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11 Posts authored by: rbcampbell Employee

Attention to firefighter cancer in recent years has helped to encourage a variety of efforts aimed at reducing exposure to harmful contaminants.

While cancer understandably has a way of capturing attention, it is important to note that there are additional health effects associated with the toxins produced during firefighting operations, including kidney and liver disorders, neurodevelopmental effects, decreased fertility, respiratory disease, coronary heart disease, cardiovascular disease, and more.

Furthermore, not all fires emit the same level of contaminants, and not all firefighters at the scene experience the same degree of exposure. Research has found higher levels of contaminants on the turnout jackets of personnel assigned to inside attack and search duties post-fire than those assigned to overhaul and backup; however, overhaul activities also entail significant exposure to contaminants because contaminants can be disturbed and enter the breathing zone.

The bottom line is that decontamination is an emerging issue that requires commitments from everyone. Fire departments need to provide environments that support best practices, while firefighters and fire officers must also accept responsibility for reducing exposures and limiting risk.

Decontamination best practices and procedures have been shared by every major fire organization to date – but they bear repeating and sharing, over and over again. They demand commitment at the department level, ownership by first responders, and guidance at every turn by fire service leadership.

Financial resources and outdated protocols continue to hamper decontamination efforts at certain departments. For instance, not every department has the ability to purchase a second set of gear or secure proper laundering solutions; but there are a number of practices that can substantially reduce harm to firefighters. Here’s 15 that may just help save a life:


  1. Perform some decontamination before leaving the scene. For example, gross decontamination with an industrial scrub brush is an effective initial step to remove debris and contaminants. It should be followed by using a garden hose or low-volume fire hose to avoid contaminating personal areas of vehicles or the fire station.
  2. Clean face pieces every time they are used. Research has found contaminants on the inside of face pieces which can lead to concerning inhalation and skin contact hazards. At the fire scene, use disposable wipes for cleaning your mask.
  3. Tools and equipment should also go through gross decontamination before returning to the station in order to avoid cross contamination.
  4. Establish a personal hand washing station to be used onsite by connecting a simple diverter valve from the apparatus heat exchange to the pump panel. Stock with soap, towels, and disposable wipes.
  5. Wear under gloves and glove liners when removing and handling contaminated gear to protect your hands from absorbing toxins on PPE and equipment.
  6. To avoid cross-contamination, remove, seal and store turnout gear, including PPE, boots, gloves, masks, and helmets, in large, leak-proof plastic bags in a designated turnout compartment (separate from the cab) before entering vehicles.
  7. If possible, avoid taking your gear home or storing PPE in personal vehicles. When this isn’t possible, as is often the case for volunteer firefighters, gear should be bagged or stored in containers and stowed outside personal space or vehicles.
  8. Open bags of gear and equipment outside the station for proper off-gassing.
  9. Prioritize decontamination laundering.
  10. Shower as soon as possible following exposure.
  11. Ensure that local exhaust ventilation systems (including those that attach to apparatus to capture diesel exhaust) are in place to reduce contaminants within the station.
  12. If your station has a laundry extractor, avoid mixing contaminated gear with less contaminated gear to reduce cross-contamination.
  13. Store decontaminated ensembles in dedicated, well-ventilated areas at the station.
  14. Wear alternate footwear inside the station to reduce contamination of indoor areas from footwear worn at the scene.
  15. Share these important steps with other crew members, and hold yourself and others accountable for doing all that you can to reduce occupational exposure to hazardous contaminants.


