Posts Tagged protecting firefighters from carcinogens

Cancer in the fire Service

Excerpts from the

Fire departments have been taking extra steps – many of which involve changing some long-held mindsets – to reduce exposure to carcinogens.

Dirty gear used to be points of pride among firefighters – and with some they might still be considered as such. But now many fire departments are trying to teach their personnel that dirty coats and soot-blackened helmets represent cancer risks to be avoided.

Studies have shown firefighters developing or at risk of developing cancer at a higher rate than the general population – nearly twice as much with some forms of cancer such as testicular or malignant mesothelioma. Some firefighters call it an epidemic that’s been sweeping through the ranks for several years now, in large part due to the toxic exposures from fires.

The International Association of Fire Fighters claims occupational cancer has become the leading cause of death for firefighters nationwide. Since 2002, 60 percent of the names added to its Fallen Fire Fighter Memorial Walls are people who died from occupational cancers. In its online checklist for reducing exposure risk to carcinogens, the IAFF starts the group of self-actions with eliminating the attitude of “The dirtier the gear, the tougher and more experienced I am.”

From keeping all gear on during overhaul, getting sprayed down, and using wet wipes on-site to washing gear and showering at the station, men and women in the fire service have been working to develop a new, more intensive routine.

Like many veteran firefighters, Kirk Stobart, president of Independence’s (MO) firefighters union can recall when blackened gear was a matter of pride.

“If your gear wasn’t dirty, you weren’t doing your job,” said Stobart, a 26-year firefighter. “They used to make fun of the people that had clean gear.”

“Back in the day, it was like a badge of honor to have dirty gear, a dirty helmet,” adds Sam Persell, assistant chief of the Central Jackson County Fire Protection District.

Said recently retired Independence Fire Chief John Greene, “The dirty gear, soot on the helmet, black snot – now we know all that is just signing your death certificate early.”

For those whose career began about the same time as Stobart, Persell and Greene, it might not be easy to ditch that attitude. Some might have scoffed at the notion of firefighting leading to cancer like it can a heart attack or stroke.

“Now we’ve gotten to the point where guys in the field don’t have to be told, do gross decon right on the scene. It’s amazing to see how well-accepted it’s been. It makes me pretty proud of what our union and management has done.”

Similarly, Persell refers to a former assistant chief in the department who received a cancer diagnosis. Persell helped enact a program of yearly physicals for all firefighters in CJC – starting from the point of hiring – and those check-ups helped catch cancer in a few firefighters, allowing them a chance to get treatment and either return to fire service or retire.

“We train them, we teach them right off the bat, to maintain a sense of wellness and health,” Persell said. “We’ll get to where we want to be. You can’t argue the data (about fire service cancer deaths). The data is there, and it’s ever-increasing. Guys are saying, ‘I don’t want my family to go through that.’”

Firefighters have often battled a far different fire than their predecessors did. The materials used in housing and other buildings contain far more plastics, petroleums and other synthetics that emit poisonous soot and fumes. Through skin absorption or inhalation, firefighters can easily be exposed, and particles can remain on gear not properly cleaned.

“Those old firefighters that taught me,? Stobart said, “they battled solid wood and natural stuff.”

For those who maintained the dirty gear badge of honor, or transported that gear in their civilian vehicle and even into their homes, it would be potentially hazardous.

Even before on-site decontamination, chiefs have implored firefighters to keep all their gear on while going through overhaul,  instead of shedding the coat and mask as some might do, particularly on warm days.

Many times, wet wipes are available to clean the hands, face and neck after a fire. Gear should be removed, if not bagged as well, to return to the station, then washed in commercial-grade extractor washers designed to fully decontaminate fire clothing. Such machines have different settings for inner and outer layers and wash only one or two sets at a time. Helmets have to be scrubbed by hand, and inside of fire trucks should also be wiped down.

Extra gear allows firefighters to shed a dirty set, shower at the station, and be ready to don clean gear and head back out if necessary in less than an hour.

Persell said he even recommends a stationary bike session to work up a sweat for further detox.

Stobart said he fears the cancer issue in the fire service will get even worse before it gets better – many veterans could already be affected, and it will take time for many anti-exposure measures to fully take root – but hopefully the veterans now are setting a positive new standard.

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Cancer in the fire service (more)

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NFPA has issued a firefighter protective hood safety bulletin as the fire service grapples with PPE contaminants and increases in job-related cancer.
Firefighters and their PPE are exposed to a wide range of toxins. According to a study by the CDC and NIOSH, firefighters have a higher chance of developing more than a dozen different cancers than the general population.

Firefighter thermal/flame protective hoods do not stop soot and chemicals from depositing on areas that are extremely vulnerable to dermal exposure. The hoods are designed to protect a firefighter’s head and neck, but they are not built to prevent toxins from being absorbed into a firefighter’s skin. The greatest number of carcinogens enter a firefighter’s body through the lungs; with the skin being the second most concerning access route. Furthermore, if the hoods are not properly cleaned, the toxins will linger in the hoods and rub against the firefighter’s skin.
NFPA is currently working on three research projects related to contamination, PPE and cancer. In the meantime, the protective hood bulletin recommends that fire departments educate personnel on PPE care and maintenance in accordance with NFPA 1851, the Standard on Selection, Care, and Maintenance of Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting.

