On June 17, 2011, a 22-year-old male paid-on-call fire fighter received fatal injuries when he was struck by bricks and falling debris during an exterior wall collapse at a commercial structure fire.

Crews worked using defensive operations for about 45 minutes attempting to extinguish the fire in the 96 year-old brick and masonry structure that housed an antique store with living quarters located in a rear addition. The victim and another fire fighter were moving a 35-foot aluminum ground ladder away from the Side D (east) wall of the structure when the top part of the exterior wall collapsed. No other fire fighters were injured in the collapse.

NIOSH REPORT: Report 2011-15     HERE

Contributing Factors

• 96 year-old brick masonry structure degraded by fire burning for over 45 minutes
• Fire fighters with limited experience entered collapse zone to move ground ladder
• Entering collapse zone in close proximity to master stream directed onto roof
• Limited visibility at side and rear of structure may have obscured signs of pending collapse
• Limited training on structure collapse hazards.

Key Recommendations

• Establish and monitor a collapse zone when conditions indicate the potential for structural collapse
• Train all fire fighting personnel on the risks and hazards related to structural collapse
• Train on and understand the effects of master streams on structural degradation
• Conduct regular mutual aid training with neighboring departments
• Designate a staging area for all unassigned fire fighters and apparatus
• Implement national fire fighter and fire officer training standards and requirements.

Fire Behavior

According to the investigating State Fire Marshal, the fire originated in the rear of structure due to undetermined causes. A thunderstorm had passed through the area approximately two hours before the fire was reported and lightning strikes were reported in the immediate area. The dispatch center received multiple phone calls reporting a fire behind the antique store near the courthouse square.

Provided Photo, All Rights Reserved

Indicators of significant fire behavior

• Smoke filled store front when first crews arrived
• Smoke pushing out cracks in the Side A and D walls and around windows on Side D
• Thickening dark brown smoke upon arrival
• No visible fire
• Windows at front broken to vent structure
• Windows on Side D broken to vent 2nd floor
• Roll up overhead door opened at C/D corner
• Fire rapidly grew and moved toward front of store, becoming visible through windows
• Smoke diminished and visibility improved at front
• Smoke continued to push out under pressure through cracks in Side A and D walls
• Fire vented through roof at rear of structure
• Thick column of turbulent dark grey-black smoke rose above structure
• Smoke increased in front and Side D of structure as fire intensified
• Smoke continued to push out cracks on Side A and D walls
• E-43 deck gun put into operation applying water to roof with 13/8-inch solid bore tip
• Elevated master stream put into operation from D-110 aerial ladder (insufficient water supply resulted in insufficient fire flow)
• E-43 deck gun re-directed hose stream to protect exposure buildings opposite Side D
• Initial collapse of roof and walls at C/D corner
• Partial wall collapse of Side D wall strikes fire fighter moving ground ladder.

Recommendations

Recommendation #1: Fire departments should establish and monitor a collapse zone when conditions indicate the potential for structural collapse.

Discussion: During fire operations, two rules exist about structural collapse: (1) the potential for structural failure always exists during and after a fire, and (2) a collapse danger zone must be established.^4-9 A collapse zone is an area around and away from a structure in which debris might land if a structure fails. The collapse zone area should be equal to the height of the building plus an additional allowance for debris scatter and at a minimum should be at least 1½ times the height of the building.

Buildings can collapse due to the structural damage directly caused by a fire, or the activities of fire fighting operations. A fire department’s familiarity with types of construction in their community is an important tool in safely fighting fires. Once a collapse zone is established, fire departments should enforce a “no re-entry” policy unless approved by the Incident Commander.

