Occupational Health, Safety and Medicine

Occupational Health, Safety and Medicine

The IAFF remains the leader in every fire fighter safety initiative for nearly a century. Our mission is to develop and disseminate knowledge within the fire service so fire fighters, paramedics and EMTs can recognize and control the safety and health hazards and occupational medicine issues associated with the profession.

The Occupational Health, Safety and Medicine Division is led by Assistant to the General President Patrick Morrison, Health and Safety Director Jim Brinkley, Deputy Director Larry Petrick Jr., an executive secretary, secretary, Burn Fund coordinator and Burn Fund assistant. We also have 16 District Burn Coordinators to assist our members in time of need.

Fire fighting remains one of the most hazardous occupations in North America. Our work entails sporadic high levels of physical exertion, uncontrolled environmental exposures and psychological stress from observing intense human suffering. Fire fighters experience inordinate numbers of line-of-duty deaths, deaths due to occupational diseases (especially cardiovascular, lung and infectious diseases, and certain cancers), forced medical retirements and line-of-duty injuries.

Since the last Convention, more than 290 of our members have died in the line of duty. Each year, tens of thousands of IAFF members are injured while fighting fires, effecting rescues, mitigating hazardous incidents and training for their jobs. It is for these reasons that we must continue our mission to make this dangerous profession as safe as possible.

We are at the immediate call of every IAFF affiliate at the most difficult time known to any fire department – the death of one of their own. We also provide direct technical assistance, review National Institute for Occupational Safety and Health (NIOSH) investigations and coordinate and assist with the federal benefits (Public Safety Officers’ Benefits – PSOB) and Line-of-Duty Death programs. This is more evident than ever with the six multiple line-of-duty deaths just in the last two years. Since we assembled in Philadelphia at our last Convention, we have assisted Bryan, TX Local 1204; Indianapolis, IN Local 416; Houston, TX Local 341; Prescott, AZ Local 3066; Toledo, OH Local 92; and Boston, MA Local 718 after multiple line-of-duty deaths. It is also the first time in our history that we experienced multiple line-of-duty deaths on the same day in two cities (Indianapolis and Bryan) on February 16, 2013. And, we had the largest loss since 9/11 when 19 members of the Granite Mountain Hot Shots fire fighters from Prescott, Arizona, died in the Yarnell Hill Fire.

Our affiliate leaders must hold those cities and departments that dismiss and refuse to use the wide array of IAFF health and safety services accountable when our members are injured or killed while protecting their communities. The IAFF will see that every city manager, every mayor, every legislator and even the president of the United States and premier of Canada understands that these deaths and injuries are more than numbers, statistics and reports to us, and that we will not allow them to sit idly by as our members put their lives on the line.

Our union will continue to fight for the delivery of adequate grant money to staff, train and equip our members to ensure they can to do their jobs adequately and, most importantly, safely. Many of the deaths and injuries experienced by our members are preventable. We continue to enhance current programs and develop new ones to address the causes of these and all line-of-duty injuries and deaths.

And, we’ll continue to work with NIOSH to ensure that each and every fire fighter fatality is investigated by the Firefighter Fatality Investigation and Prevention Program. This IAFF-created program was enacted as federal law and we expect these investigations to continue.  We provide NIOSH with ways to improve the investigation process, including follow-up evaluations for departments that suffer a line-of-duty death.

The sacred grounds of the IAFF Fallen Fire Fighter Memorial are a place where thousands gather every September to celebrate and honor the lives of our members who have died in the line of duty during the past year. Hundreds more make private pilgrimages throughout the year. Since the last Convention, 310 names have been added to the walls.

Our beautiful, hallowed site in Colorado Springs is now over 28 years old. To ensure the integrity of the site remains intact for future generations of fire fighters and their families, we will be putting forth a resolution here in Cincinnati for reconstructing the entire Memorial site. Since the granite walls were erected in 1989 – and an additional wall added in 2002 – more than 2,800 names of fallen members have been etched. Currently, the Memorial includes the names of the fallen since 1976. Local by local, the IAFF has researched every member killed in the line of duty from 1918 to 1975, and those names will be added to the new Memorial under the proposed plan. The IAFF estimates it would then take up to 30 more years before these walls are filled.

