SCOPE:
This procedure shall apply to all fire service personnel as it applies to their role within the fire service. It shall be the responsibility of all fire service personnel to be familiar with this guideline and follow its procedures as it applies to their rank or role in the fire service.
GENERAL:
1. Cancer reduction shall be addressed through different measures. These measures are most effective when they are all used together:
a. Engineering controls – Building and Apparatus
b. Gross decon of PPE and skin decon at fire incident scenes
c. PPE bagging / clean cab concept
d. PPE washing / hood laundering or exchange
e. Gross decon and post-incident cleaning of SCBA cylinders, harnesses, and masks
f. Showering and changing clothes – Shower within an hour
g. Use of SCBA during overhaul
h. Practicing a healthy lifestyle
DEFINITIONS:
1. Products of Combustion, include smoke, fumes, vapors, and particles composed of carbon monoxide, hydrogen chloride, acrolein, benzene, formaldehyde, polycyclic aromatic hydrocarbons (PAHs), sulfur dioxide, ash, tar, hydrocarbons, fibers, carbon, other gases, and semi-combusted materials.
a. PPE – Personal protective clothing, must be worn during all fire suppression and overhaul operations, or whenever products of combustion are present, regardless of location (interior or exterior).
b. SCBA – Self Containing Breathing Apparatus, must be worn during all fire suppression and overhaul operations, or whenever products of combustion are present, regardless of location (interior or exterior).
c. Hot Zone, any location in which the products of combustion are present, including, but not limited to, structure fires, vehicle fires, trash/brush/rubbish fires, or any incident in which products of combustions are present, including salvage and overhaul operations.
d. Gross decon – flushing the outside of PPE and SCBA, conducted at the incident scene prior to a full washing/cleaning upon return to station.
ENGINEERING CONTROLS:
1. Firefighters shall make use of engineering controls in the station and on the apparatus that are meant to reduce cancer. These engineer controls may include:
a. Rooftop ventilation/exhaust fans
b. Building space filtration systems
c. Direct source diesel exhaust capture systems mounted onboard the apparatus
d. Hose-based direct source diesel exhaust capture systems.
GROSS DECON OF PPE AND SKIN DECON:
1. Each fire company/department shall provide incident decontamination kits for use by personnel to perform gross decontamination at fire scenes.
2. The gross decontamination kit shall include a bucket, garden hose with nozzle, stiff brushes, mild detergent or biodegradable cleaning agent, skin cleaning wipes, and a traffic cone. A booster / hose line at low pressure may substitute for the garden hose.
3. Firefighters shall use the components of the gross decontamination kit to rinse fire debris from the outside of PPE and SCBA upon exiting the Hot Zone. Generally, gross decontamination will be performed at the first arriving Engine or Engine closest to the Hot Zone, away from personnel who have not been exposed to products of contamination. A traffic cone should be placed at the decon area to help identify the decontamination location
4. Gross decontamination shall be performed before firefighters proceed to Rehab or any other non-Hot Zone area or activity. Exception: firefighters leaving the Hot Zone to retrieve equipment or deliver information will not go through decontamination if they will be immediately returning to the Hot Zone.
5. Decontamination will be performed prior to removing SCBA to prevent respiratory exposure.
6. Decontamination shall consist of the following method:
a. Rinse the firefighter’s PPE and SCBA with low pressure water to rinse off large debris.
b. Using the designated stiff brushes and mild detergent scrub the gear with a soapy solution and repeat the rinse to further remove the contaminants. Particular attention should be given to the gloves, underarms, SCBA straps, front coat enclosures, arm cuffs, groin area, boot tops, and boot bottoms.
c. After rinsing, the firefighter will step away from the runoff area and remove the helmet, hood, regulator, mask and SCBA, gloves, coat, pants and boots.
d. The firefighter will use skin wipes to remove skin contaminants on the face, neck, ears, abdomen, hands, groin area, and helmet headband. Members shall wash their hands as the final step of skin decontamination. Used wipes must be disposed of prior to leaving the incident scene. Use of skin wipes is only the first step in the skin cleaning process. This should be followed up with a full shower and change of clothes as soon as possible after returning to the station.
