Indigenous Australians are a socially disadvantaged group who experience significantly poorer health and a higher prevalence of modifiable health behaviours than other Australians. Little is known about the clustering of health risks among Indigenous Australians.
The aims of this study were to describe the clustering of key health risk factors, such as smoking, physical inactivity and alcohol consumption, and socio-demographics associated with clusters, among a predominantly Aboriginal sample.
Participants (n = 377) attending an Aboriginal Community Controlled Health Service (ACCHS) in regional/rural New South Wales, Australia, in 2012–2013 completed a self-report touch screen health risk survey. Clusters were identified using latent class analysis.
Cluster 1 ('low fruit/vegetable intake, lower risk'; 51 %) consisted of older men and women; Cluster 2 ('risk taking'; 22 %) included younger unemployed males with a high prevalence of smoking, risky alcohol, and illicit drug use. Cluster 3 ('inactive, overweight, depressed'; 28 %) was characterised by younger to mid aged women likely to have experienced emotional or physical violence.
If future research identifies similar stable clusters of health behaviours for this population, intervention approaches targeting these clusters of risk factors should be developed and tested for Aboriginal and Torres Strait Islander Australians.
Socially disadvantaged groups, which include many indigenous populations, experience poorer health and lower life expectancy compared to those less disadvantaged [24, 29]. The health of Aboriginal and Torres Strait Islander Australians, the Indigenous peoples of Australia, reflects this disparity . Although the determinants are complex, one of the potentially modifiable contributors to the health gap is the disproportionately high prevalence of health risk factors including smoking, excess alcohol use, poor diet and physical inactivity . Cancer screening [13, 42] and survival rates  are also known to be lower among Aboriginal and Torres Strait Islander than non-Indigenous Australians.
Health risk behaviours do not occur in isolation, and often co-occur or cluster together [15, 21, 40, 41]. Many health risk factors have a synergistic effect, where the combination of unhealthy behaviours increases the risk of disease or mortality more than the effects of the single risk factors [7, 40]. Thus there are likely to be subgroups within any population who are at higher risk of disease or death due to engaging in multiple health risk behaviours .
Information about whether, and which, risk factors group or cluster together can help inform preventive health efforts to avoid or reduce disease [21, 41]. Examining the clustering patterns of multiple modifiable health risk factors and demographics associated with health clusters allows targeting of health prevention interventions towards co-occurring risk factors and for the subgroups most likely to exhibit these risk clusters [22, 50].
Data about the co-occurrence of risk behaviours among Aboriginal and Torres Strait Islander Australians are largely limited to identifying paired associations  or cumulative numbers of risk factors [8, 37, 53, 54]. Almost three-quarters (72 %) of Indigenous adults from non-remote areas reported two or more risk factors including smoking, risky alcohol consumption, physical inactivity and overweight/obesity . Similar rates of multiple risk factors were reported for Indigenous Australians attending an urban Aboriginal Community Controlled Health Service (ACCHS) .
A more comprehensive understanding of the challenges facing Indigenous people, their communities and health services may be gained by identifying specific clusters of health behaviours. Exploring such patterns through techniques such as latent class analysis allows identification of individuals exhibiting common behaviours as well as characterisation of clusters by demographics.
There is a growing body of literature exploring risk clustering across countries and populations. For example, Verger reported five clusters among French adults, including a relatively healthy cluster and four unhealthy clusters characterised by poor diet, smoking, regular alcohol drinking, and binge alcohol drinking . Among an Australian adult sample, French identified a 'safe' and a 'moderate' cluster, along with two risky clusters comprised of risky smokers and risky drinkers . Only one previous study has looked at the clustering of health risk factors among Indigenous Australians . Two clusters for Aboriginal adult men and women were reported: a 'better', and 'worse' cluster- characterised by hazardous alcohol intake, smoking and poor dietary choices . However, a limited range of risk factors and demographics were included. Given the stark difference health gap between Indigenous and non-Indigenous Australians', exploration of a wider range of health risks and socio-demographics is warranted.
The current study explored the clustering of a comprehensive range of risk factors and associated socio-demographics for a predominantly Aboriginal Australian sample. Depression was included as a 'risk factor' as it is a disease that affects many Aboriginal communities  and contributes both directly to the risk of cardiovascular disease (CVD)  and to lifestyle behaviours which increase the risk of developing CVD . Differing results of health risk clustering studies across countries and in particular for different ethnic subgroups [7, 43] highlight the need to examine health risk clusters for different social and population groups . Such information will help inform the planning and delivery of holistic preventive care efforts targeted towards co-occurring risk clusters and at-risk subgroups among people attending ACCHSs, with a focus on Aboriginal Australians.
