others were injured in the
There are other ways to stay safe, too. NFPA has been working
fire, which occurred in the Menilmontant section of Paris, a with the Center for Campus Fire Safety and other organizadensely populated area with older buildings. The building tions for a number of years to look for creative ways to reach
where Jasmine and her friends lived had no smoke alarms, college students for whom fire safety isn’t usually a pressing
no fire escapes, and narrow wooden stairwells that became concern—more information on those efforts can be found at
overcrowded and impassable in the fire. According to news nfpa.org/campus. By spreading these messages, we can take
accounts, this area of the city had previously experienced other fire safety abroad.
tragic fires with similar conditions. I can’t imagine the horror
of the scenario for these young students who had their whole LORRAINE CARLI is vice president of outreach and advocacy for NFPA.
MICHAEL HOEWELER
I
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PEOPLE ARE TALKING
Be a part of the conversation
VISIT NFPA XCHANGE, THE ONLINE
COMMUNITY THAT CONNECTS YOU WITH PEERS
WORLDWIDE AND DIRECTLY WITH NFPA STAFF.
Discover content that is important to you.
Get involved. Stay engaged. Explore. Share.
Building and
Life Safety
AHJ/
Enforcers
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nfpa.org/xchange
p
Smart Enforcement FP_05.16.indd 1
4/26/16 12:31 PM
Washington, D.C. by Gregory B. Cade
THE NFPA
VIEW FROM
CAPITOL HILL
Tech Match
A NEW EFFORT TO PAIR TECH STARTUPS WITH THE
NEEDS OF THE FIRE SERVICE
n the early 2000s, when
impressed by what I saw, there were also
I was a fire chief, I undersome notable absences of products I hope
stood the importance of
can one day be developed, such as a prodsupporting innovation
uct that offers a solution to the “Z axis
for the fire service. With
within a meter” challenge, so that incident
evolving changes in technology, the built
commanders can track in real time which
environment, and our communities, we
floor of a building their responders are on.
had to look beyond what existed to do
As I listened to a number of the presentaour jobs. We supported our firefighters’
tions, I saw great engagement and interest
participation on NFPA standards comfrom the first responders in attendance,
mittees and, as one of 28 national urban
who had a lot of thoughtful questions and
search and rescue teams, our staff played
comments on how the new technology
an up-close role in the development of
might help solve problems they face daily.
specialized training and equipment to
I believe this exchange between pri“This exchange of
meet the complex needs of responders
vate innovators and the first responder
information and ideas
to urban search and rescue events.
community is critical for both parties. In
between private tech
In keeping with the tradition of supVirginia Beach, through our department’s
innovators and the
porting innovation, I took part in a
frequent participation on standards comfirst responder
recent event in Washington, D.C., called
mittees and hands-on training, we had
community is critical
the EMERGE Accelerator Program for
many good interactions with companies
for both parties.”
Wearable Tech for First Responders. The
creating products for first responders. We
event matched first responders—law
had opportunities to test products and
enforcement, fire, and emergency medical
provide feedback without committing to
departments—with startup wearable techa purchase. In many cases, manufacturers
nology companies looking to reach new
made modifications based on our feedmarkets and get input on their ideas. The sponsors, including back. Both parties were grateful to have opportunities like the
the Department of Homeland Security, the Center for Innova- department’s annual urban search and rescue school to test new
tive Technology, a venture collaborative called TechNexus, the technology in environments that were as close to real as possible.
Pacific Northwest National Lab, and the Science and Technology
It’s too early to know how the products developed by these
Directorate, selected the participating startups from more than startups will impact first responders, but next steps include
200 that belong to a small business incubator.
working with EMERGE on a tech showcase at the upcoming
In many cases, first responders were not necessarily the NFPA Conference & Expo in Boston. NFPA can offer informed
sector that these startups originally envisioned as their market, reviews to the Department of Homeland Security and other
but these companies recognized that what they had developed organizers of these events. Such collaboration is important
could be useful in that area. Our role was to listen to their because, while technology can provide solutions, it also can
business pitch and provide feedback on whether there was a create challenges. Efforts must be made to combat the informapotential fit for their technology in the responder realm.
tion overload that may come with the wave of new technologies,
Several presenters had programmable LED lighting for and we have yet to define the safety parameters for use of these
apparel. Others introduced wearable technology that could technologies in hazardous environments. NFPA codes and stanprovide real-time monitoring of vital signs that linked to health dards could help address those challenges and many more.
databases. One company presented technology that managed
data integration and security for wearable devices. While I was GREGORY B. CADE is division director of government affairs for NFPA.
MICHAEL HOEWELER
I
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COVER STORY / THE OPIOID EPIDEMIC AND THE FIRE SERVICE
CHASING
A KILLER
As America’s opiate problem explodes, the nation’s fire
service finds itself on the front lines of a full-fledged
public health crisis. As responder resources are stretched
and as opioid-related deaths climb, fire officials are faced
with tough challenges: How much should the fire service
be expected to do? And is there a better way to do it?
By Jesse Roman
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AP/WIDE WORLD
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CHASING
A KILLER
T
he 911 dispatcher’s updates blaring
through the truck cabin grew increasingly darker as Daniel Goonan raced
to the scene of a drug overdose last
October—a desperate little boy; an
unconscious mother dying on the kitchen floor;
opiate use was suspected.
“You could hear the situation building over the
radio—the operator talking to this nine-year-old, telling him how to do CPR on his mother,” Goonan, the
fire chief in Manchester, New Hampshire, recalled.
2016, Manchester had 721 opiate
overdoses—an average of more than
two per day—and 88 opiate overdose
deaths. The fire department and local
ambulance services have administered
nearly 1,000 doses of Narcan, the
brand name for naloxone. More than
100 overdose victims have been found
unconscious, barely breathing, and
dying in hotels, restaurants, and other
public buildings, or in parked cars—
even while driving. At
least 65 people have been
brought back from the
brink of fatal overdoses
more than once in 2016,
including eight cases
where first responders
revived the same person
twice within 24 hours.
Goonan, a 32-year
department veteran, grew
up in Manchester, a brickclad former mill city on
the banks of the Merrimack River, and
admits that drugs have always been
prevalent here. “But I’ve never seen the
problem so terrible,” he told me. “It’s
like nothing I ever expected.”
The rise of opiate abuse is hardly
unique to Manchester. Opiates in the
form of prescription pills, heroin, and
increasingly powerful synthetics like
fentanyl have indiscriminately swept
across the United States like a plague,
infecting all types of communities—
from rural hamlets in Appalachia and
the rust belt to the nation’s largest
cities—with equal ferocity. In 2015, the
“This was a kid who was getting ready to go to
school, eating his Cheerios, and all of a sudden he
looks over to see his mother lying there purple.”
When Goonan and his team arrived, they administered naloxone hydrochloride, an opiate reversal
medication that can almost immediately counteract
the deadly effects of an opioid overdose—but after
the first dose the woman remained motionless.
After a second dose, her breathing finally returned,
all while “the little boy is sitting there at the table,”
Goonan said somberly.
For the Manchester Fire Department and for
thousands of others in this opiate-riddled New
England city of about 110,000, the scene has
become common. Through the first 11 months of
ISTOCKPHOTO
When Goonan and his team arrived,
they administered naloxone—but after the
first dose the woman remained motionless.
After a second dose, her breathing finally
returned, all while “the little boy is sitting
there at the table,” Goonan said.
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WHAT THEY’RE
UP AGAINST
most recent year tracked by the
Centers for Disease Control (CDC),
more that 52,000 people in the
U.S. died from drug overdoses, or
about 144 each day, with the majority of those deaths opioid-related.
Nationwide, fatal opioid overdoses
increased 652 percent from 2000
to 2015, according to CDC statistics, and every indication is that
the problem has grown worse in
2016. Many states have all but
declared full-fledged public health
emergencies.
The fire service is dealing with
several challenges as the opioid
crisis explodes. For one, call
volume has risen with overdoses,
leaving departments to bear a
slightly heavier load, typically with
the same or fewer resources. In
addition, some departments have
felt an economic toll as naloxone
prices skyrocketed—from $6 per
dose to $45 per dose since 2010,
according to one chief interviewed
for this story—as demand for the
drug increases. To carry the slack,
in some cases state and federal
governments have provided funding to departments to purchase the
medication, while in some communities private organizations have
donated hundreds of doses of the
life-saving drug.
For the typical line firefighter,
the biggest change has perhaps
been adjusting to an expanded
role as the opiate crisis worsens.
Previously, only paramedics or
higher-level EMTs were allowed to
administer drugs in most states;
over the last couple of years, however, numerous jurisdictions have
rushed to expand the types of
responders allowed to carry and
administer naloxone. Training and
oversight have been ramped up
as a result, and for the most part
states and agencies have met the
challenge to get members adequately trained before supplying
them with the drug, said Thomas
Breyer, a former firefighter and
paramedic in Ohio who is now the
director of Fire/EMS Operations
at the International Association of
Fire Fighters (IAFF).
“Training is critical because this
is a change for a lot of providers,
and when you administer any kind
of emergency services you want
the responder to have some muscle
memory—see it, do it,” Breyer said.
“It’s not as simple as ‘here is a new
medication, here’s how to deliver
it,’ and then give them a pat on the
back and let them go.”
Even with training and preparation, the crisis can at times
overwhelm responders. Last
August in Huntington, West Virginia, emergency responders saved
26 overdose victims in the span of
less than four hours. In Marion,
Ohio, a town of 35,000 people, the
city fire and rescue department
dealt with 30 overdose hospitalizations and two deaths during a
frantic 12-day stretch in 2015.
“I hate to see Marion making the
news because of this, but we need
some help,” said
Rob Cowell, the
town’s fire chief.
“We’ve picked up
overdoses from
people who were
14 years old all
the way up to
67. It’s been all
over town, across
every socioeconomic class.
Percent increase in opioid overdose
It’s a national
deaths from 2000 (355) to 2015 (1,747)
problem that we
Source: Massachusetts Department of Health
are trying to deal
The epidemic state by state
Massachusetts
392%
Opioid use in
the United States
Number of
opioidrelated
deaths
in 2000
Estimated
opioidrelated
deaths
in 2015
4,400
33,091
652%
63%
Increase in opioid deaths in
the U.S. from 2000 to 2015
Source: CDC
Percent of all fatal
drug overdoses in the
U.S. that involve some
type of opioid
Source: CDC
91
1,620%
Average number
of Americans
who die each day
from an opioidrelated overdose
Source: CDC
Percent increase in cost for
two vials of Hospira’s generic
naloxone, which sold for $1.84 in
2005 and for $31.66 in 2014
Source: Truven Health Analytics
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CHASING
A KILLER
with on the local level, and we are swimming in it and having
a hard time keeping our heads above water.”
SEARCH FOR SOLUTIONS
In some places, it’s easy to see why fire departments might
feel like they’re sinking. In Ohio, opiate-related drug overdose
deaths increased a staggering 775 percent from 2003 to 2015,
according to the Ohio Department of Health, growing from
296 deaths to 2,590. Massachusetts had 1,747 opioid drug
deaths in 2015, up from 532 in 2010, according to the Massachusetts Department of Health. Similarly dramatic increases
have occurred in New Hampshire, New Mexico, Alabama,
West Virginia, Maine, North Dakota, Indiana, Pennsylvania,
Georgia, and elsewhere.
The opioid crisis and the changes it has brought for the
fire service have produced frustration in some responders.
Last February, a firefighter in Weymouth, Massachusetts, was
suspended 90 days without pay for a Facebook post that sug-
The epidemic state by state
New Hampshire
2,258%
Percent increase of fatal overdoses
involving fentanyl from 2012 (12) to 2015 (283)
Source: New Hampshire State Medical Examiner’s office
gested letting overdose victims die. “I for one get no extra
money for giving Narcan and these losers are out of the hospital and using again in hours,” the post said. “You use, you
should lose!” The department quickly issued a
statement denouncing the post and said it did not
reflect its philosophy or values.
The vast majority of firefighters and EMTs,
however, have met the new challenge with resolve,
viewing it as a necessary response to a community
crisis. “We are an all-hazard department and so it
really doesn’t matter what the problem is—if lives
are on the line, we believe there is a social and
civic responsibility to address it,” said Matthew
Levy, the medical director of Howard County Fire
Rescue, a county in Maryland located between
Baltimore and Washington D.C. “Whether it is
an evolving threat like terrorism or an infectious
disease like Ebola, when the community calls on
the fire service, we have that responsibility to
respond. Saying it is not our problem is not the
answer or a long-term solution.”
INTERVENTION
While difficult hurdles remain for some fire
Firefighters in Ohio talk to a man who
departments, most have adjusted and have hanidentified himself as an addict and
dled the increased cost, training, and call volume
asked for help at a heroin awareness
rally in Cincinnati.
resulting from the drug crisis, Breyer and others
told me. It’s the personal toll that has been the
hardest for some responders to overcome. Bringing a person back from the brink of death, only to find them
blue and unconscious from another overdose a week later, is
sometimes difficult to bear, they said. That’s the dark reality
of the opiate epidemic that responders see every day.
“It causes first responders to say, ‘there has got to be a
better way,’” Breyer said. “If I make the same run on the same
guy week after week, we’re not solving any problem, we’re just
making sure the same person doesn’t die. But we’re not helping these people all the way—this person needs treatment.”
The mounting desperation in communities has led many
fire departments to think differently about the crisis and
Percent increase in opioid
to assume a larger role in finding solutions. “It’s to the
overdose deaths from
point here where folks begin to realize that this is not just a
2003 (296) to 2015 (2,590)
problem that someone else’s family has to deal with—we’ve
had very tragic overdoses in this county, including family
Source: Ohio Department of Health
The epidemic state by state
Ohio
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20
107
Overdose
victims found
while operating
vehicles
Overdose victims
found in hotels,
public buildings, and
restaurants
Overdose victims
found in parked
vehicles
Average number of
doses (2 mg/dose)
given for revival
45
p
1.75
88
14
Opioid-related
fatalities
Repeat individual
patients in 30 days
Number of
overdose calls
Repeat individual
patients in 7 days
721
521
Patients treated
with naloxone
All figures compiled from
January 1 to December 1, 2016
The Opioid Crisis in
Manchester, New Hampshire,
(pop. 110,000) in 2016...
13
8
Repeat individual
patients in 24 hours
19
Number of incidents
where prescription
Narcan was found at
the scene
30
Repeat individual
patients since
January 1, 2016
...And what the
Manchester Fire Dept.
is doing about it
p
members, friends, and close relations of personnel at the
fire department,” Levy told me. “When you look at the sheer
numbers and impact on the community and put it in that
perspective, you start to realize that we need to begin to craft
more out-of-the-box strategies.”
One of the more innovative strategies is Manchester’s
Safe Stations program. Beginning last May, drug addicts
seeking help were invited to visit any of the Manchester Fire
Department’s 10 fire stations—24 hours per day, seven days
a week—to begin their road to recovery. The program works
in partnership with a recovery center called Serenity Place,
which is located adjacent to the central fire station downtown.
Chris Hickey, Manchester’s director of emergency services,
got the idea for Safe Stations last spring when a relative of
a Manchester firefighter showed up at a station looking for
help. He was homeless, addicted, and desperate. “When he
started talking to us it was apparent he was serious about
getting help, but he said there was nowhere for him to go—
he had made calls and went to a few websites, but nothing
was happening,” said Hickey, a longtime EMS provider in the
city. “I was doing some work at a local recovery center at the
time. I contacted them and they said just bring him in.”
The experience gave Hickey an idea: instead of merely
treating the symptoms of addiction by rushing around the city
bringing addicts back from death, perhaps the fire department
could play a larger role by getting addicts into treatment.
Hickey took the idea to department leadership, and the program was up and running within weeks. According to Goonan,
“We jumped into the program with both feet—our thinking
was, ‘let’s stop talking and let’s start doing something.’”
When addicts looking for help arrive at a Manchester fire
station, they are greeted with a quick physical and mental
health assessment. A counselor from Serenity Place is summoned to the station to meet with the patient, who can
register on the spot in the center’s outpatient program. On
average, a patient sees a licensed drug and alcohol counselor
within 12 minutes of entering a fire station.
“When someone is ready to make a change you have to get
them at that moment,” Goonan said. “They are greeted with
no judgment, just a handshake and a comfortable place to go.
Historically this is what the fire service does—help people.”
Safe Stations
Number of patients
visiting stations
Age range of
participants
Number of unique
participants
Percent of visitors
from Manchester
821
642
Number taken to
treatment center
409
18 –70
62%
Safe Station statistics are from
May 4 to December 1, 2016.
Source: Manchester Fire
Department
When the department first opened its doors to addicts,
nobody knew what to expect. Goonan thought they’d see
maybe five to 10 people a month. From May 4 to December
1, though, there have been a total of 821 visits to Manchester
fire stations from people looking to get clean, an average of
nearly four per day. Patients have ranged in age from 18 to
70, and have come from all over New Hampshire, as well as a
substantial number from Maine, Massachusetts, and as far as
Alabama. More than 400 patients have been brought into the
Serenity Place recovery program through Safe Stations.
“Some use us as a first option, some as a last,” Hickey said.
“A lot of people who come in are broken. They are mentally
worn out, physically a mess. Many had made phone calls and
got on waiting lists, but nothing happens and they end up
frustrated.”
“UNINTENTIONAL BOOST”
The proactive rather than reactive approach to the overdose
epidemic has also lifted spirits inside firehouses, Hickey told
me. At first, some firefighters were wary of the idea, and
worried that violence might follow addicts into the stations.
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ENABLER OR LIFE SAVER?
THE OVERDOSE REVERSAL MEDICATION NALOXONE, COMMONLY
KNOWN BY ITS BRAND NAME NARCAN, IS BECOMING A CRITICAL TOOL
TO HELP RESPONDERS COMBAT OPIOID-RELATED DEATHS. BUT IS IT
ALSO EMBOLDENING ADDICTS TO TAKE GREATER RISKS?
WITH OPIATE OVERDOSE deaths at
all-time highs across the nation, most
states have moved to make the opiate
overdose reversal medication naloxone hydrochloride more publically
available in hopes of saving lives. The
drug can now be purchased without a
prescription at pharmacies in at least
14 states, and several states are also
freely distributing the drug at community health and treatment centers. As
of August, New Hampshire had given
out about 5,000 free naloxone kits,
paid for with a $500,000 federal grant,
according to the governor’s office.
Naloxone, also known by its brand
name Narcan, comes in three forms:
intramuscular injection, intranasal, and
auto-injection. The drug’s costs have
generated controversy; the auto-inject
version that used to cost $575 for
two doses now costs around $3,750,
according to Politico, and generic naloxone that a decade ago cost $1.84 per
dose can now cost 17 times that.
Making naloxone available to the
public has also been controversial.
Christopher Hickey, the emergency
services director at the fire department in Manchester, New Hampshire,
has seen strong evidence that the
medication can give addicts a false
sense of security and may lead some
to take more risks. “We often find Narcan on scene lying next to a dead body
because the person was obviously not
able to give it to themselves,” he said.