PPE BAGGING / CLEAN CAB CONCEPT
1. After gross decontamination at the fire scene the PPE shall be left outdoors for offgassing.
2. PPE shall be bagged and transported to the fire station in an unoccupied compartment of the apparatus.
PPE WASHING AND PROTECTIVE HOOD LAUNDERING/EXCHANGE:
1. Firefighters shall wash their PPE in a designated gear washing machine at the fire station before reuse.
2. The gear shall be disassembled for the purpose of machine washing. Liners and hoods shall be washed separately from outer shells and gloves. PPE shall be washed using the designated detergent for PPE. The use of nitrile gloves is required during the disassembling of the gear for washing.
3. Firefighters washing their PPE at the station shall be prompt in removing their gear from the washing machine after use and moving it to the PPE drying machine in the station, and then reassembled for service upon completion of the drying cycle.
4. Understanding that the neck, throat and ear areas of the body are highly susceptible to absorption of fireground contaminants, firefighters shall ensure that they wash their protective hood or exchange it with a clean one provided by the department if the department has established a hood exchange program. If established, the department shall provide clean protective hoods for use by firefighters after a fire and a designated place to put protective hoods that require washing. Protective hoods that have been washed and dried will then be returned to the clean hood distribution point.
GROSS DECON AND POST INCIDENT CLEANING OF S.C.B.A.:
1. To limit the transfer of carcinogens and fireground contaminants to other firefighters on future responses, SCBA shall be rinsed off and heavy debris removed at the incident scene following their use at a fire. This is to reduce the transfer of contaminants into the passenger cab of the fire apparatus.
2. Upon return to the station, the SCBA cylinders and harnesses will be washed using a stiff brush to apply a mild detergent designated by the department for SCBA cleaning. The use of nitrile gloves is required during the washing of the SCBA.
3. The SCBA will be reassembled and either rotated onto the 2nd out pumper for the purposes of drying OR they may be left assembled and ready for service on the bay floor next to the apparatus on which they belong with a fan blowing air across them. The last option would be to place the clean SCBA units assembled back into the cab of the apparatus they are assigned to and leave the cab doors/windows open for the purpose of drying the harnesses.
4. SCBA masks shall be cleaned in a soapy solution and then rinsed. The mask will then have a thorough wiping to ensure that all the soot and dirt was removed.
SHOWERING AND CHANGE OF CLOTHES:
1. Shower within an hour: Firefighters shall take a cool/lukewarm shower with soap to remove remaining skin contaminants not wiped off at the fire scene and change into clean uniforms/clothes. This shall be done as soon as reasonably possible after returning to the station or home from the station. Firefighters should NOT take a warm or hot shower, as this will open skin pores and allow skin contaminants to be absorbed into the skin.
USE OF SCBA DURING OVERHAUL:
1. During the overhaul of interior structure fires, hazardous gases and by-products of combustion continue to be released into the air as the contents and structural components continue to smolder.
2. Firefighters conducting overhaul shall remain breathing on SCBA to reduce exposure to fireground contaminants and carcinogens.
3. The company officer shall monitor personnel conducting overhaul wearing SCBA and ensure these crews are rotated out with fresh personnel as needed.
4. Firefighters completing overhaul activities shall receive a gross decontamination of their PPE and SCBA along with the use of skin decontamination wipes after doffing their PPE at the incident scene and follow all other sections of this SOP that apply.
PRACTICE A HEALTHY LIFESTYLE
1. A holistic approach to practicing a healthy lifestyle reduces the risk factors of occupational (and non-occupational) cancers. Considerations for practicing a healthy lifestyle should include:
a. Annual physicals
b. Mental health
c. Sleep / rest
d. Proper diet
e. Exercise
f. Limited or no use of alcohol and tobacco
SUMMARY:
1. While firefighters being diagnosed with cancer is not completely preventable, studies show that it can be reduced using a combination of methods.
2. (Name of Fire Company) will utilize the steps as described above in combination to achieve the goal of reducing firefighter exposure to carcinogens and fireground contaminants:
a. Engineering controls – Building and Apparatus
b. Gross decon of PPE and skin decon at fire incident scenes
c. PPE bagging / clean cab concept
d. PPE washing / hood laundering or exchange
e. Gross decon and post-incident cleaning of SCBA bottles and harnesses
f. Showering and changing clothes – Shower within an hour
g. Use of SCBA during overhaul
h. Practicing a healthy lifestyle
3. This guideline is consistent with the New Jersey State Firefighter Carcinogen Reduction and Decontamination Protocol guidelines.