Fire fighters need to recognize the dangers of operating near parapet walls or underneath overhanging awnings, porches, and other areas susceptible to collapse. Immediate safety precautions must be taken if factors indicate the potential for a building collapse. An external load, such as a parapet wall, steeple, overhanging porch, awning, sign, or large electrical service connections reacting on a wall weakened by fire conditions may cause a wall to collapse. Other factors include fuel loads, damage, renovation work, deterioration caused by the fire as well as pre-existing deterioration, support systems and truss construction.^10-12 A collapse is a possibility after fire involvement of more than 10 minutes but fire departments should not rely solely on time as a collapse predictor.¹¹

In this incident, the structure was estimated to be 22 feet high at the top of the D-side wall parapet wall so the collapse zone should have extended at least 33 feet from the structure, covering the entire width of the side-street adjacent to the structure. It is noted that fire fighters were instructed to stay away from the structure and a defensive strategy was used throughout the fire suppression operations. However, a collapse zone was never established or physically identified. Collapse zones can be physically marked by cones, caution tape and other types of physical barriers. Photo 10 taken at the incident scene showed fire fighters standing on the sidewalk as instructed opposite the wall that collapsed.

Recommendation #2: Fire departments should train all fire fighting personnel in the risks and hazards related to structural collapse.

Discussion: Proper training is an important aspect of safe fire ground operation. Both officers and fire fighters need to be aware of different types of building construction and their associated hazards.^{7, 9-10} For example, collapsing roof systems can exert pressure on supporting exterior walls, increasing the potential for wall collapse. Different roof systems may collapse at different rates.¹¹ While heavy timber roof systems will withstand more degradation by fire than lightweight engineered roof trusses, both types are subject to failure.¹² Different phases of the fire suppression activities, such as the initial attack, offensive, defensive, and overhaul phases will have different hazards. However, the potential for collapse exists in any fire-damaged structure.¹¹ One source of information related to structural collapse hazards is the National Institute of Standards and Technology, Building and Fire Research Laboratory (NIST / BFRL). A DVD containing videos and reports related to structural collapse can be obtained from the NIST website http://www.bfrl.nist.gov/.¹³

Establishing priorities is another primary factor in safe fire ground operation that should be included in fire fighter training programs. The protection of life should be the highest goal of the fire service. According to retired Chief Vince Dunn, “When there is no clear danger to civilians, the first priority of firefighting should be the protection of fire fighters’ lives and when no other person’s life is in danger, the life of the fire fighter has a higher priority than fire containment or property consideration.”¹² In this incident, there were no indications of civilians in danger inside the structure. It is noted that defensive operations were used throughout the incident.

The Illinois Fire Service Institute (IFSI) coordinates a statewide training program for individuals interested in becoming a fire fighter. This program offers a 24-hour Basic Fire Fighter course as well as Fire Fighter II and Fire Fighter III certification. The IFSI Fire Fighter II certification is roughly equivalent to the National Fire Protection Association (NFPA) Fire Fighter I and IFSI Fire Fighter III is roughly equivalent to NFPA Fire Fighter II as specified in NFPA 1001 Standard for Fire Fighter Professional Qualifications.¹ NFPA FF I reflects minimum training standards for a fire fighter who is always working under supervision. NFPA FF II addresses the assumption of command and transfer of command but does not contain specific job performance requirements (JPRs) to illustrate the required skills. The IFSI 24-hour Basic Fire Fighter course may not properly prepare new fire fighters for the hazards associated with structural fire fighting. Many fire fighters, especially in the volunteer ranks, may be called upon to fill company officer and incident commander roles when they may not have received adequate training to prepare them for the additional responsibilities that are required of fireground officers. At a minimum, fire fighters who serve as company officers and who may be expected to serve as the initial incident commander should receive training equivalent to NFPA Fire Fighter II, as defined by NFPA 1001. In this incident, the victim had not completed the minimum IFSI or NFPA training requirements for individuals operating at a structure fire. Also, the two lieutenants who served as incident commanders had not completed training meeting the requirements of NFPA Fire Fighter II as defined by NFPA 1001, which should be the minimum training requirements for a fire fighter operating as a fireground officer.

Recommendation #3: Fire departments should train on and understand the effects of master streams on structural degradation.

