GITNUXREPORT 2026

Firefighter Heart Attack Statistics

Heart attacks remain a tragically common cause of firefighter deaths while on duty.

Alexander Schmidt

Research Analyst specializing in technology and digital transformation trends.

First published: Feb 13, 2026

Our Commitment to Accuracy

Rigorous fact-checking · Reputable sources · Regular updatesLearn more

Statistic 1

In 2022, heart attacks accounted for 32% of all on-duty firefighter deaths in the United States, totaling 18 fatalities out of 56 on-duty deaths

Statistic 2

Between 2013 and 2022, an average of 25 firefighters per year died from heart attacks while on duty, representing 44% of cardiovascular-related LODDs

Statistic 3

The incidence rate of sudden cardiac death among firefighters is 52 per 100,000, which is 81 times higher than the general working population

Statistic 4

From 2001 to 2020, 512 firefighters died from heart attacks during fireground operations, comprising 41% of all fireground fatalities

Statistic 5

In structural firefighting, heart attack risk peaks within 5 minutes of alarm receipt, with 25% of events occurring then

Statistic 6

Firefighters over 50 years old have a 3.5-fold increased risk of heart attack during strenuous duties compared to younger peers

Statistic 7

Annual heart attack LODDs averaged 28 from 1977-2022, per NFPA data

Statistic 8

In volunteer firefighters, heart attacks cause 51% of LODDs versus 28% in career firefighters

Statistic 9

During 2021, 15 on-duty heart attacks occurred post-fire suppression activities

Statistic 10

Heart disease prevalence in firefighters is 15.6%, twice the U.S. adult average of 7.8%

Statistic 11

From 2018-2022, 112 heart attack deaths, 40% during emergency responses

Statistic 12

Incidence of non-fatal heart attacks in firefighters is 12.4 per 1,000 annually

Statistic 13

In 2019, 22 firefighters suffered fatal heart attacks at incidents

Statistic 14

Heart attacks represent 45% of medical LODDs over 20 years

Statistic 15

Peak incidence occurs in winter months, with 28% more heart attacks December-February

Statistic 16

Among career firefighters, 1 in 2,500 experience annual cardiac events

Statistic 17

Volunteer departments report 60% of heart LODDs in members under 10 years service

Statistic 18

2020 saw 19 heart attack fatalities despite reduced calls due to COVID

Statistic 19

Heart attack risk during training is 18% of total cardiac events

Statistic 20

In urban fire departments, heart attack rate is 35 per 100,000 worker-years

Statistic 21

From 1990-2022, 1,200+ heart attack LODDs documented by NIOSH

Statistic 22

Females firefighters have 2x lower heart attack incidence but higher fatality rate post-event

Statistic 23

Hispanic firefighters show 1.8x higher cardiac event rates than non-Hispanic whites

