Quantifying disparities in fire-related mortality of US career and volunteer firefighters: A 43-year database study

Abstract

There is no consensus on the leading causes of occupational disparities in firefighter mortality risk and whether these disparities have changed over time. This article prioritizes fire-related risks associated with mortality among US career and volunteer firefighters to inform targeted prevention efforts. We collected records of 3724 firefighter fatalities from the database between 1979 and 2021. Grey relational analysis was adopted to reveal the interrelationships between occupational risks and mortality. Firefighter mortality differed by occupation; the primary fire-related causes changed over 43 years for both career and volunteer firefighters. Volunteer firefighters exhibited higher risks across multiple variables than their career counterparts. These variables include alarm response/return, sudden cardiac death, age exceeding 60, and years of service below 10 or surpassing 30. These findings quantified disparities in the temporal evolution and fire-related occupations with elevated risk factors for deaths between career and volunteer firefighters, highlighting the need for targeted interventions.