Discussion: Master streams are an effective tool for fire suppression operations. Master streams can deliver a large volume of water over a distance while reducing the direct exposure of fire fighters to the fire. Master stream operations can also accelerate structural degradation and can increase the risk of a building collapse.^14-16 When multiple master streams are flowing water into a building, the additional weight of the water can rapidly increase the potential for structural collapse. Water weighs 8.33 pounds per gallon. A master stream flowing 1,000 gallons per minute can add an additional 8,330 pounds per minute that the structure, already deteriorated by fire, must support. In 30 minutes, the additional weight contributed by this master stream could add 249,900 pounds or 125 tons of additional weight to the structure.¹⁷ Direct impingement of the master stream at close range can also directly contribute to structural degradation by dislodging bricks, breaking windows and other building components. Master streams can also push fire throughout the interior of a structure, leading to fire spread.

Another important indicator that fire fighters and officers should look for is the presence or lack of runoff during master stream operations. If multiple outside streams are being applied to a structure and there is little or no water runoff, the water must be accumulating somewhere.¹⁵ As noted above, the additional weight added by standing water on roofs or floors can significantly contribute to the risk of structural collapse. Fire fighters and fire officers need to understand this fact and take this into consideration as part of the Incident Action Plan. If a collapse zone has not already been established, one should be established now. Fire fighters should not be allowed to enter the collapse zone without the direct permission of the Incident Commander.¹⁸

Recommendation #4: Fire departments should use risk management principles at all structure fires.

Discussion: While it is recognized that fire fighting is an inherently hazardous occupation, established fire service risk management principles are based on the philosophy that greater risks will be assumed when there are lives to be saved and the level of acceptable risk to fire fighters is much lower when only property is at stake. Interior (inside a structure) offensive fire-fighting operations can increase the risk of traumatic injury and death to fire fighters from structural collapse, burns, and asphyxiation. Established risk management principles suggest that more caution should be exercised in abandoned, vacant, and unoccupied structures and in situations where there is no clear evidence indicating that people are trapped inside a structure and can be saved.¹⁹ More importantly, the fire department must establish a standardized method or approach to assess the risks encountered at each incident especially structure fires. Structure fires are very dynamic and fast paced operations with little room for error, mistakes, or miscalculations of the significance of the risk encountered.

The Incident Commander is specifically responsible for managing risk at the incident; however, one person cannot be expected to apply these principles to an incident if the organization has not integrated a standard approach to risk management into its standard operating procedures and its organizational culture. To be effective, risk management principles must be integrated into the entire operational approach of the fire department organization. They must be incorporated within the duties and responsibilities of every officer and member. The single most important reason to establish an effective incident management system is to ensure that operations are conducted safely. Every individual assigned to the incident is responsible for monitoring and evaluating risks and for keeping the Incident Commander informed of any factor that causes the system to become unbalanced. Continuous risk assessment should be reprocessed with every benchmark or task completed until the incident is ended.²⁰

A standardized evaluation of the situation must occur at each incident starting with the first arriving officer or member of the department arriving on scene of the incident. This process starts with the scene size-up. This responsibility starts with the first arriving unit that must look at the entire incident scene versus focusing on a small part of the situation. During the size-up, the Incident Commander must remember the incident prioritizes which are:

•             Life Safety
•             Incident Stabilization
•             Property Conservation
•             Continuous – fire fighter safety

Situations where there is clear evidence or indication that there is a life safety (imminent rescue or trapped occupants) changes the focus of the strategy and incident action plan. Established risk management principles dictate that more caution is exercised in abandoned, vacant, and unoccupied structures.