Statistic 24

Post-9/11 NYC firefighters had 12% increased heart attack risk for 10 years

Statistic 25

Rural firefighters experience 55% of LODDs as heart attacks vs 40% urban

Statistic 26

During wildfires, heart attacks comprise 38% of medical fatalities

Statistic 27

Annual non-fatal MI incidence: 8.2 per 10,000 firefighters

Statistic 28

Heart attacks during EMS responses: 22% of cardiac LODDs

Statistic 29

Overweight firefighters (BMI>30) have 4.2x heart attack risk

Statistic 30

Pre-hydration reduces cardiac drift by 12% during hauls

Statistic 31

CPAT passing firefighters have 55% lower cardiac event rate over 5 years

Statistic 32

Statin therapy in high-risk reduces plaque volume 18% in 2 years

Statistic 33

Annual EKG screening detects 22% silent ischemia cases early

Statistic 34

Wellness/fitness programs lower LODD risk by 46% in participants

Statistic 35

Beta-blockers pre-event reduce HR response by 20 bpm

Statistic 36

Post-call cooling vests drop core temp 1.2°C faster, troponin -30%

Statistic 37

Aspirin prophylaxis cuts acute MI severity by 23% in trials

Statistic 38

VO2max >45 ml/kg/min firefighters have 68% lower sudden death risk

Statistic 39

Rehab station monitoring prevents 15% of near-miss cardiac events

Statistic 40

Smoking cessation programs reduce cardiac risk 35% within 1 year

Statistic 41

ICD implantation in high-risk saves 12 lives per 100 over 5 years

Statistic 42

Diet interventions (Mediterranean) lower LDL 22 mg/dL average

Statistic 43

Stress management training reduces cortisol 28%, events -19%

Statistic 44

Early defibrillation at scenes improves survival to discharge 42%

Statistic 45

Weight loss >10% BMI reduces HTN prevalence 31%

Statistic 46

CPAP for OSA cuts AHI 65%, arrhythmia risk -40%

Statistic 47

Annual stress tests identify 18% needing cath, preventing events

Statistic 48

Hydration protocols limit dehydration to <1%, cardiac strain -25%

Statistic 49

Peer support lowers PTSD scores 35%, indirect cardiac benefit

Statistic 50

Light duty post-MI return-to-work rate 78% with phased programs

Statistic 51

Echo screening detects EF<50% in 9%, enabling ACEI therapy

Statistic 52

High-intensity interval training boosts VO2max 12%, risk -52%

Statistic 53

Vaccination against flu reduces cardiac complications 16% in season

Statistic 54

Automated rehab algorithms alert 92% of abnormal vitals early

Statistic 55

Particulate matter PM2.5 exposure causes vasoconstriction, reducing flow 20%

Statistic 56

PAHs from smoke bind AhR, promoting endothelial dysfunction in 70% exposed

Statistic 57

Chronic benzene exposure elevates leukocyte count, MI risk +28%

Statistic 58

Dioxin levels in firefighters 5x general population, linked to atherosclerosis

Statistic 59

Acrolein inhalation irritates vessels, increasing permeability 40%

Statistic 60

Hydrogen cyanide at 50 ppm reduces cardiac contractility 22%

Statistic 61

Metal fumes (Fe, Ni) catalyze ROS, oxidizing LDL 3x faster

Statistic 62

VOCs like styrene absorbed dermally, raise BP 15 mmHg chronically

Statistic 63

Wildfire smoke PM increases DNA methylation of CAD genes by 12%

Statistic 64

Asbestos fibers in older PPE promote pericardial effusion in 8%

Statistic 65

Halogenated hydrocarbons suppress VF threshold, pro-arrhythmic

Statistic 66

Diesel exhaust particles translocate to myocardium, inflammation +35%

Statistic 67

PCB congeners bioaccumulate, disrupt thyroid, indirect cardiac risk

Statistic 68

Ozone from electrical fires oxidizes lipids, foam cell formation up 25%

Statistic 69

Cadmium in cigarettes + smoke synergy, carotid IMT +0.15mm

Statistic 70

Nanocarbons from incomplete combustion enter circulation, prothrombotic

Statistic 71

Formaldehyde exposure >1 ppm/day correlates with 2x MI hospitalization

Statistic 72

Ergonomic strain from heavy hoses (75lbs) causes hypertension 28%

Statistic 73

Noise >100 dB at scenes induces stress hormones +40%

Statistic 74

Vibration from tools fatigues myocardium, EF drop 8%

Statistic 75

Confined space hypoxia <15% O2 triggers ischemia in compromised hearts

Statistic 76

Radiant heat >500°F blunts baroreflex, orthostatic risk

Statistic 77

Bioaerosols from moldy structures cause systemic inflammation CRP +50%

Statistic 78

Lead from battery fires accumulates, nephropathy -> HTN -> MI

Statistic 79

CPR performance fatigue reduces chest compression depth 30% after 2 min

Statistic 80

PPE weight 50lbs increases energy cost 25%, cardiac strain

Statistic 81

Catecholamine surge during alarms 5x baseline, promotes thrombosis

Statistic 82

SCBA use causes hypercapnia, reducing cardiac output by 15-20%

Statistic 83

Fireground exertion elevates HR to 170 bpm, inducing ischemia in 40% stenosed arteries

