Monitor and Record Your Exposure
Radiation Exposure is a very serious matter. Nothing stated in this article will undermine that. But possibly the greatest risk to the health and safety of firefighters in this day and age is their exposure to toxic and smoke-filled environments. So why is it that we monitor our rad exposure but not our exposure to these other environments?
Some policies and procedures within the fire service require the appointment of an Industrial Radiation Safety Officer (IRSO) to monitor the entry and exit times of personnel and also to record their exposures from personal dosimeters and refer them for a medical assessment as required. These exposures are documented and recorded on a radiological dose record form like the one below.
Some policies and procedures within the fire service require the appointment of an Industrial Radiation Safety Officer (IRSO) to monitor the entry and exit times of personnel and also to record their exposures from personal dosimeters and refer them for a medical assessment as required. These exposures are documented and recorded on a radiological dose record form like the one below.
So it is fair to say that the service takes these types of exposures very seriously. But the prevalence of cancer from suspected exposure to smoke-filled environments is what is being touted as the greatest threat to firefighters. There are studies indicating that some cancers in firefighters are largely due to radio-frequency radiation exposure (from hand-held and vehicle mounted radio's), not inhaled carcinogens (Milham, 2009) but most information sessions, articles and studies are suggesting that firefighters exposure isn’t exclusively through inhalation.
The commonplace practice of using Breathing Apparatus in compromised atmospheres is protecting the airways of firefighters, but it doesn’t provide protection from absorption during fireground operations or after they have concluded. It also doesn’t protect firefighters from ingestion and inhalation during post fire operations when they are exposed to poor and ineffective staging of rehabilitation and poor decontamination methods.
While radiation exposure is significant and serious and should be monitored at all times, the importance placed on radiation exposure versus firefighter exposure to the toxic and smoke-filled environments seems greatly reduced. Firefighters often enter these dangerous environments without any regard for recording and documenting the exposure which appears to be at odds with placing firefighter health and safety as the very pinnacle of our actions.
Another way that firefighters are exposed is through complacency. Often their are differing measures of safety precautions taken based on the size of the fire and also the nature of the fire. A fire truck arriving on the scene of a fully involved house fire will don breathing apparatus without giving it a second thought. A fire truck that arrives at a “burnt foodstuffs” (a fire in a kitchen thought to only consist of burning food) or “fire had occurred” often question the need for breathing apparatus. Presumably from the absence of fire. Even though the stench of foodstuffs is akin to or worse than the smell of smoke from the largest of fires. So while a pot left on a stove can easily be dismissed as a safe fire or less dangerous, it can actually yield very high levels of Hydrogen Cyanide (HCN). In actual fact, a larger fire which causes significant structural damage allowing the fire to vent through the roof or another cavity can be less harmful due to the toxic gases ability to escape into the atmosphere. Just to be clear, a breathing apparatus is still required in both cases. And furthermore, Breathing Apparatus doesn't protect us from fire, it protects us from smoke.
Any fire yields smoke and where there is smoke there are toxic gases. The most lethal of these toxic gases are carbon mononxide (CO) and hydrogen cyanide (HCN), collectively referred to as the toxic twins. When combined these two gases create a toxin known to cause cardiac arrest on the fireground and sudden death. Due to modern building materials acrolein, other forms of aldehydes, ammonia, phosgene, isocyanates and thousands of other chemicals will also be present.
While the danger of Carbon Monoxide has been known for some time, it has only been in the last 10 years or so that Hydrogen Cyanide (HCN) has come under the scrutiny of fire services globally and health experts. HCN is 35 times deadlier than Carbon Dioxide (CO2) and it is not unusual for a house fire to present HCN concentrations of 200ppm which are lethal in 10 minutes. Like any gas, toxic or otherwise, HCN can enter the body the body through inhalation, ingestion and absorption which targets the heart and the brain.
There is a real perception within the fire service that the smoke plume contains the danger. Stay out of the smoke and you should be ok is the mantra often heard. The most alarming part of the HCN exposure and all other toxic gases is that they are present outside of the smoke plume. They are also present in large concentrations long after the fire has been extinguished. Perpetuated by the presence of enough heat to continue the breakdown of materials and separation of bonds to release them into the atmosphere, but not enough to support flame nor associated smoke. Think of the fire training videos you have no doubt seen showing how pyrolysis begins but with our direct presences of smoke or flame. That similar process can continue to occur into salvage and overhaul operations and also fire investigation, cause and determination. While the fire may be out, heat is still present and minimal ventilation can cause further build up of toxic gases.
The commonplace practice of using Breathing Apparatus in compromised atmospheres is protecting the airways of firefighters, but it doesn’t provide protection from absorption during fireground operations or after they have concluded. It also doesn’t protect firefighters from ingestion and inhalation during post fire operations when they are exposed to poor and ineffective staging of rehabilitation and poor decontamination methods.
While radiation exposure is significant and serious and should be monitored at all times, the importance placed on radiation exposure versus firefighter exposure to the toxic and smoke-filled environments seems greatly reduced. Firefighters often enter these dangerous environments without any regard for recording and documenting the exposure which appears to be at odds with placing firefighter health and safety as the very pinnacle of our actions.
Another way that firefighters are exposed is through complacency. Often their are differing measures of safety precautions taken based on the size of the fire and also the nature of the fire. A fire truck arriving on the scene of a fully involved house fire will don breathing apparatus without giving it a second thought. A fire truck that arrives at a “burnt foodstuffs” (a fire in a kitchen thought to only consist of burning food) or “fire had occurred” often question the need for breathing apparatus. Presumably from the absence of fire. Even though the stench of foodstuffs is akin to or worse than the smell of smoke from the largest of fires. So while a pot left on a stove can easily be dismissed as a safe fire or less dangerous, it can actually yield very high levels of Hydrogen Cyanide (HCN). In actual fact, a larger fire which causes significant structural damage allowing the fire to vent through the roof or another cavity can be less harmful due to the toxic gases ability to escape into the atmosphere. Just to be clear, a breathing apparatus is still required in both cases. And furthermore, Breathing Apparatus doesn't protect us from fire, it protects us from smoke.