NFPA has had the backs of the fire service for more than a century. To help reduce firefighter exposure to harmful toxins on the scene, in department apparatus, at the firehouse and in personal spaces, please refer to our research, standards, and resources.

electrical safety
A few weeks ago I posted a blog about the “normalization of deviance” – referring to violations of good electrical safety practice that have been rationalized as acceptable – as a possible explanation for how some electrical injuries occur. I was trying to point out that implementing detailed electrical safety procedures without fail requires a certain amount of vigilance and commitment in the face of everyday challenges at work that encourage production.
In the June issue of Occupational Health and Safety, I have some additional thoughts on the social environment of electrical safety, focusing this time on organizational safety culture. I’ll briefly summarize here why I think this angle is relevant to preventing electrical injuries. 
In recent years, there has been growing interest in safety culture as a critical influence on workplace injury experience. Essentially, the notion of safety culture argues that injuries aren’t a function of the relative hazardousness of a particular industry or work process, but also reflect the extent to which safety is an organizational priority. This isn’t exactly rocket science. People do things at work that they think will get rewarded and contribute to tangible organizational success. The most obvious way to do this is to help get product out the door on time and under budget. In this scheme of things, safety can easily get lost unless it’s prioritized as an explicit organizational value. 
Following electrical safety protocols in some cases can take time and no small amount of consultation before work can proceed. Workers who feel pressure to speed things up to get the job done may find themselves in a bind if they think doing things the right way is going to draw a supervisor’s ire or earn a poor performance review. It’s important for workers to know that the organization has their back when they need additional time to finish a job safely – and that they’re able to raise safety concerns without feeling their jobs are at risk.
Knowledge of electrical safety is essential for those who are exposed to electrical hazards in the workplace -- but equally important are conditions for ensuring that appropriate procedures are put into practice. 
Since May is Electrical Safety Month, it's time to ask the question: Is your workplace following the appropriate safety procedures? 
A few years ago, I took on some research into workplace electrical injuries sponsored by the Fire Protection Research Foundation. This work was requested by the technical committee for NFPA 70E: Standard for Electrical Safety in the Workplace. After committee chair Dave Dini and I prepared a report of our findings (which drew largely on electrical injury data and OSHA incident reports) I realized that injuries were not happening as a result of any particular shortcomings in the formal standards for electrical safety. What we did discover was failure to apply basic safety precautions that are required in the workplace. Injuries were occurring when work was knowingly performed on or around equipment that was energized, usually needlessly so. Why was this happening?
There are multiple reasons for not following electrical safety procedures; there's possible fatigue that clouds decision-making, insufficient awareness of hazards due to inadequate training, and pressure to get the job done. Another contributor is routine shortcuts in safety protocols--or, deviations from safety protocols not recognized as deviant. If experience tells you that a formal safety procedure can be passed over with no bad result, there may be a temptation to treat it as superfluous. This judgment might be reinforced by others. The boundary between normal and deviant safety practices gradually becomes blurred and the deviation becomes acceptable -- at least until deviations from safety practice result in injury or death.
In her book The Challenger Launch Decision, sociologist Diane Vaughan described the “normalization of deviance” that contributed to the ill-fated launch of the Challenger space shuttle. For more on this term and its ties to electrical injuries, please read my column in Professional Safety. And keep your eyes peeled for additional reports on workplace electrical injury in the coming months.
workplace injuries
