By Richard C. Beaulieu
For decades the fire service has accepted that injuries, illnesses, and death in the line of duty was just an occupational hazard of the most respected profession in our nation. Over the past 20 years and with the creation of the “16 Firefighter Life Safety Initiatives” in 2004, there has been a shift in that way of thinking towards not allowing injuries, illnesses, and death to be considered normal. This has led to a remarkable era of progress in health and safety with advances in technology, better personal protective equipment (PPE) and self-contained breathing apparatus (SCBA), safer fire apparatus, protection against vehicle exhaust, focus on nutrition, peer fitness programs, mental health, and member assistance programs. Despite all this progress, firefighters still place their health and safety in danger every day when mitigating building fires by removing their air during overhaul operations and not decontaminating their gear on scene.
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I once worked with a skilled and well-respected firefighter, a person whom anybody would want at their side fighting a fire, who said that if responding to a hazardous materials incident, he would rather wear Level A protection to be maximally protected no matter what the chemical is. Firefighters routinely remove their air when performing overhaul after suppression activities without a second thought. They do not consider the fact that many of the colorless gases present would require Level A protection if taken out of the context of a building fire and instead were leaking from a cylinder at a chemical facility. Basic firefighter training manuals dedicate less than a page to chemical exposure during the overhaul phase. The presence of carbon monoxide and hydrogen cyanide are well known and many departments, mine included, meter for these chemicals during overhaul. My department has been making great strides in safety during post suppression operations but there is much more to be done. Everybody has people on their job who champion health and safety, but some of these same people are often seen performing overhaul without air. This is not any one person’s fault; I too have performed overhaul in the past without air. This is a cultural change, a crucial change that must start now, a new way of thinking and a new way of teaching the next generation of firefighters. When suppression activities have ceased, the building is now a hazardous materials scene.
Every firefighter knows that the fires of today are nothing like the fires of yesterday. Residences of today are filled with products made from chemicals, and when those products burn, they create toxic, flammable, and carcinogenic gases, liquids, and particulates. Metering for carbon monoxide and hydrogen cyanide is a great practice but using it as the determining factor as to whether members should be on air leads firefighters to be in danger. There are meters that have entire libraries for overhaul chemicals that go well beyond CO and HCN. If your only capability is to meter for CO and HCN, then your policy should be to have all members on air when inside the structure, period. That will keep firefighters the safest until time, ventilation, and cooling stops the chemical reactions taking place in the building and forces those gases out of the structure. The overhaul library of one of our meters includes the following chemicals: Acetaldehyde, acrolein, acrylonitrile, ammonia, benzene, CO, formaldehyde, formic acid, glutaraldehyde, hydrogen bromide, hydrogen chloride, HCN, hydrogen fluoride, isocyanates, naphthalene, nitrogen oxides, sulfur dioxide, toluene, and vinyl chloride. Many of these chemicals, when encountered at a chemical facility, require Level A hazmat protection. Why would any of us want to breathe in these chemicals during overhaul? The simple answer is that we do not, but our mindset is wrong. During overhaul, we are still in fire operations mode when we really need to put our minds in hazmat mode. This has to be done through standard operating procedures (SOPs), training and incident commanders who shift their personnel into this mindset once suppression activities have ceased. My department is working towards incorporating the aforementioned meter with its overhaul library as one of the pieces of equipment we use to meter spaces and make decision about being in a structure without air. The tasks that must be performed to place a fire under control are the unavoidable part of our job and is the acceptable risk that we take for the protection of the public, with a full awareness that it is affecting our health and well-being. Once a fire is under control or even when changing out your bottle, however, things can be done to help reduce this danger.
It has been proven that for every five-degree increase in skin temperature there is a 400% increase in chemical absorption. A culture of safety places firefighter rehab as a critical part of any fire operations SOP. When firefighters exit a structure to change out their bottle, they should open their coat and allow the excess heat to escape to help cool their body temperature; they should also drink water and wipe their neck and wrists. Our department has commercially made wipes designed for this purpose. Cleaning the most vulnerable spaces helps reduce chemical absorption. Particulate-blocking hoods are also available and are an example of technology advancing firefighter safety. These simple steps increase well-being during fire operations. After the fire is placed under control and overhaul begins, staying on air is imperative for increased firefighter safety. After overhaul is complete, the building needs to be well ventilated and metered to ensure the safety of the investigators working to find the cause of the fire. For the firefighters involved in the operation, this is where decontamination begins.