“We once revived a girl who had a note
card on her that said, ‘If you find me
unconscious, administer Narcan, I am
a drug addict.’”
Naloxone itself is an enabling drug,
Hickey believes. “That is my opinion
as a medic,” he said. “It does fantastic
in the immediate problem, but it does
absolutely nothing in the long term. It
just enables you to cheat death that
one particular time, but it doesn’t
mean that death isn’t going to catch
up with you the next time.”
Dr. Seddon Savage, director of the
Dartmouth Center on Addiction, Recovery and Education, helped develop
New Hampshire’s public naloxone
initiative and admits that making the
medication more available could instill
a false sense of security in some users,
prompting them to take higher doses
of opioids. “That’s really regrettable,
but I think on balance more lives
are going to be saved,” she told The
Union-Leader newspaper. “I don’t think
that having it not available is going to
stop people from using heroin.”
The World Health Organization
agrees. In 2014, the organization
released an extensive report extolling
the wisdom of widely distributing
naloxone to anyone “likely to witness
an opioid overdose,” calling it “a cheap,
safe, easy-to-use, life-saving drug”
that “should be available for community distribution to people who inject
drugs, their peers and their families.”
While naloxone itself is safe to
administer and has no known harmful
side effects, proper training needs to
happen in conjunction with making
it available to the public, said Ken
Holland, a longtime paramedic in the
Boston area and a senior specialist
in emergency services at NFPA. That
includes firm instructions to call 911,
even if the overdose victim is revived
and alert, Holland said. “Narcan wears
off in 20 minutes to a half hour depending on the amount given and the
strength of the opiate the person has
taken,” Holland said. “Once that happens they are going to go right back
into respiratory arrest. Just because
you’ve given them Narcan doesn’t
mean they’ll be OK. That’s the education piece for the public, especially the
non-medical public.”
The New Hampshire Department
of Health and Human Services has
hosted a series of “train the trainer”
sessions so that providers who distribute naloxone can properly instruct
recipients how to administer the medication and what to watch out for.
Even so, Manchester Fire Chief Daniel
Goonan said he is “torn” on the issue.
“I’m sure there are more overdoses
than we realize because there is so
much Narcan out there, which is a
good thing—people are still alive because of it,” he said. “What worries me
is that people may be dying because
they don’t understand what Narcan
does. There is a half life to it—it wears
off and then you die.” —J.R.
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A KILLER
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But in the nine months the program has been operating
there hasn’t been a single incident. Instead, the program “has
worked wonders for our department mentally,” Hickey said.
“We were getting tired, angry, and frustrated going to dozens
of overdoses every month, seeing families ripped apart,
doing CPR, watching kids do CPR on their parents because
they had overdosed. But these people are coming to us before
they overdose, before they are dead, and it has quite unintentionally given everyone a boost.”
Goonan himself handles many of the intakes, like the
22-year-old woman with two young children suffering from
endocarditis who, when asked her drug of choice, replied,
“anything I can get my hands on.” Or the 61-year-old house
The epidemic state by state
Huntington, West Virginia
26
Overdose victims in a three-and-a-half-hour
stretch one day last August
painter who became hooked on pain medication when he
hurt his back on the job and two years later was addicted to
heroin and crack.
“He told me ‘I’m desperate for help, I’m going to lose
everything I have ever had—my wife, my home, my children,’” Goonan told me. “We see people like him every day. I
think the stigma is starting to lift a little bit. People are more
willing to come in and admit they have a problem.”
Manchester Fire Department officials believe the program
can work elsewhere and are helping others adopt it, including the nearby city of Nashua, which recently started its own
version of Safe Stations, and a fire district in the Bronx that
is planning to launch a pilot program this year.
Community engagement and cooperation from various
public and private organizations, ranging from hospitals,
safety agencies, health departments, local charities, and
church groups, have been key to the program’s success, Hickey
said. “We now have open lines of communication with all of
these groups, which is a huge advantage,” he said. “I think that
is one of the biggest first steps to addressing this issue.”
That holistic community approach is one others should
try to emulate, said Breyer, the fire and EMS director at
IAFF. “If we really want to solve the opioid epidemic, fire,
EMS, and all these public safety agencies need to be a part of
the bigger solution,” he said. “We all need to realize that we
can’t operate in silos. We need public health, social services,
mental health, fire—we need everyone working together
through a network.”
Many fire departments across the nation are starting to
take that approach. Beginning December 1, overdose victims
transported to the hospital by fire and rescue in Marion,
Ohio, are now met in the emergency room by a drug councilor, a significant shift for the city.
“It used to be that an overdose was charged with possession [of a controlled substance], but we’re not doing
that any more. We’re just trying to get these people help,”
Cowell said of the program, which has involved coordination
between fire and rescue, police, and a local hospital and
counseling center.
Howard County, Maryland, recently formed a communitywide drug task force with representatives from the fire
department, police, health department, corrections, hospitals, and other stakeholders.
“We all see this problem from different angles, and so I
think the most impactful thing we can do is come together to
share ideas, observations, and trends,” Levy, the fire department medical director, told me. “We are trying to break
down those barriers and begin to create a plan for a comprehensive solution.”
The group is working to create an interagency data dashboard where the various agencies can view each other’s
information with the hopes of uncovering patterns that can
lead to better-targeted intervention. They are also discussing
policy changes, such as making naloxone nasal spray publically available in strategic places across the county for the
public to use in overdose emergencies (see “Enabler or Life
Saver?” facing page).
“This is not a problem that is going away soon—this is not
Ebola, or Zika, not something that comes and goes,” Levy
said. “This is a problem of epidemic proportions and it is
going to be with us for a long, long time.”
It’s too early to know the impact these initiatives will have,
but there’s no doubt it will continue to be an uphill slog.
Despite efforts to combat the roots of the problem, initial
estimates in Marion, Howard County, and Manchester are
that each had a record-high number of opiate overdoses
again in 2016. Marion had more overdoses and deaths
through the first 11 months of 2016 than it did in all of
2015; Howard County averaged about 22 percent more opiate-related overdoses per month in 2016 than it did the year
before; and in Manchester, total opiate overdoses were up
about 6 percent through November compared with 2015.
But there’s hope, too, and signs that Safe Stations is
making progress. From August through November, Manchester saw 51 fewer overdoses and five fewer deaths than it
did during the same period in 2015. Goonan and Hickey are
hopeful that the trend will continue, but they are also realistic about the foe they are up against.
“We could be trending lower for months, and the next
thing you know a new dealer comes in with a new synthetic
opiate and we have seven or eight deaths and people start
saying it’s not working,” Goonan said. “But in my professional opinion we are certainly saving lives, and every time
someone walks through our front doors we are giving them a
real shot at recovery.”
JESSE ROMAN is associate editor of NFPA Journal.
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INSIDE THE PIPE
NFPA 25 permits
non-invasive methods
for conducting internal
sprinkler pipe assessments.
SAFEGUARD
Classroom door locking criteria
in NFPA 101 will help weed out
potentially dangerous hardware
and locking means that may not
provide safe egress.
NFPA 101
Life safety in new and
existing structures
Classroom door locking
against unwanted entry
A
By Ron Coté
lmost two years ago, I reported
on the school security workshop
organized by NFPA that brought
together more than 60 stakeholders
to identify problems and develop
solutions for the safe installation and
operation of classroom door locking
devices to prevent unwanted entry. I
asked readers for input on this timely
topic via the codes and standards revision process that will produce the 2018
edition of NFPA 101®, Life Safety Code®.
I’m pleased to report that much progress has occurred during the ensuing
22 months.
The NFPA 101 technical committee
with responsibility for the chapters on
new and existing educational occupancies considered public input and
utilized the skills and experiences of
its members to draft a comprehensive
package of provisions that will permit
classroom door locking to be done in
a safe manner. It considered public
comments submitted in response to
its draft provisions and fine-tuned the
package of requirements that is presented in the second draft report.
The locking means must be
approved, meaning that, in NFPA
parlance, it must be acceptable to the
authority having jurisdiction, or AHJ.
The AHJ takes guidance from 10 criteria, specified within the new provisions
on classroom door locking, before
granting approval.
The classroom door locking criteria will help weed out the dangerous
hardware and locking means, currently
available in the marketplace, that
do not provide safe egress from the
classroom. A key requirement is for
the presence of a feature absent in the
unproven quick fixes being offered—
namely, the classroom door must be
capable of being unlocked and opened
from outside the room via a key or
other credential. This will permit staff
to respond in a timely fashion to diffuse a threat within the classroom as
might occur where an occupant locks
the door from the inside to buy time to
attack others.
There is a criterion requiring the
unlocking and unlatching from the
classroom side of the door to be accomplished without the use of a key or tool,
and without any special knowledge
or effort. For installation of locking
hardware on new doors, the releasing mechanism must open the door
leaf with not more than one releasing
operation. For example, hardware that
releases both the latch and the deadbolt via a single operation of the door
lever might be used. For installation
of locking hardware on existing doors,
the releasing mechanism must open
the door leaf with not more than two
releasing operations. This relaxation
of the traditional single-operation
requirement applicable to egress doors
is offered in recognition of what is
practical to achieve without replacing
the door.
THINKSTOCK
In Compliance
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CODES & STANDARDS
& COMPLIANCE
Another criterion mandates that the
locking means must be capable of being
engaged without opening the door so
as not to broadcast to persons in the
corridor that the door is about to be
locked against entry. Additionally, the
releasing mechanism for the unlocking
and unlatching must be mounted in the
height range required of latch release
hardware like lever handles and panic
hardware. The locking means is not
permitted to modify the door closer or
panic hardware, a safeguard conspicuously absent from some of the unproven
hardware being touted as a school security solution. Any modifications made to
fire door assemblies must be performed
in accordance with NFPA 80, Fire Doors
and Other Opening Protectives.
The provisions permit the lock to be
engaged remotely, as from an administration area, but in such cases the lock
must be unlockable from the classroom
side of the door. This echoes the longheld tenet that building occupants must
have control over the egress system so
that they can leave on their own volition
at any time.
The criteria include a requirement
that the emergency plan address the
use of the locking and unlocking means
from within and outside the room.
Another criterion is that staff be drilled
in the engagement and release of the
locking means, from within and outside
the room, as part of the emergency
egress drills required by NFPA 101 in
educational occupancy buildings.
The provisions in NFPA 101 for classroom door locking against unwanted
entry present a carefully engineered
package that combines hardware dos
and don’ts with performance, training, and operational procedures. The
package can serve as a model to other
standards development organizations
and to school jurisdictions that have
developed homegrown, but in many
cases deficient, solutions to their security concerns.
Ron Coté is NFPA technical services lead for life
safety. NFPA members and AHJs can use the
Technical Questions tab to post queries on NFPA 101
at nfpa.org/101.
NFPA 70 + 70E
Electrical safety
The importance of
grounding and bonding of
electrical appliances
C
By Jeffrey Sargent
onnecting a household electric
range may be viewed by some
as requiring little more than
simply “connecting the dots.” However,
just because it works doesn’t mean
it’s working safely. A recent accident
highlights this important point and
demonstrates the potentially lethal consequences of an improper installation.
While browsing the online version
of a local newspaper recently, a headline—“Fatal accident in Portsmouth
condo building under investigation”—
piqued my curiosity. The story’s first
sentence indicated that a death had
occurred “from apparent electrocution.” Reading further, the victim was
identified as a 52-year-old man from a
neighboring town and that he was “in
the process of installing a dishwasher”
when the incident occurred. The story
elaborated that the actual task being
performed “may have involved replacement of an outlet.”
A follow-up story the next day provided additional detail. The victim
was a self-employed plumber who was
in the process of running the copper
water supply line to the dishwasher—
he was not performing any electrical
work, as was suggested in the first
report. The story went on to say that
it appeared the electrocution involved
the plumber coming in contact with an
electric range that “was not installed
per the manufacturer’s recommended
instructions.”
Soon after the accident, the city
electrical inspector shared the initial
findings at a local electrical inspectors’
meeting. Based on his description, it
appears that, due to improper installation practices, the frame of the range
became electrically energized. It took
an unfortunate set of circumstances for
this condition to be discovered.
The first problem he described was
the lack of a proper strain relief connector for the range supply cord. This
connector protects the cord against
abrasion and sharp metal edges as
it passes through the opening of the
range terminal box. The range was
discovered to have been nicked severely
enough—likely caused by moving it into
place—that one of the “hot” conductors had come into electrical contact
with the range, energizing the exposed
conductive surfaces. The safety net for
this condition is proper grounding and
bonding of the range’s noncurrent carrying metal parts. Because this was an
older installation, one predating today’s
requirement to install an equipment
grounding conductor in the branch
circuit to the range, it was necessary to
connect the neutral conductor supply
terminal in the range to the frame of
the range using a “bonding jumper”
provided by the range manufacturer.
When properly installed, the bonding
connection creates a circuit for ground
fault current to trip the circuit breaker
or blow the fuse protecting the range
supply circuit, de-energizing the range.
Without this safety feature in place,
the exposed metal surfaces of the range
were energized at 120 volts to ground.
The range worked, but in an unsafe
operating condition. As the plumber
contorted himself to work in the close
confines beneath the kitchen sink, it
appears that an exposed portion of his
leg came in contact with the range as he
held the grounded copper piping in his
hands, completing an electrical circuit
through his body. It is likely that the current pulsating through his body made
it impossible for him to let go of the
piping. Presumably no one reported him
as not returning home from work that
evening. His body was discovered by a
cleaning person the following morning.
It is apparent that improper installation practices created an unsafe
condition that resulted in the range
becoming a shock hazard. The range
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In Compliance
worked, but the unsuspecting plumber
could not have known that it was an
accident waiting to happen. Some may
question why we have requirements for
connectors and grounding and bonding
if the appliance works without them.
Unfortunately, there is now a statistic to
illustrate why these easy-to-install safety
features are so vitally important.
Jeffrey Sargent is an NFPA regional electrical
code specialist. NFPA members and AHJs can use
the Technical Questions tab to post queries on NFPA
70 at nfpa.org/70
NFPA 72
Fire alarms, signaling, and
emergency communication
Smoke detectors and
door release requirements
for smoke barriers
D
By Wayne Moore
oors used to protect openings in
smoke barriers provide an integral safety feature in every health
care occupancy. The 2016 edition of
NFPA 72®, National Fire Alarm and Signaling Code, provides the requirements
for the installation of smoke detectors
for door release service. Actuation of
smoke detectors release the doors and
help ensure that they close whenever
smoke invades the area near the door.
Where the release of the door takes
place exclusively from the smoke detector, using internal relay contacts, a
nationally recognized testing laboratory
must have tested and listed the detector for releasing device service.
The number of smoke detectors
required, and all of the spacing requirements found in sections 17.7.5.6.2
through 17.7.5.6.6, apply when the
detectors are used for the singular
purpose of smoke barrier door release.
If the doors must close in response to
smoke flowing in either direction in
the corridor space, the code contains
specific requirements for detector location. The code also provides graphics
of required locations that match the
requirements, based on the depth of
the wall section above the door and the
number of doors in the doorway. If the
depth of wall section above the door is
24 inches or less, for example, the code
requires one ceiling-mounted smoke
detector on one side of the doorway
only. If the designer specifies the use of
wall-mounted detectors, then the code
requires two detectors, one on each
side of the doorway.
If the depth of the wall section above
the door is greater than 24 inches on
one side only, then the code requires
only one ceiling-mounted smoke detector on the higher side of the doorway.
However, if the depth of wall section
above the door exceeds 24 inches on
both sides of the doorway, then the
code requires two ceiling-mounted or
wall-mounted detectors, one on each
side of the doorway. When the depth of
the wall section above the door exceeds
59 inches, the code requires the performance of an engineering evaluation
to determine the need for additional
detectors. Finally, when the design
specifies the use of a listed door frame–
mounted smoke detector or a listed
combination integral detector-door
closer assembly, the code requires
only one such detector when installed
according to the manufacturer’s published instructions.
The locations for ceiling-mounted
smoke detectors installed on a smooth
ceiling for a single or double doorway
must match the centerline of the doorway no more than five feet from the
door and no closer than 12 inches to
the doorway. Regardless of the depth
of wall section above the door, if the
door release intends to prevent smoke
transmission from one space to another
in one direction only, detectors located
in the space that will confine the smoke
must meet the same requirements as
outlined above for the doorways leading
from that space. When a space includes
multiple doorways, the code requires
additional ceiling-mounted smoke detectors depending on the number of doors
and the spacing between them.
Given all of this, it’s easy to see
why detector spacing for the specific
purpose of controlling smoke spread
in corridors or smoke compartments
can prove somewhat intimidating. But
smoke detectors included as part of a
code-compliant open area detection
system covering the room, corridor,
or enclosed space can satisfy all these
requirements for smoke barrier door
release service. In other words, when
smoke detectors protect a hallway or
other enclosed space using the open
area spacing of the code, none of the
requirements in sections 17.7.5.6.2
through 17.7.5.6.6 applies.
Wayne D. Moore is vice president at JENSEN
HUGHES. NFPA members and AHJs can use the
Technical Questions tab to post queries on NFPA 72
at nfpa.org/72.
NFPA 13
Water-based
fire protection systems
Does the water supply
meet the demands of the
sprinkler system?
M
By Matt Klaus
ost of the time and effort
spent on designing sprinkler
systems is devoted to locating
sprinklers and routing piping. But a
critical aspect of the system design that
typically does not get as much attention
is the water supply. The effectiveness of
a sprinkler system (and all water-based
suppression systems) depends upon
having a reliable and appropriately
sized water supply.
NFPA 13, Installation of Sprinkler
Systems, does not dictate what type
of water supply a system needs, only
that a reliable water supply capable of
providing the minimum required flow
and pressure for the system be provided. The type of supply selected is at
the discretion of the design team. This
choice is often driven by the availability and capacity of water provided by
the local water purveyor. If the system
demand can be met by the available
water supply, typically that will be the
approach of the design team.
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THINKSTOCK
SUPPLY SIDE
The effectiveness of all waterbased suppression systems
depends upon having a reliable and
appropriately sized water supply.
Determining whether the water
supply is capable of meeting the system
demand requires a hydrant flow test
to determine the system capacity or a
review of the system’s hydraulic model
(where available) to ascertain available
flow and pressure. NFPA 291, Recommended Practice for Fire Flow Testing
and Marking of Hydrants, provides a
methodology for conducting a hydrant
flow test and illustrates how the output
data should be interpreted.
In some cases, the hydrant flow
test may show that the water supply
doesn’t meet the required flow and/
or pressure demands of the system.
In those instances or in areas where
connecting to a water supply is not
an option, a fire pump or a tank and
pump system may be necessary. This
requires the designer to go outside
of NFPA 13 and look into NFPA 20,
Installation of Stationary Pumps for
Fire Protection, and NFPA 22, Water
Tanks for Private Fire Protection, for
additional design guidance on required
system components and system sizing.