The U.S. Bureau of Labor Statistics (BLS) yesterday (November 9) released data on nonfatal workplace injuries and illnesses that occurred in the U.S. in 2016, as reported by employers in private industry. The data indicate that the rate of 2.9 reportable cases per 100 full-time equivalent employees was down slightly from the 3.0 reportable cases in 2015 and follows a general downward trend in workplace injury. I took a quick look at some of the prepared tables for information on specific injury events, and here’s what the data had to say (in partial form) about injuries due to fire, explosion, and exposure to electricity: 
  • There were 720 private sector workplace injuries due to fire in 2016. Half of these injuries (360 injuries) were experienced by workers in installation, maintenance, and repair occupations, while a quarter (180 injuries) were experienced by workers in production occupations. The other leading occupational groups injured in fires were service occupations (50 injuries) and construction occupations (30 injuries). 
  • Explosions were responsible for 680 private sector workplace injuries in 2016. The leading occupational groups accounting for these injuries included transportation and material moving occupations (240 injuries), installation, maintenance, and repair occupations (160 injuries), sales and related occupations (110 injuries), production occupations (100 injuries), and service occupations (40 injuries). 
  • Workers exposed to electricity accounted for 1,640 workplace injuries in 2016, with 900 injuries due to direct exposure to injury and 520 injuries due to indirect exposure to electricity (such as injuries due to contact with electricity through a wet surface).The largest shares of electrical injuries were experienced by installation, maintenance, and repair occupations (430 injuries), construction and extraction occupations (420 injuries), service occupations (280 injuries), production occupations (90 injuries), and sales and related occupations (80 injuries). Other occupational groups experiencing injury through exposure to electricity included management, business, and financial occupations (30 injuries), office and administrative support occupations (30 injuries), farming fishing and forestry occupations (30 injuries), computer, engineering, and science occupations (20 injuries), and healthcare practitioners and technical occupations (20 injuries). 
While nonfatal injuries resulting from exposure to electricity in 2016 were at a historic low dating to 1992 (although pre-2011 injuries were coded as “contact with electric current”), nonfatal injuries due to explosion were up slightly from 2015 (670 injuries), and injuries resulting from fires in 2016 were substantially higher than 2015, when there were 600 such injuries. It’s important to remember, of course, that year-to-year fluctuations do not represent trends.
BLS will be releasing data on fatal workplace injuries in December. I plan to take a more detailed look at electrical injuries in the coming months. Those interested in taking a look at the recent BLS release can find it here:
female firefighter injuries reportA new NFPA report on female firefighter injuries finds that in the five-year period from 2010 to 2014, female firefighters in the U.S. experienced an estimated 1,260 injuries on the fireground each year. While women now comprise approximately 7% of the firefighting workforce, according to NFPA’s most recent "U.S. Fire Department Profile" by Hylton Haynes and Gary Stein, there has been little research to date that specifically focuses on female firefighter injuries. A key goal of the report is to begin describing the injury problem for women firefighters by quantifying the number of injuries and examining key incident details.
Here are findings from the report:
  • Career firefighters accounted for 65% of the female firefighter injuries and volunteers for the remaining 35%.
  • Overall, 31% of injuries resulted in lost work time.
  • The leading cause of injury was over-exertion or strain for both career (23% of injuries) and volunteer (30%) firefighters, followed by exposure to hazard (17% career; 22% volunteer), and slip or trip (16% of injuries for both affiliations).
  • The vast majority of injuries occurred while fighting structure fires.
  • Volunteer firefighter injuries were more likely to occur at natural vegetation fires (14%) than those of career firefighters (3%).
  • The leading month for injuries was July.
With a baseline of injuries and injury incident information now established, the task moving forward will be to monitor trends, make efforts to examine data in more detail, and disseminate information to partners who can use data to plan and implement intervention initiatives that address the principal sources of female firefighter injury.