Socio-demographic characteristics (age, gender, Indigenous status, education level, employment status, and exposure to physical or emotional violence in the last 12 months) significantly associated with identified health risk clusters.
An anonymous, cross-sectional health risk survey was administered on a touch screen laptop in two ACCHSs in regional and rural New South Wales (NSW). Sites were located in major towns, were staffed by Aboriginal and non-Aboriginal staff including doctors, nurses and allied health workers, and provided both on-site and outreach services to smaller or isolated communities. The two services had approximately 1250 and 2400 active patients (at least three visits in the last 2 years) respectively. ACCHSs provide culturally appropriate primary health care to Australian Aboriginal communities , with the majority of people who attend (74 - 86 %) being of Aboriginal or Torres Strait Islander origin [2, 4]. The two ACCHSs in this study represent the majority of those in NSW in terms of regional/rural location and patient numbers . Ethics approval for the study was obtained from the University of Newcastle (Reference: H-2011-0153) and the Aboriginal Health and Medical Research Council of NSW (Reference: 806/11).
Adults (≥18 years) attending the ACCHS for a general practice (GP) appointment who were physically and mentally able to provide informed consent and complete the survey were eligible. Aboriginal1 and non-Aboriginal people were invited to take part, on the assumption that non-Aboriginal people attending an ACCHS are likely have close ties to the Aboriginal community and are also therefore likely to share similar patterns of lifestyle and health risk behaviours.
Participants were approached by a Research Assistant (RA) in the waiting room and invited to complete the survey while waiting for their GP appointment. Assistance to complete the survey was offered as required. An Aboriginal RA assisted with patient recruitment for approximately half of the recruitment period, which occurred over four months in 2012 and 2013. Participants were asked to have their weight and height measured (optional), and were able to exit the survey if called in for their appointment. A RA recorded the estimated age and gender of non-consenting patients to assess consent bias. The survey was pilot tested with ACCHS staff and patients and refined prior to use. Items indicated that the touch screen survey was highly acceptable to people in this setting .
The health risk survey was presented using Digivey Survey Suite software (CREOSO Digivey Survey Centre, Arizona, USA). The survey was designed using simple language and included pictures and limited text in order to improve accuracy and minimise reading demands. For example, a picture showing a standard drinks chart and the number of standard drinks in larger alcohol containers (e.g. cask of wine or carton of beer), was displayed to assist in answering questions about alcohol consumption. Survey software used branching algorithms to tailor questions to individual participants.
Age, gender, Indigenous status, highest level of education completed, employment status, and exposure to violence in the last 12 months were self-reported. Exposure to violence was assessed using two items: a) In the last 12 months, did anyone, including people you know, use physical force or violence against you? (<yes>, <no>), from the NATSISS 2008;  and b) In the last 12 months, did anyone, including people you know, use emotional violence against you, e.g. insult you, swear or scream at you, or threaten to hurt you? (<never>, <sometimes>, <often>), derived from the HITS screening tool . Those who responded 'yes' to a) and/or 'often' to b) were classified as having been exposed to physical or emotional violence in the last 12 months.
Key risk factors which contribute to the burden of disease and injury for Aboriginal Australians were included in the health risk survey . The items used to assess health risk factors, and cut-offs used to dichotomise responses as 'at risk' or not at risk, are shown in Table 1.
Participants with missing values were removed from analysis. A single 'under-screened' variable was created to dichotomise screening status: any participant who was not screened in accordance with guidelines for any of the relevant screening tests was classified as 'under-screened'. For regression analysis, age was re-categorised into three broad groups: 18-34 yrs, 35-54 yrs and 55 + yrs. Analysis was conducted in 2013–2014.
Latent class analysis (LCA) was used to identify clusters of individuals with similar profiles of the eight health risk factors. LCA is a statistical tool used to identify homogeneous, mutually exclusive groups or classes within a heterogeneous population . The latent class model aims to stratify observed variables by an unobserved or latent categorical variable that removes confounding between observed variables . To account for uncertainty in class membership the model assigns each individual a probability of class membership. Each latent class is characterised by its estimated prevalence and the probability of individuals within that class exhibiting each of the health risk outcomes. The latent class regression model permits the inclusion of covariates to predict individuals' latent class membership .
Goodness of fit and interpretability of the clusters were used to decide on the optimal number of classes. The LCA model was fit over a range of class numbers and the Bayesian and Akaike Information Criterion (BIC and AIC) generated for each (with lower BIC and AIC suggesting better goodness of fit) . LCA analysis were performed in R 3.0.1 using the poLCA package [27, 39]. Stata (Statistical Software Release 13 College Station, TX: StataCorp LP) was used for data management and descriptive statistics.