After performing firefighting tasks inside a building, a firefighter’s gear is contaminated with numerous toxic and carcinogenic compounds. We would never doff chemical protective clothing at a hazardous materials scene without first going through a decontamination line; it is unimaginable to unzip the suit and come off air with toxic, corrosive, carcinogenic chemicals contaminating the suit. This must be the same mindset after suppression activities have ceased. Studies have shown that firefighting gear is heavily contaminated post-fire operations with Polycyclic Aromatic Hydrocarbons (PAHs), Volatile Organic Compounds (VOHs), HCN, multiple phthalates including di-(2-ethylhexyl) phthalate (DEHP), as well as many other organic and inorganic compounds. These chemicals are extremely toxic, contributing to multiple adverse health effects, and many are known carcinogens. One study showed that the VOCs found in contaminated gear lessened from evaporation, but this took up to 17-36 minutes, allowing time for this contaminated gear to expose firefighters by inhalation that leave the scene in their apparatus without going through decontamination. This contaminates not only their apparatus but their quarters as well. A decontamination line simply consisting of a scrub brush, dish soap, and water was found to reduce PAH contamination by 85%; soap must be used, since water alone is not as effective. Performing decontamination promptly after overhaul, ventilation, and metering are completed will decrease the amount of chemicals saturated in protective clothing and limit the amount of exposure to off-gassing chemicals. When leaving the scene, store as much gear as possible in a compartment away from the cab.
My department has taken extraordinary steps to decrease chemical exposure at fires. We are fortunate to have extractors and dryers in all our stations. Understandably, not everybody has this luxury. For us, this represents a cultural change, and our administration is ensuring that our battalion chiefs on scene are performing rehab, keeping firefighters on air as long as possible, ventilating and metering structures post-fire suppression, and setting up decontamination. The following sequence will reduce exposure to chemicals and hopefully help firefighters reduce their chances of adverse health effects, leading to a long and healthy retirement:
- Eat well, stay fit, and hydrate.
- Train constantly and advocate for better policies.
- Rehab appropriately including heat reduction, neck/wrist wiping, and hydration between bottles.
- Be on air whenever operating inside of a structure.
- Ventilate and meter.
- Receive soap and water decontamination.
- Keep contaminated gear out of the cab.
- Wash gear in an extractor as soon as possible (advocate for acquisition of extractors and back-up sets of gear).
- Shower as soon as possible after returning to quarters.
- Wash station uniform separately from other clothing, preferably at the station if possible.
- Clean all tools, equipment, and SCBA with soap and water.
- Keep PPE away from the living spaces of quarters.
- Always use vehicle exhaust venting systems if available.
Life safety is and always has been our top priority in the fire service. Protecting lives is contained in the first sentence of nearly all mission statements. Protecting our own lives and placing our health and safety as the top priority of our organization from policy to training to action will make us all better suited to serve the public and avoid the horrible fate of suffering from disease. Once suppression activities have ceased and overhaul begins, changing our mindset and treating the scene as a hazardous materials incident and writing SOPs that train firefighters to think this way will hopefully reduce the number of illnesses and death that many of our brothers and sisters have tragically suffered throughout the years.
REFERENCES
Alexander, Barbara. University of Cincinnati, 05/02/2012. “Contamination of Firefighter Personal Protective Gear.”
Kenneth W. Fent, Barbara Alexander, Jennifer Roberts, Shirley Robertson, Christine Toennis, Deborah Sammons, Stephen Bertke, Steve Kerber, Denise Smith & Gavin Horn (2017) “Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures”, Journal of Occupational and Environmental Hygiene, 14:10, 801-814, DOI: 10.1080/15459624.2017.1334904
Richard C. Beaulieu is a lieutenant on Rescue 1 for the Cranston (RI) Fire Department. He is a 17-year veteran of the fire service and has been serving Cranston since 2008. He has a bachelor’s degree in fire science from Providence College, is a cardiac level EMT and has been a hazmat technician since 2006. He is a NFPA 1041-certified instructor and coordinates the hazmat technician training for the Cranston Fire Department’s recruit training academy.