Scene size-up should include the following information. Scene size-up should begin at the beginning of the alarm, continue upon arrival on scene, and continue throughout the incident. Some considerations should include:

•             Life safety/occupied structure and realistic evaluation of occupant survivability and rescue potential
•             Type of Occupancy and consideration of fire load and fire behavior
•             Access
•             Building Construction
•             Environmental Conditions
•             Location and extent of the fire within the building
•             Resources Responding
•             Water Supply
•             Special Hazards/Risks
•             Time of Day
•             Color of Smoke
•             Utilities
•             Exposures affected or potential affected
•             A realistic evaluation of the ability to conduct an offensive attack with available resources.^{19, 21}

The Incident Commander should use the scene size-up to formulate a strategy and the Incident Action Plan. Incident factors and their possible consequences offer the basis for a standard incident management approach. Decisions and the action they produce can be no better than the information on which they are based. A standard information management approach is the launching pad for effective incident decision making and successful operational performance. The IC must develop the habit of using the critical factors in their order of importance as the basis for making the specific assignments that make up the Incident Action Plan (IAP). This standard approach becomes a huge help when it is hard to decide where to start.

The incident scene size-up must be viewed as a 2-part process: 1) determining the conditions of the incident scene, and 2) determining whether the fire department has on scene, has in route, or is in need of additional resources to address the challenge presented by what has been identified during the first part of the size-up process.

The IC must create a standard information system and use effective techniques to keep informed at the incident. Information is continually received and processed so that new decisions can be made and old decisions revised based on increased data and improved information. The IC can never assume action-oriented responders engaged in operational activities will just naturally stop what they are doing so they can feed the IC a continuous supply of top-grade objective information. It is the IC’s responsibility to do whatever is required to stay effectively informed.²²

During most critical incident situations, Command many times must develop an IAP, based only on the critical factor evaluation information available at the beginning stage of operations. Many times, that information is incomplete. Even though the IC will continue to improve its quality, the IC will seldom function during the fast, active periods of the event with complete or totally accurate information on all factors.²²

This is most evident during confused, compressed-time initial operations. This continual improvement in the accuracy and timeliness of incident information becomes a major IC function. The ability of the IC and the tactical and task level officers to quickly be informed and perform an analysis of the critical factors that can cause major physical and emotional setbacks to the responders and the customers will have a great impact on the health and longevity of the fire fighters, other first responders, the customers and their property.²²

In general terms, the risk management plan must consider the following: (1) risk nothing for what is already lost—choose defensive operations; (2) extend limited risk in a calculated way to protect savable property—consider offensive operations; (3) and extend very calculated risk to protect savable lives—consider offensive operations.^{19, 23, 24} NFPA 1500 Standard on Fire Department Occupational Safety and Health Program, Chapter 8.3 addresses the use of risk management principles at emergency operations. Chapter 8.3.4 states that risk management principles shall be routinely employed by supervisory personnel at all levels of the incident management system to define the limits of acceptable and unacceptable positions and functions for all members at the incident scene. Chapter 8.3.5 states that at significant incidents and special operations incidents, the Incident Commander shall assign an incident safety officer who has the expertise to evaluate hazards and provide direction with respect to the overall safety of personnel. The annex to Chapter 8.3.5 contains additional information.²⁵

This incident occurred in a structure of mixed occupancy of both commercial and residential use. First arriving crews talked to the building owner and verified that no one was inside the structure. The Incident Commander quickly adopted a defensive strategy and told fire fighters at the front door not to enter the structure. As additional resources arrived on-scene, and Command was passed to higher ranking officers, a defensive operation was maintained. A ground ladder used to ventilate the second story windows on the Side D was left in place where it was last used. Approximately 45 minutes after the first crews arrived on-scene, two fire fighters overheard discussions about the ladder being in a bad location and approached the structure to retrieve the ladder. Given the length of time the fire had been burning, the visual indicators of structural instability (smoke pushing out through cracks in the masonry walls and the sound of bricks popping), the presence of star-shaped anchor plates on the exterior wall and other factors, the best scenario would have been to leave the ladder in place until the area was deemed safe or just write the ladder off. A safer strategy for retrieving the ladder would have been to use a pike pole or other long tool to reach the ladder from a safe distance under the direct observation of other fire fighters monitoring the conditions of the exterior walls. Using a pike pole or other tool to pull the ladder down while standing as far as possible from the exterior wall, may have resulted in a different outcome.

