Experts are now pondering the health risks faced by firefighters in the wake of the deadly fire that claimed two lives from Boston's West Roxbury area.
According to them, other than the primary hazard of fires, heart attacks, which are brought on by age, poor health, stress and extreme physical demands, are the top most killers of firefighters.
Says Dr. John Burress, a Boston University Medical School professor and an occupational medicine physician: "They have on 70-plus pounds of gear and they are exerting themselves and it's high heat and stress.
"It's a perfect setup for anybody who has a predisposition for cardiovascular disease."
Across the nation, 45 percent of the firefighters who die on duty are felled by heart problems, informs Dr. Stephen Kales, a professor at Harvard School of Public Health and lead author of a study published in March on firefighter deaths.
According to him, part of the reason is the lack of required physical tests once a firefighter joins the department.
"There's a mismatch between the physical demands of certain firefighting tasks and the fitness of individual firefighters," he opines.
The West Roxbury fire which began at the Tai Ho restaurant Wednesday night before exploding into a blaze led to the deaths of Warren Payne, 53, of Newton and Paul Cahill, 55, of Scituate. In addition, 12 other firefighters were admitted for treatment of burns and smoke inhalation.
The restaurant had passed its most recent fire inspection . Yet, it was eight months overdue for another, according to published reports.In addition, it had been cited in the past for the grease buildup in the ceiling that fire officials opine might have contributed to the deadly conditions that led to the blaze.
Veteran firefighters Payne and Cahill died when the roof of the restaurant caved in under the weight of a large air-conditioning unit.
"The more dangerous the task, such as fire suppression, the greater the risk of a heart attack", opines Kales . "People have impressions that smoke inhalation is common, but it's not a very common cause of death", he adds.
However, smoke inhalation can be dangerous: When the skin around the nose or mouth is scorched, the airways can be burned, doctors warn.
In addition, firefighters who don't wear protective air masks during overhaul (when residual fires are being knocked down) are at risk of inhaling irritants such as hydrogen chloride, which is emitted from the decomposing plastic.
Meanwhile the West Roxbury community, which is home to more than 100 active Boston firefighters, offered memorial tributes at the fire station. Firefighters came from around the Boston metro area to provide support to their colleagues.
"It's the brotherhood. It's like one big family. One firefighter goes, you feel like you lost a brother or a family member," auxiliary Waltham firefighter Joe Cummin Jr. said.