By Robert Tutterow
In the July, 2010 issue of Fire Apparatus & Emergency Equipment, Montreal Fire Division Chief Gordon Routley wrote a column about how the cramped space inside today’s apparatus cabs is causing many firefighters to not wear seatbelts. Indeed, anthropometric studies have clearly shown that firefighters wearing PPE need far more seating space than other professions.
|These steps were designed to improve the appearance of the apparatus, not with firefighter safety in mind. Note the configuration is different for each of the cab doors.|
|These steps fold down when the door is opened. This allows the first step to be closer to the ground and provides a user friendly angle for getting in and out of cabs.|
Chief Routley cited a typical example of a company officer who said the space inside his ladder truck was so restricted that he had to fasten his seatbelt before closing the door and then ride sitting in a semi-side-saddle position with his legs wedged into a narrow space between the seat and the front of the cab. The National Fire Protection Association (NFPA) 1901 apparatus standard requires an 18-inch minimum seat width. This is clearly not enough. This situation will only get worse since new Environmental Protection Agency (EPA) regulations are causing most engine compartments to be larger than in the past.
Chief Routley references a preliminary study conducted by the National Fallen Firefighters Foundation on the cab space needs of today’s firefighters. The results of that study led to a more extensive study by the National Institute for Occupational Safety and Health (NIOSH) that should be released soon. Chief Routley challenges apparatus makers to reconfigure cab designs by looking at alternatives for positioning the engine and lowering the frame rails.
Here is another challenge that directly correlates to Chief Routley’s challenge. The apparatus manufacturers, the component manufacturers, and the NFPA Technical Committee on Apparatus need to improve cab entrance and egress. Both challenges equate to an overall improvement in the envelope of cab ergonomics. In addition to crew areas being too small, today’s cabs are too high. And, the contortions required to get in and out of cabs are dangerous.
The issue of cab entrance and egress has been mentioned in this column several times in the past. However, a recent review of firefighter injuries in my department quantifies the need for improvement. (It is one of three injury reduction goals that have been set by the department.)
The firefighter injury review looked at data from Jan. 1, 2009 through the end of October 2010. In the most recent 22 months, my department, which has slightly more than 1,000 firefighters, experienced 22 injuries (one a month) involving firefighter cab entrance and egress. The 22 injuries resulted in 92 days of lost time, 315 days of restricted duty, an incurred cost of $107,739.77 and an actual cost of $44,259.80. (Incurred cost is the amount set aside for treatment of the injury once a diagnosis is made.)
It must be noted that the actual cost figures will continue to rise as treatment is still being provided to some of the injured firefighters. Numbers like that cannot be ignored, and this data was sent to our chassis manufacturer. I suspect most other departments of similar size have similar results.
The description of the injuries as stated by the firefighters in their injury reports included these accounts:
- “I was stepping off the engine and turned my left ankle when I stepped on the floor.”
- “I stepped off the engine while in the station and my knee gave way.”
- “I was putting gear on truck at shift change, went to step off truck, left foot slipped and twisted my knee.”
- “I was stepping out of the officer’s side of the engine and fell back and hit my head and shoulder against locker.”
The two most serious injury descriptions were these:
- “I was stepping off of engine after retrieving portable radio. The engine was in the station at the time. My foot rolled as it made contact with the bottom step and I fell, landing on my left ankle. I felt something pop in my ankle and realized I could not walk. I was transported by ambulance to the hospital ER.”
- “During morning apparatus checkout, I stepped out of apparatus and lost my grip causing me to miss the bottom step of the driver’s door. I landed on right foot and hyper-extended my right knee.”
There are a couple of common denominators to the above described injuries. Each occurred at the station, and each occurred while exiting the cab. In fact, 13 of the 22 of the injuries occurred at the station while only four occurred while entering the truck. Only two of the injured were wearing PPE at the time. Only one of the 22 injuries occurred at a working fire. That is revealing. We tend to think of these type injuries only occurring at emergency scenes as firefighters quickly leave the truck in full PPE and miss a step or step on an uneven surface and injure a knee or ankle.
This issue of getting into and out of cabs goes beyond injuries to the lower extremities. For example, we had several firefighters require rotator cuff surgery during 2007 and 2008. In almost every case, the firefighters were engineers.
More than one of our engineers thought that getting in and out of the cab contributed to their shoulder damage. Upon further review, we discovered that they were grabbing the steering wheel to help pull themselves up into the cab. Naturally, the steering wheel would move a bit and create an unstable grab handle. That created an unanticipated strain to the shoulder. Though there was no identifiable single incident that could be attributed to an injury, it is believed the cumulative effect of this repetitive motion was a major contributor to the shoulder damage.
Inexplicably, this is an issue that has not been on the radar screen of firefighter safety endeavors. Maybe they are too mundane since they don’t capture headlines like injuries that occur during the fire fight or the emergency response. During interviews, many of the injured firefighters thought their incidents were just “freak” happenings and they were just not being careful. When events occur in isolation (with no national database), we fail to see the big picture.
An interesting sidebar to this review of injuries is that half of my department’s reported firefighter injuries for the fiscal year 2010 occurred at the fire station. That is equal to number of fireground injuries, EMS incident injuries, hazmat injuries and special ops injuries combined! What’s wrong with this picture? We talk about firefighting as a dangerous occupation, but actual workplace injuries reveal a slightly different picture than the public perception – and probably our own perception.
One of my theories as to why there are so many injuries in non-emergency situations is that firefighters are not as focused while doing the ordinary and routine activities. If this theory is true, then it further illustrates we have design issues with apparatus cab entry and egress.
More on this topic in next month’s column.
Editor’s Note: Robert Tutterow is safety coordinator for the Charlotte (N.C.) Fire Department. His 34-year career includes 10 as a volunteer. He has been very active with the National Fire Protection Association through service on the Fire Service Section Executive Board and technical committees involved with safety, apparatus and personal protective equipment. He is a founding member and president of the Fire Industry Equipment Research Organization (F.I.E.R.O.).