Recommendation #5: Fire Departments should utilize the Incident Command System at all emergency incidents.

Discussion: National Fire Protection Association (NFPA) 1500 Standard on Fire Department Occupational Safety and Health Program, 2007 Edition²⁵ and NFPA 1561 Standard on Emergency Services Incident Management System, 2008 Edition²⁶, both state an incident management system should be utilized at all emergency incidents. Most often, this system is commonly known as or referred to as the Incident Command System (ICS).

The Incident Command System is intended to provide a standard approach to the management of emergency incidents. The many different and complex situations encountered by fire fighters require a considerable amount of judgment in the application of the Incident Command System. The primary objective is always to manage the incident, not to fully implement and utilize the Incident Command System. The Incident Commander should be able to apply the Incident Command System in a manner that supports effective and efficient management of the incident. The use of the Incident Command System should not create additional challenges for the Incident Commander, but rather provide a systems approach to ensuring for a successful outcome of the incident.²⁶

Most incidents are considered routine and involve a small commitment of resources, while few incidents involve large commitments of resources, complex situations, and are low frequency/high risk events. It is imperative that the Incident Command System be able to accommodate all types and sizes of incidents and to provide for a regular process of escalation from the arrival of the first responding resources at a routine incident to the appropriate response for the largest and most complex incidents. The Incident Command System should be applied, even to routine incidents, to allow fire fighters and other first responders to be familiar with the system, prepared for escalation, and aware of the risks that exist at all incidents.²⁶

NFPA 1561, Chapter 3.3.29 defines an incident management system as “A system that defines the roles and responsibilities to be assumed by responders and the standard operating procedures to be used in the management and direction of emergency incidents and other functions.”26 Chapter 4.1 states “The incident management system shall provide structure and coordination to the management of emergency incident operations to provide for the safety and health of emergency services organization (ESO) responders and other persons involved in those activities.”²⁶ Chapter 4.2 states “The incident management system shall integrate risk management into the regular functions of incident command.” ²⁶

The incident management system covers more than just fireground operations. The incident management system must ensure for command and fire fighter safety which includes situational evaluation, strategy and the incident action plan, personnel accountability, risk assessment and continuous evaluation, communications, rapid intervention crews (RIC), roles and responsibilities of the Incident Safety Officer (ISO), and interoperability with multiple agencies (law enforcement, emergency medical services, state and federal government agencies and officials, etc.) and surrounding jurisdictions (automatic aid or mutual aid responders).

One of the most critical components of this system is the development and implementation of an Incident Action Plan (IAP). For the fire service, the majority of times the Incident Action Plan is communicated verbally. The IAP is based on the resources immediately available and those responding. The goal is determined in accordance with the incident priority from which a strategy must emerge; tactical objectives, aimed at meeting the strategy, are determined and specific assignments made. A personnel accountability system should be established as assignments are made. The important point is that the Incident Commander communicates the IAP to tactical and task level supervisors.

Recommendation #6: Fire departments should designate a staging area for all unassigned fire fighters and apparatus.

Discussion: NFPA 1561 Standard on Emergency Services Incident Management System defines staging as a specific emergency management function where resources are assembled in an area at or near the incident scene to await instructions or assignments.²⁶ Staging provides a standard controlled method to keep reserves of responders, apparatus, and other resources ready for action at the scene of the incident or close to the scene of the incident (within two – three minute response times). Staging also provides a standard method to control and record the arrival of apparatus and resources.

When the Incident Commander requests additional resources for an incident, the IC is responsible for designating a staging area. Depending on the size and complexity of an incident, multiple staging areas may be used. This is based on the response route of the resources, to stage resources by typing (e.g. engines, brush trucks, medic units, law enforcement, etc.), or due to location near the incident. The staging area manager documents the available resources. This helps the Incident Commander to keep track of the resources that are on the scene and available for assignment, and to know where they are located and where specific units have been assigned. The Staging Area Manager reports to the IC unless an Operations Section Chief has been assigned, then the Staging Area Manager would report to the Operations Section Chief.