ProtectiveHoodBulletin to keep firefighters safer from carcinogens and hazardous substances. For additional information, visit NFPA’s PPE cleaning page.

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Cancer in the fire service (more)

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A Richmond fire chief battling stage four cancer is using journey, and the journey of his new scooter, to spread a critical message to firefighters across the country.

Battalion Chief David “Chico” Creasy said his chemotherapy treatments have severely limited his mobility since his cancer diagnosis in 2014. Richmond Firefighter Roger Myers knows the realities of cancer intimately, so he devised a plan to help Chief Creasy. He lost his father to cancer in December, so he decided to give him his father’s scooter.

“[My dad] built a bond of friendship with Battalion Chief Creasy while the two battled cancer,” Myers said. “[My dad] expressed that if he ever lost his battle, he wanted his friend Chico to have anything he could provide to help him continue his.”

Myers arranged the largest bucket brigade ever to deliver the scooter from Florida to Richmond. Dozens of fire departments in five states have signed on to help transport it, but the firefighters helping out will also receive a message from Creasy.

“The more we got to talking about it, the more we realized this was a platform to spread Chico’s message to the fire service,” Myers said.

“When you’re battling the fire, you also have to realize you’re battling a lot of toxic materials,” Creasy said. “[and] need to be more aware about how we can get cancer, what we can do to avoid it.”

Creasy said he has no family history of cancer, so his doctors believe his 48 years battling fires likely led to his illness. He points to studies that have found firefighters are exposed to up 50,000 toxins or carcinogens when responding to a structure fire and hopes every firefighter helping his new scooter along the way will research the cancer risks they face on a daily basis.

His doctors say he is doing better than most patients in his circumstance. Creasy credits that, in part, to the support of he has gotten from firefighters across the country.

The financial challenges of cancer are also impacting Creasy’s journey. He said he pays thousands of dollars out of pocket each month to pay for treatments not covered by his insurance. It is one reason Creasy urges all firefighters to explore their cancer insurance options.

On top of the scooter, Myers set up a Pay Pal account to help the family pay for medical expenses.

You can track the scooter’s journey of Facebook; it’s expected to arrive in Richmond on January 12.

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Cancer in the fire service (more)

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In February 2014 we wrote that protective hoods are the most vulnerable area of the firefighter’s ensemble. That’s because hoods lack any type of barrier characteristics to keep out the superfine particles that absorb a variety of hazardous chemicals including carcinogens.

This shortcoming was coupled with NIOSH studies and other research showing carcinogen buildup on firefighters’ skin, particularly on the neck and face areas unprotected by the SCBA face piece. Further, that skin absorbs chemicals easily around a person’s jaw line led to the obvious conclusion that current-day hoods have little effectiveness in keeping out soot.

In January 2015, we assisted the IAFF with a study to show how much particle penetration takes place throughout the entire structural firefighting ensemble. After that, there could be no doubt that the hood is one of the serious gaps in firefighter protection that needs to be solved.

An overwhelming number of firefighter hoods consist of two layers of knit material fashioned into a sock-like hood that stretches over the firefighter’s head with an opening for the SCBA face piece and bib that is supposed to stay tucked inside under the top of the coat.

The current requirements in NFPA 1971 considers hoods an interface device for providing thermal protection in areas where other ensemble elements do not always provide complete coverage, such as the SCBA face piece, helmet ear covers and coat collar. Yet as the firefighter moves, the hood shifts and leaves the interface areas exposed to the hostile environment.

When the revision process for the NFPA 1971 standard began, a specific task group was charged to come up with possible ways for minimizing firefighter exposure to the carcinogens and other harmful substances contained in soot. One way to achieve complete particle blockage could be to install a moisture barrier as part of the hood composite, similar to the way garments use the same barrier materials.

The increased layering of the hood and the further encapsulation of the head pose additional stress to an already physiologically challenged first responder firefighter. We therefore suggested that a total heat-loss test be applied to these newly reinforced portions of the hood at levels far above those required for garment composites. In this way, the maximum amount of heat stress relief could be provided without compromising the particle holdout capabilities of the new hoods.

These proposed requirements will not be adopted in one form or another until mid-2017. Meanwhile, several manufacturers and fabric suppliers have been working on prospective hood products to reduce firefighter exposure to soot and the adsorbed chemicals contained in smoke particles. These products encompass a variety of new hood designs and combinations of different barrier materials, including both new particle filter layers as well as conventional moisture barriers.

All of the new products, many unveiled this past spring, are certified to current requirements in NFPA 1971 as regular hoods. The new particle barrier hood criteria are not finished. As would be expected, the new hood products are more complex, use new materials and are consequently more expensive. The fact that these hoods are more costly means that fire departments will expect the hoods to stay in service longer.

This brings into question the hoods’ durability over an extended period with multiple cleanings and how well the particle-blocking capability and relative fit will be maintained.  And since the new hoods incorporate an additional layer, they are also somewhat heavier and will have higher thermal insulation than conventional hoods. The greater levels of heat protection means firefighters will perceive heat to a lesser degree than the already do, which can be good or bad depending on how firefighters are trained to react to heat.

The industry still has to work out these issues, particularly as the new version of NFPA 1971 comes to fruition. In minimizing exposure to carcinogens, PPE use is only one of several approaches needed to solve this problem.

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