The consent rate was 69 %. There were no significant differences between the age and gender of consenters and non-consenters (p's > .05; data not shown). Non-Aboriginal people were significantly more likely to consent, as compared to the proportions of active Aboriginal and non-Aboriginal patients registered as attending the ACCHSs, χ2 (1, N = 4091) = 9.71, p = 0.002. There were 377 surveys with complete demographic and risk factor data available for the LCA (27 surveys were excluded due to missing values; 3 of these due to refusal to have weight measured). Sample demographics are shown in Table 2.
The risk factor profile of the sample is shown in Table 3. The most prevalent risk was inadequate fruit or vegetable intake (84 %), followed by being overweight or obese (69 %), inadequate physical activity, and being under-screened (each 52 %).
Models with one to four latent classes were estimated without regression variables. Based on the minimal AIC value, the 3-class model was the best fit for the data [AIC (3 class) = 3688; AIC (2 class =3697)]. The BIC indicated a 2-class model was the best fit [BIC (2 class) = 3753; BIC (3 class) = 3792]. The 2-class model consisted of two groups based on high prevalence of risky health behaviours, or high prevalence of overweight/obesity. The 3-class model presented a richer grouping of risk factors (discussed in detail below), including division of the overweight cluster into a sub-cluster distinguished by depression and lack of physical activity. The 3-class model was deemed to be more interpretable and was therefore decided to be the preferred model. When covariates were included in the latent class regression model, the 3 class model also had the minimal Chi-square goodness of fit value (χ2 = 274.80), indicating the preferred model on this criterion .
Class 1- Low fruit/vegetable intake, lower risk (51 %): had the highest prevalence of poor diet characterised by inadequate fruit or vegetable intake, and a relatively high prevalence of being overweight, although not as high as class 3. Class 1 had the lowest prevalence of other risk factors including smoking, risky alcohol intake, drug use, depression, and under-screening.
Class 2- Risk taking (22 %): had the highest prevalence of behaviours including smoking, risky alcohol and drug use. Class 2 also had a relatively high prevalence of low fruit/vegetable intake, but was associated with the lowest prevalence of inadequate exercise and being overweight.
Class 3- Inactive, overweight and depressed (28 %): had the highest prevalence of inadequate physical activity, being overweight and depression. Class 3 had the lowest relative prevalence of having a poor diet, although the majority of this cluster still reported inadequate fruit and vegetable intake. Class 3 had a low to moderate prevalence of all the other risk factors including smoking, risky alcohol and drug use.
All three clusters were associated with a similar prevalence of under-screening.
Class 2-Risk taking: had significantly higher odds of being male, being aged less than 55 yrs, being unemployed and of having been exposed to violence in the last 12 months. There was a non-significant trend for those in the risky cluster to have Year ten or below schooling compared to a TAFE/other qualification.
Class 3-Inactive, overweight and depressed: had significantly higher odds of being female and of having been exposed to physical or emotional violence in the last 12 months. There was a non-significant trend towards class 3 having higher odds of being aged 35-54 yrs compared to age 18-34 yrs.
Three distinct clusters of health risk factors, distinguished by socio-demographic characteristics, were identified within this predominantly Aboriginal sample. Aboriginal status was not a significant predictor of class membership, suggesting the risk patterns observed here may be a strong reflection of the overall social disadvantage of the client group of the ACCHSs, and that intervention approaches targeting the clusters reported here would be appropriate for the entire ACCHS client base (and not only for Aboriginal patients).
There is very little previous research exploring the clustering of risk factors among Aboriginal communities. Burke et al. identified a better and 'worse' cluster for both males and females . Our study confirmed a clustering of alcohol, smoking and poor fruit/vegetable intake, but more strongly for males than for females. Additional clusters based on lower-risk plus poor fruit/vegetable intake, and physical inactivity, overweight, and depression, also emerged. As Burke et al. did not assess body mass or depression, their study could not have identified these additional clusters of risks factors.
Health risk cluster studies in other populations have tended to report a 'healthy' cluster, together with various numbers and types of unhealthy clusters [14, 16, 22, 25, 28, 43, 49]. Unhealthy clusters range from those based primarily on physical inactivity, [14, 25] poor nutrition, [16, 49, 55] risky alcohol, [22, 43, 49, 55] smoking, [22, 49, 55] to both smoking and risky alcohol . Variable associations with physical inactivity have also been reported: Poortinga (2007) found that higher physically activity clustered with smoking and drinking,  while others have reported the opposite . These disparate clustering results emphasise difficulties in comparing across studies using different analytical approaches, risk factors and definitions of risk [7, 40]. They further emphasise the potential lack of generalizability of such results, and the importance of conducting research for specific populations, such as Indigenous Australians.