When companies or resources arrive in staging, they report to the Staging Area Manager and stand by for assignment. The Staging Area Manager records and keeps an inventory of all resources and equipment assigned to Staging. A system needs to be in place that details what needs to occur when Staging starts to run low on resources. Staging lets “Command” know when resources are low, and Command orders more resources through Dispatch.

Staging provides an avenue for reducing overall incident communications, and maintaining control of resources throughout the incident operations.

Recommendation #7: Fire departments should conduct pre-incident planning inspections of buildings within their jurisdictions to facilitate development of safe fireground strategies and tactics.

Discussion: National Fire Protection Association (NFPA) 1620 Standard for Pre-Incident Planning, 2010 Edition, states “the pre-incident plan shall provide critical information for responding personnel at the time of dispatch and shall include initial actions based on the priorities of life safety, scene stabilization, and incident mitigation.” This standard also states that “the primary purpose of a pre-incident plan is to help responding personnel effectively manage emergencies with available resources. Pre-incident planning involves evaluating the protection systems, building construction, contents, and operating procedures that can impact emergency operations.”²⁷ A pre-incident plan identifies deviations from normal operations and can be complex and formal, or simply a notation about a particular problem such as the presence of flammable liquids, explosive hazards, modifications to structural building components, or structural damage from a previous fire.^{7, 27-28}

In addition, NFPA 1620 outlines the steps involved in developing, maintaining, and using a preincident plan by breaking the incident down into pre-, during- and post-incident phases. In the preincident phase, for example, it covers factors such as physical elements and site considerations, occupant considerations, protection systems and water supplies, hydrant locations, and special hazard considerations. Building characteristics including type of construction, materials used, occupancy, fuel load, roof and floor design, and unusual or distinguishing characteristics should be recorded, shared with other departments who provide mutual aid, and if possible, entered into the dispatcher’s computer so that the information is readily available if an incident is reported at the noted address. Since many fire departments have tens and hundreds of thousands of structures within their jurisdiction, making it impossible to pre-plan them all, priority should be given to those having elevated or unusual fire hazards and life safety considerations.

Pre-plan information should include predicted alarm assignments based upon the fire potential. This will help to ensure that needed resources are dispatched immediately, even if they are some distance away or will provided through mutual aid. If the expected fire potential dictates that 30 fire fighters are needed and the authority having jurisdiction only has 15 fire fighters, the pre-plan should identify the mutual aid resources available to safely and effectively mitigate the expected fire scenario. The pre-plan information should take into consideration the need for incident command and command level officers to fill roles such as safety officer, accountability, tactical level management (i.e. division or group supervisor), RIT / RIC supervision, staging, rehabilitation, IC support ( chief’s aide or staff assistant to monitor radio communications, track crew assignments, resources availability, etc.) and other functions as necessary. When the need for these positions are considered in the pre-planning process, these positions can be rapidly filled throughout the initial alarm assignments, allowing for crew and supervisory integrity while placing more experienced command level support officers in the roles needed to ensure effective supervision and support in the hazard zone. In this incident, pre-planning the structure could have identified the potential collapse hazards associated with the structure due to the age and type of construction, the presence of the star-shaped anchor plates on the exterior walls, and the high fuel load present. It is noted that the Fire Department A had an unwritten policy that any fires in the older commercial structures within the city would be fought defensively.

Recommendation #8: Fire departments should conduct regular mutual aid training with neighboring departments.