The plan also calls for additional seating to accommodate the families of the fallen during the annual ceremony, including overarching themes of family, honor, pride and community. In addition, the entry would be more prominent and include more prestigious signage and landscaping to emphasize the park’s integrity.

If approved by the delegates at this year’s Convention, the rebuild would begin immediately following the September 2014 service and completed in time for the September 2015 observance.

We continue to update and expand our web site for information on IAFF member pipe and drum bands and honor guards. The site is now functional with all the information made available by our members participating in the IAFF-massed band and honor guard during our annual Fallen Fire Fighter Memorial. We have attempted to place every IAFF-affiliated pipe and drum band, as well as honor guard that serve state and provincial wide. Additional resources, including all music that is played at our Memorial, is also available. IAFF affiliates can also update and make any necessary changes to the information on their pipe and drum band and/or honor guard directly on the site.

The IAFF Pipes and Drums and Honor Guard database and web site provide opportunities for our members in bands or honor guards to assist not only with our Memorial service, but with other memorial services, holiday parades and educational events hosted by IAFF affiliates and fire departments throughout the United States and Canada. More importantly, these members may be available to assist a local in the event of a line-of-duty death.

We are currently working on changes to the Public Safety Officers Benefits (PSOB) program. The Hometown Heroes Survivors Benefits Act of 2003 became in 2003 to cover heart attacks and stroke. Since the implementation, there has been a systematic and successful effort to take management control of the PSOB program away from the program’s director and staff. These changes directly affect the survivors of fallen public safety officers by delaying consideration of their claims and providing an unnecessary level of complication to the process.

The Department of Justice (DOJ), which administers the PSOB program, has made major improvements to the process for reviewing and approving claims. Over the last several years, the program had become laden with excessive bureaucratic requirements and unreasonable delays in paying benefits to families of the fallen that were a result of the unnecessary and troublesome intervention by the DOJ’s Office of General Counsel.

Our union was instrumental in getting Congress to pass the initial PSOB program, and is the principal author of every amendment affecting IAFF members’ coverage and the benefit amounts. Delay in payments of those benefits had increased, hurting the families of fallen fire fighters. The IAFF has been at the forefront in advocating a thorough review of these issues and a process to reform the program by taking the Office of General Counsel out of the process.

The PSOB program is now entirely managed within the Bureau of Justice Programs. This change will ensure that benefits are paid quickly and efficiently to the survivors of those killed protecting their communities.

I’m pleased to report that we have completed our work as directed by Resolution 25 passed at our 2012 Convention to establish an online cancer awareness, prevention and education program. This collaborative effort with the Firefighter Cancer Support Network, our Medical Residence Program, Johns Hopkins University and the National Institute for Occupational Safety and Health included a detailed literature and Internet review of current information about recognizing and preventing occupational cancer for the fire and emergency medical services, the development of a curriculum to address exposures, research and prevention programs on fire fighter occupational cancer – including resources to support the topics presented on the development of an interactive multimedia platform for the delivery of each of the modules and the additional resources, including video. These are now accessible through the online IAFF Learning Management System.

Since our last Convention, we have secured more than $6 million in health and safety funds from the federal government. These funds assist in the development and deployment of programs including our Fire Ground Survival training program, Wellness-Fitness Initiative, behavioral health education, building codes awareness, fire behavior and scald prevention.

