title: Surveillance of traumatic firefighter fatalities: an assessment of four systems.
abstract: OBJECTIVE
  Firefighters regularly respond to hazardous situations that put them at risk for fatal occupational injuries. Traumatic occupational fatality surveillance is a foundation for understanding the problem and developing prevention strategies. We assessed four surveillance systems for their utility in characterizing firefighter fatalities and informing prevention measures.
  
  
  METHODS
  We examined three population-based systems (the Bureau of Labor Statistics' Census of Fatal Occupational Injuries and systems maintained by the United States Fire Administration and the National Fire Protection Association) and one case-based system (data collected through the National Institute for Occupational Safety and Health Fire Fighter Fatality Investigation and Prevention Program). From each system, we selected traumatic fatalities among firefighters for 2003-2006. Then we compared case definitions, methods for case ascertainment, variables collected, and rate calculation methods.
  
  
  RESULTS
  Overall magnitude of fatalities differed among systems. The population-based systems were effective in characterizing the circumstances of traumatic firefighter fatalities. The case-based surveillance system was effective in formulating detailed prevention recommendations, which could not be made based on the population-based data alone. Methods for estimating risk were disparate and limited fatality rate comparisons between firefighters and other workers.
  
  
  CONCLUSIONS
  The systems included in this study contribute toward a greater understanding of firefighter fatalities. Areas of improvement for these systems should continue to be identified as they are used to direct research and prevention efforts.
authors.affiliation: Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Safety Research, Surveillance and Field Investigations Branch, 1095 Willowdale Rd., MS-1808, Morgantown, WV 26505, USA. cestes@cdc.gov
authors.forename: Chris R
authors.initials: CR
authors.lastname: Estes
authors.forename: Suzanne M
authors.initials: SM
authors.lastname: Marsh
authors.forename: Dawn N
authors.initials: DN
authors.lastname: Castillo
mesh_terms: D000062:Accidents, Occupational / Q000401:mortality*; D000293:Adolescent; D000328:Adult; D000368:Aged; D003625:Data Collection / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D005390:Fires / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016272:Occupational Health; D014481:United States / Q000453:epidemiology; D014947:Wounds and Injuries / Q000401:mortality*; D055815:Young Adult