KEEPING IT SAFE ROBERT TUTTEROW
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In August 2013, the Firefighter Cancer Support Network
(FCSN) issued a white paper titled Taking Action Against
Cancer in the Fire Service. The white paper was an output
of a workshop conducted in April 2013 with more than
30 participants and reviewers representing a cross-
section of the fire service and subject matter experts.
The 13-page report lists numerous statis-
tics that illustrate the complexity of cancer
in firefighters. These include several reports
that firefighters are more prone to develop
cancer than the general population, despite
the fact that firefighters are in better physi-
cal shape than the general public. One of the
participants, Dr. Grace LeMasters from the
University of Cincinnati, said, “Pinpointing
the cause of cancer is extremely difficult
because firefighters are not exposed to just
one agent. They are exposed to multiple
cancer-causing agents. Because of the mul-
tiple exposures and the multiple routes of
exposure—they inhale carcinogens and car-
cinogens are absorbed through the skin—it
is also highly unlikely for firefighters to get
only one type of cancer.” The report clear-
ly states that the two routes of greatest con-
cern for carcinogens to enter the body are
through the lungs [failure to wear self-con-
tained breathing apparatus (SCBA) during
overhaul] and skin absorption.
Apparatus and Equipment
Now, what about apparatus and equipment as they relate to cancer? The report
credits manufacturers for the many products that help minimize firefighter cancer
risks. These include turnout gear cleaning
equipment, diesel exhaust extraction systems, SCBA, and decontamination equipment and supplies. However, the white
paper is quick to point out that manufacturers should refrain from advertisements that
show firefighters wearing soiled, contaminated (i.e., carcinogen-laden) personal protective equipment (PPE), including helmets.
Consider the following scenario that
occurs on a daily basis in many fire depart-
ments in the United States. The department
responds to a working fire. Following the
working fire, the members board the appa-
ratus, still wearing their contaminated gear,
and return to the station. A bit later in the
day, they get a nonfire call, such as an EMS
call. They board the apparatus and imme-
diately sit on the cross-contaminated appa-
ratus seats. On arrival at the scene, they
administer patient care while wearing con-
taminated clothes. Is it time to think about
a cover for the apparatus seat while wearing
PPE? Think toilet seat cover.
At first this idea might seem a bit
absurd, but further contemplation will
reveal some validity to the concept.
Although that might not be the solution, it is an example of how the fire service needs to focus on ways to minimize
the risks of cancer. Another approach is
issuing nonstructural response PPE for
the bulk of the emergency responses. This
could keep contaminated structural PPE
out of the apparatus cabs and isolated
in a dedicated compartment. The white
paper also calls on manufacturers to support funding to develop curricula for
training materials to address firefighter
cancer awareness and prevention.
The white paper calls on architects to
understand and address design for cancer
concerns in new and renovated fire stations.
This includes floor plans with a “workflow”
that has a decontamination area adjacent
to the apparatus floor, overall station air
exchange, dedicated storage areas for PPE,
and overall design and features that address
the firefighter who has just returned from a
fire as contaminated.
The report goes on to identify further
research needs and calls on all fire service
organizations to work together in “taking
action against cancer in the fire service.”
The report concludes with 11 immedi-
ate actions firefighters can take to protect
against carcinogens. These are as follows:
1. Use SCBA from initial attack to the conclusion of overhaul. Not wearing SCBA in
both active and post-fire environments
is the most dangerous voluntary activity
in the fire service today.
2. Perform gross field decon of PPE to
remove as much soot and particulates
3. Use wet wipes to remove as much soot
as possible from your head, neck, jaw,
throat, underarms, and hands immediately and while still on the scene.
4. Change your clothes and wash them
immediately after a fire.
5. Shower thoroughly after a fire.
6. Clean your PPE, gloves, hood, and helmet
immediately after a fire.
7. Do not take contaminated clothes or PPE
home or store it in your vehicle.
8. Decon fire apparatus interior after fires.
9. Keep bunker gear out of living and sleeping quarters.
10. Stop using tobacco products.
11. Use sunscreen or sun block.
Strikingly, none of these recommendations require additional budget allocations, nor do they require special training.
All they require is common sense hygiene
ROBERT TUTTEROW retired as
safety coordinator for the Charlotte (NC) Fire
Department and is a member of the Fire
Apparatus & Emergency Equipment editorial
advisory board. His 34-year career includes
10 as a volunteer. He has been very active
in the National Fire Protection Association
through service on the Fire Service Section
Executive Board and technical committees
involved with safety, apparatus, and personal
protective equipment. He is a founding member
and president of the Fire Industry Equipment
Research Organization (F.I.E.R.O.).