While it is true that management and labor often disagree on many issues, we continue our untiring efforts to eliminate any division between management and labor when it comes to our safety. We have developed an unprecedented system that brought management and labor together to work on the issues that affect members’ health and safety. This system of cooperation and communication led to the development of our Wellness-Fitness Initiative, the Candidate Physical Ability Test (CPAT), the Peer Fitness Trainer (PFT) program, implementation of NFPA 1710 and the Fire Ground Survival training program. While we are proud of these achievements, the IAFF will never allow any organization or individual to stand in the way of our efforts to continue to develop and implement critical life-saving programs. We continue to maintain and enhance this collaboration to solve the day-to-day health and safety problems of fire and EMS departments to make our job safer.

We developed the Fire Ground Survival training program to ensure that training for MAYDAY prevention and MAYDAY operations are consistent between all fire fighters, company officers and chief officers. Fire fighters must be trained to perform standard, potentially life-saving actions if they become lost, disoriented, injured, low on air or trapped, and such training exercises must be consistent throughout the fire service. For decades, we have trained for success – we teach how to put a fire out or mitigate other hazards. What we failed to consistently do is train for when failure does occur, and without such training fire fighters do not have the practiced skills to rely on if and when they get into trouble.

This initiative relies on the experiences our members have faced on the fire ground so that fire fighters in the same situation will be able to perform standard actions. The online Fire Ground Survival Awareness Program was launched September 1, 2010. In June 2011, we fully integrated the online awareness program into the IAFF Learning Management System and more than 21,430 of the 26,630 registered members have completed the online component and are certified at the awareness level. That’s an additional 11,000 members certified in the last two years.

The skills portion of the program is delivered in the Train-the-Trainer (T-t-T) format. The IAFF recognizes that many jurisdictions already have qualified instructors on staff. The T-t-T format provides 32 hours of lecture and practical training from an instructor’s perspective to allow an instructor-candidate the opportunity to observe an IAFF master instructor delivering the course materials. This four-day workshop, delivered through a network of host sites, is available to assist the instructor-candidate in preparing for the IAFF Fire Ground Survival certification so they can provide the Fire Ground Survival program to the members of their department. As of March 2014, 33 T-t-T classes have been held and 912 fire fighters have been certified at the trainer level. The potential exposure to the Fire Ground Survival operations level training includes 187 departments and 64,961 members.

The next phase of implementation is to make this program accessible to all affiliates regardless of size and location. We have now strategically located and deployed four IAFF Fire Ground Survival Mobile Training Apparatus to truly mobilize this initiative. This will ensure that the training is disseminated throughout their geographical region. Using our affiliates on the frontlines, we will be able to deliver this critical life-saving training in areas where the lack of a training facility would have previously prevented the delivery of what has become the gold standard in survival training.

We are currently working with Underwriters Laboratories (UL), National Institute of Standards and Technology (NIST), National Fire Protection Association (NFPA) and our Fire Ground Survival instructors on a new Fire Behavior Course curriculum. Development and implementation will be patterned after our highly success Fire Ground Survival program. The three primary tasks in this project include: development of a free online fire behavior curriculum, development of didactic curriculum for recruit and incumbent fire fighters and officers, and instruction for modifying current state and local department policies and procedures to ensure fire behavior training is implemented.

We were awarded a $455,130 grant from the Centers for Disease Control and Prevention (CDC) to conduct outreach activities to increase enrollment in the World Trade Center Health Program (WTCHP), which was established with the passage of the Zadroga Act to provide medical monitoring and treatment services for workers and residents affected by the September 11 terrorist attacks. The dedicated WTCHP web site where members can access fact sheets, brochures and enrollment eligibility information has been completed. The website contains information regarding the latest research on World Trade Center-related health effects, including cancer. As of March 2014, there are 67,788 fire fighters, 16,594 first responders (FDNY) and 37,360 other first responders enrolled in the program.