Any fire yields smoke and where there is smoke there are toxic gases. The most lethal of these toxic gases are carbon mononxide (CO) and hydrogen cyanide (HCN), collectively referred to as the toxic twins. When combined these two gases create a toxin known to cause cardiac arrest on the fireground and sudden death. Due to modern building materials acrolein, other forms of aldehydes, ammonia, phosgene, isocyanates and thousands of other chemicals will also be present.
While the danger of Carbon Monoxide has been known for some time, it has only been in the last 10 years or so that Hydrogen Cyanide (HCN) has come under the scrutiny of fire services globally and health experts. HCN is 35 times deadlier than Carbon Dioxide (CO2) and it is not unusual for a house fire to present HCN concentrations of 200ppm which are lethal in 10 minutes. Like any gas, toxic or otherwise, HCN can enter the body the body through inhalation, ingestion and absorption which targets the heart and the brain.
There is a real perception within the fire service that the smoke plume contains the danger. Stay out of the smoke and you should be ok is the mantra often heard. The most alarming part of the HCN exposure and all other toxic gases is that they are present outside of the smoke plume. They are also present in large concentrations long after the fire has been extinguished. Perpetuated by the presence of enough heat to continue the breakdown of materials and separation of bonds to release them into the atmosphere, but not enough to support flame nor associated smoke. Think of the fire training videos you have no doubt seen showing how pyrolysis begins but with our direct presences of smoke or flame. That similar process can continue to occur into salvage and overhaul operations and also fire investigation, cause and determination. While the fire may be out, heat is still present and minimal ventilation can cause further build up of toxic gases.
Do you use a P2 Mask for Salvage and Overhaul? Fire Investigation? Cause and Determination?
Is it providing the protection you think it is?
So, for the most part, it is accepted that we are exposed? But what can we do about it?
The simple solution is to adhere to best practice and the policies and procedures of your department but on top of that to inform and arm yourself with advancements in research to identify how we are exposed and what better we can do through PPC and decon methods to mitigate our exposure.
Once that is done, there is another responsibility. Monitor and record your exposure.
Battalion Chief (Ret.) Robert Avsec served the Chesterfield County (VA) Fire and EMS Department for 26 years. He, like all good leaders, espouses that it is the individual that is responsible for their own safety and wellbeing. To that end, Mr Avsec advises that it is high time for firefighters to begin documenting their exposures to toxic and smoke-filled environments. Just as it is mandated for radiations exposure.
Mr Avsec calls for detailed recording of the events you attended and the nature of your exposure. He even goes as far as to say that this record should be retrospective. The details of the recording should include:
If it's good enough for radiation, it's good enough for toxic environments. Start your personal record now!
The simple solution is to adhere to best practice and the policies and procedures of your department but on top of that to inform and arm yourself with advancements in research to identify how we are exposed and what better we can do through PPC and decon methods to mitigate our exposure.
Once that is done, there is another responsibility. Monitor and record your exposure.
Battalion Chief (Ret.) Robert Avsec served the Chesterfield County (VA) Fire and EMS Department for 26 years. He, like all good leaders, espouses that it is the individual that is responsible for their own safety and wellbeing. To that end, Mr Avsec advises that it is high time for firefighters to begin documenting their exposures to toxic and smoke-filled environments. Just as it is mandated for radiations exposure.
Mr Avsec calls for detailed recording of the events you attended and the nature of your exposure. He even goes as far as to say that this record should be retrospective. The details of the recording should include:
- Date and time of incident or training exercise;
- Location of incident or training exercise;
- Length of your time in the hazard area;
- What was burning (e.g., skipbin or dumpster contents, wood-frame single-family dwelling, overturned over-the-road fuel oil tank truck, etc.)
- Protective clothing and equipment you were wearing and using in the hazard area; and
- Name of the incident commander or person in charge of the training exercise.
If it's good enough for radiation, it's good enough for toxic environments. Start your personal record now!
Article written by Brett Carle with thanks to Robert Avsec and the authors listed in the references below.
To submit your own article, please email info@firefightercancercoalition.com
References:
Draeger USA, Dangerous Toxic Twin Toxic Gases for Firefighters. Available at: https://www.youtube.com/watch?v=gBrBPKk8pY0 Milham, S. (2009) Most cancer in firefighters is due to radio-frequency radiation exposure not inhaled carcinogens. Medical Hypotheses, 73, 788-789. doi:10.1016/j.mehy.2009.04.020 Fire & EMS Leader Pro, (2018) Why YOU need to track your on-the-job exposures - Robert Avsec, Executive Fire Officer. Available at: http://www.fireemsleaderpro.org/2018/07/30/why-you-need-to-track-your-on-the-job-exposures/
Draeger USA, Dangerous Toxic Twin Toxic Gases for Firefighters. Available at: https://www.youtube.com/watch?v=gBrBPKk8pY0 Milham, S. (2009) Most cancer in firefighters is due to radio-frequency radiation exposure not inhaled carcinogens. Medical Hypotheses, 73, 788-789. doi:10.1016/j.mehy.2009.04.020 Fire & EMS Leader Pro, (2018) Why YOU need to track your on-the-job exposures - Robert Avsec, Executive Fire Officer. Available at: http://www.fireemsleaderpro.org/2018/07/30/why-you-need-to-track-your-on-the-job-exposures/