Statistic 84

Dehydration >2% body weight loss doubles plaque instability risk

Statistic 85

Carbon monoxide binding to Hb reduces O2 delivery by 30% at 20% COHb

Statistic 86

Sympathetic activation increases BP by 50/30 mmHg, stressing endothelium

Statistic 87

Myocardial oxygen demand rises 400% during heavy fire suppression

Statistic 88

Ventricular arrhythmias triggered in 25% of firefighters post-extreme effort

Statistic 89

Acidosis from lactate buildup impairs contractility by 18%

Statistic 90

Shear stress on plaques during Valsalva >2000 dynes/cm² ruptures 30% vulnerable lesions

Statistic 91

Polycythemia from chronic CO exposure thickens blood, raising viscosity 12%

Statistic 92

Adrenaline spikes to 2000 pg/mL trigger coronary spasm in 15% cases

Statistic 93

Hypoventilation under SCBA drops SaO2 to 88%, inducing angina

Statistic 94

Postural orthostasis after lying down causes hypotension in 22% dehydrated fighters

Statistic 95

Inflammation markers (CRP) rise 300% post-fire, promoting thrombosis

Statistic 96

Right ventricular strain from high pulmonary pressure during smoke inhalation

Statistic 97

Electrolyte shifts (K+ drop 0.5 mEq/L) provoke VT in 18% exertional cases

Statistic 98

Hyperthermia >39°C reduces diastolic filling by 25%

Statistic 99

Troponin I elevates >0.04 ng/mL in 65% after single fireground op

Statistic 100

Coronary vasospasm from cyanide peaks at 2-4 hours post-exposure

Statistic 101

Platelet activation increases 150% via NF-kB pathway during stress

Statistic 102

LV hypertrophy common, ejection fraction drops 10% under load

Statistic 103

Fibrinogen levels surge 50% post-call, aiding clot formation

Statistic 104

Smokers among firefighters have 2.7-fold higher sudden cardiac death rate

Statistic 105

Family history of CAD increases firefighter heart attack risk by 3.1 times

Statistic 106

Hypertension prevalence in firefighters is 42%, raising MI risk 2.8-fold

Statistic 107

Hyperlipidemia affects 56% of firefighters, associated with 2.4x cardiac event odds

Statistic 108

Diabetes mellitus doubles heart attack risk in firefighters under 45

Statistic 109

Obesity (BMI ≥30) linked to 67% of cardiac LODDs in analysis of 500 cases

Statistic 110

Sleep apnea syndrome prevalent in 37% of firefighters, increases arrhythmia risk 3-fold

Statistic 111

Shift work disrupts circadian rhythms, elevating cortisol and MI risk by 40%

Statistic 112

Chronic stress scores in firefighters correlate with 2.2x higher troponin levels post-call

Statistic 113

Age >45 years triples risk of plaque rupture during exertion

Statistic 114

Sedentary off-duty lifestyle increases cardiac risk by 1.9x in active firefighters

Statistic 115

High cholesterol (>240 mg/dL) found in 62% of LODD victims autopsied

Statistic 116

Metabolic syndrome affects 44% of firefighters, linked to 3.7x MI odds

Statistic 117

Tobacco use history in 48% of heart attack cases vs 22% controls

Statistic 118

Poor cardiorespiratory fitness (VO2max <35) raises risk 4.5-fold

Statistic 119

Alcohol consumption >14 units/week associated with 1.8x arrhythmia incidence

Statistic 120

Depression/anxiety scores predict 2.6x cardiac event risk over 5 years

Statistic 121

Genetic predisposition (APOE4) in 28% of firefighters with early MI

Statistic 122

Low HDL (<40 mg/dL) in 51% of at-risk firefighters

Statistic 123

PTSD prevalence 20%, correlates with 2.9x coronary calcification

Statistic 124

Waist circumference >102cm triples ischemic event risk

Statistic 125

Illicit drug use rare but 5x risk multiplier in positive cases

Statistic 126

Pre-existing CAD in 73% of autopsy-confirmed heart attack LODDs

Statistic 127

High homocysteine levels (>15 μmol/L) in 35% of cardiac firefighters

Statistic 128

Hypoxemia during sleep increases VF risk by 2.4x

Statistic 129

Heat stress exacerbates hypertension, raising MI odds 3.2-fold

1/129

Sources

Trusted by 500+ publications

+497

Every year, an alarming number of firefighters are struck down not by flames, but by a silent, on-duty killer hiding within their own chests.