We continue to build on the success of the Wellness-Fitness Initiative, Candidate Physical Ability Test and Peer Fitness Trainer program, and are currently working with our WFI Task Force to update the WFI and produce the fourth edition of the manual. To assist our affiliates that are engaged in the process of developing and managing wellness and fitness programs, we have expanded the WFI Resource, an online resource featuring information on successful programs, contacts for those with successful programs and the experiences of others. Currently, 23 affiliates, including the 10 cities on the Fire Service Joint Labor/Management Wellness-Fitness Initiative Task Force. Each fire department’s wellness program is searchable by jurisdiction, and jurisdictions are broken down by WFI Task Force and non-WFI Task Force departments. We will continue to add resources as they are submitted by additional departments to make new information available. This is not limited to the Task Force jurisdictions, and all IAFF affiliate departments are invited and encouraged to submit information on their programs.

In addition, the WFI Resource includes program descriptions of  fire fighter wellness-fitness programs representing fire departments of all sizes across the United States, combination and career fire departments, programs that provide a range of wellness-fitness services and various approaches to program delivery, copies of program management SOPs in a format that can be downloaded and edited, photographs of program-related equipment and setups, copies of purchasing specifications for program-related equipment in a format that can be downloaded and edited, information on Fire Protection and Safety (FP&S) grant-funded programs, copies of successful FP&S grant proposal materials, contact information for wellness-fitness program managers, fire fighter wellness-fitness related materials, downloads of wellness-fitness materials and streaming video of existing wellness-fitness related materials that have been developed by participating fire departments and IAFF affiliates.

Our online Fit to Survive resource continues to expand and includes new features providing expert advice and practical information on staying fit and healthy. Fit to Survive continues to be one of our most popular resources, and we continue to update the health, wellness and nutrition information and the Menu Planner. A Meal Generator lets users select ingredients from an intuitive interface, display healthy meal recipes based on the options selected, calculate calories and nutritional data and alert users when their selections may not adhere to USDA nutrition guidelines. Other features of Fit to Survive include Fit to Survive On the Run, an application that includes a quiz about making choices when dining out and provides nutrition information to help you make the best possible choice when eating on the run. The Fit to Survive Fire Drill features several surveys with questions about nutrition and exercise.  Members can compare other users’ answers and read about healthy facts related to the topic. The next phase will be to incorporate this application into the broader IAFF mobile app platform. We encourage all of our members to take advantage of this information to further increase member wellness and save fire fighter lives.

Another goal of the WFI Task Force was to develop a fair and valid evaluation tool in the selection of fire fighters to ensure that all fire fighter candidates possess the physical ability to complete critical tasks effectively and safely. Since its initial release in 1999, the Candidate Physical Ability Test has become the most widely used program to evaluate a candidate’s physical ability to enter training to become a fire fighter. Currently, we have 1,170 (up from 1,046 just two years ago) IAFF-licensed jurisdictions conducting the CPAT.  These jurisdictions are conducting this program using the identical testing procedures and recruiting and mentoring programs.

We are safeguarding the integrity of the most widely-used and fully-validated program by following up on complaints of misuse and contacting departments suspected of conducting the CPAT without proper licensure. We implemented new guidelines with the approval of our WFI Technical Committee that specifically addresses limited licensees. We currently have 35 limited licensees, each paying an annual $5,000 fee. The funds are now used to audit those agencies issued a limited license to ensure they are administering the CPAT in compliance with the CPAT program.

To assist in our data collection effort, we have updated our secure web-based application, CPAT Administration, a database program developed to provide a tool for all CPAT licensees that support all aspects of administering the CPAT program. This application enables fire departments to effectively schedule recruiting and mentoring events, EEOC- required events, PFT trainers and CPAT tests. The system also includes national comparison reports and tracks trends to improve validity and reliability of CPAT, and provides for site administration, candidate management, scheduling, event and assignments management, letters, rosters and more. This program has now been provided to all CPAT licensees.  Additionally, we have created the online tutorial to assist our members that use this program to its full capability.

It has been more than a decade since the initial release of the CPAT. To further ensure the validity and reliability of CPAT, the IAFF partnered with the University of Texas at Austin to perform a complete validation study. More than 150 participants of varying ages and levels of experiences performed the CPAT as part of this validation study. The data collected indicates that the CPAT is still a valid and reliable test to evaluate the physical abilities of candidates. We strongly believe this will further enhance our program, and allow for increased diversity within our fire service, with physically capable candidates. Our staff will continue to provide technical assistance to departments where CPAT has been authorized for use and to departments requesting assistance to implement the CPAT program.