A few weeks ago, we received an inquiry in the Research, Data and Analytics Division for data on the number of fires in U.S. fire stations.  The request originated with a reporter, who may have been inspired to follow up on a recent news report of a fire at a volunteer fire station in Missouri that destroyed the building and the department’s three vehicles.  In any case, it wasn’t a question I’d encountered before or given much thought to, but it was certainly a reasonable question and merited running the numbers. 


So what did we learn?


Using data from the National Fire Incident Reporting System (NFIRS) and the NFPA Fire Experience survey, we estimate that between 2010 and 2014, there were an average of 100 structure fires at U.S. fire departments each year, with direct property damage each year estimated at $2.5 million.  There were no fatalities resulting from these fires.  The data also indicate that there were another 170 vehicle fires at fire stations each year over the same time period, with an annual average of $2.1 million in direct property damage and one civilian injury associated with these fires.  It’s worth noting that the vehicles on fire station grounds could include personal as well as official vehicles. 


One-third of the fire station structure fires (32% of total) originated in a kitchen or cooking area.   This is often the case with occupancies that have kitchen facilities.  Almost one-quarter (23%) of the structure fires had incident type codes that indicated a cooking fire confined to the object of origin. Cooking fires accounted for just 3% of direct property damage associated with fire station fires.  The second leading area of origin was garage or vehicle storage area, with 9% of fires and 8% of direct property damage, followed by fires originating in an office, with 6% of fires -- but 15% of direct property damage.  Vehicle fires most often originated in the vehicle’s engine area, running gear, or wheel area of the vehicle (44% of total), with another 18% originating in the passenger area, and 12% in the cargo or trunk area. 


As with other types of properties, fire stations are at risk of fire, whether due to mechanical or electrical failure, cooking materials, arson, or due to some other factor.  Fortunately, many of these fires are small and don’t substantially impact fire department services.  But in other cases, the fires may cause significant damage to vehicles, equipment, and infrastructure, and thereby threaten to disrupt vital services, as well as potentially undermine the health and safety of firefighter health and safety.  Prevention efforts are accordingly as important inside the fire station as they are in the community.

The arrival of summer brings more than the prospect of outdoor activities and family vacations. 


For firefighters, summer is a time when the already intense physical demands of firefighting become still more challenging.  As we know, lifting and carrying heavy firefighting equipment and performing such tasks as rescues, extinguishment, and forcible entry – all while wearing cumbersome turnout gear and personal protective equipment – is arduous in the best of circumstances.  Add hot and humid weather conditions to the equation and the work of fighting fires can easily become relentlessly taxing. 


In our most recent report on Patterns of Firefighter Fireground Injuries during 2010-2014, we found that July was the peak month for injuries, with an estimated monthly average of 3,140 injuries (10% of the annual total).  It’s reasonable to assume that the influence of weather conditions on the firefighter work environment had something to do with this finding.  The types of injuries that occurred in July also suggested the influence of hot and humid seasonal conditions.  For instance, the report found that July had the highest share of injuries involving exhaustion/fatigue symptoms (15% of the annual total), as well as the highest share of injuries caused by strain or sprain (34% of the total).  Each of these outcomes can be reasonably associated with hotter weather-related work environments.   


It’s important to keep in mind that the direct effects of working in hot weather are only part of the issue here.  While heat exhaustion, heat stroke, and other heat-related outcomes represent serious health threats in their own right, the ability of firefighters to make good decisions and maintain situational awareness can also be compromised by fatigue that is exacerbated in hot weather conditions.  In the fireground environment, where situations are dynamic and the consequences of miscalculation can prove fatal, it’s essential that fire departments have a program in place that recognizes the mental as well as physical implications of extreme weather conditions.


There are a number of steps that fire departments should take in order to safeguard firefighter safety and health when temperatures begin to soar – and it’s important to emphasize that this extra care extends to training, as well as fires in the community. At the top of this list, ensuring that firefighters are in good physical shape, always a critical factor, takes on additional importance in the summer months.  Also important are ensuring proper hydration, rest and rehabilitation, adequate staffing, and medical monitoring by safety officers. 


Hazards are always going to be part of firefighting, and weather conditions will be what they are.  But planning, preparation, and standardized protocols can minimize risk for firefighters during emergency response and training, in hot weather months and throughout the year.  Guidance on safety procedures is available in NFPA 1584 Standard on the Rehabilitation Process for Members during Emergency Operations and Training Exercises.

There is increasing concern in public safety and public health communities about the potential exposure of first responders to fentanyl, a powerful synthetic drug with health effects ranging from drowsiness to respiratory failure.   Fentanyl can be taken into the body through different routes, including inhalation, ingestion, and dermal absorption, depending on the situation and the form of drug.  Because of the hazards of fentanyl and its serious health concerns, the National Institute for Occupational Safety and Health (NIOSH) has developed recommendations for safe work practices and the use of appropriate personal protective equipment for activities in which fentanyl or its analogs may be present. 


