Alison Stewart (2:27)

So in the episode, you use the neighbor's dog as a way in. Yes, explain the neighbor's dog to us.

Ben Nadif Haffrey (2:34)

So it was, I think it was, you know, These late night sirens, it would be like 3am I'd be lying in bed and I'd hear a siren. I'd be like, man, that's just really loud. Is that necessary? Does it need to be that loud? Especially this late at night. And then there was also a dog who was living somewhere in our vicinity, who, whenever this siren would go off, would howl really loudly, which I found quite charming and also sort of interesting. I was like, is he also bothered by this siren? So I set out to find this dog.

Alison Stewart (3:02)

Let's listen to the dog. His little voice. Oh, the poor guy.

Ben Nadif Haffrey (3:12)

Little voice. He sounds like a werewolf. He's really. It's like bell. Or I'm like, poor little guy. Yeah. People have been complaining about sirens in New York for like basically a century. And so I was like, you know, adding one more flustered writer to the chorus isn't really going to change things. But maybe if I can find this dog, he could help unlock the problem for me.

Alison Stewart (3:31)

And then you guys made a spreadsheet. Explain the spreadsheet.

Ben Nadif Haffrey (3:33)

Right. So my wife is a data scientist, so, you know, things are. There's a lot of spreadsheets flying around the home. I thought that maybe the best way to figure out where exactly this dog was located was would be to keep track of all the times we heard the siren over the course of a day. And if we heard it from the front of the house, the back of the house, if the dog was howling along or not. Our apartment is small enough that front, back, really not a big difference. You hear it all over the place. This was not particularly useful, but eventually I was just walking down the street one day and a siren was coming by, and I saw this yellow lab retriever mix sort of stiffen in front of me and begin to bellow. And I was like, there he is, there he is.

Alison Stewart (4:14)

Listeners, let's get you in on this conversation. Maybe you've worked as a first responder. When did you get to use the emergency call? How often are you running hot? Do you think using the siren makes your response faster or more effective? 212433, WNYC 212-433-9692. Is there a future in New York where sirens could be used more strategically? We'd like to know what you think. 212-433-9692. Or do you live near a fire station, on a hospital or police precinct and hear the sirens? How does the loud siren affect you if it passes you in the street, if it passes you in your house? We want to hear your calls. 212-433-WNYC 212-433-9692. You point out in your episode that much of our EMS system today relies on the same principles. When EMS was launched in the 70s. That's amazing. What did you learn about the history and the circumstances of, of EMS when it was first deployed in the U.S.

Ben Nadif Haffrey (5:13)

Yeah, this was a thing. So I sort of shifted focus pretty early in my research process from looking into the loudness and the noise of a siren into looking at this question that many paramedics and EMS medical directors have studied, which is, do are sirens actually a useful intervention? Like how often do they save a critical amount of time, which we can get into later? But part of what I learned is that the emergency medical services in the United States are really a relatively recent phenomenon. It. It sort of there wasn't. It takes off around the same time as 911 in 1968. This is two years after a very influential report called I believe Accidental Death and Disability, which was by the National Academy of Sciences about traffic accidents, which was this sort of new epidemic, people getting really hurt far from their home. And so they wanted to have a centralized place people could call to summon an ambulance, a first responder to. To treat someone who was injured and maybe didn't have the time needed to get to the hospital. So there's this big push in the late 60s, early 70s to change how we did emergency medicine around the same time that we're innovating a lot in emergency rooms themselves. And it really takes off in the early 70s, around the same time as there's a sort of influential TV show promoting this new intervention too.

Alison Stewart (6:32)

This is so funny. The TV show Emergency. I remember Emergency. Really, I truly remember Emergency.

Ben Nadif Haffrey (6:38)

Were you a viewer?

Alison Stewart (6:39)

Randall Mantouf, remember that? That was the best. Play the theme.

Ben Nadif Haffrey (6:44)

Yeah, he's pretty.

Alison Stewart (6:49)

Ringer'S lactate.

Ben Nadif Haffrey (6:50)

Remember.