No wellness program is complete without addressing the behavioral health of those involved. The behavioral health of uniformed personnel is every bit as important as their physical health. Yet, historically, it has been largely ignored or taken for granted with few departments having a comprehensive behavioral health program. Traditionally, medical and physical fitness take precedence over emotional or behavioral fitness in the fire service. However, it is clear from the aftermath of 9/11, Hurricane Katrina, Super Storm Sandy and other disasters that priorities are now changing because of the shift in types of response in the profession. Exponentially, fire fighters are being called upon to assist in the most disturbing and devastating times in people’s lives. Fire fighter suicides are now at alarming levels.

The IAFF Standing Committee on Labor/Employee Assistance Programs met during the John P. Redmond Symposium in August 2013 to continue the development of a comprehensive training program for labor and management on behavioral health issues. The Committee agreed that the IAFF’s role should be to provide the necessary resources and that labor and management must work together to implement the training. The overall goals are to decrease suicides in the fire service, decrease and prevent mental health symptoms in fire fighters and to increase the overall wellness of fire fighters. In addition, to be successful, the program must address the stigma surrounding mental health services, emphasize the confidentiality of the program and provide services that are accessible to members, including an employee assistance program (EAP).

Our Peer Fitness Training program has not only been extremely successful, but it is becoming the most recognized fitness instructor program for the fire service. We have now conducted 235 workshops (26 since the 2012 Convention) in 40 states, Washington, DC and five Canadian provinces with more than 6,677 fire fighters participating in certification classes and sitting for the certification exam. The PFT program trains our own fire fighters to help other fire fighters to exercise properly and prevent the epidemic injuries that affect our members. We now have a program to maintain PFT certification through all ACE live and distance learning courses, ACE-approved professional conferences or symposia, CPR, AED and First-Aid Training or equivalent and to successfully pass the ACE Personal Trainer Certification Exam. Online continuing education credits (CEC) modules are available for PFTs for a quick and easy approach to earning CECs. Further, any earned CECs will be accepted towards renewal of our PFT certification from all NCCA-accredited certification organizations and the Canadian Association of Fitness Professionals.

We are revising our delivery methods, including the integration of the certification program into the IAFF Learning Management System to provide greater hands-on training during the actual certification course. We encourage all affiliates and departments to support this program, which demonstratively has enhanced all programs that the IAFF has developed within the Wellness-Fitness Initiative.

Wellness and fitness, while a very important aspect of fire fighter health and safety, is only one piece of our health and safety operation. We were awarded a $100,000 cooperative agreement with United States Fire Academy to update and revise our 1997 EMS Safety-Techniques and Applications and the January 2002 Guide to Developing and Managing an Emergency Service Infection Control Program. The materials released this spring combines these previous publications into one revised and updated consolidated document that provides the most up to date comprehensive information regarding EMS responder health and safety, including infection control for local-level EMS and fire departments.

Our entire health and safety staff has remained active in ensuring that federal Occupational Safety and Health (OSHA), state and provincial and NFPA standards are correctly developed, implemented and enforced. We continued our work on the Interagency Board on Standardization on Equipment Interoperability to get the U.S. Department of Homeland Security (DHS) to adopt a number of NFPA standards for emergency responders. Once adopted by DHS, these standards set requirements for all federal agencies and state and local officials responsible for procuring equipment and services used by emergency responders.  The documents adopted require that any procurement decisions related to professional qualifications, occupational safety and health, training, fire apparatus, personal protective clothing, powered rescue tools and other equipment to fully adhere to these standards when using federal funds.