Reported predictors of health risk clusters also vary across studies. Young males tend to be in clusters characterised by smoking and/or risky alcohol, [7, 10, 14, 49, 50, 55] or to have a greater numbers of risk factors  Women tend to be in healthier clusters, although some studies report female gender associated with clusters characterised by physical inactivity,  poor diet,  smoking,  or even with a more pronounced clustering of risky behaviours than men . Older age tends to be associated with less risky behaviours, as does higher education, income, and other measures of higher socio-economic status [7, 10, 14, 16, 21, 22, 25, 28, 41, 44, 45, 49, 50].
Our demographic results are broadly consistent with these previous findings regarding gender and socioeconomic status, although there was no significant relationship between education level and cluster membership. Regarding depression and preventive screening, previous work reports an association between lower psychological distress or depression [14, 21, 45] and healthier clusters . Lower compliance with preventive screening or medical check-ups was associated with clustering of other risky behaviours,  or with an 'inactive' cluster among a sample of women . In contrast, we found that depression was associated specifically with inactive and overweight women, rather than with more risky behaviours or with poor diet. We found no substantial differences in screening behaviours across clusters [23, 25]. However, our measure of under-screening may not have been sensitive enough to reveal differences between clusters.
Several study limitations should be noted. Reliance on self-reported risk factor status may affect the accuracy of our results, including potential social desirability bias. Although validated measures were used where possible, [19, 46] many show only moderate sensitivity and specificity (such as short measures of physical activity or diet), and most have not been specifically validated for use with Indigenous Australians. The cut-offs used to dichotomise risk status (based on national guidelines) classified a large proportion of the sample as at-risk. Different clustering patterns may have resulted if we had restricted 'at-risk' status to, for example, obese participants, or to the consumption of less than five (vs seven) serves of fruit and vegetables per day. Finally, the small sample size, rural/regional setting, and inclusion of non-Aboriginal participants, may limit the generalisability of our results to other settings, such as for Aboriginal Australians living in urban areas.
Our clustering results support the idea that this population could benefit from interventions targeting multiple, related health risk behaviours, either simultaneously or sequentially [43, 49]. Alternatively, interventions aimed at addressing single risk factors may need to consider other risk factors which are likely to be present . The relatively small variation in fruit and vegetable intake and under-screening across the sample suggests that almost all people attending an ACCHS would benefit from improved diet and screening. About a quarter of clients (typically younger, unemployed males), appear most likely to benefit from targeting risky behaviours such as smoking, alcohol and drug use; but with an aim to maintain healthy BMI and exercise levels. About a third of clients, particularly overweight women aged 35-55 yrs, may benefit from an intervention approach which targets, or at least considers, the impact of depression and role of physical or emotional violence on physical activity levels and body weight. Finally, just over half of ACCHS clients, particularly those aged over 55 yrs, may require assistance focusing mainly on diet and weight. Our results further suggest that social change focusing on employment and reducing stress and violence may produce additional health benefits for Aboriginal communities. Given these patterns, it should be possible to design and tailor programs which cater particularly for the client groups most likely to need them.
Although multiple behaviour change interventions have shown potential for improving health,  evidence about their effectiveness remains limited, [18, 40] particularly for Aboriginal and Torres Strait Islander populations . Further research including Aboriginal communities from a diversity of settings is required to establish whether the clustering patterns reported here are generalizable more broadly. If future research identifies similar stable clusters of health behaviours for this population, intervention approaches targeting these specific clusters of risk factors should be developed and tested for Indigenous Australians.
1Our sample included two participants of Torres Strait Islander origin and five participants of both Aboriginal and Torres Strait Islander origin. As the study was conducted in New South Wales, we have used the term 'Aboriginal' refer to all of the Aboriginal and Torres Strait Islander participants, following the guidelines of the New South Wales (NSW) Department of Health, in recognition that Aboriginal people are the original inhabitants of NSW .
Many thanks to all the staff (in particular the CEOs, Leanne Dryden, Steve Terrey, Jill McDonald, and the reception staff) who supported this research, and to the participants who kindly completed the survey and made this study possible. Many thanks also to L/Prof Rob Sanson-Fisher for valuable input into the project.
NN developed the study materials, conducted data collection, undertook analysis and interpretation of the data, and drafted the manuscript. CP made substantial contributions to the study conception and design, provided support during data collection, and assisted with drafting and revision of the manuscript. NT and SB provided feedback on study design and specific study materials, facilitated and provided assistance with data collection, and provided critical feedback and revision of the manuscript. CO provided expert advice and oversaw statistical analysis and provided critical feedback and revision of the manuscript. HT made substantial contributions to study implementation and provided critical feedback and revision of the manuscript. All authors have given final approval for this version of the manuscript to be published.


