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JFRD STRATEGIES
From the above revelations, it is apparent that what we have learned must become ingrained and followed up by actions. What if we thought of a fire run as a hazardous materials incident? Every type of fire is releasing hazardous materials from its container (structure). When ignited, dozens of organic and inorganic compounds are released into the air. Some cause cancer; all are toxic. Products of combustion include heat (humans, the environment, and structures don’t do well with heat) and free carbon (soot). When combined with the other elements, soot becomes toxic as well and reduces the percentage of oxygen in the atmosphere.
The following actions the JFRD has taken are from its policies and standing operating procedures:
Treating the Fire Run as a Hazardous Materials Incident
The fire service has never looked at structure fires as hazardous material events. Why? One reason might be that the three federal agencies (the Department of Transportation, the Environmental Protection Agency, and OSHA) that first coined the term hazardous materials and passed laws governing their manufacture, transportation, use, and disposal have been around only since 1967. Structure fires have been around since man learned how to cook brontosaurus burgers in grass huts back in the day.
The federal laws governing response, Code of Federal Regulations Title 40 OSHA 1910.120, and National Fire Protection Association (NFPA) 471, Recommended Practice for Responding to Hazardous Materials Incidents, and NFPA 472, Standard for Competence of Responders to Hazardous Materials/Weapons of Mass Destruction Incidents, and numerous structural standards have always separated and treated hazmat events and structure fires differently. For example, according to federal law, if a PPE garment (level A, B, C, or D) becomes contaminated with a carcinogen, it cannot be reused. You must dispose of it. However, the NFPA says you can wear bunker gear that is continuously exposed to carcinogens for up to 10 years.
NFPA 1851, Standard on Selection, Care, and Maintenance of Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting, 2014 edition, states the following:
Sec. 7.1.2. “Ensembles and ensemble element shall be evaluated by the wearer for application of appropriate cleaning level after each use.
Sec. 7.2.1. “The end users shall be responsible for the routine cleaning of their issued ensemble and ensemble elements.”
Sec. 7.2.4.1. Routine cleaning procedures for cleaning garment elements shall be used only for spot cleaning of the element and shall be performed in that utility sink. Sec. 7.2.4.3. Cleaning of the entire garment elements shall be accomplished using advanced cleaning procedures.
Sec. 7.3. Ensemble and ensemble elements that are soiled shall receive advance cleaning prior to reuse. (14)
The JFRD has taken the approach that all bunker gear is to undergo advanced cleaning every six months, at minimum; but if it is heavily soiled from a structure fire, it is to be cleaned as soon as practical.
The JFRD has taken a revolutionary approach to the concept that a fire is a hazardous materials incident. We determine levels of zoning (hot, warm, and cold); meter for chemicals; compare federal laws for hazmat incidents vs. those for structural fires; and, stress situational awareness, especially understanding what chemicals are being released at a structural fire; identifying the hazard is the first step in a hazmat incident).
All atmospheres are considered immediately dangerous to life or health (IDLH), and we treat our PPE as objects that are contaminated with carcinogens. Firefighters are required to always wear SCBAs during overhaul and clean bunker gear at all times (unless it is impossible to do so such as if there are multiple successive fires and they do not have a chance to launder/swap gear).
Wilson relates that in late 2008 and 2009, the JFRD attempted to use five-gas meters to clear the atmosphere so firefighters could remove their SCBAs during overhaul. However, NIOSH found a correlation between the products of combustion in particle form as well as in gas form. Therefore, our previous logic of using gas meters to clear structures for overhaul is flawed and dangerous.
We need to wear SCBA with face piece at all times, especially since “clean air” also contains hazardous substances. APRs are not an option. NIOSH requires that 100 percent of the chemicals be identified before an APR can be used. As far as our department is concerned, that is not an option because there is no way to certify that we have identified every single substance in our working atmosphere.
The JFRD uses the guidelines for handling radiological events-Time, Distance, and Shielding. Firefighters view the products of combustion in the same way as they view radioactive materials. They must limit their TIME of exposure, once the main part of the fire is knocked down or their time has been exhausted; they must DISTANCE themselves from the scene and go to the rehabilitation area (Rehab), and they must SHIELD themselves from their contaminated bunker gear, as if it were an enemy that wants to kill them. In other words, use the following contamination-reduction and firefighter-protective techniques:
- Use a booster hose at the scene to perform gross decon of your PPE.