The trickier scenario is where the
hydrant flow test indicates that the
water supply can meet the system
demand, but just barely. NFPA 13 does
not cite a specific safety factor when
considering the water supply, but
sound engineering judgement should
be used in these cases. The designer
should consider several factors when
considering the hydrant flow test data
and may choose to make adjustments
based on those factors, including the
time of day and season when the flow
test was conducted; typical usage in
the water supply; maturity of the water
supply, considering the potential for
the community to grow significantly
or whether most development is done;
and planned modifications to the facility. Failure to make the appropriate
adjustments or include the appropriate safety factor could lead to an
under-supplied system.
It is important to remember that
NFPA 25, Inspection, Testing, and
Maintenance of Water-Based Fire Protection Systems, considers a system
that does not have an adequate water
supply to be impaired. This can lead to
required fire watches until the system
demand can be supplied or, in some
circumstances, an order to temporarily
close the facility. While those scenarios
represent extreme examples of what
can happen, they typically occur when
the system was designed without consideration of future development or
implementing a safety factor into the
design. When such issues arise, the
facility owner is responsible for remediation of the deficient water supply.
As a result, it’s critical that the facility
owner has a clear understanding not
just of what’s required to meet the
minimum demand, but also what the
long-term assessment of the water
supply looks like.
For more information on water
supply adjustments, visit nfpa.org/
WaterFlowData.
Matt Klaus is NFPA technical services lead for fire
protection engineering. NFPA members and AHJs
can use the Technical Questions tab to post queries
on NFPA 25 at nfpa.org/25.
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Perspectives
Q&A
s mass shootings like the one that
left more than four dozen dead
at an Orlando nightclub in June
have become more frequent in the
United States, hospitals have begun
to anticipate and train for treating victims of similar events, according to a recent article in U.S.
News & World Report. But what happens when
the hospital itself—or any other type of health care
facility—is targeted by a would-be shooter?
That’s a question Michael Marturano has dedicated much of his time to over the last several
years. Marturano is safety officer for St. Luke’s, a
health care system in Duluth, Minnesota, a job he
took on in 2002 when the organization’s administration saw a greater need for emergency planning
A
H E A LT H C A R E FA C I L I T I E S
WIDE OPEN
WHY IT’S IMPORTANT FOR HEALTH CARE FACILITIES
TO TRAIN EMPLOYEES ON PROCEDURES
THAT ADDRESS ACTIVE SHOOTER EVENTS
Interview conducted and edited by Angelo Verzoni
VULNERABILITY
The accessibility of many health care facilities can make them
vulnerable to shooter incidents, according to some experts.
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VIEWPOINTS ON FIRE
AND LIFE SAFETY
following the 9/11 terrorist attacks. For years, his
primary concern focused on terrorist-led chemical and biological attacks, Marturano told NFPA
Journal in a recent interview, citing the anthrax
scare that swept the nation in the weeks after 9/11.
But around 2010, in the wake of events such as the
2007 shootings at Virginia Tech, the concern began
to shift to the possibility of a shooting in a hospital.
Marturano went to the St. Luke’s administration with a bold new idea: Hold an active shooter
drill for hospital staff, complete with law enforcement involvement and a gun loaded with blanks.
“That’s the only way people are going to really
understand how they will respond,” he argued,
likening the need for such training to the need
to conduct regular fire drills. The administration
agreed, and in 2012 the first
active-shooter training was
held at a St. Luke’s clinic.
Since then, Marturano, an
NFPA member, has taken his
education efforts to other St.
Luke’s facilities and beyond,
leading trainings for anywhere from 30 to 150 staff
members at a time at more
than a dozen health care
facilities throughout Minnesota and Wisconsin.
NFPA Journal spoke with
Marturano about the importance of preparing health
care facilities for situations
involving active shooters,
some of the challenges
involved with the training,
and measures health care
workers can take to stay safe
in active shooter events.
THINKSTOCK
What makes health care
facilities so vulnerable to
attacks from shooters?
We’re wide open. We don’t
run you through a metal
detector on your way in.
Surgery’s locked down, the
birthing center is locked
down, but the other 80 percent of the building is pretty
open. You’ve got sales people coming in, family
members coming in, you’ve got meetings with a
lot of community folks, and they need to get in.
How common are shootings at health care
facilities?
In the United States, there haven’t been hospitals
that have been targeted in mass shootings, but
there have been incidents overseas. In the U.S.,
you’re basically looking for disgruntled employees
or murder-suicides. That’s the biggest risk nursing homes have—a murder-suicide with grandpa
ending grandma’s life and then taking his own,
and you hope it stops there. There have also been
cases where a family member was not happy with
the care that a doctor or nurse gave a loved one
and they went in and shot them. I see that as
more of the risk right now—the murder-suicide,
the disgruntled employee who was fired, the
family member who’s not satisfied with the care.
How prepared are health care facilities to deal
with active shooters?
St. Luke’s is well prepared. However, other facilities I’ve done trainings at were not prepared at
all. Most of them didn’t even have a plan. So we’ve
shared our plan with them. I’ve developed a template, and I say, “Here’s a template. You can follow
it, you can come up with your own, or you can use
it as a guideline.” That’s why people are asking me
to do this, because they just aren’t prepared.
What should health care workers watch for that
might indicate a shooting is likely to occur?
We start with awareness. If you’re at the front
desk, what do you need to be aware of? For example, if somebody’s standing or pacing outside your
door and they’re looking in the windows and it’s
80 degrees outside and they’ve got a coat on, that’s
not normal. If you look at your patient list—and
you know most of your patients unless they’re
new—and you’ve got Bob and Carol and Ted and
Alice coming in today and that’s not one of them
outside, maybe you need to call 911 because at that
point you’re still able to function.
What do you mean by “still able to function”?
If you wait until something happens, you might
not be able to pick up that phone and make a call.
If someone walks in and pulls out a gun, there’s a
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Perspectives
very good chance you’ll lose your fine motor skills.
You may go into auditory exclusion. You might
experience tunnel vision and time dilation—something can seem like it took forever but it was only
five seconds. The police chief I worked with last
week at a vet’s home was actually in one of these
situations. He was a member of a SWAT team that
responded to a call at a residence. A guy came
out and started shooting. All the chief could do
was bring up his gun, put it on the target, and
pull the trigger—he wasn’t able to move out of the
way. Forty-two shots were fired in total between
police and the gunman and the chief never heard
a shot. All he heard was his M-16 going click, click,
click as it ejected a round and loaded another.
He thought it was a 10-minute gun battle, but it
was over in about three seconds. The chief wasn’t
injured but the shooter was killed. So if somebody
with 17 years of law enforcement experience and
eight years of military experience can lose fine
motor skills, go into auditory exclusion, and experience time dilation, what are you going to do if
you never think about this until it happens? By listening to the training and the drills, you’re much
better prepared.
assignment as you’re walking around the building is to find all the exits and go out those exits
and see where they go. When you’re running, you
have to call 911. You need to call a number to let
people know where you are and that you’re safe.
You need to let others know why you’re running
out of the building. Your other homework assignment when you’re walking around the building is
to look for doors that lock. Put a dot on the door
or something so if people are running down the
hallway and they see that symbol they know that
door locks from behind. For hide, if you can’t lock
the door, can you move your desk in your office
“What can you fight with?
Your name badge, your
shoes, your belt, your
pen, your wedding rings.
Hydrogen peroxide,
alcohol hand sanitizer.
You’ve got to make a plan.
We’re training you to win.”
How do you get people to overcome, or at least
manage, that physiological response?
That question is a hard one to answer because
I really don’t know how somebody’s going to
respond. Working through it, though, doing drills,
two to three scenarios like that, is what does it. In
the case of the police chief, it was muscle memory
that got him through this. He said if it wasn’t
for his training, which taught him to bring his
gun up, put it on target, and pull the trigger, he
would probably be dead. If I could, I’d do trainings quarterly in all my clinics, but we, like most
organizations, don’t have the capacity. I read an
article that said if you really want somebody to get
good at responding to active shooter situations,
you really need to do training quarterly for the
first year or two and you need to do it twice a
year thereafter. The more you can work through
it, the more drills you do, the more you can work
through the issues you may have had the first
time. You’re trying to build muscle memory.
nfpa.org/
perspectives
READ more on
shooter events and
how safety officials
can provide civilians
with training on
how to prepare and
respond in these
incidents.
Let’s say a shooter enters the building and
begins firing. What now?
Your options are run, hide, and fight, and that’s
basically it. Run-Hide-Fight is one of the more
well-known programs recognized by the federal
government. Let’s start with run. The first thing
is awareness—where are the exits? If you come
in the same door every day, your homework
up against it? Maybe you need to rearrange your
filing cabinet so you can easily push it against the
door if you have to. I show people how to use their
foot up against the door to keep the door shut,
how to use a belt on a door that opens out, how to
use a transfer belt—which is a belt that nurses and
other staff use to assist patients with walking—on
fire doors to keep them shut, how to use anything
from your clothes to your shoelaces to your lanyard on your name badge to secure a door.
NFPA 101®, Life Safety Code®, requires that
doors not be locked so as to prevent egress.
Does this present a challenge in your training?
If you’ve got to lock a door to save patients or
yourself, you do it—you do whatever you have to
do. I wish we could make it easier. I can’t put a
deadbolt on fire doors because of the code, but in
this particular case, what’s the difference if I put
a chain on the door or I take my belt off and tie it
around? That takes time. If I can’t get it done fast
enough, then I’m dead and everybody behind that
door’s dead. Why couldn’t I just put a deadbolt on
it? So I’m wrestling with that. I’m talking to some
of the fire marshals around here. They get it, but
because of the way the code’s written, we don’t
have that option. We need to sit down and think
about what we need to do.
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What about the fight scenario?
This is a measure of last resort. The message is just because a door has a lock on
it doesn’t mean it can’t be breached. Once
you’re in there, what do you fight with?
And this is the fight of your life, for
your life. What can you fight with? Your
name badge, your shoes, your belt, your
pen, your wedding rings. Hydrogen
peroxide, alcohol hand sanitizer. You’ve
got to make a plan. Go into a room and
look around and give yourself 10 seconds to figure out what you can fight
with. We’re training you to win.
Beyond the human side—training
people how to respond—what structural changes can be made to save
lives in these situations?
Just breaking the field of view. As an
example, if you’ve got somebody who
comes in with a long gun and there’s a
countertop that’s 12 feet long and it’s
wide open, they have nothing stopping
them from just making a sweep with
that firearm and continuing to shoot.
So we talk about creating barricades.
We talk about if you have to get up and
run a long distance, what can you do
to break up that view? We talk about
changing the culture on locking doors.
We talk about where to put up cameras.
Patients are obviously a high-risk
group in emergency situations, with
some of them immobile. Does your
training address patient safety?
Yes, and that’s a tough one. You want
employees to know that they need to
go home tonight, that being a hero and
shielding somebody with your body
doesn’t do anybody any good because
if the shooter has any kind of decent
handgun or rifle, they’ll get two people
with one shot. You can’t sit there and
try to round up patients when the
shooter is nearby because you’re a
target yourself, and we don’t want you
to be a target. The most important
thing you can do is get to a phone and
call 911. If there’s a mass notification
system in the facility, you need to be
able to access that, too, so if the shooter
is on the first floor, the folks on the
other floors can get themselves and
patients behind doors and to safety.
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International by Donald P. Bliss
THE NFPA VIEW ON
GLOBAL FIRE AND LIFE
SAFETY ISSUES
Viva Los Voluntarios
HELPING THE VOLUNTEER FIRE SERVICE IN LATIN AMERICA
FULFILL ITS LIFESAVING MISSION
recently travelled to
In Brazil, severe economic challenges
Argentina for the 10th conhave made it difficult to fund public
ference of the Organización
safety functions managed primarily by
de Bomberos Americacareer firefighters. Efforts are underway
nos (OBA), the volunteer
to establish more volunteer firefighting
firefighters association of the Americas,
units to offset gaps in locations where
and quickly learned that the spirit of the
career firefighters cannot provide suffivolunteer fire service is alive and well in
cient coverage. Those locations include
Latin America. The commitment and
São Paulo state, where NFPA recently
enthusiasm of the 1,000 men and women
provided guidance on volunteer recruitwho participated in the conference were
ment, retention, training, and oversight.
inspiring, despite the challenges many of
Many South American nations also
them face in their home countries.
have limited capabilities for collecting
In a relatively short period, OBA has
and analyzing the fire incident data cru“As I have seen
become a go-to resource for volunteer
cial for understanding and addressing
firsthand throughout
departments looking to gain proficiency
local and national fire problems. NFPA
the world, volunteer
on a wide range of fire and rescue topics.
helped Argentina develop its national fire
firefighters are
The organization now represents more
incident registry, which could serve as a
hungry for knowledge
than one million volunteer firefighters
model for other nations in the region.
and are proud of their
across North and South America, includBut it’s not all doom and gloom. Fireservice.”
ing those in the United States who belong
fighters also told me that the public
to The National Volunteer Fire Council.
appreciates the risks they take to make
As an associate member of OBA, NFPA
their communities safer. In most counhas an important voice in advocating for
tries, the fire departments also benefit
the health and safety of volunteer firefrom a profound spirit of volunteerism
fighters across the continent, and we have been a big OBA and giving back, which makes up for some of the financial
supporter since its inception. My goal at the conference was shortfalls. Chile, for instance, is the only country in the world
to identify more ways for NFPA to help the Latin America fire with an entirely volunteer fire service. In Guayaquil, Ecuador’s
service fulfill its lifesaving mission.
second largest city (population 2.3 million), the fire department
As I’ve seen around the world, volunteer firefighters are hungry comprises 1,400 volunteers and only 200 career staff. Argentina
for knowledge, are proud of their service, and have a “we can do has some 42,000 volunteer firefighters and 900 firefighting assoanything” attitude when it comes to challenges. Latin American ciations across the nation. Fire department cooperation is also
firefighters are no different, even in the face of daunting chal- a strength. The leadership of the Guayaquil Fire Department
lenges. Many I spoke with at the conference told me they are told me it is their duty to support and assist their neighboring
frustrated because they don’t believe political leaders understand departments, in spite of their own resource struggles.
their needs or recognize the importance of the fire service. Too
While not every problem was solved during OBA’s conference,
many fire departments in Latin America are severely strapped for solutions and possible initiatives were identified. There are many
funding that would allow them to upgrade their equipment and ways NFPA can help with our standards, training, and technical
fire stations, and seek donations of used fire trucks and personal expertise. Most important, despite the challenges, these nations
protective equipment from foreign fire departments. In Buenos are making it work with dedication and commitment.
Aires, I saw two 1970s-era U.S.-built Class A pumpers serving a
DONALD P. BLISS is vice president of field operations for NFPA.
volunteer station in a congested, high-risk district.
MICHAEL HOEWELER
I
38 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
International Column_01.17 SJS NW edit.indd 38
12/21/16 6:56 PM
Every Home Fire Has A Story
Michelle Allyn and her daughters were home when it erupted into flames. They
escaped, but the home was destroyed. When it came time to rebuild, the family installed
fire sprinklers, which can reduce the risk of dying in home fires by 80 percent.
Learn how home fires have impacted people in the place they feel safest.
FACES OF FIRE
A CAMPAIGN OF NFPA’S FIRE SPRINKLER INITIATIVE
FireSprinklerInitiative.org/Faces
Photo: ©2016 Bob Handelman
FacesofFireAd 10-2016#2_nfpa.indd 1
11/3/16 4:34 PM
Research by Casey Grant
THE FIRE
PROTECTION
RESEARCH
FOUNDATION
Global Stewards
ELIMINATING A GREENHOUSE GAS THREAT MEANS DEALING WITH
POTENTIALLY HAZARDOUS ALTERNATIVES
n October, the gavel
The fire protection community is no
fell on a landmark
stranger to this sort of problem. The
climate change agreeKigali Agreement was the result of the
ment, reached in Kigali,
28th meeting of the Parties to the MonRwanda, to phase out a
treal Protocol, a landmark treaty first
specific family of manmade chemicals
signed in 1987 by the United States and
used in air-conditioners and refrigera23 other countries and since expanded to
tors. While eliminating these chemicals,
much of the world. At that first Montreal
called hydrofluorocarbons, or HFCs,
Protocol meeting, the nations agreed to
makes sense for the environment, the
unprecedented trade restrictions to phase
alternatives that have been offered have
out the production of the family of Halon
the fire protection community on alert.
chemicals, considered the primary culUnlike last year’s Paris Agreement
prits of the growing hole in the Earth’s
and other efforts to cut back on carbon
stratospheric ozone layer, a climatological
“Because of the
dioxide from the use of fossil fuels, the
disaster in the making.
widespread use
new Kigali Agreement is a legally bindAs a result, the fire protection comof refrigeration
ing accord focused on the reduction of
munity engaged with environmentalists
systems and
a single family of chemicals. Governand world governments to coordinate
products, a change
ment representatives from more than
and assist with the phase-out of Halon
to HFC alternatives
170 nations worked together to forge
produced for fire protection. Automatic
with flammable
the agreement, with the ultimate goal of
suppression systems using Halon 1301 for
characteristics
reducing the warming of the planet by
computer rooms and similar applications
means we need
at least half a degree centigrade by the
needed to find alternatives, and the search
to recalibrate our
end of this century—the United Nations
led to the development of NFPA 2001,
fire protection
target to prevent dire environmental cliClean Agent Fire Extinguishing Systems,
approaches.”
mate-change consequences.
and other efforts. At its headquarters,
HFCs are a prime target for those
NFPA proudly displays a poster signed by
hoping to make a dent in the climate
the Montreal Protocol signatories in 1987.
change problem because, while the overAlthough the required action today with
all volumes of HFCs are much less than
HFCs is different, the spirit of need and
other greenhouse gases, such as carbon dioxide, they have dra- importance on the world scene is similar to the path we traveled
matically greater heat-trapping characteristics. That’s become in the 1980s with Halon 1301. Three decades ago the fire promore of an issue as HFCs have become the heat transfer fluid tection community responded nobly to the consequences of an
of choice in air-conditioners and refrigerators over the last sev- important world treaty protecting tomorrow’s world, presently
eral decades, mainly because they have superior performance on loan to us from future generations. The environmental comcharacteristics, including minimal fire danger. But that may munity is stepping forward through world governments to make
not be the case as alternatives are sought.
our world a better and safer place. This rings true with NFPA
This will be a significant challenge. Because of the wide- and other stakeholders in the fire protection community, who
spread use of refrigeration systems and products, a change likewise are dedicated to making our world a better and safer
to HFC alternatives with flammable characteristics means we place. I’m confident we will rise again to meet the challenge.
need to recalibrate our fire protection approaches for anticiCASEY GRANT is executive director of the Fire Protection Research Foundation.
pated new hazards.
MICHAEL HOEWELER
I
40 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
Research Column_01.17 SJS NW edit_2.indd 40
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Announcing a
NEW Certification for
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ECIALIST
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A professional credential for facility managers that highlights knowledge
of the many challenges associated with fire alarm and signaling
inspection, testing, and maintenance as well as how to keep their
facilities in compliance with the 2016 edition of NFPA 72®, National Fire
Alarm and Signaling Code.