Discussion: Although there is no evidence that the following recommendation would have prevented this fatality, it is being provided as a reminder of a good safety practice. Mutual aid companies should train together and not wait until an incident occurs to attempt to integrate the participating departments into a functional team. Differences in equipment and procedures need to be identified and resolved before an emergency occurs when lives may be at stake. Procedures and protocols that are jointly developed, and have the support of the majority of participating departments, will greatly enhance overall safety and efficiency on the fireground. Once methods and procedures are agreed upon, training protocols must be developed and joint-training sessions conducted to relay appropriate information to all affected department members.

Fire departments should develop and establish good working relationships with surrounding departments so that reciprocal assistance and mutual aid is readily available when emergency situations escalate beyond response capabilities. Both fire departments involved in this incident were participating members in the Mutual Aid Box Alarm System (MABAS), a mutual aid system designated to assist with mutual aid response of fire, emergency medical services (EMS), specialized response teams, and station coverage during a state declared disaster or when an incident overwhelms the available resources of a participating community. This incident did not escalate to the size of a MABAS event. Both departments reported that they planned to implement mutual aid training with neighboring departments but had done so on a limited basis up to the time that this incident occurred.

Recommendation # 9: Fire departments should ensure that fire fighters wear a full array of turnout clothing and personal protective equipment (i.e. SCBA and PASS device) appropriate for the assigned task while participating in fire suppression and overhaul activities.

Discussion: Although there is no evidence that the following recommendation would have prevented this fatality, it is being provided as a reminder of a good safety practice. The proper selection and use of personal protective equipment (PPE) is required by OSHA regulations, recommended in NFPA standards, and is good safety practice. Chapter 7.1.1 of NFPA 1500, Fire Department Safety and Health Program, 2007 Edition, states “the fire department shall provide each member with protective clothing and protective equipment that is designed to provide protection from the hazards to which the member is likely to be exposed and is suitable for the tasks that the member is expected to perform.” Chapter 7.1.2. states “protective clothing and protective equipment shall be used whenever a member is exposed or potentially exposed to the hazards for which the protective clothing (and equipment) is provided.”²⁵ The incident commander should establish the level of protective clothing necessary to enter the fire zones (hot, warm, and cold). The OSHA Respirator Standard Title 29, Code of Federal Regulations (CFR) 1910.134 lists requirements for SCBA use in immediately dangerous to life or health (IDLH) atmospheres.²⁹ While the lack of personal protective equipment (PPE) and clothing did not contribute to the fatality that occurred at this incident, it is generally recognized that SCBA should be worn and used at all times when fire fighters may be exposed to smoke and other hazardous atmospheres. Photos taken during the incident show fire fighters working in close proximity to the burning structure who were not wearing proper respiratory protection (see Photo 7, Photo 8 and Photo 11).

In addition, standard setting organizations, national fire service organizations and other interested parties should:

Recommendation #10: Implement national fire fighter and fire officer training standards and requirements.

Discussion: In 2008, the National Volunteer Fire Council (NVFC) adopted a policy position that all volunteer fire departments should establish a goal to train all personnel to a level consistent with the mission of the fire department, based on the job performance requirements outlined in NFPA 1001: Standard for Fire Fighter Professional Qualifications. The NVFC is committed to ensuring that volunteer firefighters have an appropriate level of training to safely and effectively carry out the functions of the department(s) that they belong to. ³⁰

“The roles and responsibilities of the fire service have evolved over the years. As the breadth and scope of what it means to be a firefighter has expanded, to varying degrees depending on the jurisdiction, the necessity for training within the fire service has grown. Unfortunately, a large number of volunteer fire departments are still operating with personnel who are not trained to a level consistent with national consensus standards for basic firefighter preparedness. This can lead to ineffective and unsafe responses that put lives and property at risk.” ³⁰ This issue actually encompasses the entire fire service and not just the volunteer ranks.

