Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures

Abstract

Firefighters' skin may be exposed to chemicals via permeation/penetration of combustion byproducts through or around personal protective equipment (PPE) or from the cross-transfer of contaminants on PPE to the skin. Additionally, volatile contaminants can evaporate from PPE following a response and be inhaled by firefighters. Using polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) as respective markers for non-volatile and volatile substances, we investigated the contamination of firefighters' turnout gear and skin following controlled residential fire responses. Participants were grouped into three crews of twelve firefighters. Each crew was deployed to a fire scenario (one per day, four total) and then paired up to complete six fireground job assignments. Wipe sampling of the exterior of the turnout gear was conducted pre- and post-fire. Wipe samples were also collected from a subset of the gear after field decontamination. VOCs off-gassing from gear were also measured pre-fire, post-fire, and post-decon. Wipe sampling of the firefighters' hands and neck was conducted pre- and post-fire. Additional wipes were collected after cleaning neck skin. PAH levels on turnout gear increased after each response and were greatest for gear worn by firefighters assigned to fire attack and to search and rescue activities. Field decontamination using dish soap, water, and scrubbing was able to reduce PAH contamination on turnout jackets by a median of 85%. Off-gassing VOC levels increased post-fire and then decreased 17-36 min later regardless of whether field decontamination was performed. Median post-fire PAH levels on the neck were near or below the limit of detection (< 24 micrograms per square meter [µg/m]) for all positions. For firefighters assigned to attack, search, and outside ventilation, the 75 percentile values on the neck were 152, 71.7, and 39.3 µg/m, respectively. Firefighters assigned to attack and search had higher post-fire median hand contamination (135 and 226 µg/m, respectively) than other positions (< 10.5 µg/m). Cleansing wipes were able to reduce PAH contamination on neck skin by a median of 54%.

Airborne contaminants during controlled residential fires

“…While firefighters' lungs may be protected by SCBA, some airborne chemicals could penetrate or permeate the turnout gear and be absorbed through skin. [31,36] These results, as well as the area air concentrations measured inside the structure during the fire, are also important for understanding the potential risks to trapped occupants or firefighters who run out of air or otherwise remove SCBA.…”

“…The study design is described in detail elsewhere. [25,30,31] Briefly, using a repeated-measures design, study participants were grouped into 6 crews of 12 firefighters and each crew was deployed to a pair of fire scenarios using 2 different fire attack tactics (order of introduction was balanced). Six fire scenarios were suppressed using an interior attack from the "unburned side" (advancement through the front door to extinguish the fire) and 6 fires were suppressed with transitional attack (water applied into the bedroom fires through an exterior window prior to advancing through the front door to extinguish the fire).…”

Understanding the Economic Benefit Associated with Research and Services at the National Institute for Occupational Safety and Health: An Approach and Three Case Studies

“…Because the NIOSH study (Daniels, Kubale, et al, 2014) had a large sample and was based in the United States, fire chiefs, firefighters, and policymakers considered it more credible than any of the previous U.S. studies or studies in other countries, where safety standards, construction materials, and other environmental factors can be very different. In addition, NIOSH's experimental studies highlighted exposure pathways that could increase firefighters' risk of cancer, as well as steps that could be implemented to reduce this risk (e.g., Fent, Evans, and Couch, 2010;Fent, Eisenberg, Evans, et al, 2013;Fent, Eisenberg, Snawder, et al, 2014;Fent, Evans, Booher, et al, 2015;Fent, Alexander, et al, 2017). Moreover, those familiar with the industry described a cultural change following NIOSH's work: Where a dirty uniform had earlier been seen as a "badge of courage" or evidence of a positive marker that one was "a real firefighter," this was no longer a widely held belief after the publicizing of the NIOSH results.…”

“…One recent NIOSH study showed a 54-percent reduction in PAH exposure to neck skin by using cleansing wipes and an 85-percent reduction in PAH surface contamination from on-scene wet decontamination by using dish soap (Fent, Alexander, et al, 2017). However, there have been no systematic attempts to estimate the overall effect.…”

“…Firefighters with more exposure to fires also had a lower incidence of colorectal and prostate cancers, which the authors suggested came from a "healthy worker survivor effect," 35 possibly enhanced by medical screening. The NIOSH publications received significant attention, and the institute continued to explore the specific mechanisms causing the increased cancer risk and control measures to mitigate it (Fent, Eisenberg, Snawder, et al, 2014;Fent, Evans, Booher, et al, 2015;Fent, Alexander, et al, 2017;Fent and Evans, 2011;Horn et al, 2016). It also produced several additional reports to publicize and disseminate its research (e.g., Fent, Evans, and Couch, 2010;Fent, Eisenberg, Evans, et al, 2013;Fent, Musolin, and Methner, 2013).…”