For more information, go to www.nfpa.org/cfaitms
NFPA Cert.Alarms.indd 1
12/20/16 6:28 PM
H E A LT H C A R E FA C I L I T I E S
DEFINING
RISK
NFPA 99
What health care providers,
facility designers, and
enforcers need to know about the riskbased approach of
BY MICHAEL CROWLEY
feature 99_01.17 SJS NW.indd 42
12/21/16 8:06 PM
P H OTOS T H I N KSTO C K
feature 99_01.17 SJS NW.indd 43
12/22/16 11:44 AM
THE
HEALTH CARE
REGULATORY
WORLD IS
CHANGING
AGAIN.
July 5 was the first
day that health care
facilities across the
country were required to comply with
the 2012 edition of NFPA 101®, Life Safety
Code®, as well as the 2012 edition of NFPA
99, Health Care Facilities Code. As reported in
NFPA Journal and elsewhere, the move followed a
four-year effort by the U.S. Centers for Medicare &
Medicaid Services (CMS) to update the safety codes
and standards for the facilities it oversees, which
include all hospitals, nursing homes, ambulatory
surgical centers, and related facilities that accept
federal Medicaid and Medicare reimbursement. The
CMS adoption of NFPA 101 and NFPA 99 means it
can levy severe financial penalties and even shut
down facilities that do not follow the codes. CMS
field use and surveys utilizing the new criteria
began November 1.
While the update from the 2000 edition to the
2012 edition of NFPA 101 is a significant one for
thousands of health care facilities, the move from
the 1999 edition of NFPA 99 to the 2012 edition
presents an additional wrinkle, namely in the use
of what’s known as “risk categories” to determine
the level of protection required. Previous editions
of NFPA 99 used occupancy type as the basis to
MICHAEL CROWLEY is a vice president of Jensen Hughes
and chair of the NFPA 99 Correlating Committee.
determine the level of protection or type of system
to provide. A major trend in health care delivery,
however, has been to move procedures and treatments out of acute-care settings such as hospitals
and into buildings or spaces with flexible use, such
as office buildings and ambulatory care facilities.
The 2012 edition of NFPA 99 allows for flexibility
and cost savings for hospitals by matching the
types of equipment and systems to the risks posed
to patients by the procedures being provided
rather than the building occupancy type where
those procedures take place. Some new ambulatory
care facilities and business occupancies containing
facilities that provide health care procedures may
see increases in cost. Under the new risk-based
approach of NFPA 99, requirements matching the
procedures will now require providers (who are
also sometimes referred to as owner/operators),
designers, and authorities having jurisdiction
(AHJs) to discuss new projects based on the safety
of patients and caregivers. Occupancy-based protection requirements have been deleted.
Chapter 4 of NFPA 99 addresses the risk and
requires a risk assessment for new construction
and equipment. Existing construction and equipment will need to follow the inspection, testing,
and maintenance (ITM) of the risk category associated with the existing system or equipment.
Existing systems or equipment may need evaluation to determine the proper risk category. The
THINKSTOCK
DEFINING
RISK NFPA99
44 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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risk assessment will evaluate systems or
equipment and help users assign one of
four risk categories:
CATEGORY 1 is for facility systems
or equipment in which failure of such
equipment or system is likely to cause
major injury to or death of patients
or caregivers. Related text in Annex
A describes the technical committee’s
intent for major injury.
CATEGORY 2 is for facility systems
or equipment in which failure of such
equipment or system is likely to cause
minor injury to patients or caregivers.
Related text in Annex A describes the
technical committee’s intent for minor
injury.
CATEGORY 3 is for facility systems
or equipment in which failure of such
equipment or system is not likely to
cause injury to patients or caregivers
but can cause discomfort.
CATEGORY 4 is for facility systems
or equipment in which failure of such
equipment or system will have no
impact on patient care.
A specific risk assessment method is
not mandated in NFPA 99. Any method
the provider is comfortable with is
acceptable, but it must be a defined
procedure and must be documented.
Different systems or equipment serving the same area may have different
risk categories assigned based on the
risk assessment. CMS has indicated it
will not require the submittal of risk
assessments for review. However, if
there is an issue or a question about
construction features provided in the
facility, the risk assessment will be a
key document.
The CMS adoption of the 2012 edition of NFPA 99 omitted Chapters 7, 8,
12, and 13. CMS stated it did not have
jurisdiction over Chapter 7 (information
technology and communication systems),
Chapter 8 (plumbing), and Chapter 13
(security management) and will not regulate those areas. Chapter 12 (emergency
management) was deleted and replaced
with a later CMS rule that included emergency management requirements that
were published on September 16.
While the deleted chapters are not
required for CMS conditions of participation (CoP), they nevertheless
contain important information regarding telecommunication/information
technology, nurse call, grey water, black
water, grease traps, security vulnerability assessments, security equipment,
and security operation. Consider these
chapters as added resources if you need
to address those topics.
Other notable changes in the 2012
edition of NFPA 99 include the removal
of anesthetizing location ventilation
to prevent the recirculation of smoke,
though NFPA 90A, Installation of
Air-Conditioning and Ventilating Systems, is still required for the proper
HVAC detection and control. In addition, all operating rooms are now
considered wet-procedure locations,
and electrical systems must be designed
to address the wet-procedure designation; a risk assessment conducted
by the health care governing body can
be used to mitigate the wet-procedure
definition. Also, health care laboratory
requirements have been removed, and
NFPA 45, Fire Protection for Laboratories Using Chemicals, is referenced for
laboratory requirements.
Specific changes aside, it is the adoption of the new risk-based requirements
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DEFINING
RISK NFPA99
of NFPA 99 that will likely generate the
most questions in the coming months.
The answer to the question “What do I
need to do to comply?” depends on your
role in the health care facility environment. To get you headed in the right
direction, I can offer some preliminary
guidance for three key groups—providers, designers, and AHJs.
Procedures and risk:
THE PROVIDER PERSPECTIVE
Providers are responsible for the
day-to-day operations, renovations,
additions, and new construction of
health care facilities. They also must
know the procedures planned for the
facilities.
Providers typically employ health care
engineers or facility managers, as well
as project managers and construction
managers, who are responsible for new
construction or additions and the people
who may be charged with developing or
conducting risk assessments. This can
be assigned to the designer, but the provider must offer the worst-case scenarios
for procedures or treatments in the new
construction or addition. Clinical staff
should be consulted to confirm the type
of procedures planned for the facility.
Limiting the types of procedures
allowed is an option available to
the owner/operator, and policies for
controlling or limiting the types of
procedures should be documented for
future use. NFPA 99 allows the flexibility
to limit the procedure type and thereby
reduce the risk category. A Category 1
system in general will be more robust
and expensive than a Category 2 system,
and if the provider can limit the procedures, a lower risk category can be used.
The introduction of new procedures
to an existing facility must be accompanied by a risk assessment. The newly
introduced procedure may increase
the risk category, such as moving from
a Category 3 risk to a Category 2. This
increase in risk will require compliance
with the higher risk category for existing or new systems and for equipment
associated with the new procedure. Risk
assessment documentation for new
equipment, procedures, and systems
should include but not be limited to
the risk assessment method and the
persons or groups involved with the
assessment. The conclusion of the risk
assessment should be clearly stated with
any assumptions or limitations listed.
This process can be done in house or in
concert with the designers.
Existing equipment or systems can
pose unique challenges. Existing systems
not in strict compliance with NFPA 99
are permitted to be continued in use as
long as the AHJ has determined that
such use does not constitute a distinct
hazard to life. The extent and application of the NFPA 99 risk assessment
methods for existing equipment or
systems are not directly spelled out by
the code, though Chapters 5 through 11
YES OR NO?
How a qualitative risk assessment is based on a few simple questions. Using a
series of yes-or-no questions can be an effective health care facility risk assessment
if the parties involved understand the procedures that will be performed in the facility, as well as the equipment or systems that will be used for those procedures.
In the event of a system loss,
does a patient die?
YES The procedure is a Category 1 risk.
NO The next question to ask is…
In the event of a system loss, does a
patient experience discomfort?
YES The procedure is a Category 3 risk.
NO The next question to ask is…
In the event of a system loss, is a
patient injured?
YES The procedure is a Category 2 risk.
NO The next question to ask is…
In the event of a system loss, is
there no impact on a patient?
YES The procedure is a Category 4 risk.
contain requirements stating which sections apply to existing equipment and
systems. In general, these are the ITM
and operational requirements.
Existing equipment or systems
may never have had a risk category
assigned, so to provide the correct risk
category designation and resulting
requirements, the provider will have to
evaluate the existing system. This evaluation should determine the equipment
or system arrangement and compare
it to NFPA 99 requirements for Category 1, Category 2, and Category 3
levels of risk. A simple example would
be to review the medical air system. If
the system is not merely a single path
supply and has the capability of redundant or parallel process, it is probably
a Category 1 system, meaning the
equipment’s ITM requirements need to
match that level of risk. It was not the
intent of NFPA 99 to require upgrades
to existing systems unless the risk to
patients has changed via a new procedure or as a result of new equipment.
Documentation for determining
the existing equipment or system risk
category should be retained unless you
are following the Category 1 existing
requirements. All the required ITM documentation must be available for AHJ
review. For acute-care facilities such as
hospitals, the ITM requirements and
documentation have not changed from
previous editions of the code. NFPA 99
still references the requirements for
NFPA 10, Portable Fire Extinguishers;
NFPA 13, Installation of Sprinkler Systems; NFPA 25, Inspection, Testing and
Maintenance of Water-Based Fire Protection Systems; and NFPA 110, Emergency
and Standby Power Systems.
The need for collaboration:
THE DESIGNER PERSPECTIVE
The 2012 edition of NFPA 99 also
requires a new approach on the part
of most designers of health care facilities. The requirements based on a risk
assessment require an evaluation of the
equipment or system and a determination of the risk posed by worst-case
procedures, a process that should
involve the provider, including clinical
staff. Designers may be presented with
the risk assessment by the provider,
46 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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thus minimizing their involvement
with the risk category determination.
Designers involved with the risk
assessment would offer the provider
insight into the design options available
and the cost implications of a lower risk
category. Designers for new equipment
and systems have the opportunity to
reduce cost or provide flexibility to the
provider based on their input into the
risk assessment process. Once the risk
category is determined and documented,
the designer can select the category of
equipment or system required for the
facility. Facility design discussions will
now include the provider (including
clinical staff) and the designer for many
more systems and equipment than
under previous editions of NFPA 99.
Collaboration will be needed on medical gas, vacuum, electrical distribution
systems, electrical equipment, gas equipment, HVAC, and more.
Chapter 6 (electrical systems) has
addressed the risk by adding new definitions on types of patient rooms. A
critical care room, for example, is considered a Category 1 risk; a general care
room is a Category 2 risk; a basic care
room is a Category 3 risk; and a support room is considered a Category 4
risk. Type 1, Type 2, and Type 3 essential
electrical systems correspond to risk
categories 1, 2, and 3. The code allows a
risk category assessment by room.
In the case of expansion of existing
equipment or systems, designers will
need to research the existing equipment
or system to determine the existing
risk category. Chapters 5 through 11
address the expansion of equipment and
systems. The new portion of the equipment or system will comply with the
requirements for new construction. A
risk assessment will be required for the
new section. Depending on the work,
upgrades may be required in the existing system or equipment.
Designers should turn over any risk
evaluation documentation for new or
existing equipment or systems to the
provider. Designers can also assist the
provider in updating and revising a risk
assessment already in place. New and
expansion design documents should
identify the risk category used for
the system design. While CMS is not
requesting the submittal of the risk
assessment, local AHJs may require the
risk assessment as part of the design
submittal—you should check with
the local and state AHJs for submittal requirements. Specific limitations
should be listed and provided to the
owner for Category 2 and 3 systems.
This is not a requirement but would
be helpful documentation for future
changes or AHJ inspections.
Understanding risk:
THE AHJ PERSPECTIVE
The new health care requirements will
also affect AHJs. CMS is setting the
requirements for conditions of participation, and most state licensing entities
will follow the same rules. Local building
departments will follow the reference
requirements for the local building
codes. In some cases, the referenced edition of NFPA 99 may be different from
the 2012 edition required by CMS; in
AHJs should know that Chapters 14
and 15 do not require a risk assessment.
Chapter 14 (hyperbaric facilities) covers
new installations, ongoing operation
requirements, and the documentation
required to demonstrate compliance.
(There are two levels of systems: one for
single-patient hyperbaric chambers and
one for multi-person chambers.) Chapter
15 (fire protection features) is a collection of requirements for the reference
standards such as NFPA 10 and NFPA
13. The focus of Chapter 15 is on fire
protection features that have presented
compliance issues in the past. A section
on fire loss prevention in operating
rooms has been expanded to address fire
prevention and emergency procedures.
Orientation and training for the operating staff on operating room fires is new.
Documentation of this training should
be available to the AHJ.
AHJ inspections of acute-care facilities will not change significantly under
A major trend in health care delivery has been
to move procedures and treatments out of
acute-care settings such as hospitals and into
buildings or spaces with flexible use, such as
office buildings and ambulatory care facilities.
general, the most stringent requirements
will apply unless the AHJ agrees to the
CMS criteria.
Local AHJs may not have extensive
experience with the application of the
2012 edition of NFPA 99. The local AHJ
may have adopted all chapters of NFPA
99, which would require that facilities
also be in compliance with Chapters 7, 8,
12, and 13, which are omitted under CMS
requirements. For new construction,
the local AHJs will have more oversight.
Ongoing operation will require the AHJ
to review the ITM documentation. CMS
has not requested documentation submittal to review the risk assessment, but
the local AHJ will most likely request the
documentation to support the proposed
new designs. CMS requires risk assessment documentation and expects it to be
available during inspections.
the new referenced edition of NFPA
99. The required documentation will
change to reflect the newly adopted
reference standards. Documentation
requirements for the equipment and
systems solely regulated by NFPA 99 for
acute care facilities will remain similar
to previous editions. Fire loss prevention in operating rooms and emergency
procedure requirements addressing
operational criteria for use of flammable germicides and antiseptics are new.
The AHJ inspections for new nonhospital health care facilities will
require an understanding of the various risk categories. Merely looking
at the building occupancy type will
not provide adequate information to
determine the type of equipment or
systems required by the 2012 edition
of NFPA 99.
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THE
IN THERE
H E A LT H C A R E FA C I L I T I E S
THE
IN THERE
by Stephanie Schorow
NEWSCOM
Hyperbaric chambers have been touted for their healing
and restorative powers, but a proliferation of the devices
has experts concerned about the potential fire hazard
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HEALING O2
A patient in a Florida medical center
undergoes hyperbaric oxygen treatment
following surgery.
he family of Francesco Martinisi only
wanted the best for their four-year-old
son, born with cerebral palsy. His father
brought him to the United States from
Italy, hoping the boy would be helped by
breathing pressurized oxygen in a hyperbaric chamber at a Florida clinic. His 62-year-old grandmother
even came into the chamber to keep him company.
On May 1, 2009, the chamber erupted in fire, fed
by the oxygen inside. Unable to get out, Francesco
and his grandmother endured five minutes of flames
that burned more than 90 percent of their bodies.
Neither survived.
The incident and other serious accidents involving
hyperbaric chambers have alarmed many in the lifesafety community, including Tom Workman, director
of quality assurance and regulatory affairs for the
Undersea and Hyperbaric Medical Society. Workman,
a member of the Hyperbaric and Hypobaric Facilities
Committee of NFPA 99, Health Care Facilities Code, has
been tracking the proliferation of hyperbaric chambers around the country. While he believes the vast
majority of the chambers in hospitals or clinical health
care facilities are operated safely and effectively, he
sees ominous developments in the use of chambers in
non-clinical settings and in private homes. u
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Traditionally used to treat decompression issues (commonly called “the
bends”) in underwater divers, HBO2
has been deemed effective for treating
other conditions, including carbon
monoxide poisoning, air or gas embolism, non-healing diabetic wounds,
thermal burns, and exceptional blood
loss—the FDA currently lists 14 uses for
HBO2, which is commonly prescribed
to speed healing of wounds such as
soft-tissue infections and crush injuries. There are also a host of HBO2 uses
that have not been officially endorsed;
athletes across a variety of sports have
claimed HBO2 helps speed recovery
from injuries or hard physical efforts,
and celebrities, including Madonna and
Michael Jackson, have famously touted
the purported health benefits of their
HBO2 regimens.
In the confined space of a hyperbaric
chamber, though, fires can be catastrophic, experts say. “We know that
an increase in pressure and oxygen
concentration can result in increased
burning and burning rates of material,”
said Jonathan Hart, NFPA staff liaison
for NFPA 99, in which Chapter 14 spells
out safety procedures and precautions
for hyperbaric chambers. According to
a 1997 study published by the Undersea
and Hyperbaric Medical Society, from
1923 to 1996, 77 deaths resulted from 35
fires in clinical hyperbaric chambers.
Fires and explosions in HBO2 facilities
worldwide have been caused by static
electricity, electrical devices, chemical
handwarmers, and other sources.
That’s why experts stress that such
chambers must be carefully built
and maintained—a challenge as they
NEWSCOM
“It’s a big issue and it unfortunately
keeps getting bigger and bigger,” said
Workman, who hopes to alert fire marshals and other authorities to the spread
of hyperbaric chambers that do not
comply with NFPA code provisions.
Hyperbaric oxygen therapy (HBO2)
involves breathing near 100 percent
oxygen in an environment in which the
atmospheric pressure is raised to three
times higher than normal, in either a
multi-person or a single-person chamber. Hyperbaric chambers are classified
by the U.S. Food and Drug Administration (FDA) as Class II medical devices,
meaning manufacturers must first
prove to the FDA that such devices are
at least as safe and effective as previous legally marketed devices before
they can be sold for medical treatment
purposes.
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t USES AND DANGERS
The Florida clinic where a woman and her grandson
died in a fire that occurred in a hyperbaric chamber in
2009. Inset, a woman with her comatose son undergoing
hyperbaric oxygen treatment in the same clinic in 2008.
The treatment is used to address an array of conditions
not authorized by the FDA.
offices, spas,
sports clubs, strip
malls, and other
settings where
operators promote pressurized
oxygen as a treatment for a host of
conditions ranging from autism, multiple sclerosis, and AIDS to Alzheimer’s
disease, Bell’s palsy, and depression—
treatments not authorized by the FDA.
Indeed, the FDA has issued consumer
alerts warning of sham promises of
But Workman and others say the devices
are not being manufactured, housed,
operated, or maintained in a manner
consistent with NFPA 99, increasing the
risk of fire or explosion—and, as a result
of the mechanical or physiological effects
of higher pressure, injury or death.