This International also oversees the activities of IAFF representatives on all NFPA, Canadian General Standard Board (CGSB) and the International Codes Council (ICC) committees. We have updated our procedures for coordinating our efforts in the standards development process to ensure our representatives are adequately prepared to represent our interests. Our two-day Standards Development Summit in 2013 provided these representatives with the background and information needed to be successful in their role as an IAFF representative in the standards making process.

Multiple standards have been identified that reflect the needs of our members. We worked directly with the NFPA and the Technical Committee responsible for NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments to ensure that the standard and the IAFF/IAFC Wellness-Fitness Initiative were consistent.

The NFPA 1710 Technical Committee on Fire and Emergency Service Organization & Deployment-Career continues to support the ongoing studies to determine what staffing levels, response times and deployment of resources work best when responding to a variety of fire (including single occupancy, multi-occupancy and high rise structures) and EMS events in an effort to minimize the safety risks to fire fighters, paramedics and the public.  The Committee is continuing its work effort on a number of issues to enhance the standard.

Nothing is more important to fire fighter safety than the ability to communicate to each other on the fire ground or other emergency. We petitioned the NFPA to initiate the development of a standard that will identify the operating environment parameters, as well as the minimum requirements for the design, performance, testing and certification of two-way, portable (i.e., hand-held) land mobile radios (LMR) for use by emergency services personnel during emergency incident operations without compromising compatibility with field emergency services communications networks. This new standard (NFPA 1802) will also establish minimum requirements for the proper function of the electronics embedded in or associated with emergency services electronic safety equipment where exposed to hostile thermal, immediate dangerous to life and health and non-hostile emergency scene environments.

The IAFF informed the NFPA that LMRs are a critical safety tool that must be in the hands of every responder at every emergency scene, and meet the unique demands of the job of fire fighting. Fire fighters must be able to communicate in cold and hot temperature extremes and in wet and humid atmospheres full of combustion byproducts and dust while under or above ground, inside and below buildings and in rubble piles. Other environmental challenges include loud noise from apparatus, warning devices, tools and the fire itself. As part of this project, a definition of the fire fighting environment must be established and performance and design criteria developed to ensure operability.

As a result of IAFF lobbying efforts, Convention action and extensive comments, NIOSH has completed a rulemaking process to change the time used for end of service time indicator (EOSTI) on SCBA. The EOSTI is intended to alert users when the breathing air supply has been depleted to a certain percentage of capacity and is relied on by fire fighters to warn when their reserve supply of breathing air is low. The previous regulation required that the indicator alarm is activated when the breathing air capacity of the respirator is reduced to within 20 to 25 percent. The IAFF fully supported the NIOSH position of revising its regulations to allow greater latitude with regard to setting the indicator alarm and ensuring it would not reduce the amount of protection afforded to fire fighters and other SCBA users.  The NFPA has now amended its standard (NFPA 1981) to increase the indicator setting to 33 percent (+5%/-0%), however the NIOSH regulation change was necessary to allow NFPA to make the change. The IAFF believes that the NIOSH and NFPA changes will result in a more meaningful alarm that will reduce fire fighter fatalities and may also offer greater protection for users in other industries.

During the past two years, we have continued our efforts to maintain and secure effective health and safety legislation on the state, provincial and local levels, including heart, lung cancer and infectious disease laws, as well as legislation to address staffing, notification, right-to-know and effective protective clothing and equipment.

The IAFF remains at the top of these issues, whether at arbitration or public hearings, to address safe staffing, medical research on breathing air quality, fire station exposures and design or protective clothing advances or failures. We have increased our efforts, not just in adding and ensuring proper regulations for heart disease to the U.S. federal PSOB legislation, but in obtaining state and provincial presumptive benefits for health, lung cancer and infectious diseases. During the past two years, we have provided direct assistance and expert testimony throughout Canada and the United States.

We are especially proud that in the past two years, we have further assisted our affiliates in obtaining and – in some cases – maintaining presumptive legislation by providing written assistance and direct technical testimony before legislative bodies.