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text:
LAIRDSVILLE LIVE BURN DEATH
ghettotruckster
I AM AN ASSISTANT INSTRUCTOR ON A LIVE BURN TEAM IN ERIE COUNTY, NY. TO DATE IN OUR TRAINING , OVER 20 BURNS IN 3 YEARS, WE HAVE NEVER ( KNOCK ON WOOD) HAD A SINGLE INJURY INCLUDING MINOR SCRAPES BURNS ETC.WE PRIDE OURSELVES IN THIS FACT. I CANNOT FATHOM HOW ANY MEMBER CAN ACT AS A VICTIM IN SUCH A SCENARIO SEEING THAT THE OUTCOME OF THE RED DEVIL IS VERY UNPREDICTABLE.WE WOULD NOT CONSIDER DOING SUCH AND WE HAVE SOME VERY SEASONED TRAINING PERSONNEL ON OUR TEAM INCLUDING SEVERAL PAID FIREFIGHTERS.THE DEATH OF AN 18 YEAR OLD VOLUNTEER ( WHO IS MORE THAN LIKELY INEXPERIENCED) PROVES THAT FOOLING WITH THE FIRE CAN BE DANGEROUS.THIS DEATH WAS TRAGIC AND UNCALLED FOR AND HOPEFULLY THIS WILL NOT REFLECT NEGATIVELY ON THOSE LIVE BURN TEAMS THAT CONDUCT SUCH TRAINING WITH SAFETY AS THEIR #1 CONCERN...
GeorgeWendtCFI
MembersZone Subscriber
Your attitude about the "unpredictable" "Red Devil" is exactly the reason that FF continue to die in training fires. It has happened before and will happen again if people don;t start to learn and remember the basics of fire dynamics.
The outcome of this incident 1000% predictable. How many room and contents fires do we go to that involve upholstered furniture? How many of them go to flashover in a short time? Answer: A whole lot of them. Why should this fire have acted any differently? Because it was a training fire? The science of fire is the same whether it is a job or a training fire.
Please tell me exactly what standard or recommended practice calls for using upholstered furniture as the source of smoke? Don't waste your time, you won't find one.
You want a shock? Go to the web page for the National Institute of Standards and Technology's Bureau of Fire REsearch Laboratory. Navigate through the site and look up the heat release rate for a typical sofa bed. Then tell me if this was "unpredictable".
PROUD, HONORED AND HUMBLED RECIPIENT OF THE PURPLE HYDRANT AWARD - 10/2007.
distchief60b
District Chief
First and foremost....our thoughts and prayers go out to the department as well as all of the families involved in this horrible event. I have a teenage son involved in firefighting and this hits home! We pray for you and god bless you in this troubled time.
As a firefighter I am saddend by this tragic death as are others. As an instructor...I am also saddened...but you can add in appalled!
Tragic...YES....We are working for "0" tolerance for firefighter fatalities...remember? To have a brother pass in a training incident is totally uncalled for... We are supposed to be training them....not killing them.
The cause of this can be discussed for ever and we can what if it until the next milenium. Bottom line is...READ NFPA 1403...What does it say about using "live victims?"
My opinion only
[ 10-01-2001: Message edited by: captstanm1 ]
09-11 .. 343 "All Gave Some..Some Gave ALL" God Bless..R.I.P.
IACOJ Minister of Southern Comfort
"Purple Hydrant" Recipient (3 Times)
BMI Investigator
The comments, opinions, and positions expressed here are mine. They are expressed respectfully, in the spirit of safety and progress. They do not reflect the opinions or positions of my employer or my department.
Dalmatian90
-- "Live victims" and "Live fire" never, ever mix. Even if you can't afford a smoke machine or smoke bombs...put a Nomex hood on backwards to blackout your mask for "rescue exercises." Without even the risk of fire flashing over, you still have a risk of smoke inhalation if the victims' SCBA mask gets knocked off during the rescue evolution.
Rescue & Fire Suppression are two different topics, and each should be taught alone so you can concentrate on that situation. Doing rescue training with your attention divided means you might not see something that hurts the victim. Doing fire training with something else going on means you may not see a dangerous situation develop. If you mix, use a dummy so you can concentrate on the fire known the victim can't get hurt.
