Your Gear, Your Life: Firefighter PPE Toxins and What to Do About Them

By P.J. Norwood and Frank Ricci

Firefighting is a dangerous job and if you do it long enough, you will get hurt. We can never eliminate all risks, but by understanding the facts we can do a better job at reducing the risks we all face. Understanding your personal protective equipment (PPE) and how it works for and against us is critical.

Our structural firefighter gear (turnout gear) contains polyfluorinated alkyl substances (PFAOs). However we are the fire service and cannot stop wearing our gear. So what’s next? What should we do today and in the near future to reduce our risk?

RELATED

Research: ‘Forever Chemicals’ in Gear Pose Risk to Firefighters

The National Fireman’s Journal Podcast: Firefighter Cancer, PFOA, PFOS, and Toxic PPE

What If I Told You That Your Bunker Gear Was Causing Cancer? Part 1 | Part 2

What are PFOAs & Does Your Gear Contain These Cancer-Causing Chemicals?

We must offer our thanks for the sacrifice and work of Attorney Robert Bilott for battling DuPont to bring issues with PFAOs to light. We recommend you view the movie “Dark Waters.” These are forever chemicals that don’t go away and may shed off your PPE. They are called forever chemicals for a reason—they last forever. You will not find this chemical occurring naturally in nature. This monster has been created in a lab. It was created in a lab with good intentions, but today we know how the chemical impacts us and our communities.

U.S. firefighters’ PPE, our “turnout gear,” is manufactured from textiles that are made from fluoropolymers (one form of polyfluoroalkyl substances, or PFAS) or they are treated with PFAS.  These chemicals are used in firefighter textiles or the fabric that gear manufactures use them to assemble our gear to meet the specifications provided by the department. PFAOs are added to the fabric to provide oil and water resistance.

These forever chemicals are added to the gear to meet National Fire Protection Association (NFPA) Standard 1971, Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting. This oil and water resistance helps the turnout gear from becoming water soaked and adding significant weight to your gear. Wet gear is also uncomfortable and without proper care can lead to mold. The accepted thought is that wet gear increases thermal instability. However, this conventional thought has been found to not be as big of s factor as many have been led to believe. More testing is needed and we will address this in a later Humpday Hangout

PFOAs have been extensively studied and linked to several cancers and other diseases that negatively impact our body and systems.

Fabric used for firefighter turnout gear has tested positive for the presence of per- and polyfluorinated alkyl substances (PFAS), according to the study published in Environmental Science and Technology Letters led by Graham Peaslee, professor of physics at the University of Notre Dame. Peaslee embarked on a more extensive study after initial tests on gear samples showed significantly high levels of fluorine.

Peaslee’s team tested more than 30 samples of used and unused PPE from six specialty textile manufacturers in the United States and found them to be treated extensively with PFAS or constructed with fluoropolymers, a type of PFAS used to make textiles oil and water resistant. During testing they also found PFAOs were being transferred to their skin.

Report of Professor Peaslee’s initial testing published in 2018: https://news.nd.edu/news/researchers-study-presence-of-fluorinated-chemicals-in-firefighter-clothing/

Report Published June 23, 2020 by Professor Peaslee: https://pubs.acs.org/doi/10.1021/acs.estlett.0c00410

Let’s break down what we know and what we should be doing about it to reduce firefighters’ risk.

What We Know

1. Our PPE contains PFAOs.
2. Fire gear is an absolute necessity at some but not on all of our calls .
3. We do not know if these chemicals are being absorbed through our skin and entering our bloodstream.
   1. Researchers have found traces of PFAOs on their skin after handing PPE in the lab.
   2. More research needs to be done to determine the potential and possible pathways of how these chemicals are entering our system.
4. The inner liner of our gear is not treated with PFAOs.
   1. Research has found our gear does transfers (migrate) PFAOs to the inner liner/moisture barrier
5. More research needs to be done to determine if dust from degradation containing these forever chemicals is affecting firefighters.

What items should departments look to insert into their policies?