It has been the decades’ long goal of the IAFF to prevent occupational cancer from afflicting our members, and we have developed specific programs for both primary and secondary prevention for our members and their fire departments to implement. Primary prevention is aimed at stopping a cancer from developing in the first place, and includes avoidance of hazards and behavioral changes to decrease individual risk factors for cancer. This includes IAFF programs on personal protective equipment, diesel exhaust control devices, tobacco cessation programs and nutrition programs. Secondary prevention includes techniques that detect early cancer or precancerous conditions so that early interventions can decrease the risk of advanced disease that we have incorporated into mandatory annual medical evaluations under the Wellness-Fitness Initiative.

To further assist our affiliates in this area, we developed a valuable online resource to help IAFF affiliates and our members better understand the applicable presumptive laws in the states and provinces. We have worked diligently to secure and maintain presumptive legislation addressing heart disease, lung disease, cancer and infectious diseases. We continue to update and expand this resource with detailed information on the legislation for each state and province.

We are continuing our efforts working with affiliates in several states and provinces that have passed laws banning brominated flame retardants (Polybrominated diphenylethers (PBDEs) including Penta-, Octa- and Deca-BDEs). Regardless of the current efforts, both with the manufacturers of flame retardants and the Environmental Protection Agency (EPA), the IAFF will continue to support efforts to protect our members on the state and provincial levels from carcinogenic fire retardants and fire fighter exposures to toxic materials. We believe that many of the state and provincial legislative efforts to evaluate all flame retardants are good programs, especially to ensure that any new flame retardants developed as a result of the ban are evaluated for toxicity and that efforts are prescribed to reduce and eliminate exposures.

Our extremely successful Medical Residency Program, which was initiated at Convention in August of 1986, is now 28 years strong with more than 150 medical residents. Throughout their rotations at the IAFF, medical residents spend time familiarizing themselves with the occupational health concerns of fire fighters by reviewing the different studies, reports and medical requirement standards maintained in our health and safety department, as well as conduct extensive literature reviews and actively pursue advice and guidance from physician experts to assist in helping our affiliates. On a daily basis, they provide extensive research assistance on issues related to fire fighters health to further protect our members and provide information to affiliates in support of workers compensation claims. In addition, our medical residents provide expert testimony for state and provincial associations advancing presumptive legislation in their states and provinces.

Our program works directly with Johns Hopkins University, but we are continuing our cooperative agreement with the Uniformed Services University of the Health Sciences (USUHS) to also receive Occupational and Preventative Medicine residents. These physicians are members of the U.S. Armed Forces and, therefore, their residency is paid for by the military branch in which they serve. Because of this agreement, at times, the IAFF has two medical residents at the same time.

All of our health and safety issues the focus at our John P. Redmond Symposium, held biennially in conjunction with the Dominick F. Barbera Emergency Medical Services Conference. The 2013 event featured an innovative presentation platform and new technology to enhance the educational experience, including two days of plenary sessions and two days of topic-specific workshops and information sessions. Members from the United States and Canada, as well as a number of international fire service organizations, attend this conference.

Over the past several years, the IAFF has provided growing levels of assistance to members adversely affected by natural and man-made disasters. Our Disaster Relief Fund provides financial assistance if members are displaced from their home or suffer a catastrophic loss with resulting financial hardship following such a disaster. Disbursements are granted for immediate housing, food, medical supplies and services, clothing and other similar disaster relief. Since the last Convention, the IAFF has assisted 1,048 members with relief funds due to flooding, fires and wildfires, in addition to relief to our members due to Hurricane Isaac and Super Storm Sandy, as well as flooding in Calgary. Disaster relief assistance was provided to 970 IAFF members throughout New York, New Jersey and Connecticut in October 2012, totaling $485,000.

Through the occupational health, safety and medical efforts of the IAFF, the fire service today is indeed a safer place to work. Together, we are helping our fire fighters come home after each of their tours. We will continue to provide any and all mechanisms to continue with our efforts to improve the health, safety, fitness, wellness and survival of each and every IAFF member.