-- Never, ever use any petroleum based products of any kind in a training fire inside a structure. That means no kerosene, diesel, plastic, etc. If you have old furniture, use them as search obstacles in a room remote from the fire rooms. Remember, the smoke put out by petroleum based products contains a lot of unburned fuel. The smoke put out by Hay & Pallets doesn't contain much unburned fuel. Take a guess which one is likely to suddenly intensify with added heat or added oxygen or both.
IACOJ Canine Officer
kfd232
Rescue Randy.
amazingly he was designed for that very purpose. better yet... he doesn't die from smoke inhalation or burns. I've only been in the fire service for about 5.5 years but have been involved in plenty of live fire training. I was shocked to read about this tragic loss. Uncalled for, sad, tragic, and after reading the fire company vice presidents quote, outraged.
"He just joined (September) 20th. He was only on two controlled burns and now he's gone. It's sad that we have to lose young guys like that," said fire company Vice President John Klein.
I say to you Mr. Klein this:
YOU DON'T HAVE TO LOSE YOUNG GUYS LIKE THAT!!!
Further more...
A rookie with 2 months experience ever being put into this situation is absolutely crazy!
If you, Mr. Klein, feel that firefighters have to die like this anywhere at anytime you sir need to not ever be associated with the fire service again. Good Day to you Sir!
I'm sorry for being angry, but it hurts me to see a life wasted that way.
Be safe brothers
PAVolunteer
I absolutely agree with the other posts on here that, most likely, this could have been prevented. On the other hand, none of you were there (unless you were and haven't said so yet), so you don't know first hand what happened. Let's not play Monday morning quarterback and condemn them for what's already happened. Let's just learn from it and not let it happen again. We all know that hindsight is 20/20.
Lt206Cove
Hello from West Virginia! First off, I have been in the fire service for 19 years. During that time, I have seen many changes. I can recall when there were few if any burn standards for live burn training. That has all changed as I am sure it has for most states. Live burns are few and far between due to these strict standards. In May, I attended a live burn in Charleston, West Virginia. These instructors followed the standards to a "T" to prevent students from injury. They used skids for the live burn training in a "controled" burn within a structure.
It is my understanding that this guy only had about a week in the department and should not have been put in a scenario like this. Live burn and rapid intervention are two seperate levels of training as far as I am concerned. In West Virginia there are a list of pre-requisites (sorry for the spelling error) that most instructors require before you are allowed to take a live burn course. As for rapid intervention; Jim Crawford from Pittsburgh Fire, PA. taught my class and in my opinion set the stage for RIT standards to be developed. When I took his course, we used simulated smoke from smoke machines. It was an intense course which required some experiance even in a simulated environment. It is beyond me to think that while under live fire, instructors chose to run a rapid intervention scenario with firefighters with little experiance. In my department the vast majority is simulated environments to build the firefighters experiance level prior to taking an advanced course where live fire conditions exist. It has proven very successful. Our Chief then evaluates if he/she should take the advanced course based on their simulated training and over all ability.
Bottom line,... I think that there should be standards set by each department for training each member and building them up to the level where they can be placed in "Live Burn" training. I also feel that the standards for live burns need to be revisted and revised. However, there is no better training then the true structure fire. Even then, firefighters need to meet certain criteria before entering a building.
DSmits
OK at times I tend to agree about the Monday morning quarterback issue but apparently WE AINT LEARNING. The standard on live fire training has many safety issues in it. I would find it hard to believe that 10 people on scene (quoted from the article) was sufficient. Two fires? What are they nuts? Why don't we throw in a chemical weapon or two, a bus into the house and a few more things. Somebody didn't have the proper backup. Someone apparently doesn't realize that upholstered furniture is dangerous. Someone DIDNT read the standard. Someone has sadly been killed unnecessarily. It is time for EVERYONE to also learn more about building construction. It WILL get you killed boys and girls. Get it through your heads. I don't like some of things in the standard either but I know their necessary. Just as a note we used a MSA camera last time for liver training to watch the crews and we were able to identify a F/F that was getting quite apprehensive. Now that we have the remote TV for the camera I believe we will be able to conduct training even safer. It may even be a good thing for us to recommend be added to the standard.
I am not monday morning quarterbacking anything..... I simply asked about NFPA 1403 and was it used? I dont know what happened...and I dont care... You can call it Monday morning QB if you like...but...if it stops another fumble....then...hmmmmm...maybe someone paid attention...
WE are losing too many people.....
Part of the problem is not identifying "near misses" or as some more accurately call them "near catastrophes." The fire service as a whole does not document when we did something that we shouldn't have and got away with it. Mostly due to human nature, we don't want to put on paper when we screwed up, but are still around to talk about it. Who knows, Lairdsville, and other departments, may have done this exact same scenario a hundred times in the past, but never changed an unsafe act due to the fact that no one got hurt. Things will certainly change now.