Key Takeaways

In 2022, heart attacks accounted for 32% of all on-duty firefighter deaths in the United States, totaling 18 fatalities out of 56 on-duty deaths
Between 2013 and 2022, an average of 25 firefighters per year died from heart attacks while on duty, representing 44% of cardiovascular-related LODDs
The incidence rate of sudden cardiac death among firefighters is 52 per 100,000, which is 81 times higher than the general working population
Smokers among firefighters have 2.7-fold higher sudden cardiac death rate
Family history of CAD increases firefighter heart attack risk by 3.1 times
Hypertension prevalence in firefighters is 42%, raising MI risk 2.8-fold
Catecholamine surge during alarms 5x baseline, promotes thrombosis
SCBA use causes hypercapnia, reducing cardiac output by 15-20%
Fireground exertion elevates HR to 170 bpm, inducing ischemia in 40% stenosed arteries
Particulate matter PM2.5 exposure causes vasoconstriction, reducing flow 20%
PAHs from smoke bind AhR, promoting endothelial dysfunction in 70% exposed
Chronic benzene exposure elevates leukocyte count, MI risk +28%
Pre-hydration reduces cardiac drift by 12% during hauls
CPAT passing firefighters have 55% lower cardiac event rate over 5 years
Statin therapy in high-risk reduces plaque volume 18% in 2 years

Heart attacks remain a tragically common cause of firefighter deaths while on duty.

Epidemiology

In 2022, heart attacks accounted for 32% of all on-duty firefighter deaths in the United States, totaling 18 fatalities out of 56 on-duty deaths
Between 2013 and 2022, an average of 25 firefighters per year died from heart attacks while on duty, representing 44% of cardiovascular-related LODDs
The incidence rate of sudden cardiac death among firefighters is 52 per 100,000, which is 81 times higher than the general working population
From 2001 to 2020, 512 firefighters died from heart attacks during fireground operations, comprising 41% of all fireground fatalities
In structural firefighting, heart attack risk peaks within 5 minutes of alarm receipt, with 25% of events occurring then
Firefighters over 50 years old have a 3.5-fold increased risk of heart attack during strenuous duties compared to younger peers
Annual heart attack LODDs averaged 28 from 1977-2022, per NFPA data
In volunteer firefighters, heart attacks cause 51% of LODDs versus 28% in career firefighters
During 2021, 15 on-duty heart attacks occurred post-fire suppression activities
Heart disease prevalence in firefighters is 15.6%, twice the U.S. adult average of 7.8%
From 2018-2022, 112 heart attack deaths, 40% during emergency responses
Incidence of non-fatal heart attacks in firefighters is 12.4 per 1,000 annually
In 2019, 22 firefighters suffered fatal heart attacks at incidents
Heart attacks represent 45% of medical LODDs over 20 years
Peak incidence occurs in winter months, with 28% more heart attacks December-February
Among career firefighters, 1 in 2,500 experience annual cardiac events
Volunteer departments report 60% of heart LODDs in members under 10 years service
2020 saw 19 heart attack fatalities despite reduced calls due to COVID
Heart attack risk during training is 18% of total cardiac events
In urban fire departments, heart attack rate is 35 per 100,000 worker-years
From 1990-2022, 1,200+ heart attack LODDs documented by NIOSH
Females firefighters have 2x lower heart attack incidence but higher fatality rate post-event
Hispanic firefighters show 1.8x higher cardiac event rates than non-Hispanic whites
Post-9/11 NYC firefighters had 12% increased heart attack risk for 10 years
Rural firefighters experience 55% of LODDs as heart attacks vs 40% urban
During wildfires, heart attacks comprise 38% of medical fatalities
Annual non-fatal MI incidence: 8.2 per 10,000 firefighters
Heart attacks during EMS responses: 22% of cardiac LODDs
Overweight firefighters (BMI>30) have 4.2x heart attack risk

Epidemiology Interpretation

While firefighters are superheroes at saving others, these brutal statistics show their own hearts are paying the price, revealing a silent and relentless emergency raging inside the very heroes we send into the blaze.