In a recent blog, NIOSH provides more details on fentanyl and exposure risks for first responders and provides links to its interim recommendations for law enforcement when dealing with fentanyl. The NIOSH blog also encourages the first responder community to offer comments related to fentanyl. 


The Drug Enforcement Agency (DEA) has also prepared a briefing guide for first responders.


NFPA has seen a flurry of activity from first responders regarding exposure to fentanyl and carfentanil, and posted a blog warning about the health and safety risks to first responders when the NIOSH recommendations first came out. While NFPA has no official guidance to offer at this time, several documents or standards may be useful for first responders in taking precautionary measures.  These include:


  • - Standard for Competence of Responders to Hazardous Materials/Weapons of Mass Destruction Incidents
  • - Standard for Competencies for EMS Personnel Responding to Hazardous Materials/Weapons of Mass Destruction Incidents
  • - Standard on Fire Department Occupational Safety and Health Program
  • - Standard on Breathing Air Quality for Emergency Services Respiratory Protection
  • - Standard on Protective Clothing and Ensembles for Emergency Medical Operations


Earlier this year, NFPA Journal® also reported on first responders grappling with the opioid crisis in their cover story "Chasing a Killer."

In a previous blog, I wrote about a new surveillance system to collect data on wildland firefighter fatalities (the Wildland Firefighter On-Duty Death Surveillance System) under the aegis of the National Institute for Occupational Safety and Health (NIOSH).  As mentioned, NFPA’s Fire Incident Data Organization (FIDO) is one of three separate sources of information on wildland firefighter deaths that will be utilized in this effort.  I want to follow up in this blog with a brief description of some of the new system’s mechanics, as well as early findings. 


A starting point is to identify the criteria that NIOSH has established for determining just what counts as a wildland firefighter death, a necessity that emerged when NIOSH researchers found discrepancies between the numbers of fatalities reported by the three information sources owing to differences in how the deaths were defined. 


Consequently, NIOSH drew up a multi-part case definition to ensure consistency of its fatality data.  Here, fatalities are defined as any fatal injury or illness sustained among wildland fire fighters while on-duty at a wildland fire-related event or while performing wildland fire duties in the U.S.; wildland fire is defined as a non-structure fire occurring in vegetation or natural fuel, including prescribed fire and wildfire, and wildland firefighter is distinguished as a person with a principal function of fire suppression, whether in a career or volunteer capacity.  NIOSH also further defines on-duty as:


-- a wildland fire or non-fire activity

--the act of responding to or returning from a wildland fire; performing other officially assigned wildland fire or wildland fire fighter duties

--being on call, under orders, or on standby duty, other than at one’s own home or place of business, and

--events covered under the Hometown Heroes Survivors’ Benefits Act of 2003.


As deaths and incident details are received from the three data sources, they’re entered into the NIOSH surveillance system, sometimes after follow-up to reconcile conflicting information. Drawing on the three data sources, the NIOSH surveillance system has identified 247 wildland fire fighter deaths that occurred between 2001 and 2012.  Already, the strength of combining data sources is suggested by what NIOSH found when comparing its injury count to those of the individual data sources.  NIOSH reports that 181 of the 247 deaths (73%) were captured by all three data sources, while 31 of the deaths (13%) were commonly identified two data sources, and 35 deaths (14%) were identified in one source only. 


Moving forward, the payoff of the surveillance system will be determined by how effectively it can be used by partners who can leverage the data to target high risk practices or populations, identify training needs, promote protective factors, evaluate prevention outcomes, inform policy, or contribute in other ways to the ultimate goal of reducing wildland firefighter deaths.