- Remove your PPE before entering the clean rehab area.
- Bag and tag the PPE for cleaning.
- Wipe all of your exposed skin areas with handy wipes.
- After you have cooled down and have taken your vital signs, prepare to leave for the station. You may have to borrow an apparatus from one of the relief companies.
- Arrange for a clean set of loaner gear on scene or delivered to the station.
- Return to the station; cool down and take a shower.
- Change into a new uniform.
- Take your vital signs again.
An Offensive and a Defensive Approach to Structure Fires
Our department has been an aggressive and successful interior firefighting department. However, that approach is harmful. “The fire service’s approach to managing fires and its perception of overhaul are literally hurting us,” explains Wilson. “We’ve been playing a game with an Offense only; no Defense, and the numbers are catching up to us.”
As It Used to Be: The first assignment (the offense) goes into the structure fire, makes the interior attack, and knocks down the fire to the smoldering stage. Fire crews would go outside, take a breather, and go back in and finish overhauling the building, many times with a lower level of PPE and SCBA protection. This is the stage at which many injuries occur not only because of decreased PPE but also because of exhaustion and a decrease in situational awareness (not paying attention as carefully as before).
The JFRD Revolutionary Proposal: The Defense, a secondary assignment sent from distant districts to ensure adequate coverage of the jurisdiction will complete the overhaul portion of the fire. The health and safety officer (HSO) will manage the W-4 group (see below), except for the overhaul team, which the IC will control. The HSO, working in concert with the incident commander (IC), will determine when this “health and safety” benchmark is needed. The HSO position is staffed by a rescue chief, who will be dispatched on all working assignments. This position cannot be cancelled; it is a mandated position for the JFRD. The incident safety officer (ISO) is assigned by the IC as the second- or third-arriving suppression chief.
The Defense will have a minimum of one additional engine, ladder, rescue (advanced life support transport unit), Rehab 37 (JFRD rehab bus unit), and Air 5 (JFRD air supply truck).
Notification of Crews
For years, the JFRD used W-signals to let incoming units know the amount of resources needed to handle a situation: W-1 for a one-unit response, W-2 for an engine and a ladder response, and W-3 for the entire assignment. We added the W-4 response, the health and safety benchmark, for transitioning on fire scenes to meet the following criteria:
- Primary units have exceeded the use of one bottle of air prior to a signal 77 (under control).
- Primary units have exceeded 40 minutes of strenuous activity prior to a signal 77.
- The fire is a second-alarm or greater.
The key principle in this revolutionary direction is, “It is mandatory to wear SCBA and PPE during overhaul, no exceptions.” The goal is to adopt these principles as the new “Best Practices” for overhaul throughout the fire service.
Annual Medical Examinations
Annual examinations are recommended by the Firefighter Cancer Support Network. Early detection and early treatment are essential to increasing survival. Except for the JFRD hazmat team and members over the age of 50, the JFRD does not provide annual medical examinations. The incidents documented here and scientific research, however, show there is substantial need for annual medical screenings for all JFRD members.
One idea that has surfaced is that the fire service should stop calling PPE “bunker gear.” Since our “gear” is covered in contaminates, the last place it needs to be is next to the “bunk.” One heroic JFRD captain who passed away from bladder cancer used to say that he put his “bunker boots” beside his bunk every night because he liked the smell of the fires that he had been to. If only he and others who have since passed away from cancer and other occupation-related exposure diseases only knew the dangers involved! This article is dedicated to the memory of those Jacksonville firefighters who died from exposure to toxic compounds while in the line of duty.
Wilson notes: “In the JFRD, many past and present heroes, from the rank of district chief down to firefighter, have succumbed to the effects of cancer. In at least two cases, the firefighters were being treated simultaneously in an oncology facility. They were either familiar with each other or had been working on the same chemical plant fire years prior.
As previously mentioned, the IAFF has been pushing for presumptive cancer legislation in all 50 states. Currently, only 34 states have this legislation; Florida is not one of them. Through the Firefighter Cancer Support Network, measures have been introduced to garner information from departments around the state, consolidate it, and make it available to the Florida Professional Firefighters and the IAFF so they can pursue their efforts for a cancer presumption law for Florida’s firefighters.”