There are no reliable figures of the
number of these home-use chambers
(also called mild hyperbaric chambers) currently in use, but Workman
estimates there are “many thousands”
of them—certainly more than the
“The affidavit from the
sheriff’s department
reads like a list of failures
to meet the code.”
proliferate. The number of hyperbaric
chambers operated by hospitals or
health care clinics increased from
about 27 nationwide in the early 1970s
to about 1,350 today, according to data
from the American Hospital Association, cited by Workman. These facilities
generally voluntarily comply with NFPA
99 and NFPA 101®, Life Safety Code®, to
ensure Medicare and/or Medicaid reimbursement, he said.
BEYOND CLINICAL
FACILITIES
But it isn’t the clinical hyperbaric facilities that pose the most concern. “That’s
not where our problem really lies,”
Workman said. “Our problem lies in
those [facilities] outside that umbrella.”
Hyperbaric chambers have been
established in alternative-medicine
miracle cures brought about by HBO2.
Workman estimates there are about
200 freestanding or non-affiliated
hyperbaric facilities in the U.S. Some
are in clinical settings or medical office
buildings and are run by physicians
with appropriate medical staff, while
others are in buildings deemed business-class occupancies.
That’s only part of his concern. Private
citizens, some influenced by celebrity
athletes—including former National
Football League star Terrell Owens, who
touted breathing pressurized oxygen
as a way to recover from injuries—are
purchasing portable, low-pressure
fabric hyperbaric chambers, also known
as “bag chambers,” for home use. The
devices retail from $7,000 to more than
$17,000 and can be set up and put into
operation within hours after delivery.
number of chambers that are in use in
hospital- or clinic-based facilities. “So
many people look up to professional
athletes—they see a TV clip of a big
football player with a chamber over
his shoulder and think, ‘What’s good
enough for him is good enough for
me,’” Workman said.
The FDA classifies bag chambers as
medical devices and authorizes their
use only for acute mountain sickness
brought on, in part, by exposure to
high-altitude, low-oxygen environments.
But manufacturers and operators, using
cleverly worded ads, are promoting the
bags for a variety of what are referred to
as “off-label” uses, such as weight loss,
anti-aging, or improved stamina, as well
as for more serious conditions.
What is of key concern to life-safety
officials is that the bags do not currently
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THE
IN THERE
KNOW YOUR HYPERBARICS
Ten tips for AHJs
More than 18 organizations and agencies, ranging from professional societies to federal regulators, have responsibility for the practice of hyperbaric oxygen treatment. However, many local and state authorities having
jurisdiction (AHJs), including fire marshals, have little knowledge of how
hyperbaric chambers operate and the regulations that govern their use.
Many may not even be aware that such devices are operating within their
jurisdictions. Here are 10 points for AHJs to consider.
1
AHJs should attempt to track the establishment and use of hyperbaric chambers operating in their jurisdictions, particularly those operating outside local
hospitals or medical clinics. Tom Workman, director of quality assurance and
regulatory affairs for the Undersea and Hyperbaric Medical Society and a member of the Hyperbaric and Hypobaric Facilities Committee of NFPA 99, suggests
that AHJs visit such establishments and establish relationships with owners.
2
NFPA 99 defines three classes of hyperbaric chambers, each with its own
stringent design and operational criteria: Class A, which is a multiple-person
occupancy; Class B, a single-person occupancy; and Class C, which is for
animals or animal research.
3
Low-pressure, portable fabric hyperbaric chambers are authorized by the
FDA only for treatment of acute mountain sickness. While cleared by the
FDA as a Class II medical device, these devices generally do not comply with
ASME PVHO. Although only 11 states specifically mandate compliance to
ASME PVHO, the requirements in NFPA 99 and NFPA 101 call for compliance
with that standard and cover all hyperbaric oxygen therapy devices, according to Workman.
4
Local AHJs have the authority to mandate that hyperbaric chambers in
their jurisdictions be accredited by a recognized third party involved with
hyperbaric oxygen education or operations, Workman said. Currently Utah
and parts of the State of New York require such accreditation for medical
insurance reimbursement.
5
Be aware that patients undergoing treatment in hyperbaric chambers may
not have the capacity for self preservation in an emergency. That is why
chamber operators must be in visual or audible contact with patients or in
sight of the chamber control panel at all times.
6
Patients should not be allowed to wear street clothes into a chamber unless
specifically authorized by the operation’s safety director.
7
Patients should not bring cell phones, laptops, or other electronic devices
into a chamber.
8
If a chamber creates a concentration of more than 23.5 percent oxygen,
both the device and the patient should be electrically grounded.
code requires that oxygen be vented to the outside of buildings to
9 NFPA
prevent potentially dangerous O build-up.
observe what appear to be safety violations but are unclear on how
10 IftoAHJs
proceed, they can call the professional medical societies that cover hy2
perbaric medicine for clarification and guidance, including the Undersea and
Hyperbaric Medical Society (919-490-5140 or 877-533-8467; uhms.org) and
the American College of Hyperbaric Medicine (414-269-5340; achm.org).
AHJs who are NFPA members can contact the NFPA Advisory Service group
at 1-800-344-3555.
comply with the design and fabrication
safety requirements of ASME's Safety
Standard for Pressure Vessels for Human
Occupancy (ASME PVHO) and/or NFPA
99. The bags are designed to be used
with compressed air, but many users
connect them to oxygen concentrators.
NFPA 99 requires that the exhaust of
all hyperbaric chambers be piped to the
exterior of buildings. Without such venting, oxygen can build up to dangerously
high levels in both the chamber and the
immediate vicinity, Workman said.
It all adds up to a significant firesafety concern. “We don’t know what
the oxygen percentage can be inside
the bag—if the oxygen level is too high,
flash time is reduced and you don’t have
any response time in a [fire] event,”
said James Bell, technical supervisor
of Hypobaric & Hyperbaric Safety,
Intermountain Medical Center & LDS
Hospital, and chair of the Hyperbaric
and Hypobaric Facilities Committee
of NFPA 99. NFPA codes also stipulate
that if the oxygen inside a chamber is
in excess of 23.5 percent, the patient as
well as the chamber must be electrically
grounded because a static charge could
increase the risk of fire.
There are other risks as well. In June,
2011, in North Carolina, a 19-year-old
male being treated for autism suffocated
in a fabric chamber when a valve became
disconnected. The family, who allegedly
learned of the device at an autism conference, sued the manufacturer, claiming
it marketed the chamber as safe for
unsupervised use despite knowing the
valves could disconnect. The case was
settled out of court. “Your lungs are
actually really fragile,” Bell said of the
physical hazards associated with the
devices. “It only takes a couple of inches
of water pressure or half a [pound per
square inch] to injure your lungs.”
Other dangers include wearing
non-approved clothing. NFPA 99
requires either cotton or cotton-poly
clothing inside chambers to minimize
the hazard of static electricity, which
can be more easily generated by some
synthetic fabrics. Items left in pockets,
such as mobile phones, can also present
static electricity hazards inside chambers. Workman cited a facility where
patients were issued portable CD players
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PRO'S EDGE?
The popularity of hyperbaric chambers for home
use—also known as mild hyperbaric chambers or
"bag chambers"—has been fueled by endorsements
from professional athletes, including former Major
League Baseball pitcher Rafael Soriano.
to take inside the chamber, a practice he
described as a “significant fire risk.” In
July 2014, a woman in a New York City
spa found herself trapped in a $100-perhour inflatable hyperbaric chamber and
could not summon staff. She texted a
help message to a friend, who alerted
firefighters. NFPA 99 requires that
during chamber operations with an
occupant in the chamber, a chamber
operator will be physically present and
maintain contact with the occupant.
“Someone needs to be there who is qualified to be there,” Bell said.
NEWSCOM
FOLLOWING THE CODE
Physicians may legitimately prescribe
HBO2 for off-label uses; the FDA does
not regulate the practice of medicine.
The issue is how such uses are marketed. “The FDA has gone on record
publically with several warning letters to facilities for promoting their
chamber for off-label indications,”
Workman said. Compounding the Martinisi tragedy in Florida, for example,
is that HBO2 has not been clinically
determined to help cerebral palsy. The
secondary market—where chambers are
sold through venues like Craigslist—is
another area of concern; a device that
may have originally been set up and
used according to code may not be used
appropriately by a new owner.
Workman and others want to see
greater NFPA code compliance by fabric
bag manufacturers, and for local authorities to be more aware of the potential
hazards of chambers in non-clinical
settings. When a hyperbaric chamber
is installed in a hospital or clinic, occupancy and health safety codes must be
met. In cases of non-affiliated chambers,
fire marshals and others may not even
be aware that chambers have been
installed and are being used in their
jurisdictions, Workman said.
Workman believes facilities in malls
and sports clubs should adhere to the
provisions of the Life Safety Code even
when they insist they do not represent
a health care occupancy. In states that
adopt NFPA 101, such facilities may be
covered by Chapter 8, which applies
to hyperbaric chambers and specifically refers to NFPA 99. “If NFPA 101
is adopted, then there is a regulatory
mandate for authorities to use when
enforcing codes through plan review or
routine inspections, regardless of occupancy type,” Hart said.
And that makes a difference. Operators who follow NFPA code “have
a pretty good record,” Bell noted. In
North America, from 1968 to 2009,
there were no reported deaths related
to fire in any facilities operating hyperbaric chambers that complied with
NFPA codes, Bell said.
An investigation of the Martinisi
case in Florida found that while the
refurbished chamber had been built
to code, it was neither properly maintained nor operated according to code
at the time of the fire. The device was
not grounded, the occupants were wearing street clothes, and the intercom
was not working. The grandmother
apparently adjusted a cushion, and a
buildup of static electricity generated a
spark—enough to trigger a violent fire in
the oxygen-enriched environment. She
banged on the chamber to get someone’s
attention, but when an attendant did
appear, the chamber had to be depressurized for 90 seconds before it could be
opened. Prosecutors said the chamber
was not designed to hold two people and
that it had not been properly cleaned.
Investigators found numerous electrical
issues and broken indicator lights covered with electrical tape. “In my opinion,
the accident may not have happened
if the facility had been diligent with
following the minimum code set out in
NFPA 99,” Bell said. “The affidavit from
the sheriff’s department reads like a list
of failures to meet the code.”
Once the device was installed, “no
one was coming in looking at it,” Workman said. “There was no reason for
the fire marshal to come back”—a fact,
he said, that underscores the need for
more education and greater awareness of the risk of non-code-compliant
hyperbaric chambers.
STEPHANIE SCHOROW is a writer in Boston.
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Firewatch
GUTTER CREDIT
A construction heater was blamed for a fire that
destroyed a large housing complex being built
in Indiana, resulting in $5.5 million in damage.
54 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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12/21/16 6:45 PM
FIRE INCIDENTS
FROM NFPA FILES
INDIANA
Heater blamed for $5.5 million
residential construction fire
A fire at a multi-unit residential construction site (pictured at left) caused an
estimated $5.5 million in damage. There
were no injuries reported.
A passerby called 911 to report the
fire just before 5 a.m., but investigators
indicated that the fire had a lengthy
head start before it was first spotted.
Newspapers reported that 14 fire
departments responded to the fire,
which continued to burn three hours
after units first reached the scene.
Cold temperatures were blamed for
equipment icing up and complicating
extinguishment.
Investigators determined that the
fire started when a construction heater
in a third-floor hallway ignited nearby
combustibles. The fire originated on
one side of a firewall near the center of
the building. Because doors had not yet
been installed, the fire was able to travel
to an unprotected side, where there was
substantial fuel, then traveled via the
attic throughout the entire structure.
Residential sprinklers and smoke
alarms were not yet operational.
The structure was three stories in
height and constructed with a wood
frame and walls and wood joist floor
framing, with a wood truss roof frame.
No information was available on
the square footage of the structure.
However, newspaper reports indicated
that the complex had 306 units ranging
from 642 to 1,346 square feet (56 to 125
square meters).
MICHIGAN
Smoking materials, supplemental
oxygen blamed for fatal fire
Firefighters were able to evacuate a
resident after responding to a report of
fire from a neighboring apartment, but
LOUISIANA
Cooking materials cause deadly fire
A male resident died of smoke inhalation injuries after cooking materials left
on a stove ignited as he slept, resulting
in a fire that spread to cabinets and
then throughout the kitchen and other
areas of the home.
Firefighters responded after a passerby spotted the fire at midnight and
called 911.
The house was a single-story structure and occupied a ground floor area
of 800 square feet (74 square meters). It
was constructed with a wood frame and
roof deck and asphalt shingles. It was
not equipped with smoke alarms or an
automatic extinguishing system.
The fire caused an estimated $20,000
in damage to the structure, which was
valued at $40,000, and $3,000 to its
contents, valued at $5,000.
N F PA . O R G / J O U R N A L • NFPA JOURNAL
Firewatch_01.17AA SJS NW EDIT.indd 55
CHRIS ALLEN, FISHERS FIRE DEPARTMENT
Residential
the resident succumbed to smoke inhalation injuries after being transported
to a local hospital.
Investigators determined that the
fire started when smoking materials
ignited a recliner and believe that the
resident fell asleep while using supplemental oxygen. News reports indicated
that crews pulled the resident from the
apartment as fire spread through the
living room.
The fire was limited to the victim’s
unit, which was part of a larger apartment complex.
Smoke detectors located in hallway
common areas successfully activated,
but investigators were unable to determine whether a stand-alone smoke
alarm in the victim’s residence was
operational. The apartment was not
protected by a sprinkler system.
The complex was three stories in
height and had a ground floor area of
9,717 square feet (903 square meters).
The fire caused $75,000 in damage
to the structure, which was valued at
$4 million, and $35,000 in damage to
apartment contents.
| 55
12/21/16 6:46 PM
Firewatch
NEW YORK
Stove used for heating starts fatal
apartment fire
One man died in an early morning
apartment fire that started when items
of clothing caught fire after they were
placed near a stove to dry.
Firefighters were summoned to the
fire in a 15-story apartment complex
by a neighbor’s 911 call at 2:37 a.m.
First arriving units found heavy smoke
conditions in the victim’s apartment on
the sixth floor, but indicated that the
fire had largely burned itself out by the
time they reached the scene.
Crews found the occupant unconscious and face down in a rear living
room near the kitchen and pulled him
into the hallway, passing him to another
crew, who carried him to the third
floor to perform CPR. The resuscitation
efforts were unsuccessful and a medical
examiner on the scene indicated that the
victim succumbed to apparent smoke
inhalation injuries. One firefighter was
taken to the hospital for treatment of
strain injuries in his neck.
Investigators determined that the
occupant was using the gas stove to
heat the apartment. He had left laundry hanging from kitchen cabinets over
the stove when the clothing caught fire.
The apartment was equipped with
a battery-operated smoke alarm in the
hallway. The fire department noted
that a centrally monitored smoke alarm
would have permitted faster notification. The apartment was not equipped
with sprinkler protection.
The building was constructed with
concrete walls and floor framing and a
concrete-on-steel roof deck.
No information was available on the
dollar value of losses.
MISSOURI
Assisted living facility damaged in
fire started by smoking materials
A fire at an assisted living facility that
investigators attributed to smoking
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materials caused more than $3 million
in damage. No injuries were reported in
the fire.
The fire department was notified of
the fire at 5:45 a.m. by a monitoring
company after a fire alarm sounded at
the care facility. A second alarm was
called when a responding firefighter on
his way to the engine house observed
heavy fire from the care facility’s third
floor and attic.
The first arriving crew reached the
scene at 5:53 a.m. to find fire in two
apartments on the third floor and the
attic. Facility staff informed the crew that
all residents had been evacuated from
the building, which contained 108 units.
The initial crew deployed a handline
and began to knock the fire down from
the ground. A second apparatus arrived
at 5:55 a.m. and was assigned to establish a water supply to the first engine
and set up a ladder. The crew from the
second apparatus was then instructed
to use a supply hose to suppress the
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56 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
Firewatch_01.17AA SJS NW EDIT.indd 56
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remaining fire that could not be extinguished from ground level.
At 6 a.m., two firefighters initiated
a primary search of the third floor
to confirm that all rooms were clear.
Additional arriving crews conducted
searches of the building’s remaining
floors and wings. Primary and secondary searches of the entire facility were
complete by 6:32 a.m.
Due to freezing conditions, incident
command contacted the local public
works department to apply salt in
areas where crews were working and
to keep roadways open for transporting
residents, who were evacuated to a
local high school gymnasium. A local
hospital also made space available for
residents until other arrangements
could be made.
Investigators determined that the
fire started when discarded smoking
materials that had been deposited in a
planter on a third floor balcony ignited
an artificial plant, then spread to the
exterior sidewall, roof, and deck.
The facility was a three-story,
multi-family residence with three
wings and occupied a ground floor
area of 23,389 square feet (2,173 square
meters). It was constructed with a
wood frame and walls and had asphalt
shingling. The facility was equipped
with smoke detectors in all living areas
and heat detectors in the attic space, as
well as an automatic sprinkler system.
Two sprinkler heads opened and prevented fire from entering the rooms,
although parts of the interior suffered
extensive smoke and water damage.
The fire caused $3 million in damage
to the structure and $80,000 to contents.
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MICHIGAN
Smoking in bed blamed for blaze
that kills one, injures another
An early morning house fire claimed the
life of one resident and caused moderate
injuries to a second, but two other residents were able to escape.
Firefighters were dispatched to the
scene at 5:16 a.m. and arrived nine minutes later to find heavy smoke showing
from a side window on the second floor
of the house. Two occupants standing outside the residence informed
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N F PA . O R G / J O U R N A L • NFPA JOURNAL
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Firewatch
firefighters that two additional occupants were still inside. Firefighters
learned that the remaining occupants
were likely located in the room where
smoke was showing, as well as in a
front bedroom also on the second floor.
Crews began rescue efforts by ladder
at the front bedroom, but were met
with heavy smoke after breaking the
window. Unable to see anybody inside
after sweeping the interior with a thermal imaging camera, the rescue team
was forced to retreat to ground level
when fire spread quickly through the
room and out the window.
While the initial rescue was still in
progress, a second rescue team entered
the house and attempted to locate the
victim in the side room. Inside, they
spotted a male victim on the stairs
and quickly removed him from the
house, then returned to mount an
interior attack on the fire. Crews continued their rescue efforts at the front
of the house by taking a handline up
the ladder and extinguishing the fire
in order to permit entry. The body of
a female resident was found in the
bedroom.
The injured resident was transported
to an emergency care facility. Media
reports indicated that he was released
after treatment for burn injuries.
A newspaper report quoted the fire
department’s investigator as indicating
that the fire was caused by smoking
materials while a resident was smoking
in bed.
Damage to the house, a two-story
structure, was estimated at $45,000.
MICHIGAN
Woodstove ashes start fatal fire
An elderly man suffered fatal injuries in
a house fire that began when ashes from
a woodstove ignited a cardboard box in
which they were being stored.
A friend of the resident called 911
after stopping by the house and discovering the fire.
According to news reports, flames
could be seen shooting from the windows and from the roof of the house
shortly after the fire was detected.
Firefighters from at least six departments assisted in fighting the fire and
were said to be at the scene for several
hours.
Investigators indicated that the fire
started in the basement, where the
wood stove was located, and spread
via an open stairway to the main floor
where the victim was located. The
man was unable to escape due to poor
health and was found in the doorway of
the residence. The cause of death was a
combination of burn and smoke inhalation injuries.