For more on the NIOSH wildland firefighter fatality surveillance initiative, see:

The National Institute for Occupational Safety and Health (NIOSH) has a long-standing research program in firefighter safety and health.  Because the demands and hazards of wildland firefighting differ in some important ways from structural firefighting (such as the need to carry heavy equipment over difficult terrain and long work shifts that may last multiple continuous days), NIOSH recently introduced the NIOSH Wildland Fire Fighter On-Duty Death Surveillance System.  Of particular note to NFPA audiences is that our own Fire Incident Data Organization (FIDO) is one of three data sources that NIOSH is utilizing in creating this data collection system.

Just to be clear, surveillance in this context refers to the public health practice of systematically collecting and analyzing injury data in order to help identify opportunities for prevention.  Think of fatal injury surveillance data as representing the “who, what, when, where, how and why” elements of injury events.  By studying trends and identifying the circumstances of these deaths, it will be possible to better identify risk factors and to support prevention measures.


The reason that NIOSH is using three reporting systems is that different systems have different methods of identifying and defining cases for inclusion. Different criteria may be used in determining what constitutes a work-related fatality, for instance, such as whether to include a firefighter who suffers a fatal heart attack following an arduous work shift, but who was no longer on duty.  Consequently, even though each of the reporting systems follows the same outcome of interest – wildland firefighter deaths -- they may produce slightly different numbers.  By drawing from each of the three data sources, NIOSH hopes to create as complete a count of wildland firefighter deaths as possible, and also to assemble more detailed information on injury events than is available from a single data source.


NFPA’s internal FIDO database itself is an information-rich database that draws upon multiple data sources, including fire departments and other investigation reports.  Launched by NFPA in 1971, FIDO data also includes records for significant fire incidents that don’t involve firefighter fatalities.  In addition to FIDO, the other two data sources that NIOSH will be using in its surveillance effort are the National Wildland Fire Coordinating Group (NWCG) Safety Gram and the firefighter fatality data system sponsored by the United States Fire Administration (USFA). As the new system evolves, it should facilitate research that homes in on some of the special hazards of wildland and identifies opportunities for intervention.


I’ll have more on the new surveillance system and some of its early findings in a follow-up blog.

NFPA’s new report,
Patterns of Firefighter Fireground Injuries, indicates that seasonal factors are likely to influence the types of injuries experienced by firefighters. NFPA estimates that there were an estimated 30,290 firefighter fireground injuries each year during the five years from 2010 to 2014.  The vast majority of injuries came in the course of fighting structure fires, with fires at residential properties accounting for almost three-quarters of the total (73%).


The leading causes of fireground injuries included overexertion/strain (26% of total), exposure to hazard (21%), slip or trip (13%), contact with object (13%), and fall (11%.  The leading symptoms associated with these injuries involved strain or sprain (28%), pain only (13%), thermal burn (13%), cut or laceration (7%), and exhaustion/fatigue (6%).


Fireground Injuries by Cause of Injury in January, July, and All Months,  2010-2014 Annual Averages

Seasonal factors as a likely influence on injury events were most noticeable in hot and cold weather months, with January and July each recording the highest numbers of injuries. However, the leading injury events in January differed from those in July.  Slips and trips caused the highest share of January injuries (21%), substantially higher than the portion of slips and trips in July (9%) or the annual average (13%). Injuries caused by falls were also proportionately higher in January (14% of annual total) than they were in July (8%) or the annual average (11%).  In July, on the other hand, 34% of injuries were caused by overexertion or strain, compared to 18% in January and 26% of the annual average (26%), likely reflecting hot weather working conditions.


Information on seasonal factors in firefighter injury causation should be useful for firefighter health and safety officers in alerting crews to potential hazards and leading discussions about injury prevention strategies.  Firefighters are likely to have little control over some potential interventions (such as staffing levels), but realizing that there are times when special attention is needed to proper hydration, lifting techniques, fitness assessments, fall hazard awareness, and other injury prevention practices may help mitigate seasonal influences on firefighter injury.

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