Alison Stewart (6:53)

Remember that?

Ben Nadif Haffrey (6:54)

I love how many ways the siren is featured in the theme song. It's like, it's in the music. It's layered on top of the music.

Alison Stewart (7:00)

Well, I was watching my son, he was watching 91 1. I was like, hey, have you heard of emergency?

Ben Nadif Haffrey (7:04)

Yeah, but he's like, he was like, no, mom rolled.

Alison Stewart (7:07)

But how did a TV show play into the role?

Ben Nadif Haffrey (7:12)

So there was this whole thing where you needed to. A lot of the sort of hangover of this era is that we really needed to sell people on the idea of using 911 and what the emergency services did. And so of course, people were familiar with fire departments and police departments, but they weren't really used to calling for service in the way we are now. And in 1971, the team behind Dragnet was looking for a new television show. And I think they were exploring a few different kinds of emergency response scenarios. And they got interested in the LA paramedic unit, which was one of two of 12 paramedic units in the entire country in 1971. And it seemed like a sort of rich terrain for a new show. And so they began to make the show. And the pilot episodes are really all about the legal battle to make legal paramedicine because in many places it was illegal to administer unauthorized medical care if you weren't a doctor, if you weren't in a hospital. It was a real patchwork of laws that had to change all over the country in order to make it so that we could use paramedics and ambulances the way we do now. And what the show was doing is really dramatizing this kind of climate change classic scenario of someone is hurt, there's not enough time to get them to the hospital. We need to get there as quickly as possible to administer on the scene medical care. And in the time that the show was on the seven years, EMS became a sort of nationwide phenomenon. It went from those 12 programs to being something that was really everywhere.

Alison Stewart (8:47)

So when did you become interested in why the sirens are so loud? Because you need EMS services.

Ben Nadif Haffrey (8:53)

You do, you absolutely need EMS services. And I am not even arguing that we shouldn't have sirens at all. But part of what was interesting to me is, well, so if EMS is really a thing that happens in the 60s and 70s, the siren is comparatively an ancient technology. It's from, it's, you know, comes up at the end of the 18th century, its first use as warning signals in the 1850s on steam trains. And then when it becomes electronic in the 1880s, that's when you start to see it heading towards the siren. We know now on emergency vehicles. But I think that we have not significantly updated or re examined the way we use sirens on emergency vehicles since that's happened. And part of what was fascinating to me is learning about all these paramedics and EMS medical directors who were asking these basic questions because I think sort of boils down to we don't think of sirens as risky, but they are. And we think of every 911 call as super time sensitive and urgent, but they're not. And I think these things are kind of bound up in how we learned to learn about EMS and paramedicine in the first place through shows like Emergency.

Alison Stewart (10:03)

Let's take a couple of calls. Bob is calling from the Upper west side. Hi Bob, thank you for taking the time to call, all of it.

Bob (10:10)

Hi, thank you. Thank you for what you do. Actually, the thing that made me reach for the phone is when you said this has never been studied. And where I live on the Upper west side in the 90s, it is an ever present hospital. Ambulance is going to the hospital. And my contribution is that as a young man, I was in the rescue squad in my hometown in New England. It was a volunteer fire department. And I can tell you, people really love turning on sirens and being in a vehicle where other vehicles get out of your way. I mean, it's a very exciting thing to do and I'm sure that contributes to it, especially since it's never actually been studied. In London they have much less. I've traveled and I've been in London have many fewer sirens and fewer lights on their emergency vehicles. Anyway, thanks, Bob.

Alison Stewart (11:04)

Appreciate you calling. Let's talk to Lars from Brooklyn. Hi Lars, thanks for calling, all of it.