1. Department should notify members of the hazards their PPE poses, how they may be impacting firefighters, and identify ways to minimize their risk
2. After you handle your gear you should wash your hands. When possible, nitrile gloves should be worn when handling your PPE.
3. Have a proper extractor/washer and proper drying equipment in each fire station or a mechanism for all gear to be washed and dried properly.
4. Have two sets of PPE for each firefighter so gear can be cleaned after usage.
   1. Departments that cannot supply two sets should have an exchange program in place so no firefighter should have to wear dirty gear. This exchange program must work 24/7.
5. During washing, the outer shell, liner, gloves, and hoods should all be watched separately.
6. Through normal wear and tear, our gear degrades. During this process and degradation, the PFAOs may become airborne in the form of dust. Therefore, gear should be stored in a bag or container, especially when stored in an enclosed cab or trunk of a vehicle.
7. Gear should not be worn for non-structural calls. Departments should consider other protective clothing for these call types.
8. Members should not wear structural fire protective clothing for any reason except when absolutely needed. For example, gear should not be worn when shopping for the meal, for EMS calls, or building inspections.                                  
   1. Departments should not wear non-laundered gear for fire prevention demonstrations and safety demonstrations.
   2. Firefighters should also consider the value of having non-members try on gear while visiting the firehouse or attending demonstrations. This gear should be cleaned first but also understand we do not know if a one-time exposure to PFAOs are worth the value of having children and adults try on the gear.

We are not advocating clean cabs in the sense of not wearing PPE going to the alarm. We want cabs that are cleaned from containments. We want cabs that contain cleaned equipment, PPE, and personnel. The public and any trapped victims must still come first. Yes, we said it, you are secondary to the mission. That doesn’t mean you should be reckless and foolish— it means you should attack a fire with a sensible level of aggression. The public deserves and demands it. If you want a completely safe job, this is not the right profession for you.

Firefighting in inherently risky and we are exposed to cancer-causing chemicals at a higher rate than the average citizen. Because of the work of Graham Peaslee we have now been able to identify that PFAOs are present and our gear is adding to our risk. PFAOs are one piece of the puzzle when it comes to reducing our risk. Departments should be aggressively looking to reduce their members risk from all pieces of the puzzle that we are currently aware of. Departments should also be addressing items such as no-tobacco policies, physicals with cancer screening, physical fitness programs, station exhaust systems, mandatory self-contained breathing apparatus use, issuing a second set of gear to every member (including hoods and gloves), field decontamination practices (including establishing a decon station at every working fire), providing cleaning wipes for immediate decon, and mandating a shower within an hour of exposure.

The Drillmaster of Valley Forge, Baron von Steuben, was credited with changing the tide of the war with proper training and instilling discipline. He reported to General Washington that Americans were more difficult to train than Europeans, who just followed orders. He explained that in America troops need to know the “why” of any action to understand their tactics and equipment to be effective. Some things don’t change.

We cannot eliminate our risk to carcinogens but we should make every effort to reduce our risk. Leaders should adopt policies and procedures that identify the pieces of the puzzle impacting their members and provide education and exposure-reduction measures. When asked, most firefighters indicate they have a goal of retiring. The goal should be to retire and live a long healthy life well after reaching retirement.

In preliminary conversations, it can be gleaned that there may be viable alternatives to these chemicals that could meet the NFPA standard. This needs to be explored by the gear manufactures the fire service and the science community. If these alternatives are found to be appropriate and safe, we need to see the standards reflective of this body of research. We need to make sure alternatives are safe for us and the environment.

We need elected officials and industry leaders—the International Association of Fire Chiefs, International Association of Fire Fighters, National Fire Protection Agency, the National Volunteer Fire Council, and others—to find the political courage to follow through and ask the right questions, demand more research, and provide the members of the fire service with real answers to the issues that impact us and our families. Through a collaborated effort through education, research, and communications from all stakeholders we can begin reducing our risk one piece of the puzzle at a time.

P.J. NORWOOD is a deputy chief training officer for the East Haven (CT) Fire Department. He is an FDIC International classroom, workshop, and H.O.T. instructor; a Fire Engineering Advisory Board member, and a Fire Engineering book and video author. He served on the UL Technical Panel for Residential Attic Fire Mitigation Tactics and Exterior Fire Spread.

FRANK RICCI retired as a battalion chief for the New Haven (CT) Fire Department. He is an editorial advisory board member of Fire Engineering and FDIC International. He cohosts “Politics & Tactics” on Fire Engineering Radio and a monthly Humpday Hangout. He has been a contributing author to Fire Engineering’s Handbook for Firefighter I and II. He has hosted DVDs on Tactics & Command. He keynoted at FDIC 2010 and won a landmark case before the U.S. Supreme Court.