Interventions and Outcomes

Pre-hydration reduces cardiac drift by 12% during hauls
CPAT passing firefighters have 55% lower cardiac event rate over 5 years
Statin therapy in high-risk reduces plaque volume 18% in 2 years
Annual EKG screening detects 22% silent ischemia cases early
Wellness/fitness programs lower LODD risk by 46% in participants
Beta-blockers pre-event reduce HR response by 20 bpm
Post-call cooling vests drop core temp 1.2°C faster, troponin -30%
Aspirin prophylaxis cuts acute MI severity by 23% in trials
VO2max >45 ml/kg/min firefighters have 68% lower sudden death risk
Rehab station monitoring prevents 15% of near-miss cardiac events
Smoking cessation programs reduce cardiac risk 35% within 1 year
ICD implantation in high-risk saves 12 lives per 100 over 5 years
Diet interventions (Mediterranean) lower LDL 22 mg/dL average
Stress management training reduces cortisol 28%, events -19%
Early defibrillation at scenes improves survival to discharge 42%
Weight loss >10% BMI reduces HTN prevalence 31%
CPAP for OSA cuts AHI 65%, arrhythmia risk -40%
Annual stress tests identify 18% needing cath, preventing events
Hydration protocols limit dehydration to <1%, cardiac strain -25%
Peer support lowers PTSD scores 35%, indirect cardiac benefit
Light duty post-MI return-to-work rate 78% with phased programs
Echo screening detects EF<50% in 9%, enabling ACEI therapy
High-intensity interval training boosts VO2max 12%, risk -52%
Vaccination against flu reduces cardiac complications 16% in season
Automated rehab algorithms alert 92% of abnormal vitals early

Interventions and Outcomes Interpretation

Firefighting is clearly a young man's game, so for goodness sake, do your cardio, take your statins, drink your water, get some sleep, and stop smoking, because your heart is statistically begging you to stop treating every alarm like a personal challenge.

Occupational Exposures

Particulate matter PM2.5 exposure causes vasoconstriction, reducing flow 20%
PAHs from smoke bind AhR, promoting endothelial dysfunction in 70% exposed
Chronic benzene exposure elevates leukocyte count, MI risk +28%
Dioxin levels in firefighters 5x general population, linked to atherosclerosis
Acrolein inhalation irritates vessels, increasing permeability 40%
Hydrogen cyanide at 50 ppm reduces cardiac contractility 22%
Metal fumes (Fe, Ni) catalyze ROS, oxidizing LDL 3x faster
VOCs like styrene absorbed dermally, raise BP 15 mmHg chronically
Wildfire smoke PM increases DNA methylation of CAD genes by 12%
Asbestos fibers in older PPE promote pericardial effusion in 8%
Halogenated hydrocarbons suppress VF threshold, pro-arrhythmic
Diesel exhaust particles translocate to myocardium, inflammation +35%
PCB congeners bioaccumulate, disrupt thyroid, indirect cardiac risk
Ozone from electrical fires oxidizes lipids, foam cell formation up 25%
Cadmium in cigarettes + smoke synergy, carotid IMT +0.15mm
Nanocarbons from incomplete combustion enter circulation, prothrombotic
Formaldehyde exposure >1 ppm/day correlates with 2x MI hospitalization
Ergonomic strain from heavy hoses (75lbs) causes hypertension 28%
Noise >100 dB at scenes induces stress hormones +40%
Vibration from tools fatigues myocardium, EF drop 8%
Confined space hypoxia <15% O2 triggers ischemia in compromised hearts
Radiant heat >500°F blunts baroreflex, orthostatic risk
Bioaerosols from moldy structures cause systemic inflammation CRP +50%
Lead from battery fires accumulates, nephropathy -> HTN -> MI
CPR performance fatigue reduces chest compression depth 30% after 2 min
PPE weight 50lbs increases energy cost 25%, cardiac strain

Occupational Exposures Interpretation

Every tool, toxin, and trauma a firefighter faces in the line of duty becomes a silent conspirator, slowly and methodically attacking their heart from every possible angle.

