When the roof of a burning house collapsed beneath Modesto firefighters James Adams and Jason Clevenger earlier this month, it offered a reminder that fighting fires is one of the more dangerous jobs.
They were fortunate they work on crews trained to react to just such a circumstance, and who quickly got them out of the garage inferno at 2305 Coston Way. Those countless hours of training and response are the reason Adams and Clevenger are recovering at Sacramento's University of California Medical Center, being treated instead of being memorialized.
Every year, roughly 100 firefighters die in the line of duty in the United States. But the single biggest reason isn't collapsed floors, ceilings or walls in the buildings.
Try heart attacks and other cardiac-related issues.
A 2007 study by the New England Journal of Medicine showed that heart attacks claim 45 percent of firefighters who die in the line of duty. Likewise, the National Institute for Occupational Safety and Health reviewed 439 incidents that resulted in firefighter deaths nationwide from 1984 to 2008. Nearly 160, or 36 percent, were attributed to cardiac problems.
The second-greatest cause? Vehicle accidents -- firetrucks rolling over on the way to fires, irresponsible drivers hitting firefighters at the scene. Some died because they were ejected from vehicles en route to an incident. One firefighter died when a car crashed into the firehouse door, pinning him between the door and a parked engine. In another strange case, a junior firefighter was struck by a car while riding his bicycle to battle a blaze.
Many of these deaths, cardiac and vehicle, involved volunteer firefighters who often don't get the same levels of training -- professionally and physically -- as full-time career firefighters, said Jim Brinkley, director of communications for the Washington, D.C.-based National Association of Firefighters.
Cardiac issues, he said, might happen while fighting a fire but also could occur en route or after returning to the station.
"When you look at the cardiovascular (issues), you might have an 80-year-old volunteer calling bingo, then going to a fire and having a heart attack," Brinkley said. "A volunteer department is a part-time organization. They aren't on duty 24 hours a day (shifts). They put in time when they can. With career departments, there are better wellness programs, medical evaluations, fitness evaluation, rehabilitation and behavioral health (programs)."
The heart problems occur for a number of reasons, from the stress of the job to the smoke and chemicals the firefighters might inhale during a fire to cholesterol issues a firefighter might develop with age, said Hugo Patino, battalion chief with the Modesto Fire Department.
Modesto's department consists entirely of paid, full-time firefighters. A fitness incentive program was lopped because of budget cuts a couple of years ago.
"If you went to the annual fitness program, the department would fund your gym dues," he said.
But since that funding evaporated, the department has increased the amount of exercise equipment at each station, and the firefighters are given time to work out. Some firefighters work with personal trainers at the stations, and others lead peer physical training programs. Yet others pay for their own gym memberships.
The result, he said, is reflected not only in stronger hearts but stronger firefighters.
"I cannot remember the last time it happened to us," Patino said, referring to a Modesto firefighter suffering a heart attack on the job.
Because firefighters in good physical condition are better able to avoid injury or worse while training to do the technical things the job requires.
Such as rescuing two of their best friends from a burning building.
Jeff Jardine's column appears Sundays, Tuesdays and Thursdays in Local News. He can be reached at firstname.lastname@example.org or 578-2383.