Once we swallow our pride and start acknowledging that certain things that we do all the time are unsafe, and we shouldn't be doing them, accidents like this will unfortunately continue to occur. In our department, we have changed SOP's significantly over the past year (or two) from unsafe practices (which we never really thought about because nothing ever happened), to practices, when compared to the ways of the past, are much safer.
Also, it was my understanding that the couch was on the first floor and was supposed to be controlled by a handline, and a burn barrel was on the second floor to create smoke. Does this make it any better? Probably not. However, we have to remember that no one meant for this to happen, and at the time the instructors/trainees thought that the level of risk was acceptable ... something just went terribly wrong. Does this mean we don't learn from it? Absolutely not.
FireCapt1951retired
I was an instructor for over 16 years and I would never have considered using a live victim in a burn. This should not have been done.
I was always taught by the instructors that trained me to use dummies and if you couldn't afford one use 2 1/2" line and dress it in bunker gear. Actually works pretty well, just takes time to make it.
The instructors screwed up by allowing someone with little or no experience to even be the victim and worse yet, they didn't leave an instructor with the individual. I still wouldn't condone the use of live victims.
This was a bad idea from the start and I think the instructors are in a world of [email protected] right now and would imagine that this will effect them for the rest of their lives.
Never use live victims in a live burn scenerio period!
[ 09-28-2001: Message edited by: FireLt1951 ]
smokebstr
How can anyone claim to be running a controlled burm drill in a building where you are igniting materials, especially a couch or sofa. We do live burns in computer controlled buildings. We use natural gas or propane as a fuel and shutting down a scenerio is no harder that hitting a panic button in any given room. To believe that we can control a fire that would require the use of water to extinguish is taking to much of a risk, and obviously we now know, if we didn't before that you cannot predict how the fire will burn. In this day and age of smoke machines why would anyone opt for a hard to control, or predict live burn.
This is an edited version of my post to another thread about this murder when someone asked about the press article on this.
Here is the text of an article. My comments follow:
New York Firefighter Perishes In Training Exercise
KEN LITTLE
The Observer Dispatch
WESTMORELAND -- Investigators are trying to determine how a training exercise fire burned out of control Tuesday night, killing a Lairdsville firefighter and seriously injuring two other volunteers.
Bradley Golden, 19, of McQuade Avenue, Clinton, died on the second floor of a vacant house at 7355 Route 5 as smoke and flames quickly filled the structure about 7 p.m. He was pulled from the wood-frame building by firefighters and rushed to St. Elizabeth Medical Center, where he was pronounced dead, authorities said.
An autopsy performed Wednesday night at St. Elizabeth Medical Center showed Golden died of asphyxia due to smoke inhalation, Oneida County Coroner Mark Bentz said. Golden's death was ruled accidental, he added.
Adam Croman, 19, son of Lairdsville Fire Chief Lance Croman, jumped from the second floor of the burning structure. Benjamin Morris, 19, was pulled from the second- floor area by firefighters. Croman and Morris suffered burns and other injuries and were airlifted to the burn unit at University Hospital in Syracuse. Croman was listed in serious condition Wednesday night and Morris was listed in fair condition, a hospital spokeswoman said.
A steady stream of Lairdsville volunteers and supporters checked in Wednesday at their Norton Avenue station to discuss the tragedy. Croman stopped by briefly before visiting his son in the hospital. Croman described the training session as a "rapid intervention team exercise" conducted by the Lairdsville, Westmoreland and Lowell fire departments.
"We were simulating having down personnel and the other two companies were going in to get the down personnel," said Croman, who was able to speak with his son after the incident.
"He told me he pushed them toward the stairs and he jumped out the window with a full pack on," Croman said. "For some reason we don't know, the other two didn't make it out."
Adam Croman and Morris were experienced members of the Lairdsville Fire Department, each with several years service. Golden had been with the department about one month and was a provisional member, officials said.
Golden was enthusiastic about being a firefighter and helping others, Croman said.
"He loved it. He thought this was the greatest thing in the world," Croman said. "Somebody had asked him where he was living and he told him jokingly that he was living at the firehouse."
Investigators from the Oneida County Sheriff's Department, the state Office of Fire Prevention and Control, federal Occupational Safety and Health Administration and other agencies went through the charred red structure Wednesday.
"We're working with all the agencies to find out what happened," said sheriff's department Lt. Joseph Lisi. Robert Walsh, first assistant chief and safety officer at the Westmoreland Fire Department, said Wednesday controlled fires were set on the first and second floors. The fire on the first floor got out of control, went up the walls and staircase of the structure and trapped the three men upstairs, he said.