The house was a two-story structure with a ground floor area of 1,200
square feet (111 square meters). It
was constructed of wood with asphalt
shingles. The house was equipped with
smoke alarms that were found to be
operational.
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Firewatch_01.17AA SJS NW EDIT.indd 58
12/7/16 2:31 PM
12/21/16 6:47 PM
The structure, valued at $94,000, and
its contents, valued at $50,000, were a
total loss.
OHIO
Kerosene heater blamed for fire that
kills three children
A fire that claimed the lives of three children started when a kerosene heater was
tipped over and ignited carpet and paneling, with fire rapidly spreading through
the residence.
The fire department was notified of
the blaze by a 911 call from the children’s mother.
The fire department indicated that
the mother was trying to move the
heater when it tipped over. According
to newspaper reports, the exit was
blocked by fire and the mother straddled a window while trying to get the
children out, but fell out of the window
and was unable to get back inside.
Firefighters arrived at the structure,
a manufactured home, and used a hose
line in their initial attack on the fire.
Reports indicated that the hose line
provided a quick knockdown. The children had succumbed to their injuries
by the time crews gained entry.
The fire department indicated that
the family was using the kerosene heater
in order to save money on heating bills.
The home was constructed with a
wood frame and walls, wood and steel
beam floor framing, and a metal roof
deck. It occupied an area of 984 square
feet (91 square meters). It was not
equipped with smoke alarms or automatic extinguishing equipment.
The home and contents were valued
at $14,000 and were a total loss.
NORTH CAROLINA
Overloaded receptacle blamed for
fatal fire in manufactured home
A female resident suffered fatal smoke
inhalation injuries after an electrical
receptacle outlet ignited nearby combustible materials and started a fire that
spread throughout the interior of her
manufactured home.
The fire department was summoned
to the scene at 11 p.m. following a 911
call from a passerby, but investigators indicated that there was a 15- to
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Firewatch
20-minute delay between ignition and
detection because the residence was
situated in a remote location.
News reports indicated that neighbors tried to put out the fire and
rescue the victim after seeing heavy
smoke and flames shortly after 11 p.m.
Firefighters needed approximately 25
minutes to extinguish the fire, according to the reports.
The victim had a hearing disability
and unspecified physical disability.
Investigators determined that ignition
occurred in an electrical wall receptacle
outlet in the rear of the structure. In
news accounts, investigators indicated
that the electrical receptacle outlet was
overloaded and that it overheated and
ignited nearby combustibles. A newly
purchased space heater may have contributed to the overloading.
The home was equipped with smoke
alarms, but investigators could not
determine whether they operated.
Firefighters found no evidence to indicate that the home was equipped with
smoke alarms for the hearing impaired.
The manufactured home had a wood
frame and metal roof, with a ground
floor area of 400 square feet (37 square
meters). The structure and its contents,
collectively valued at $40,000, were a
total loss.
ARIZONA
Sprinkler extinguishes kitchen fire at
apartment complex
Cooking oil left heating on a stove started
a grease fire that spread to overhead
kitchen cabinets before a sprinkler in
the ceiling activated and extinguished
the flames.
Firefighters were dispatched to the
fire at 7:13 p.m. when a resident of the
apartment complex called 911 to report
that the sprinkler system had activated
in a neighboring unit and that he could
smell a burning odor.
Crews reported nothing showing
from the exterior as they arrived on the
scene of the two-story structure. Crews
entered the building and found that
one sprinkler head had activated in the
apartment of fire origin on the second
floor, with fire in the kitchen extinguished. Incident command assigned
crews to shut off water flow and to
undertake salvage and secure utilities.
Investigators determined that a
resident of the apartment was heating
cooking oil on the stove when he went
outside, then heard an outdoor alarm
sounding after the sprinkler system
activated.
Information on damages and the size
of the structure were not available.
TENNESSEE
Man dies when propane heater
ignites flammable vapors
An elderly man died from burn injuries
sustained after a propane heater ignited
flammable vapors in his garage.
The fire department was dispatched
to the victim’s residence after a passerby reported seeing a person on
fire running from the garage. Crews
observed smoke and fire coming from
the garage when they arrived at the
scene, and a police officer directed
crews to a nearby carport where the
victim was located.
Shortly afterward, an emergency
medical services team arrived with a
cot and burn blankets and took control
of the patient while firefighters extinguished spot fires in the garage. The
victim was transported to a university
medical center but succumbed to burn
injuries later that evening.
Investigators determined that the
victim operated a vehicle painting
business out of his garage and that he
was preparing to paint a vehicle when
heat from a propane heater ignited
paint thinner vapors, which subsequently ignited flammable liquid on his
person and clothing. The garage was
not equipped with an approved vehicle
paint booth.
The garage was a single-story structure constructed with concrete block
walls, concrete flooring, and a wood
roof frame, with asphalt shingling. It
occupied an area of 624 square feet (58
square meters).
The structure was not protected by
smoke alarms or an automatic sprinkler system.
The fire caused an estimated $10,000
in damage to the structure, which was
valued at $50,000, and $10,000 in
damage to the contents, also valued at
$50,000.
PENNSYLVANIA
Electrical wiring causes house fire
that kills elderly resident
An elderly resident died when degraded
electrical wiring ignited combustible
material in a wall cavity in the kitchen
of his residence.
The fire department was summoned
to the scene following a neighbor’s call
to 911 at 1:15 a.m., but investigators
estimated that the fire had burned for
an hour before it was detected.
According to news reports, firefighters discovered flames shooting from
the rear of the house upon arrival, but
they located the victim on a couch in a
front room of the home. The man was
rushed to the hospital, but succumbed
to smoke inhalation injuries shortly
afterward.
Reports indicated that the resident
had an unspecified mobility disability.
The house was equipped with smoke
alarms in the living room, the bedroom, and on the second floor. The
engine company indicated that the
smoke alarms were activated by the
fire. The house did not have sprinkler
protection.
The two-story house was constructed with brick walls and a
wooden roof frame, with an asphalt
roof deck. The home occupied a
ground floor area of 700 square feet
(65 square meters).
The house, valued at $80,000, and
its contents, with an estimated value of
$50,000, were a total loss.
FIREWATCH is compiled and written by Richard Campbell of NFPA’s Research Division. Firewatch is a collection of fire incidents involving a variety of occupancies and fire
types. The intent of Firewatch is to illustrate the range of fire scenarios encountered by the fire service, present the challenges contained in those incidents, recount how the fire
service addressed those challenges, and record the effectiveness of fire protection systems, where such systems exist. The incidents are identified by NFPA’s Research Group
from fire reports submitted to NFPA by responding fire departments. Some of the fire incidents that appear in Firewatch are augmented with details provided by media accounts.
60 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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Commercial
MASSACHUSETTS
Sprinkler extinguishes department
store fire caused by electrical fixture
A sprinkler system controlled a fire in a
department store that was caused by a
short in a light fixture.
The fire department was notified of
the fire at 11:01 a.m. through the store’s
fire alarm system and calls to 911. The
first units on the scene reported heavy
smoke upon arrival and recommended
that a second alarm be called. After
entering the store, crews found that the
sprinkler system had almost completely
extinguished the fire. Firefighters
pulled pillows and bedding stock that
were stored on the shelves and still
smoldering into sprinkler spray in
order to complete extinguishment.
Visual conditions throughout the
store were reduced by heavy black
smoke. Crews stretched a hose line into
the fire area while searching for extension. No extension of the fire was found
after a search of the facility.
Crews set up positive pressure ventilation fans to ventilate the structure
and also used carbon monoxide meters
to check air quality in the department
store and the larger mall in which it
was situated. Due to concerns with the
air quality, the local board of health
was called to the scene. The entire
mall was temporarily closed, with the
exception of one store that had solid
barrier doors separating it from the
rest of the mall.
Estimates were not available on
dollar loss from the fire, but reports
indicated that damage was limited
to smoke damage and the damage to
shelving and merchandise.
Investigators determined that an
electrical short in a fluorescent light
fixture in a department store caused
plastic to melt and drip onto merchandise stored on a shelf below,
starting a fire that spread to other
items along three layers of shelving
over a length of approximately 20
feet. However, two heads of a wet pipe
sprinkler system activated and almost
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Firewatch
completely extinguished the fire before
firefighters arrived, preventing further
damage.
The building was constructed with
block walls, cement slab floor framing,
and steel truss roof framing with a
metal roof deck and a roof covering of
rubber over foam insulation.
The building was one story in height
and had a ground floor area of 10,000
square feet (929 square meters).
MISSOURI
Sprinkler system extinguishes
office fire
A fire that started in the ceiling of
an equipment closet in a four-story
office building was knocked down by a
single sprinkler by the time firefighters responded to the scene, just four
minutes after being dispatched by an
alarm company.
The fire began at approximately 7
p.m. in the area of a fan located in the
ceiling of the closet, which was being
used as a computer room. When firefighters arrived, no signs of fire were
visible from the exterior of the building, but smoke could be seen banked
down to four feet from ground level
inside.
Crews laid a hose to the front
entrance and an interior crew entered
the building, where it determined
that the fire had been extinguished
and advised that they could perform
overhaul with a pressurized water
extinguisher. Firefighters shut down
the sprinkler system and used fans for
ventilation while checking for extension inside the building.
Investigators were unable to
determine whether the ceiling fan
malfunctioned and started the fire or
whether network wires fell on the fan
and caused it to overheat. Media coverage indicated that the assistant fire
chief said that the fire would have been
much worse if the sprinkler system had
not worked as intended.
The four-story building had a
ground-floor area of 5,000 square feet
(465 square meters) and was protected
by an automatic sprinkler system and
smoke detectors on all floors.
Damage to the building, which had
an estimated value of $3.7 million, was
estimated at $20,000.
ARKANSAS
Overloaded electrical circuit starts
fire that kills building owner
An early morning fire in a commercial
building that was not rated for residential
use claimed the life of the owner, who was
using the storage room as a living area.
The fire department responded to
the fire following a 911 call from a passerby at 2:30 a.m.
Newspaper coverage reported that
heavy smoke was pouring from the
building when firefighters arrived on
the scene. The reports indicated that
crews entered the building and began
ventilating it, then found the victim in
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62 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
Firewatch_01.17AA SJS NW EDIT.indd 62
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a storage room while performing salvage and overhaul operations.
The victim’s body was transported
to the state crime lab. The victim was
determined to have died as a result of
smoke inhalation injuries.
Investigators found multiple electronic appliances and extension cords
plugged into a power strip in the
storage room and believe that the fire
started when an overloaded electrical
circuit ignited unknown combustible materials nearby, then spread
throughout the structure. Investigators
indicated that the fire originated in an
area that was between the victim and a
suitable exit.
The fire chief reminded the public in
news reports that extension cords were
for temporary use and should not be
used for appliances that require significant amperage.
The building was a single-story structure constructed of metal, with a steel
roof and concrete floor. It had a ground
floor area of 2,880 square feet (268 square
meters). It was not protected by either
automatic detection or sprinkler systems.
The building and its contents, collectively valued at $75,000, were a total loss.
ARIZONA
Sprinkler douses spontaneouscombustion blaze
A late-night fire in a commercial establishment undergoing interior renovation
was extinguished by an automatic sprinkler system before firefighters arrived at
the scene.
The fire department was alerted to
the fire by a water flow switch alarm at
10:08 p.m. and was on the scene within
five minutes. There were no signs of fire
upon arrival. After gaining entry to the
building, firefighters observed a smoky
haze and found that a sprinkler had
activated over an area of wood that was
still smoldering. Crews ensured that the
fire was out and secured the water flow
from the suppression system.
The fire originated near the south
wall of the building, where a display
case was being constructed with wood
panels in the area below the activated
sprinkler. Investigators learned that
panels had been treated with varnish
earlier in the day and noted that
the fired burned upwards and outwards from ground level between the
wooden panels, which bore distinct
“V” patterns of burn marks on the
inside. Investigators also noted the
presence of open cans of wood varnish
and rags soaked with varnish and oil
throughout the store. The investigation concluded that a reaction between
incompatible products or the spontaneous heating of rags and materials
containing organic oils had ignited
surrounding combustibles.
No details were available on the
size of the building. The fire caused
no damage to the structure, valued at
$500,000. The loss to contents, valued
at $10,000, was estimated at $50.
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Firewatch
w
Industrial
NEBRASKA
Sprinklers extinguish fire at
manufacturing plant
Firefighters were summoned to a manufacturing plant in the early morning
hours by an automatic alarm after heat
from a butane torch ignited a plastic
storage shelf, but crews found that the
facility’s sprinkler system had already
extinguished the fire prior to arrival.
The fire department reported that
a worker had used the butane torch
before storing it on a plastic shelf in
the facility’s tool crib. The hot parts of
the torch ignited and melted the shelf,
setting off the fire alarm and sprinkler
system. The worker, who also used
a fire extinguisher to douse the fire,
suffered smoke inhalation injuries and
was transported to the hospital for
treatment.
Newspaper reports indicated that
several workers were evacuated from
the facility.
The facility was protected throughout by heat detectors with sprinklers.
The plant, which manufactured filters
for automobiles, was a single-story
structure constructed with block and
steel walls, concrete floors, a steel roof
deck, and rock and tar walls. The size
of the facility was listed as 595,200
square feet (55,296 square meters).
Damage to the structure, which was
valued at $100 million, was estimated at
$10,000, while its contents, valued at $50
million, experienced $30,000 in losses.
Assembly
CALIFORNIA
Church fire blamed on faulty wiring
Faulty electrical wiring was blamed for
starting an early morning church fire
that caused damage estimated at nearly
$2 million.
The fire department was alerted
to the fire by a dispatch center after
the church’s alarm system activated.
However, investigators estimated that
it took approximately six hours for the
fire to be detected because the accumulation of heat over a large area delayed
ignition. Investigators reported that
the building had multiple wiring code
violations.
Newspaper reports indicated that
firefighting crews attacked the fire
inside the church but were forced to
evacuate when fire threatened to
collapse the roof. The reports stated
that only the walls of the church were
left standing in the aftermath of the
fire, which was described as a threealarm blaze.
The fire started in the ceiling over
an assembly area near the stage. Investigators determined that an electrical
overcurrent blew out a section of
PREPAREDNESS DAY
For the fourth year running,
NFPA is partnering with
State Farm to provide up to 150
project awards of $500 each.
MAY 6, 2017
Work on projects that
help your community
become safer from wildfire.
#WildfirePrepDay • WildfirePrepDay.org
Sponsored by
NFPA and State Farm are pleased to support the 2017 Wildfire
Community Preparedness Day campaign, but have not assessed or
evaluated any of the community projects, activities or initiatives.
Recognition of any kind in no way implies endorsement or approval
of a project, its safety or effectiveness, and the supporters disclaim
all liability in connection with any such project, activity or initiative.
NFPA 2017 Magazine.indd 1
The application period opens
January 9th and closes
March 3rd 2017.
®
Check out our project resources,
including advice on how to
prepare your grant application,
template press releases, project
ideas and fillable flyer. What
will you accomplish on Wildfire
Community Preparedness Day?
12/14/16 9:16 PM
64 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
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the electrical conduit system in the
ceiling, which subsequently ignited
combustible material in the assembly
area below.
The church was constructed with
a wood frame, which included heavy
timber, wood walls, and roof deck, with
asphalt shingles and a stucco exterior.
The structure was two stories high
and had a ground floor area of over
10,000 square feet (929 square meters).
The fire caused $1.8 million in
damage to the church, which was
valued at $2.1 million, and $400,000
in losses to its contents, valued at
$500,000.
OHIO
$7 million arson fire destroys church
and its contents
Firefighters responded to an early
morning report of a possible structure
fire to find heavy smoke emitting from
a church roof, with firebrands discharging from the same area. Incident
command ordered a second alarm
shortly after initial firefighting units
reached the scene at 6:31 a.m., while
also requesting police assistance for
traffic control and two additional command officers.
The church property consisted of
four adjoining buildings. An assessment of the primary building indicated
that it was fully involved from the
basement to the roof, but heavy fire
conditions prevented assessment of
an adjoining structure. Incident command mounted a defensive strategy to
contain the fire to the two buildings
already involved.
One pumper was positioned at the
south side of the structure to provide
an aerial attack while crews from a
second pumper established a water
supply. A third pumper was positioned
at a rear corner of the building to prepare master stream operations. Two
additional pumpers supported these
positions. A captain assigned to safety
officer duties rotated crews for the
duration of operations.
Aerial operations were initiated from
a second location with the arrival of
a ladder truck from a mutual assistance company, while crews used hand
lines for exposure protection and suppression activities. When conditions
permitted, the two exposed structures were investigated for possible
fire extension in the roof, which was
accomplished through a ventilation
cut in the roof after the interior ceiling
proved too difficult to open. Minor
extension was found and extinguished
with a hand line.
The fire was brought under control
at 9:25 p.m., approximately three hours
after operations began. Newspaper
reports indicated that the state fire
marshal determined the cause of the
fire to be arson.
The church and its contents, collectively valued at $7 million, were a
total loss.
N F PA . O R G / J O U R N A L • NFPA JOURNAL
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12/22/16 1:00 PM
WORKING TOGETHER,
WE CAN SOLVE ANYTHING.
WHAT BETTER WAY
TO DO THAT
THAN LITERALLY
GETTING TOGETHER.
NFPA C&E 2pg.indd 2
12/20/16 6:37 PM
JUNE 4-7, 2017
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NFPA C&E 2pg.indd 3
12/20/16 6:37 PM
First Responder by Ken Willette
DISPATCHES
FROM THE
EMERGENCY
RESPONDER
COMMUNITY
Engaged & Mobilized
HOW THE FIRE SERVICE IS TACKLING THE PROBLEM
OF FIREFIGHTER CANCER
n recent years, fire-
with logs of their occupational expofighter occupational
sures. These efforts are supported by
exposure to carcinogens
extensive research, as well as improved
has re-emerged as a prime
access to valuable data. A host of related
concern of the fire service
research work is also underway, such as
and the national organizations that repa Fire Protection Research Foundation
resent them. I use the term “re-emerged”
study on proper decontamination of firebecause it’s hardly new. When I was a
fighter protective equipment. I have also
young firefighter in the 1970s, I recall
seen the emergence of advocacy groups,
veterans remarking that smoke from the
such as the Firefighter Cancer Support
fires we were fighting was more acrid and
Network, that are focused on raising
biting than in the past. They theorized it
awareness of occupational exposures and
was because of the increased use of plaspreventative measures.
tics in homes and vehicles, a trend that
NFPA is examining what role it should
“Cancer in the fire
even back then we understood as detriplay in reducing firefighter occupational
service has been on
mental to our health.
exposures and how we as an association
our radar for decades,
A 1981 article, “Firefighter Exposure
can convert our wealth of information—
but the difference now
to Carcinogens,” published by NFPA,
data amassed over years of standards
is the activity around
presented a comprehensive overview of
development, training, research, and
the issue—today the
related research and listed a number of
analysis of firefighter deaths and injucancer problem
products and chemicals believed to boost
ries—into knowledge that will raise
is being met by a
cancer rates. Interestingly, the article menfirefighter awareness of the preventative
tsunami of initiatives.”
tions earlier work that found an increased
steps they can take.
incidence of nose and throat cancers in
The fire service itself is also more
firefighters, as well as higher rates of intesinvolved than ever—I have rarely seen
tinal, rectal, colon, and brain cancers.
the fire service community become this
If cancer in the fire service has been
engaged with an issue in such a short
on our radar for decades, what’s different now? One key dif- amount of time. All of the key national fire service organizaference is the amount of activity around the issue; in the past tions are aggressively taking steps to address this issue. They’re
there was a trickle, but today the cancer problem is being met doing it by making the topic a focus of their conferences and
by a tsunami of initiatives. These activities hit the issue from publications, investing resources to educate their members
multiple angles—scientific, operational, behavioral—and are about the dangers of exposure during firefighting operations,
complemented by the commitment of individual firefighters and addressing the gaps in current decontamination and stanto be proactive in addressing their personal exposure.
dard operating procedures. Many individual fire departments
There has never been more research or technology focused have implemented programs to minimize occupational expoon this issue than there is today. I just returned from the 2016 sure to carcinogens and support those combatting cancer.