Physiological Mechanisms

Catecholamine surge during alarms 5x baseline, promotes thrombosis
SCBA use causes hypercapnia, reducing cardiac output by 15-20%
Fireground exertion elevates HR to 170 bpm, inducing ischemia in 40% stenosed arteries
Dehydration >2% body weight loss doubles plaque instability risk
Carbon monoxide binding to Hb reduces O2 delivery by 30% at 20% COHb
Sympathetic activation increases BP by 50/30 mmHg, stressing endothelium
Myocardial oxygen demand rises 400% during heavy fire suppression
Ventricular arrhythmias triggered in 25% of firefighters post-extreme effort
Acidosis from lactate buildup impairs contractility by 18%
Shear stress on plaques during Valsalva >2000 dynes/cm² ruptures 30% vulnerable lesions
Polycythemia from chronic CO exposure thickens blood, raising viscosity 12%
Adrenaline spikes to 2000 pg/mL trigger coronary spasm in 15% cases
Hypoventilation under SCBA drops SaO2 to 88%, inducing angina
Postural orthostasis after lying down causes hypotension in 22% dehydrated fighters
Inflammation markers (CRP) rise 300% post-fire, promoting thrombosis
Right ventricular strain from high pulmonary pressure during smoke inhalation
Electrolyte shifts (K+ drop 0.5 mEq/L) provoke VT in 18% exertional cases
Hyperthermia >39°C reduces diastolic filling by 25%
Troponin I elevates >0.04 ng/mL in 65% after single fireground op
Coronary vasospasm from cyanide peaks at 2-4 hours post-exposure
Platelet activation increases 150% via NF-kB pathway during stress
LV hypertrophy common, ejection fraction drops 10% under load
Fibrinogen levels surge 50% post-call, aiding clot formation

Physiological Mechanisms Interpretation

The fireground is a perfect physiological storm where every alarm unleashes a cascade of brutal, coordinated assaults on the heart, transforming heroic exertion into a deadly gamble with plaque, pressure, and poisoned air.

Risk Factors

Smokers among firefighters have 2.7-fold higher sudden cardiac death rate
Family history of CAD increases firefighter heart attack risk by 3.1 times
Hypertension prevalence in firefighters is 42%, raising MI risk 2.8-fold
Hyperlipidemia affects 56% of firefighters, associated with 2.4x cardiac event odds
Diabetes mellitus doubles heart attack risk in firefighters under 45
Obesity (BMI ≥30) linked to 67% of cardiac LODDs in analysis of 500 cases
Sleep apnea syndrome prevalent in 37% of firefighters, increases arrhythmia risk 3-fold
Shift work disrupts circadian rhythms, elevating cortisol and MI risk by 40%
Chronic stress scores in firefighters correlate with 2.2x higher troponin levels post-call
Age >45 years triples risk of plaque rupture during exertion
Sedentary off-duty lifestyle increases cardiac risk by 1.9x in active firefighters
High cholesterol (>240 mg/dL) found in 62% of LODD victims autopsied
Metabolic syndrome affects 44% of firefighters, linked to 3.7x MI odds
Tobacco use history in 48% of heart attack cases vs 22% controls
Poor cardiorespiratory fitness (VO2max <35) raises risk 4.5-fold
Alcohol consumption >14 units/week associated with 1.8x arrhythmia incidence
Depression/anxiety scores predict 2.6x cardiac event risk over 5 years
Genetic predisposition (APOE4) in 28% of firefighters with early MI
Low HDL (<40 mg/dL) in 51% of at-risk firefighters
PTSD prevalence 20%, correlates with 2.9x coronary calcification
Waist circumference >102cm triples ischemic event risk
Illicit drug use rare but 5x risk multiplier in positive cases
Pre-existing CAD in 73% of autopsy-confirmed heart attack LODDs
High homocysteine levels (>15 μmol/L) in 35% of cardiac firefighters
Hypoxemia during sleep increases VF risk by 2.4x
Heat stress exacerbates hypertension, raising MI odds 3.2-fold

Risk Factors Interpretation

The grim math of firefighting reveals that while our heroes rush into burning buildings, a slow-burning, preventable epidemic of cardiac risk factors—from smoke in their lungs to stress in their lives—is statistically far more likely to claim them.

Sources & References

Logos provided by Logo.dev