Lars (11:10)

Hi, thanks for having me. By the way, I was a childhood fan of emergency myself, so I love fire trucks and all that, and I understand the need for emergency vehicles. I get it. When I've lived in New York since 1990, and I used to live right off of First Avenue in the East Village, and you'd hear the sirens wailing up First Avenue to all those hospitals in the 20s and 30s. But you know, I remember late at night they would actually only do the whoop, whoop thing. Late at night they would go through mostly empty First Avenue and as they approach the intersections, they slow down and go whoop, whoop. They always have their lights on. There's a distinctive difference between how they use the sirens during the day and how they use it in the middle of the night. And I don't know what the connection is, but the correlation in my mind is that after 9 11, the emergency vehicle started wailing at all times of day or night. I don't know if that's a connection, but I know now that where I live in Brooklyn now, I'm in front of a straightaway of one parkway connecting to another with no intersections in between it. And in the middle of the night they'll just be wailing their sirens. And there's not only no one on the street, but there's no possibility of anybody. There's no sidewalk along it. There's no intersection of Traffic coming and there's no reason to be wailing that siren at three in the morning. And I feel like there was, there was at one point there must have been a directive that's saying late at night, you know, just minimize the noise you make, except for at intersections. And somewhere along the way that got lost. I was just wondering if in your research for this, have you come across any of these, any kind of directive that used to tell them to keep the noise down a little bit?

Ben Nadif Haffrey (12:46)

So yeah, it's, it's a really interesting question. It is a kind of patchwork history. I think part of the context for what's happening in New York right now is that there's a lot of concern about response times. So response times have been going up to, to 911 life threatening medical emergencies. They're at 11 minutes 21 seconds in the start of 2025. And that is really a function of having a, an under resourced paramedic EMTs, EMS service in the city. There's a lot of concern about pay, recruiting, retention, and when you have fewer ambulances on the street, then it's harder to get to the places you need to get in the time that you want to get there. And so I think that part of this, I've not actually been able to confirm this with fdny, but I would imagine that in trying to keep response times down, when you feel stretched like this, there's a tendency to use this iron more, especially because you know that a lot of citizens are concerned about response times too. And this actually goes back to sort of Bob's comment from earlier. I, in speaking to the paramedics and EMTs that I did working on this story, I actually found that none of them really felt that it was just a blast to use the siren, but they did feel like there was an expectation from a community that they use it. So I talked to one EMS medical director in Berrien County, Michigan who read some of the research that I've been alluding to and can sort of explain about later that made a case against using sirens because they really significantly increase the risk of accidents for ambulances and they don't usually save a clinically relevant amount of time for the vast majority of cases, mass, vast majority of calls. So he halved the number of lights and sirens that he was using in his ambulance service. And what he found was that there was this huge outcry from the people in his community who were like, well, you're killing us. You, like you don't care. You're like not going to get here on time. I'm going to have a heart attack and I'm not going to be resuscitated in time because you're not using your lights and sirens. So it is an amorphous and sort of ubiquitous problem that has to do as much with our expectations of what emergencies look like, what 911 calls look like as it does with first responders. Guidelines. There are guidelines. There are in the operating manual for which call segments Every, every 911 call is coded in a different way when it's, when it comes from the dispatcher. And codes one through three tend to be the most critical time sensitive ones. So in things like that, you'll always see, almost always see someone using their lights and sirens. But then we most likely are using our lights and sirens for a large segment of calls that are not critical or time sensitive in the same way. And that I think changed in 2017. There was a reorganization of what was coded as life threatening that I think affected this too.

Alison Stewart (15:45)

We'll have more on this. Ben Nadif Heffery is my guest. He's the senior producer for Pushkin Industries. We're talking about a new episode Ben reported for the podcast Revisionist History. It's called Running Hot. Listeners, how do sirens affect you when you pass one on the street? Or maybe you work as a of first responders. How often are you running hot when responding to an emergency? Our number is 2124-3396-9221-2433. WNYC. We'll have more after a quick break. This is all of it on wnyc. I'm Alison Stewart. My guest in studio is Ben Nadoff Heffrey, a senior producer for Pushkin Industries. We're speaking about a new episode Ben reported for the PO Revisionist History. It's called Running Hot. Ben looked into why emergency vehicle sirens are so loud and whether or not the noise is actually effective in a faster response time. Let's talk about how loud they are medically. What do we know about how sirens, how they can damage their hearing?