NFPA Responder Forum, where the use of data and technology
The needle is moving, and the momentum is increasing. If
in addressing risk from occupational exposures was illustrated we stay dedicated to the cause, I am confident we can dramatirepeatedly. We heard about wearable sensors that analyze prod- cally reduce or eliminate this scourge that has plagued the fire
ucts of combustion, predictive analytics that can estimate what service for decades.
firefighters are exposed to on the fireground, and enhanced
data collection and reporting that can provide firefighters KEN WILLETTE is fire service segment director at NFPA.
MICHAEL HOEWELER
I
68 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
First Responder Column_01.17 SJS NW.indd 68
12/21/16 6:55 PM
NOT ALL
SPRINKLERS
CAN SAVE
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Home fire sprinklers reduce civilian fire deaths by 80%,
reduce direct property damage per fire by 70%, and reduce
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10/27/15 4:09 PM
Wildfire by Lucian Deaton
THE VIEW
FROM NFPA’S
WILDFIRE DIVISION
Backyard Smarts
ADDRESSING THE GLOBAL WILDFIRE PROBLEM BY
UNDERSTANDING LOCAL NEEDS
uring a trip to Chile in
Stakeholder needs emerged again on
November, Michele Steina visit to Juan Antipi, a Mapuche comberg, NFPA’s Wildfire
munity near Galvarnio in central Chile.
Division Manager, shared
We walked around the community, suran observation that struck
rounded by hillsides and plantation forest,
me. “Everyone in the world at risk from
as local leaders explained their struggles
wildfire should know what they can do
with continual years of drought. They
to be safer,” she said.
told us how the effects of climate change
Across the planet, people are workhave increased their wildfire risk as the
ing to achieve this knowledge through
soils dry and fire seasons grow longer. We
countless wildfire preparedness prolearned about a longstanding relationship
grams and strategies. At times we may
the community had with a local saw mill
trip over how to pronounce their titles,
and how this partnership has led to posibut the real challenge is to understand
tive steps being taken to blunt the risk and
“Issues related to
how these programs work and what
impact of drought and fire. It was a great
wildfire risk take on
their impacts are on their communities.
lesson in community partnerships.
new meaning when
Seeing firsthand the challenge commuInvaluable interactions like this are why
you learn about the
nities face with wildfire and the efforts
NFPA’s
wildfire team spent 2016 visiting
needs of stakeholders,
underway to confront it strengthens
stakeholders around the world, including
not from a lecture or a
NFPA’s knowledge and furthers its work
South Africa, the United Kingdom, and
book, but by standing
to spread more life-saving information
Canada. It’s why we’re working with new
with them in their
and knowledge across the globe.
partners in Spain and Lebanon, and it’s
own backyards.”
Over 2016, NFPA’s Wildfire Division
why the Wildfire Division is aligning its
worked hard on this effort, and that
international messaging with the work of
work will continue in 2017. The diviNFPA’s Field Operations. All of this offers
sion’s international efforts are part of the
us new ways to understand wildfire stakelarger NFPA goal of understanding our
holders both domestically and abroad.
stakeholders’ needs. Issues such as residential growth in the
As we learn important lessons from these trips, we also find
wildland/urban interface (WUI) and wildfire risk take on new other ways to help. In Chile, for instance, representatives from
meaning when you learn about the needs of stakeholders, not CONAF, the country’s national forestry agency that works with
from a lecture or a book, but by standing with them in their communities to prepare for wildfires, told us that they are trying
own backyards.
to figure out how to sustain community action over time and were
On our trip to Chile this fall, the effort to understand stake- happy to learn how NFPA’s Firewise Communities Program model
holder needs took on new meaning for me when we visited can help them achieve that goal.
the Mapuche community of Isla Huapi. The Mapuche are an
It’s as guests in the backyards of others that we can truly begin
indigenous ethnic group in Chile and Argentina. Standing on to understand our stakeholders’ needs and the challenges prean island hillside accessible only by a 45-minute ferry ride into sented by their distinct fire landscapes. Getting out and seeing
the middle of a lake, an Isla Huapi resident shared with me these programs, people, and communities firsthand also makes
his connection to the land, his understanding of wildfire, and us more aware of opportunities to help within NFPA’s existing
his people’s efforts to keep their ancestral homeland safe from resources to make everyone safer from wildfire.
potentially destructive development. Development in the WUI
LUCIAN DEATON is a project manager in NFPA’s Wildfire Division.
has significant meaning and consequences for them.
MICHAEL HOEWELER
D
70 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
WildfireColumn_01.17 SJS NW edit.indd 70
12/21/16 7:02 PM
WE’VE GOT
YOU COVERED.
Introducing the new NFPA Journal app for Android,
and the updated app for Apple iOS.
Now you can read the award-winning NFPA Journal on all of your
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The apps are easy to use, offer a great reading experience, and they’re free.
NO MATTER WHAT PLATFORM YOU’RE ON,
WE’VE GOT YOU COVERED.
R
COVER STORY
RESILIENCY
COVER STORY
Training
the
Brain
RESILIENCE
A new team of NFPA data experts
is developing powerful new tools that tap
a century’s worth of information and
may soon reshape how fire and safety
A big-picture
look
onejobs
of the most
professionals
doat
their
compelling concepts in
safety and emergency preparation, and the role codes + standards
By in
Jesse
Romanresilience happen. By Jesse Roman
can play
making
Illustration by Harry Campbell
AS AN EXAMPLE OF RESILIENCY, it’s tough to beat the tardigrade. The eight-
S
itting on shelves, in cabinets, and on microfilm
GETTING SNOWED
IN BOSTON
A NEW STANDARD
ON DUST HAZARDS
IN PERSPECTIVES:
POWER TO THE PATIENTS
+
July/August 2014
legged, millimeter-long
aquaticofinvertebrate
can survive being frozen at minus 328 degrees
in the basement archives
NFPA’s headquarters
are thousands of documents that
Fahrenheitnear
andBoston
heated
to more than 300 degrees Fahrenheit. It can survive in oxygencollectively tell the story of fire in the United
depleted water
stretching
its body
maximize
oxygen absorption. It can repair its own
States.by
Countless
narratives,
charts,to
photos,
and
maps recall the circumstances behind numerous calamities,
DNA
to survive radiation levels 1,000 times higher than what other animals can withstand.
from conflagrations that destroyed entire cities to detailed
It can
dial of
down
metabolic
activity,
curl indusinto a near-lifeless ball, and live in suspended
histories
fire inits
some
of America’s
most obscure
tries and occupancies.
animation
for a decade or more. Dehydrated tardigrades exposed for 10 days to the harsh
About 90 minutes away, in a data center in Springfield,
vacuum
and deadly
outer
space have returned to life within 30 minutes of
Massachusetts,
sits thesolar
latestradiation
addition toof
NFPA’s
data
depository. Beneath the casing of an unremarkable lookbeing
plopped back into water. ¶ The tardigrade’s resiliency—its ability to respond, withing metallic box lies an assortment of circuits and chips
that adapt,
NFPA staff
hasquickly
nicknamed
Crosby, after NFPA’s
firstsurvive events that would kill other creatures.
stand,
and
recover—allows
it to
secretary, Everett Crosby, who, more than a century ago,
There
is no animal on earth more resilient, save perhaps humans.
first championed the idea of collecting data to reduce fire
A BIGGER + BETTER
CONFERENCE PREVIEW
FIGHTING OIL +
GAS FIELD FIRES
40
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March/April 2015
www.nfpajournal.org
DATA CONNECTIONS
loss. While the reams of paper in NFPA’s archives dutifully recall the past, Crosby has the potential to reveal the
future, taking what has already happened to unlock what
may come. u
NFPA JOURNAL MARCH/APRIL 2015
The Metropolitan Transportation Authority's post-Hurricane
Sandy improvements have included concrete lining and waterproofing operations of train tunnels beneath New York City.
As in the animal kingdom, human resilience is often
a matter of life and death. Throughout history, societies
lacking resilience suffered terrible ends; people died, while
cities and civilizations collapsed and faded away. According
to Stephen Flynn, the founding director of the Center for
Resilience Studies at Northeastern University, modernity
has done nothing to change this fact of life.
“It will be the most resilient communities, companies,
and countries that will prosper in the 21st century—those
that are not resilient, that are fragile and brittle, will end up
isolated and will fail in the current global environment,”
said Flynn. “There is no risk-free place on the planet. People
will live, invest, and gravitate to places that are more resilient and flee those that are not. It is crucial as a country to
get this right.”
Viewed through a hazards and security lens, resilience
can be defined as the ability to withstand a disruption, blunt
the impact, recover quickly, and adapt to emerge stronger
and better prepared than before. It is achieved on both a
small scale, as in a local business or a hospital, and on a
large scale, such as building resiliency into an urban transit
system, a regional power grid, a city, or even a nation. Resiliency can mean erecting better levees in New Orleans,
Photograph: Metropolitan Transportation Authority (NYC)
installing power redundancies in hospitals or airports, or
even building stronger community bonds in neighborhoods. Since 2010, the federal government has focused on
resiliency as a key concept to national security and combating the effects of climate change.
Several reports have identified the importance of codes
and standards for bolstering resiliency efforts. “Organizations such as NFPA have a critical role to play in building
resilience into communinfpa.org/resilience
ties and systems,” Flynn
NO
EASY
FIX
said. “While researchers
can identify the ‘what’ and
‘how’ to make our societies
more resilient, practical innovations that draw on the
latest knowledge, tools, and
technologies are unlikely to
see early and wide adoption unless they are quickly
embedded into codes and
standards.”
Over the last year, NFPA
has considered the role it
Read more on the concept of
resilience, including:
“Disaster Resiliency and NFPA
Codes and Standards,” a new
report by the Fire Protection
Research Foundation;
“The National Security
Strategy of the United States
of America,” from 2010;
The Community Disaster
Resilience project conducted
by the National Institute of
Standards and Technology;
A case study on how MassPort
plans to make Boston's seaport
and airport storm-resilient.
MARCH/APRIL 2015
NFPA JOURNAL
41
THE FIRE SERVICE CONFRONTS
THE NATION’S OPIOID EPIDEMIC
NFPA.ORG/JOURNAL
JANUARY | FEBRUARY 2017
HOW NFPA’S BOLD NEW DATA ANALYTICS EFFORT COULD TRANSFORM FIRE SAFETY
NFPA.ORG/JOURNAL
NOVEMBER | DECEMBER 2016
RRESILIENCE
DATA CONNECTIONS
What it is, what it looks like, and how NFPA
codes + standards are shaping its evolution
HOW NFPA’S BOLD NEW DATA ANALYTICS EFFORT COULD TRANSFORM FIRE SAFETY
OFFICIAL MAGAZINE OF THE NATIONAL FIRE PROTECTION ASSOCIATION
Recovery begins in the Breezy Point neighborhood
of Queens, New York, ravaged by flood and fire
during Superstorm Sandy in 2012.
NFPA.ORG/JOURNAL
NOVEMBER | DECEMBER 2016
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F I R E S E R V I C E O C C U P AT I O N A L S A F E T Y
ʻʻ
ʼʼ
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From fireground command to PPE to daredevil driving practices, firefighting
in decades past was a proud and grimy fraternity with few rules or established
procedures—and an alarming number of firefighter deaths and injuries.
With the adoption of NFPA 1500, Fire Department Occupational Safety and
Health Program, in 1987, however, all that began to change. Thirty years later,
NFPA Journal surveys some of the key architects of the standard to recount
its story so far: its creation, controversies, and lasting impact.
BY JESSE ROMAN
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GETT Y IMAGES
I
N MAY 1987, NFPA MEMBERS formally voted to accept NFPA 1500,
Fire Department Occupational Safety and Health Program, the first comprehensive national standard addressing the health, safety, and well-being
of members of the fire service. Never before in its 200-year history had
the nation’s fire service been given such a comprehensive set of minimum
requirements to keep its members safe—an amazing fact, considering the
profession’s danger and the numbers of firefighters who had been killed
or injured on the job.
The new document addressed requirements for a wide range of safety
topics, from equipment and training to fire apparatus, professional qualifications, medical exams, and the development of health records, safety
committees, and best practices. For the first time, fire trucks were required
to have safety belts, and firefighters were required to ride inside the truck. Fire engine
drivers would be given rules and training. Firefighters would get medical exams. Equipment
would have to be tested to ensure it met a minimum level of safety. Firefighters would be
required to use breathing apparatus, and departments would have to keep health records
and investigate and record incidents and accidents.
The suggestions seem obvious today, but 30 years ago many considered them to be radical. The document’s technical committee was swamped with public comments, at the time
the most ever received by an NFPA document. Some predicted doom and proclaimed its
passage would lead to the end of the American fire service. Others hailed the document as
a long-overdue attempt to address the service’s poor safety record. Everyone acknowledged
it was, at the very least, a bold disruption of the status quo.
The document’s impact has been dramatic. In the three decades since NFPA 1500 was
created, average annual firefighter line-of-duty deaths have been slashed nearly 40 percent
as the overall number of response calls has more than tripled. Firefighter injuries are
down about 30 percent. Meanwhile, equipment, apparatus, procedures, incident command,
fireground operations, and more have all developed with firefighter safety in mind. It's
all part of what Dr. Denis Onieal, deputy administrator of the U.S. Fire Administration,
has termed “the fire service's evolution from a calling to an occupation to a profession.”
The real legacy of NFPA 1500 has been to “cause a cultural shift in the fire service—it
caused the fire service for the first time to focus on health and safety, and over a period
of years it has had an effect,” said J. Gordon Routley, division chief for the Montreal Fire
Department as well as a longtime firefighter in Phoenix and an original NFPA 1500 technical
committee member. “We went from an attitude of, ‘This is a dangerous business and we
have to accept the risks,’ to saying, ‘It is a dangerous business but we have to go about it as
safely as humanly possible.’ I think that culture of safety is there now; it is still evolving,
but it’s firmly planted. You can’t go back from it.”
NFPA Journal spoke in depth with Routley and many of the others responsible for crafting the first version of NFPA 1500, as well as some early adopters and longtime firefighters
whose profession the document profoundly changed. They reflected on their fire service
careers prior to NFPA 1500 and on the creation, reaction to, and legacy of this seminal fire
service health and safety standard. u
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GETT Y IMAGES
“Depending on who the officer was,
you might hear, ‘Don’t even bother
grabbing that SCBA—that’s not how
we fight fire around here.’”
N F PA . O R G / J O U R N A L • NFPA JOURNAL
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The 1960s and 1970s:
The Cowboy Approach
“On-scene operation involved a lot of freelance. It was almost a freefor-all in how we approached fire. Nobody had any accountability.
Described roles and coordination were pretty new.”
—Alan Brunacini, former chief of Phoenix Fire Department, original chair of NFPA 1500 technical committee.
“It was a cowboy approach to firefighting.”
—J. Gordon Routley, division chief with the Montreal Fire Department, former assistant to the fire chief in Phoenix, and original
member of the NFPA 1500 technical committee.
“We wore whatever PPE came in as the lowest bid…You’d see fiberglass helmets with no inserts or shock protection, plastic gloves that
would melt on your hands, non-fire-protective pants, maybe two
pieces of breathing apparatus for an on-duty crew of six to eight firefighters. Training was minimal and handed down, with no defined
knowledge of what we should know.”
—Ken Willette, former fire chief in Concord, Massachusetts, currently first responder segment director at NFPA.
“Depending on who the officer was, you might hear, ‘Don’t even bother
grabbing that SCBA—that’s not how we fight fire around here.’”
—Scott Kernwood, current fire chief of the Hutto (Texas) Fire Rescue,
who joined the NFPA 1500 technical committee in 1988.
ʻʻ
BY THE ’80s, SELF-CONTAINED
BREATHING APPARATUS HAD BEEN
AROUND FOR A WHILE, BUT IT
WAS CULTURALLY DIFFICULT TO
GET FIREFIGHTERS TO USE IT …
IT WAS ALL PRETTY SUICIDAL.
ʼʼ
“We all had trucks with open cabs, no seat belts, riding on back steps
or tailboards. I can remember driving down the road in the pouring
rain, and there would be more water inside the truck than outside. Or
driving when it was snowing, you’d just hunker down to get away from
the biting cold.” —K.W.
“We drove like we were crazy.” —A.B.
“The first firefighter funeral I went to was in Easthampton, Massachusetts, for a firefighter who fell off of a truck while responding.
A little later I went to the funeral of a firefighter who died when a
brick façade collapsed on his head—he was wearing an aluminum
helmet with no shock protection. As a young firefighter, it didn’t
cross my mind that those deaths were unnecessary.” —K.W.
“All that said, there was a bit of glamour and
romance to it. After a call, you’d take your turnout
gear off and throw it into the truck, step on the
back, grab hold with one hand and take off. For a
young firefighter there was a certain thrill, a certain coolness about it.” —K.W.
“Part of the drama of being a firefighter is risking
your life, and we still do.” —A.B.
Early rumblings of change
In the late 1970s and early 1980s, things
began to shift. While still uncommon, some
fire departments across the country began
hiring safety officers and creating safety programs. There was a quiet but growing sense
that fire departments needed to take more
accountability in protecting their employees.
“I think there started to be a general recognition
in the fire service in the 1980s that we were injuring and killing way too many firefighters.”
—Phil Stittleburg, chief of the La Farge (Wisconsin) Fire Department, member of the NFPA 1500
technical committee starting in 1988, and former
chair of the NFPA Board of Directors.
“By the ’80s, self-contained breathing apparatus
(SCBA) had been around for a while, but it was
culturally difficult to get firefighters to use it … it
was all pretty suicidal.” —A.B.