"The couch just started burning out of control and it went right up the stairs," Walsh said.
Tuesday night's fire was started on the first floor in a queen-size sofa bed, while the fire on the second floor was ignited in a container, Walsh said.
About 10 firefighters were on the scene when the fire flared up, Walsh said, with water close at hand and constant radio contact being maintained.
"It was the same drill situation as before, but something went terribly wrong," Walsh said.
It was at least the third training exercise at the vacant home on Route 5, which was scheduled to be taken down in a controlled burn exercise in October, Klein said.
Lairdsville was in charge of the drill, Walsh said. The fire company has been taken out of service, with neighboring companies answering Lairdsville's calls, officials said.
"It's somber plus here right now," Croman said. "Our department is out of service until the funeral, at the very least."
Adam Croman attends Onondaga County Community College and studies fire protection services while serving as a Moyers Corners firefighter, his father said.
John Talerico, a former Lairdsville firefighter and a friend of Croman, was one of many who stopped by the firehouse Wednesday.
"He was going to be a professional," Talerico said. "He was dedicated. This is what he was going to be." Morris, he said, recently enlisted in the Marine Corps and planned to begin service in December.
The American flag was back at half staff Wednesday outside the Lairdsville and Westmoreland fire stations, after having been in the same position for several weeks in honor of the victims of the terrorist acts Sept. 11 in New York City and elsewhere.
"A lot of firefighters are shook up. Everyone's devastated," Walsh said.
At the fire scene Wednesday, neighbor Christine Stockbridge stood at her door and surveyed the nearby charred structure where Golden died.
"Nobody in the world would dream this would happen," said Stockbridge, who once lived in an apartment in the burned-out building.
Stockbridge said her grandson is a Clark Mills firefighter. She appreciates the sacrifices they make. "You wouldn't want them to quit," she said.
Contributing: Observer-Dispatch reporter Bill Farrell
This story breaks my heart because this kid did not have to die. There have been at least three, serious, live burn training incidents involving deaths or serious injuries that mirror this incident. One was in Milford Michigan, one was in Boulder, CO and one was in Parsippany, NJ. In each and every one the people running the drill did not recognize the hazards of heat release rates and flashover. That is what happened here. What is the thought process behind someone lighting a sofa bed on fire in an acquired structure to "create smoke".
Am I bashing? You bet. I investigated the Parsippany, NJ incident. Three recruit fire fighters recieved disabling burns when they were sent into a school bus, with metal plates welded over the windows with a foam rubber couch burning in it, as a "smoke house". The fire also involved two garbage bags of shredded paper, a tire, two barrles of wood and a wooden door. The bus flashed over 30 seconds after the were sent in and trapped the men. My agency presented a case to a Grand Jury seeking to charge the instructors with Aggravated Assault and Attempted Murder. The grand jury instead issued a presentment that ended up changing the face of fire service training in NJ.
I wrote an article on this case that appeared in the March 1994 issue of Fire Engineering Magazine. Here's the last paragraph of my article.
"This incident and the firefighter injuries were caused by a foreseeable series of events resulting from a disregard of safety procedures and standards by the fire officials involved. The mistakes made in this incident have been made before and will be made again unless an effort is made to educate the fire service community and strengthen existing regulations. Perhaps this incident can be the impetus behind that change."
I wish I weren't so right. You see, it isn't Monday Morning Quarterbacking when there are so many details that mirror so many past incidents. There is an enormous segment of the fire service that never reads the journals, never goes to schools and looks at those who do with disdain. unitl we get rid of them, this type of tragedy will continue to happen.
WEll.....I will add some fule to this fire....here is an extraction from an EMAIL I received. The person obviously has checked into this tragedy based on the information he/she sent me. I will not give his name...but...it is obvious he/she has read this Forum and the person will eventually give us more information... Read and sit down...you will not believe this...
.....I payed a visit to the two firefighters who survived in the crazy incident.[B].......It sounds like your already ****ed off about this so this will really prime your pump. Not only did they not have a handline in place, but they didn't even have apparatus at the drill site! The apparatus was stagging at the firehouse 2 miles away awaiting a call from the crew to get started to the drill site once the fire was set.
When the companies arrived the house was rocking and the guys were trapped and burned. The rest of the story would **** you off even more so thats all I'm going to tell you........
The above was copied and pasted out of the EMAIL I received.... If it is true....then....someone needs to be in some serious trouble.
Well guys, if what captstanm1 said is true, I retract everything I said regarding "Monday Morning Quarterback" and not second guessing because we weren't there. If this is true, I absolutely agree w/ Mr. Wendt, whoever was in charge should be in jail. What a terrible situation ...

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