Out of the Frying Pan…

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Cardiovascular and Chemical Exposure Risk in Modern Firefighting

 
Firefighters risk their lives to protect our communities every day. When they go into a burning building, they face danger not only from the heat of the flames, but also from the dangerous chemicals in the smoke. In recent years the extent of cardiovascular and chemical exposure dangers that firefighters encounter have become much clearer. Safety has always been a huge priority for the fire service, but the facts about this issue are still being uncovered.

The materials used in buildings and furniture used to be pretty predictable: wood, basic metals, and alloys. These things were bad enough, but add in synthetic materials, paints, treated upholstery, heavy metals, and combustible lithium ion batteries and the smoke and fires get worse1.

Side-by-side comparisons of a legacy room versus a modern room shows that the modern room burns hotter, faster, and produces more smoke. The result is cesspool of toxic fumes that firefighters bathe in whenever they enter a burning structure. Their self-contained breathing apparatus (SCBA) may help them from inhaling these things, but cannot stop toxic soot from settling into gaps on gear and rising into the air or coming into contact with skin.

Many of the products found in household objects today contain volatile chemicals. When these products burn, those chemicals are sent into the air, adding more hazards to an already dangerous environment. Firefighters’ equipment in turn absorb these chemicals, and firefighters can encounter them long after they have left a fire scene. This is especially true if the equipment is not cleaned and cared for in the prescribed manner.
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The image of dirty, scarred gear being a symbol of a seasoned firefighter is fading as new generations look at the potential health effects of improperly handled equipment. A recent survey conducted by Fire Rescue 1 asked more than 1,200 firefighters what they want from their personal protective equipment (PPE)2. Their top response indicated that they wanted PPE that repels cancer-causing particles. Not all firefighters appear to have this in mind. Surprisingly, the same survey showed that 12 percent said they rarely ever wash their gear, and 33 percent reported cleaning it only twice a year.

Although there is no sure-fire way to completely eliminate exposure to these chemicals, there are preventive measures that can help reduce some of the harmful effects. One simple method is for firefighters to clean both their gear and themselves after every fire. This might sound like a given, but as with anything one does frequently, people may become complacent about cleaning themselves before resting, eating, or touching things they have frequent contact with.

This means that cleanliness, especially of the hands, is very important. These harmful chemicals can be introduced to the firefighters’ skin when they wipe away sweat, scratch their nose, take a bite of food, or similar common actions.

Health Effects

The true health effects of the exposure have not been fully analyzed because researchers have not been able to recreate the physical environment of a modern fire where accurate data can be collected. A partnership between the Illinois Fire Service Institute, the UL Firefighter Safety Research Institute, the National Institute for Occupational Safety and Health, and the University of Illinois at Chicago has completed a study to better understand how responding to modern fire environments relates to the two leading health issues facing firefighters today: cardiovascular and chemical exposure related to carcinogenic risk.

The motivation for the study consisted of three things3: to better understand the dangers of modern residential fires, to reign in firefighter cardiac events, and to identify carcinogens among the toxic chemicals involved.

During this study, they tested the temperatures in a structure, as well as biometrics from the firefighters such as body temperature (before, during, and after the fire), blood, urine, breath and heart rates. At the time of printing, the final report is not yet available, but there is an interim report that goes through every detail of the study. The Interim Report covers the specific aim of the study4 which is outlined below.

  • Conduct realistic firefighting tactics with 12-person teams responding to residential fire environments that contain building materials and furnishings common in the 21st century
  • Measure the production and transfer of thermal energy and products of combustion through modern personal protective equipment (PPE) and onto/into firefighters’ bodies and evaluate how these variables are influenced by:
    • Tactical decision (interior only vs. transitional attack)
    • Operating location (interior fire suppression/search vs. exterior operations vs. interior overhaul)
  • Measure cardiovascular disruption for up to 12 hours following firefighting and evaluate how these variables and recovery from firefighting activities are influenced by:
    • Tactical decision (interior only vs. transitional attack)
    • Operating location (interior fire suppression/search vs. exterior operations vs. interior overhaul)
  • Measure markers of toxic exposure (chemicals or their metabolites in blood, urine, and breath) for up to 12 hours following firefighting and evaluate how these variables are influenced by:
    • Tactical decision (interior only vs. transitional attack)
    • Operating location (interior fire suppression/search vs. exterior operations vs. interior overhaul)
    • Skin cleaning and/or use of decontaminated gear
    • Evaluate effectiveness of skin cleaning procedures in reducing contamination on the skin, particularly on the neck.
    • Evaluate effectiveness of gross on-scene fire ground decontamination procedures in minimizing secondary exposure risk from off-gassing PPE.

Unfortunately, not every danger involved with modern firefighting can be avoided, but there are ways to mitigate the risk of coming into contact with harmful chemicals and carcinogens. Even something as simple as mandating firefighters to wash off after every call can go a long way to ensuring their health.

Until more information is known about this health issue, consider reviewing the Interim Report and taking stock of the multiple interim recommendations which are available even before the full report is put together. The anticipated release date of the detailed fire service toolkit is 2017, and will consist of a comprehensive overview of the information available as well as tactical considerations.

If your district isn’t already a member, participation in the Colorado Firefighter Heart and Circulatory Benefits Trust provides access to some resources, many of which are available at no additional cost, to help firefighters identify cardiovascular problems before they become life threatening. For more information on that program, visit our Colorado Firefighter Heart and Circulatory Benefits Trust Fund.

Sources:
1- http://www.theatlantic.com/health/archive/2015/09/our-toxic-homes/404722/
2- http://firerescue1-praetorian.netdna-ssl.com/State-of-PPE.pdf
3- http://www.ppe101.com/2016/03/report-cardiovascular-and-chemical-exposure-risks-in-modern-firefighting/
4- http://www.firefighternation.com/sites/default/files/CardioChemRisksModernFF_InterimReport2016.pdf

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