REFERENCES
1. L’Abbé, KA & Tomlinson, GA. (1992, April 24). “Fire Fighters in Metropolitan Toronto: Summary of the Mortality Study.” Toronto, Canada.
2. Bolstad-Johnson, DM, et al. (2000 September/October). “Characterization of Firefighter Exposures during Overhaul. Phoenix, AZ, USA.”
3. LeMasters, GK, et al. (2006 November). “Cancer Risk among Firefighters: A Review and Meta-Analysis of 32 Studies. Cincinnati, Ohio, USA.”
4. IAFF. (2008 November/December). “Fighting Fires, Fighting Cancer.” International Fire Fighter, 24.4.
5. National League of Cities. (2009 April). “Assessing State Firefighter Cancer Presumption Laws and Current Firefighters Research.” Washington, D.C., USA.
6. United States Fire Administration. (2013, November 5). “Study of Cancer Among Firefighters.” Retrieved from Firefighter Health and Safety, Firefighter Fitness: http://www.usfa.fema.gov/fireserivce/firefighter_health_safety/health_fitness/cancer.shtm.
7. Daniels, R, Kubale, T, & Yinn, JH. (2013). “Mortality and Cancer Incidence in a Pooled Cohort of US Firefighters from San Francisco, Chicago, and Philadelphia (1950-2009).” Cincinnati, OH: Occupational and Environmental Medicine.
8. Underwriters Laboratory. (2010). Firefighter Exposure to Smoke Particulates. Northbrook, IL: Underwriters Laboratory.
9. Wildfire Today. (2009, April 21). “Cancer Among Seattle Firefighters.” Retrieved from Firefighter/Cancer link Update: http://wildfiretoday.com/tag/cancer/page/2/.
10. KOMO News. (2004, November 1). “Station 31 given clean bill of health.” Retrieved from KOMONEWS.com: http://www.komonews.com/news/archive/4137076.html“>http://www.komonews.com/news/archive/4137076.html.
11. Stranahan, S. Q., & King, L. (2000, 04 30). Philadelphia Inquirer, ” Beyond the Flames.” Retrieved from “In the ashes of a blaze, a heroic sacrifice remains”: http://inquirer.philly.com/specials/2000/fire/stories/fire30.asp.
12. Brown, N. J., & Snedeker, S. M. (2010). BCERF Alert for Women Firefighters: Chemical Exposures in Your Workplace and Breast Cancer Risk. Retrieved from Cornell University: Program on Breast cancer and Environmental Risk Factors: http://envirocancer.cornell.edu/learning/alert/fire08.cfm.
13. Davis, S. R. (2012, October 22). “Evaluation of a Bladder Cancer Cluster in a Population of Criminal Investigators with the Bureau of Alcohol, Tobacco, Firearms and Explosives-Part 1: The Cancer Incidence.” Journal of Environmental and Public Health, p. 10. Retrieved from www.hindawi.com/journals/jeph/2012/101850.
14. NFPA. (2014, 10 20). NFPA org. Retrieved from NFPA 1851, Standard on the Selection, Care, and Maintenance of Protective Ensembles for Structural Firefighting and Proximity Fire Fighting: http://www.nfpa.org/codes-and-standards/document-information-pages?mode=code&code=1851&docnum=1851&tab=nextedition.
Author’s note: Many of the ideas presented have surfaced as the climate in our organization has been changing toward protecting our members from cancer. The impetus for this movement has been JFRD’s Division Chief of Operations Kurtis R. Wilson, who initiated the cultural change within our department.
TREVOR NELSON is a district chief with the Jacksonville (FL) Fire and Rescue Department, where he has served for 23 years and commands the hazardous materials team on his assigned shift as well as five stations in the Southside area. He began his career with the Macclenny (FL) Fire Department and subsequently served in the Baker County (FL) EMS service and the Orange Park (FL) Fire Department. He has associate degrees in fire science, fire officer, and EMS management from Florida Community College at Jacksonville; a bachelor of applied science degree in fire department management from Florida State College in Jacksonville; and a master’s degree in public administration from Barry University in Miami Shores, Florida.
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