“I was always concerned, baffled, and agitated
at some of the dumb things we did that hurt
firefighters. I guess I developed a concern about
safety and welfare in our organization and how
we did things on the fireground. To be kind, it was
not very well organized.” —A.B.
“We were seeing annual firefighter line-of-duty
death numbers in the 120s to 140s back then. A lot
of them we knew were preventable but it was just
the accepted way of doing business.” —J.G.R.
“Leading a fire department in a rapidly growing
city like Phoenix created a lot of opportunity to
do things differently. We started making a lot of
changes in the 10 to 15 years before the development of NFPA 1500. A lot of what we did in
the standard was a reflection of what we’d done
here in Phoenix…we were seen as a group of revolutionary wacko safety nuts in the fire service.”
—A.B.
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“I was assistant fire chief in Phoenix at the time,
serving under Chief Brunacini, so I was one of the
safety zealots. We had a reputation for this avantgarde approach to safety.” —J.G.R.
“Anybody who ever worked with Chief Brunacini [original chair of
the NFPA 1500 technical committee] knows he is a man with vision.
He had crystal-clear vision of what needed to happen to improve
safety for firefighters and got us moving in the right direction.” —M.L.
“Those early safety adopters out in the desert,
their voices grew louder and louder, and more
people started saying we need to address this on a
national level.” —K.W.
“People were yelling, screaming, disagreeing. That enthusiasm never
upset me—I think that’s the way you resolve things and do new stuff.
These were not just physical changes we were proposing, they were
cultural changes.” —A.B.
“We realized the ideal process for accomplishing that was the codes and standards structure
of NFPA. That is a place you can identify those
things we can do differently and connect it to a
system that gives it feet—structure it, distribute it,
inform people of it, and settle some of these internal conflicts.” —A.B.
“There was huge pressure on us. At the time I was also chair of the
health and safety committee for the International Association of Fire
Chiefs (IAFC), and there was a lot of anxiety at IAFC about the NFPA
1500 project going in too radical a direction. That was like being
between a rock and a hard place. I was in the middle of a lot of flack. I
think everyone on the committee was.” —J.G.R.
“The development of the standard was an effort to
plant a flag as far as getting serious about health
and safety in the fire service.” —J.G.R.
In 1983, amid a growing chorus of concerns
and persistence of those passionate about
safety, NFPA assembled a technical committee
to spearhead the development of a new
standard aimed at developing minimum
occupational health and safety requirements
for the fire service. The first committee consisted of 19 members and four alternates.
“It wasn’t a bunch consultants who wrote this, it
was a bunch of sweat hogs who got together. We
were the people who had to live standards we
created.” —A.B.
“I was married on Saturday, and on Sunday I was
off to Phoenix for our first committee meeting.”
—Murrey Loflin, firefighter and researcher at the
National Institute for Occupational Safety and
Health, and original member of the NFPA 1500
technical committee.
“It was a great group of people. You had thoughtful people, creative people, people who were very
bombastic, some very quiet. They were all there
because they wanted to make the fire service safer
and I think that is what kept us going.” —A.B.
“It was kind of like making sausage. The ideas
flowed, and it was my job to capture all the ideas
in the room, make sense of them, provide structure, and come back and say, ‘Here’s what we got
out of the last meeting.’” —J.G.R.
“Regardless of the organization you represented, everyone realized
the importance of what we were trying to do because it had never
been done before.” —M.L.
Before & After
Deaths and injuries since the
adoption of NFPA 1500
1978–1987
Annual
average
number of
firefighter
deaths
2006–2015
1978–1987
Annual
average
number of
firefighter
injuries
2006–2015
1980–1987
Annual
average
number of
incidents
1978–1987
Annual
average
sudden
cardiac
deaths
131.3
100,766
11,247,500
59
81
73,000
2006–2015
28,864,000
2006–2015
34
Source: NFPA
N F PA . O R G / J O U R N A L • NFPA JOURNAL
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“I can’t tell you how many people told us this
would be the end of the American fire service,
that they wouldn’t be able to do business if NFPA
1500 was adopted.” —J.G.R.
“One of the biggest concerns was what the financial
impact would be. Along with that was the concern
that noncompliance could lead to liability, that
departments would be sued constantly by the public
if they didn’t meet every part of NFPA 1500.” —P.S.
“When the time came, we got something like 1,200 to 1,400 public
comments on the document, which was absolutely unheard of in
the NFPA standards-making process.” —M.L.
“It was a huge job boiling all the comments down. I can vividly
remember sorting through cartons of paper to do the distilling. I
think that three of us spent the best part of a week in a back room
to get it down to a series of issues and alternative proposals that the
committee could deal with in a few days of meetings. Some brought
out things that we didn’t think of in our approach, and the process
did improve the document.” —J.G.R.
“When it was time to vote on the final document at annual meeting
there was a lot of discussion and people testifying, but as I remember it passed easily. It was the kind of thing that was hard to vote
against. For someone to stand up at a meeting and object to the
notion that you ought to wear respiratory gear and a seat belt, even
if you have strong opinions about it, it’s not the kind of issue people
take on in public.” —A.B.
A standard is born
Passage of the document didn’t mean that some in the fire
service weren’t enraged by the presence of NFPA 1500.
Before, during, and after the vote, the controversy continued.
Many people in the fire service loudly voiced their displeasure
and predicted doom as a result of the new standard.
“NFPA 1500 was a lightning rod. It raised the discussion to a
national level.” —K.W.
“People were shocked. Their thinking was, ‘A group of idiots got
together in a hotel room and now they’re telling us we can’t do this
or that any longer.’ We were violating a lot of traditional practices in
the fire service that had been there for 200 years.” —A.B.
“There was a requirement for departments to
maintain a confidential health database, and
there was a great deal of concern about how confidential it would actually be, especially in small
departments.” —P.S.
“I was very well qualified to do this. I was a
change agent in Phoenix for 20 years before NFPA
1500, and I had stood up in front of people for
20 years defending these approaches. As a chief,
I was used to getting up in the morning and by 6
a.m. having 20 guys screaming at me. I had some
preconditioning and training for it.” —A.B.
The final standard said that authorities
having jurisdiction (AHJs) were responsible
for determining a phase-in schedule for
departments to adopt the new provisions.
Ultimately, the new standard was adopted
sporadically and in pieces across the nation.
Some departments moved swiftly to incorporate
NFPA 1500, while others resisted.
“When you’re going from having no concept of
safety to a safety zealot’s approach, you don’t do
that in one step, you bite off pieces and take it one
at a time. I think our goal was for departments to
get it all done in a reasonable time. I think that’s
what’s happened over 29 and a half years. Things
that were once thought of as extremely radical
back then are now common practice.” —J.G.R.
“I’d say within eight to 10 years most fire departments had incorporated many elements of NFPA
1500. The changes we made were long overdue, and
that helped this move along pretty quickly.” —A.B.
NFPA.ORG/MAKING1500
Read more on the creation of NFPA 1500, and listen
to a podcast on the standard’s impact on firefighter
deaths and injuries related to riding on apparatus.
GETT Y IMAGES
MIXED RESPONSE
Reception to the new NFPA 1500 varied widely, from departments
that embraced it to those who regarded it as a fire service threat.
“There was concern about if NFPA 1500 might impact
operations or prevent us from doing our job and
saving lives. The answer was obviously no.” —K.W.
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“As a safety officer in Tulsa, when NFPA 1500
came out this was my document to work with, and
it made my job easier—it validated my job. But I
would run into resistance. I got a lot of, ‘Oh, it’s
the safety guy again, why is he on my fire scene?,’
or ‘What do you mean I have to use my SCBA?,’ or
‘We’ve been doing it this way forever, just let us do
our jobs.’” —S.K.
“The departments that adopted NFPA 1500 early
became the models—they expressed the art of
the possible. Other people see it and say, ‘Hell,
I can do that.’ It turns out you can ride on the
inside of a truck just as easy as on the outside.
It sounds stupid to even say that, but that was a
huge change for us. A lot of people went to fully
enclosed cabs and life went on.” —A.B.
“After NFPA 1500 came out, many firefighter unions
used it in collective bargaining negotiations to
make sure that the equipment the department purchased met NFPA guidelines. I still remember being
part of our bargaining committee that got language
in the agreement, so going forward the chief would
have to consider NFPA-compliant equipment and
couldn’t dismiss it because it cost more.” —K.W.
“People said we would go to hell in a handbasket,
then you saw somebody who made those changes
and they didn’t go to hell, and they couldn’t find a
handbasket. In fact, they were doing a lot better.
They weren’t killing themselves, and they were a
lot healthier.” —A.B.
A cultural shift
and new challenges
“In the 30 years since NFPA 1500 came out, there
has been an entire cultural shift, so much so that the
kids today think that the way we do it is the way it’s
always been, and that’s really a good thing.” —S.K.
“Operationally almost everything we do today has
something to do with NFPA 1500. It has affected practices, systems, procedures, and technologies.” —A.B.
“So many things in NFPA 1500 are just common
practice now. Fully enclosed cabs and seat belts in
trucks. Having a structural approach to incident command and not trying to do things unless you have
enough people to do it safely. Insisting that people
have appropriate levels of training for things they’re
expected to do. Using breathing apparatus all the
time. Routine medical exams. Making sure people
are medically and physically fit to do the job.” —J.G.R.
“When I got involved with NFPA 1500, if it was mentioned anywhere
in a fire station or around fire chiefs it was, ‘Don’t talk about that
document, it’s going to break the fire service.’ Now it’s, ‘Of course
we meet NFPA 1500, it’s the right thing do. Of course we protect our
people and make sure they have the right PPE.’” —S.K.
The work to refine and update the standard continues.
The 2017 edition of NFPA 1500, the document’s seventh
edition, will be released later this year.
“From its inception, NFPA 1500 has continued to evolve and grow.
Who would have thought that today the standard would need
sections on responding to active shooter events, or exposure to
pandemics?” —K.W.
“The issue jumping out today is the firefighter cancer issue. We have
to change our way of doing business to reduce our cancer exposure.”
—J.G.R.
“We are addressing the cancer issue now in NFPA 1500, talking
about making sure decontamination is done on the scene of the fire
before you get back to the station. You’re going to see changes in
technology, in PPE, even in apparatus.” —S.K.
“We always prided ourselves in being dirty, but we need to clean our
clothing and keep it clean. Those are the radical crazy ideas coming
out today.” —J.G.R.
“Behavioral health is also an area where I think changes to NFPA
1500 can have the most change across the response community. It is
such an under-acknowledged problem right now.”
—John Montes, longtime Boston paramedic and NFPA staff liaison
to NFPA 1500.
“This last edition we started looking at professional development,
which is very important. You don’t want to promote a firefighter on
a Friday, and on Monday he’s wearing a white shirt and you’ve given
him nothing for the hard drive upstairs. We’ve got to make sure that
happens.” —M.L.
“Another big issue is the use, application, and sensible implementation of technology. How do we use it in a practical way that makes
humans safer and more effective?” —A.B.
“There’s no doubt that we are light years ahead of where we were,
but there is still a long way to go—we are still killing almost 100 firefighters per year and we’re still seeing unacceptable levels of injuries.
The generation coming into the fire service now will be able to push
it to an even higher level.” —S.K.
“We’ll never be done. The more you learn, the more you learn what
you don’t know. We need to keep being students—thinking, reading,
writing, and listening.” —A.B.
JESSE ROMAN is associate editor of NFPA Journal.
N F PA . O R G / J O U R N A L • NFPA JOURNAL
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Pitotless Nozzle Kit simplifies the test
process for a variety of required flow
tests, including standpipe testing,
PRV testing, and Hose Valve Testing.
Available in both 1½” and 2½” sizes
and varying thread types, an In-Line
HYDRO FLOW PRODUCTS, INC. Pitotless Nozzle Kit accurately measures flow rates as low as 45 GPM
Phone: 888.202.9987
and as high as 1,432 GPM.
Fax: 847.434.0073
E-mail: service@flowtest.com
www.HoseMonster.com
A kit includes the following:
· Line gauge for measuring static
system pressures.
· Pitotless nozzle/differential
chamber for FM-approved flow
rates.
· Digital manometer
· Slow-closing gate valve
· Durable carrying case with
closed-cell foam insert.
N F PA . O R G / J O U R N A L • NFPA JOURNAL
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12/22/16 1:29 PM
Announcing a
NEW Certification for
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CERTIFIED SPRINKLER ITM SPECIALIST
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A professional credential for facility managers that highlights knowledge
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For more information, go to www.nfpa.org/csitms
NFPA Certification.indd 1
12/20/16 6:45 PM
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In the Series AH2-CC, Victaulic
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Victaulic, the world’s leading
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The new hose retains key qualities
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the confidence in proper installation,
indicated by the orange and white
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N F PA . O R G / J O U R N A L • NFPA JOURNAL
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12/22/16 1:34 PM
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— SPECIAL ADVERTISING SECTION —
VIKING
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The Viking Corporation has introduced a new residential 5.8 (84)
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“As paramedic firefighters, we were first to enter
the smoke-filled house. The floor collapsed
and I could feel Arnie sliding away from me.
Then everything just erupted in flames.”
– Jo Brinkley-Chaudoir
retired paramedic and firefighter
and one of the many faces of fire
Lieutenant Arnie Wolff, 55, died in the fire.
Home sprinklers would have saved the entire
house and – most importantly – Arnie’s life.
GUTTER CREDIT
TAKE ACTION TO REQUIRE THE INSTALLATION
OF HOME FIRE SPRINKLERS IN YOUR STATE.
www.FireSprinklerInitiative.org/Faces
www.firesprinklerinitiative.org/faces
N F PA . O R G / J O U R N A L • NFPA JOURNAL
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NFPA Alt.Fuel_nfpa.indd 1
6/24/15 3:12 PM
Ad Index
ADVERTISING SALES
NFPA JOURNAL, the magazine of the National Fire
Protection Association, reaches 60,000 members six times a
year. If you are interested in becoming an advertising partner,
call us to see how Journal can help you reach your audience.
ANSUL www.ansul.com/solutions ........................... IFC
BUILDINGREPORTS
www3.buildingreports.com/NFPA 2016.................... 1
DACS Inc. www.dacsinc.com .................................... 57
HALOTRON www.halotron.com................................37
HYDRO FLOW www.hosemonster.com..................... 63
NFPA www.nfpa.org......... 19, 21, 39, 41, 56, 58, 62, 64,
66-67, 69, 71, 82, 84, 86
NOHMI BOSAI LTD. www.nohmi.co.jp/english......... 65
PITTSBURG TANK & TOWER MAINTENANCE CO., INC.
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McCall Mohanna
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RED HAWK FIRE & SECURITY
www.RedHawkUS.com............................................. 61
SIMPLEXGRINNELL
www.TycoSimplexGrinnell.com................................. 7
STARLINK FIRE
www.napcosecurity.com/starlink.......................... IBC
UNIVERSITY OF MARYLAND
www.advancedengineering.umd.edu/grad-engr...59
VICTAULIC www.victaulicfire.com............................ BC
VIKING www.vikinggroupinc.com................................5
NOTICE CONCERNING ADVERTISING
NFPA reserves the right to accept or reject any advertisement submitted for publication in NFPA Journal. However, NFPA
does not attempt to investigate or verify claims, including claims of compliance with NFPA codes and standards, made in
advertisements appearing in NFPA Journal. The appearance of advertising in NFPA Journal in no way implies endorsement
of, or approval by, NFPA of any advertising claims or of the advertiser, its product, or its services. NFPA disclaims any
liability whatsoever in connection with advertising appearing in NFPA Journal.
“I now feel more comfortable living
in this home. If my kids are home
alone and something happens
again, fire sprinklers would give
them time to get out.”
— Michelle Allyn, lost her home to fire and rebuilt
with fire sprinklers
Every home fire has a story.
Learn how these tragedies have altered the
lives of fire survivors and how fire sprinklers
may have altered the outcomes.
FireSprinklerInitiative.org/Faces
FACES OF FIRE
A CAMPAIGN OF NFPA’S FIRE SPRINKLER INITIATIVE
Photo: ©2016 Bob Handelman
MichelleFacesofFire1/2pg#1.indd 1
10/7/16 12:00 PM
N F PA . O R G / J O U R N A L • NFPA JOURNAL
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Looking Back
FIRE INCIDENTS AND
OTHER NOTABLE EVENTS
FROM SAFETY HISTORY
H E A LT H C A R E FA C I L I T I E S
HOSPITAL
HORROR
THE HARTFORD HOSPITAL
FIRE OF 1961—HARTFORD,
CONNECTICUT
By Mary Elizabeth Woodruff
n the afternoon of December 8,
1961, a fire broke out in a trash
chute in the basement of the
Hartford Hospital, possibly from
a lit cigarette thrown down the
chute. The smoldering fire caused gases to collect in an upper portion of the chute; a spark
or ember ignited the trapped gasses, causing
the trash chute door on the eighth floor to
blow open. Fire exploded from the trash chute
door on the ninth floor, blowing the chute’s
door off and igniting cane-fiber ceiling tiles in
the hallway. Burning tiles dropped to the floor,
igniting the wainscoting and causing fire and
heavy smoke to quickly move through the halls
of the ninth floor.
Hospital staff and arriving firefighters began
closing fire doors and the doors to patient rooms.
Whether patient room doors remained closed
or not determined who lived and who died in
the Hartford Hospital fire; survivors were found
only in rooms where the doors remained closed
throughout the fire. Some survivors said that
the pressure from the fire outside was enough
to cause the rolling door latches on room doors
to release, and that the doors had to be held or
braced to remain closed. Firefighters brought the
fire under control in a matter of minutes, but the
blaze still managed to kill 16 people.
Within days, changes were underway to
improve hospital fire safety. Connecticut
O
limited smoking in hospitals and banned combustible building materials.
The use of trash and laundry chutes was banned as well, unless they were
constructed with a “charging” room that separated chutes from main corridors with fire-safe construction. Over the next few years, improvements
to the Hartford Hospital included sprinklering corridors, stairwells, and
patient rooms, and rolling door latches were replaced with latches that
held doors more securely—the types of changes that were vital to improving hospital safety throughout the country.
THE NFPA LIBRARY AND ARCHIVE holds a rich collection of books, reports, and photographs that document important moments in fire history. To provide better electronic access for researchers and to preserve our unique archival holdings, work has begun to digitize the files of the Fire Record Department, the original NFPA department
responsible for collecting and analyzing information and compiling statistics about key fires and other events. The incidents featured in “Looking Back” are drawn from this
collection and will eventually be part of NFPA’s online archive. For information visit nfpa.org/library.
THE HAMILTON ARCHIVES, HARTFORD HOSPITAL
FAST & DEADLY
Hartford Hospital
staffers observe
firefighting operations
during a blaze that
killed 16 people in 1961.
88 | NFPA JOURNAL • J A N U A R Y / F E B R U A R Y 2 0 1 7
Looking Back_01.17 SJS.indd 88
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FIRELOCK NXT™ AUTOMATIC VALVE SYSTEMS
REFERENCE MATERIAL
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© 2016 VICTAULIC COMPANY. ALL RIGHTS RESERVED.
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