Ben Nadif Haffrey (16:53)

So there's a lot of different sirens in use in the city. They I think 118 decibels to 120 decibels is the range I've seen cited most often. Sound that's 120 decibels loud can damage your hearing immediately. That is, it's, it's, it's just quite a dangerous thing to be in close proximity to that without hearing protection. And this is a thing that first responders suffer from as well. There's actually a. Thousands of firemen sued the makers of the famous fire siren, which is called the federal Q2B, because they. Because they had experienced a lot of hearing loss. And there's a couple ways that noise is dangerous for people. The first is obviously, you know, keeps you up, it distracts you. It's harder for the studies showing there's learning loss in kids when they're exposed to a lot of noise in the classroom. Other studies show that like a 5 decibel reduction can cause to. In overall noise can cause a pretty significant reduction in hypertension and heart health rates or heart disease rates in the neighborhood. So it's tied to our physical health in all these ways. But just losing your hearing, especially when you're an older person who's lost their ear hearing, it means it causes like, brain atrophy. It can lead to earlier onset dementia, partially because you withdraw from social settings and are just kind of disconnected from your life because you've lost this really important sense.

Alison Stewart (18:17)

But New York is very loud.

Ben Nadif Haffrey (18:19)

It is one of the 10 loudest cities in the world.

Alison Stewart (18:22)

Is that because of sirens or sirens loud? Because New York's loud.

Ben Nadif Haffrey (18:26)

You know, it's really a chicken or egg situation, but it's, you know, little column a little column B. That is one of the things people say about why sirens need to be as loud as they are is that cars have gotten better insulated. And so you need to have sirens be extra piercing and loud to get through them. Cars are also getting quieter though, so traffic noise is reducing. So it's kind of both things can be true. But this is one of the reasons that I've been most inclined towards this idea about, well, when are sirens useful? Like, how often do we need to use them, whether or not we change the sound.

Alison Stewart (18:59)

Let's talk to Gary from Manhattan. Hi, Gary, thank you so much for calling all of it. You're on the air.

Gary (19:06)

Thank you, Allison. I live on the corner of 6th Avenue and 14th street, and sirens are the bane of my existence. And they are. They're heart stopping. They are. They're just dreadful. I also spend a lot of time in European cities, London and Paris and Berlin. And one thing I know is they have just as many emergencies as New York, yet they use the oscillating sirens and the lights. Why can't New York City adopt the oscillating sirens? They certainly get. They can be heard inside of cars. I've been in cars where they've been in use and the Lights, of course, help to identify that there's an emergency vehicle, in your view. But why can't we have them?

Alison Stewart (19:59)

Yeah, Ben, why not?

Ben Nadif Haffrey (20:01)

I'm trying. I'm trying. This is actually, I thought of this as well when I was reporting this, and it turns out that this has been proposed a number of times in the New York City Council. Helen K. Rosenthal proposed it in 2019, and then I believe it was Carlina Rivera who proposed it in 2023. And it has gone nowhere both times. There was a hearing most recently on the most recent bill. I think people are really sensitive about making changes to this particular thing because it feels so important and no one likes imagining that you would change the sound and all of a sudden someone's going to need help and not get it in time, which I think we have an overblown sense of. These are extremely important jobs. But it's. We tend to imagine everything as if it's the television show emergency, and it's not. So, yeah, I think that there's really good evidence from Europe that that siren is just as effective as ours. It's not, in fact, always quieter. Some of them are, but it is less shrill and so less irritating. One piece of hearsay I heard about this that I was unable to fact check is that it was Holocaust survivors didn't want to hear European sirens because it reminded them of Europe, the emigres in the United States. This seems to me like a fact that's too good to check and is surely apocryphal. But that is. That is something that a first responder who's been in the service since the 80s told me.

Alison Stewart (21:31)

Let's talk to Richard, who's calling from West 77th Street. Hi, Richard, thank you for calling, all of it.

Richard (21:37)

Hi, Alison, thanks for having this particular episode.

