The military got it right, and the fire service -- long considered a paramilitary culture -- has emulated good behavior.

Of course, I am talking about the recent stand down for firefighter safety. Long practiced in the military when planes or helicopters fall from the sky or when Navy captains run their ships into other ships at sea, a stand down is held to review existing policies and practices to determine if they are applicable in today’s world. The fire service adopted this stand down position after noticing an alarming increase in the rate of firefighter deaths this year.

The fire service has a tradition of adopting safety practices. Countless articles published by individuals offer worlds of experience to promote safety practices for our industry. Coupled with OSHA and state regulations, we strive to create the ultimate safety environment to prevent firefighter fatalities with rules, regulations, policies, training, high-tech equipment, good strategic planning and good leadership.

The environment we can’t control, however, is the firefighter. The highest death toll is not from building collapse, vehicle accidents, falls or entrapment, but from death the old fashioned way -- cardiac arrest. A recently published 10-year study by the National Fire Protection Association found that about half of American firefighters who died of sudden cardiac arrest or suffered heart attacks had known heart conditions and about 75% had heart conditions that simple medical testing could have detected. According to the study of firefighter line-of-duty deaths from 1995 to 2004, 440 firefighters or 43.7% of those who died on the job, experienced sudden cardiac death, typically triggered by stress or exertion. The study also revealed that 308 of those firefighters for whom medical data was available, 134 had previously suffered a heart attack, undergone bypass surgery or had other cardiac surgical interventions and an additional 97 firefighters had severe blockage of the coronary arteries, although that may have been an unknown factor prior to death.

What are we doing to prevent this unnecessary loss of life? We have created programs to address this issue. We have formulated and promoted the Wellness Fitness Initiative; we are training peer fitness trainers, purchasing fitness equipment for the fire stations, encouraging fitness programs on duty, and urging our firefighter to eat better, not to smoke and evaluate their risk factors.

What are the firefighters doing for themselves? It’s hard to tell. Some departments have successfully implemented Wellness Initiatives and medical screening, including physical evaluations. The results have been surprising: the consensus is that most firefighters are healthy and there are few silent medical problems found on most of those evaluations. Other firefighters undertaking a medical evaluation have discovered some correctible hidden health problem and had them corrected. For a few, the medical problem is so severe that even after correcting the medical problem, the firefighter was unable to return to work and had to retire or find other employment.

The prospect of forced retirement may be driving many firefighters away from seeking preventative medical examinations. It’s an understandable fear: “What happens to my family if I can’t work?” There may also be a more perverse notion at work: “If I die on the job, my family will be taken care of for life.”

Realize that medical issues are not only about you and some selfish motivation or fear of the unknown – it’s about your family, your fellow firefighters and of the community that depends on your health and fitness.

This year as of June 9, 26 firefighters have perished by heart attack and 30 from other causes. This is at a rate of 9.3 firefighters dying per month and of those dying nearly 50% were from a heart attack.

What should we do? I encourage every firefighter to get a comprehensive medical evaluation from a physician who knows what you do for a living. Detect those correctible conditions – hypertension, diabetes, coronary artery disease, colon cancer, prostate disease and other career- and life-ending conditions. Get into the gym and start a comprehensive cardiac- and strength-building program. Seek financial assistance from your insurance carrier or other grant programs to fund these efforts. Eat better, quit smoking, wear your seat belt and pay attention to yourself. You only get one life.

Get out of the dark ages of denial and create a personal stand down for wellness and fitness. Seek appropriate medical intervention and save your life. Do it today, because tomorrow may be too late.

Deputy Chief John K. Murphy has been with Eastside Fire & Rescue since 1988 and has been in the fire service since 1974. Murphy is the deputy chief of support services and the administrative fire chief for the City of Sammamish, Wash. He was a paramedic firefighter for more than 20 years and a practicing physician’s assistant since 1977 in family and emergency care. He is also an adjunct instructor for Central Washington University’s paramedic program and a frequent speaker on legal and medical issues at local and national fire service conferences. A fellow of the American College of Clinicians, Murphy received physician’s assistant training from the University Of Utah School Of Medicine, and bachelor’s and master’s degrees from Central Washington University. He is also a graduate of the Executive Fire Officer Program at the National Fire Academy and holds a law degree from Seattle University School of Law.