“As the need for proper training has become more urgent, many volunteer fire departments are finding it increasingly difficult to attract new members. The average age of volunteer firefighters has risen steadily over the past two decades, as many young people move out of rural areas and the ones who stay find themselves with less free time to devote to training.” ³⁰

Standard setting organizations, states and authorities having jurisdiction should move to develop national standards so that fire fighters across the United States are trained to the same minimum levels. The Illinois Fire Service Institute (IFSI) coordinates a statewide training program for individuals interested in becoming a fire fighter. This program offers a 24-hour Basic Fire Fighter course as well as Fire Fighter II and Fire Fighter III certification. The IFSI Fire Fighter II certification is roughly equivalent to the National Fire Protection Association (NFPA) Fire Fighter I and IFSI Fire Fighter III is roughly equivalent to NFPA Fire Fighter II as specified in NFPA 1001 Standard for Fire Fighter Professional Qualifications.¹ NFPA FF I reflects minimum training standards for a fire fighter who is always working under supervision. NFPA FF II addresses the assumption of command and transfer of command but does not contain specific job performance requirements (JPRs) to illustrate the required skills. The IFSI 24-hour Basic Fire Fighter course may not properly prepare new fire fighters for the hazards associated with structural fire fighting. Many fire fighters, especially in the volunteer ranks, may be called upon to fill company officer and incident commander roles when they may not have received adequate training to prepare them for the additional responsibilities that are required of fireground officers. At a minimum, fire fighters who serve as company officers and who may be expected to serve as the initial incident commander should receive training equivalent to NFPA Fire Fighter II, as defined by NFPA 1001.

Fire department members that are assigned to or assume supervisory positions at an incident scene must have an additional level of competencies that are necessary to ensure for the safety of themselves and the members they supervise while mitigating the hazard encountered. A company officer must have the correct combination of practical experience, training and skill sets that correspond with their job requirements and expected functions in order to execute the expected duties in a safe, effective, efficient and competent manner. The company officer fulfills a mission critical role within the fire service that directly affects department personnel, public safety and community accord. The title carries with it the opportunity to ride the “front seat” and be in charge of directing a company to address incident operations and demands dictated by the company’s function, responsibility, and task assignment. NFPA 1021, Standard on Fire Officer Professional Qualifications provides clear and concise job performance requirements (JPR) that can be used to determine if an individual, when measured to the standard, possess the skills and knowledge to perform as a fire officer.³¹ Fire departments should ensure that all fire fighters who are expected to perform the duties of a company officer or greater responsibility have the necessary knowledge, experience and receive adequate training equivalent to NFPA Fire Fighter II, as defined by NFPA 1001 and Fire Officer as defined by NFPA 1021.

Additional References:

•  Chicago: Anatomy of a Building and its Collapse
• Chicago: Anatomy of a Building and its Collapse-PDF Download
• Operational Safety Training Aide: Ordinary and Heavy Timber Constructed Occupancies Training Download from Commandsafety.com
• Lessons Learned: Buffalo, NY Three Alarm Fire and Double LODD Report
• San Francisco: Collapse of Bowstring Truss Roof Seriously Injures Fire Fighter
• FDNY: The Waldbaum Fire Collapse FDNY 1978 Remembrance
• Ordinary Construction Floor Collapse: http://www.cdc.gov/niosh/fire/reports/face200923.html
• Brick Parapet Wall Collapse: http://www.cdc.gov/niosh/fire/reports/face200821.html
• Partial Roof Collapse: http://www.cdc.gov/niosh/fire/reports/face200509.html
• Roof Collapse during interior operations: http://www.cdc.gov/niosh/fire/reports/face9617.html
• Trapped during fire suppression operations at a millwork facility: http://www.cdc.gov/niosh/fire/reports/face200807.html
• Don’t forget o research some of the Near Miss Reports on the NFFNMRS: http://www.firefighternearmiss.com/ 
• Two career fire fighters die and 19 injured in roof collapse during rubbish fire at an abandoned commercial structure – Illinois
• Brick Parapet Wall Collapse: http://www.cdc.gov/niosh/fire/reports/face200821.html
• Brick Chimney Collapse: http://www.cdc.gov/niosh/fire/reports/face9906.html