Ben Nadif Haffrey (21:40)

Thank you.

Richard (21:40)

I actually, I'm a physician here in New York, and I actually testified at the hearings that Gail Brewer was part of at the City Council, talking about the same problem. The fact remains that not only are the sirens in New York one of the major contributors to hearing loss, which is sort of like the biggest public health threat most people don't know about. But other than that, as far as the noise is concerned, it's actually outrageous. One of the main problems we face and other cities have done experiments with, is to have criteria part of the ambulance driver's knowledge, and they can put it up in their cabin. But there are certain categories of people that should probably have sirens accompanying their trip. In New York, as a matter of fact, when those criteria are applied. It was in one city, 92% of patients were transported without lights and sirens and the other 8% had them. Because of these criteria were put in place and the differences of response times, I should say differences in arrival times and going to the hospital times has also been compared without sirens and then with same time of day, same routes, etc. And the difference between sirens and non sirens ranges from 42 seconds to about three minutes. And none of that was considered significant as it related to the patient's conditions by the physicians who were in the ER receiving them.

Alison Stewart (23:21)

I'm going to dive in here because Ben, you did some reporting on this.

Ben Nadif Haffrey (23:24)

Yes. I'm really happy that you brought this up. This is the thing that really blew my mind as well. I think those numbers come from a 2017 white paper by a EMS medical director named Douglas Kupas, who's really the leading researcher on, on this, on this question. He found from a number of studies going back several decades that the range is 42 seconds to 3 minutes and 48 seconds of time saved. Another study found it was 1 and a half minutes on average in urban settings, 3 and a half minutes in the countryside. So that's like it. Sirens save time. Is that a clinically relevant amount of time for most 911 calls? No. And there's another great study by a chief medical officer in Fort Worth named Jeff Jarvis, who using a data set of over 5 million 911 calls that happened in, in 2018, was able to look at, well, how often were we using our sirens? And the answer was about 86% of the time. And then he said, well, how often were paramedics making even vaguely potentially life saving interventions? And the answer was less than 7% of the time. So there's a delta of 80% about there between how often we really need to make sure we're on the scene right away and how often we're acting as if with the siren. And that's not to say the other calls don't matter, they absolutely do. But given that using lights and sirens increases the risk of an accident in an ambulance by over, by over 50%, it's, you have to think of it, another person told me, as a medical intervention. So the risks have to be outweighed by the benefits in order to be using lights and sirens.

Alison Stewart (25:05)

And our last minute, what is your hope for how New York will consider sirens and a wider EMS system?

Ben Nadif Haffrey (25:14)

So we have this big concern about response time right now. And what I am most worried about is that we'll make the same mistake twice that we will say the only thing that matters is getting our response times down and therefore the siren has to be sounding all the time. I think that this is an opportunity to look at the other things, the other indications that the system is working and take care of other factors in how our EMS service is working, like how paramedics and EMTs are treated, how many ambulances are on the street. I want that. But I also want us to look specifically at these questions that these researchers have looked at in other cities and towns, like how much time are the sirens saving us here and to what percentage of calls do we need to be saving that amount of time? Because I think that we can change the criteria around how often we're running hot and it'll just serve everyone better.

Alison Stewart (26:05)

The name of the podcast is Revisionist History. The episode is called Running Hot. Ben Natasha Free thank you for joining us.

Ben Nadif Haffrey (26:14)

Thank you for having me back.

Alison Stewart (26:16)

We didn't have any news break.

Ben Nadif Haffrey (26:17)

I know. Thank God.

Alison Stewart (26:18)

Thanks Ben. I'm Alison Stewart. I appreciate you listening and I appreciate you. I will meet you back here next time.

Progressive Insurance (26:28)

NYC now delivers the most up to date local news from WNYC and Gothamist every morning, midday and evening with three updates a day. Listeners get breaking news, top headlines and in depth coverage from across New York City by sponsoring programming like NYC Now. You'll reach our community of dedicated listeners with premium messaging and an uncluttered audio experience. Visit sponsorship.wnyc.org to get in touch and find out more.