Respiratory protection for firefighters--evaluation of CBRN canisters for use during overhaul

The role of personal protective equipment (PPE) in reducing firefighter exposure to chemical hazards: A systematic review

This paper aims to investigate the effectiveness of personal protective equipment (PPE) in reducing firefighter exposure to various hazardous chemicals from the smoke emitted during fires. A systematic review of peer-reviewed articles was undertaken utilizing five databases: Medline, Embase, Web of Science, Scopus, and CINHAL. Studies published between 2013 and 2023 that investigated the effectiveness of PPE in reducing firsthand exposure to at least one chemical were included. Extracted data were grouped into two overarching themes related to PPE: (a) Respiratory Protection and (b) Personal Protective Clothing (PPC). Overall, 21 studies met the inclusion criteria and were considered for further analysis. Respiratory protection, particularly self-contained breathing apparatus (SCBA), offered the most protection in preventing inhalation exposure to chemical hazards. There was limited evidence on the effectiveness of firefighter turnout gear in reducing skin contamination. Combustion contaminants, especially highly volatile compounds like benzene, were found to permeate and penetrate through and around the protective clothing. In conclusion, certain respirators, particularly SCBA, provided the best protection against inhalation exposure to chemicals; however, PPC did not appear to provide complete protection, particularly against the more volatile chemicals like benzene.

Hierarchy of contamination control in the fire service: Review of exposure control options to reduce cancer risk

The international fire service community is actively engaged in a wide range of activities focused on development, testing, and implementation of effective approaches to reduce exposure to contaminants and the related cancer risk. However, these activities are often viewed independent of each other and in the absence of the larger overall effort of occupational health risk mitigation. This narrative review synthesizes the current research on fire service contamination control in the context of the National Institute for Occupational Safety and Health (NIOSH) Hierarchy of Controls, a framework that supports decision making around implementing feasible and effective control solutions in occupational settings. Using this approach, we identify evidence-based measures that have been investigated and that can be implemented to protect firefighters during an emergency response, in the fire apparatus and at the fire station, and identify several knowledge gaps that remain. While a great deal of research and development has been focused on improving personal protective equipment for the various risks faced by the fire service, these measures are considered less effective. Administrative and engineering controls that can be used during and after the firefight have also received increased research interest in recent years. However, less research and development have been focused on higher level control measures such as engineering, substitution, and elimination, which may be the most effective, but are challenging to implement. A comprehensive approach that considers each level of control and how it can be implemented, and that is mindful of the need to balance contamination risk reduction against the fire service mission to save lives and protect property, is likely to be the most effective.

Evaluation of CBRN Respirator Protection in Simulated Fire Overhaul Settings

Overhaul is the phase of firefighting after flames have been extinguished but when products of combustion are still being released. While positive pressure self-contained breathing apparatus (SCBA) provide the highest level of respiratory protection during overhaul, use of air-purifying respirators (APRs) with suitable filters could potentially provide a lower weight, longer duration option for first responders. The objective of this study was to assess whether an APR with a chemical, biological, radiological, and nuclear (CBRN) canister could be recommended as substitution for SCBA during overhaul. A total of 15 simulated standard overhaul environments were created by burning household materials. Sampling was conducted using mannequin heads fitted with full facepiece respirators with either a CBRN canister or SCBA. In-mask and personal samples were collected for aldehydes, polynuclear aromatic hydrocarbons, inorganic acids, aromatic hydrocarbons, nitrogen dioxide, and particulate matter. An additional six simulated high-exposure overhaul environments were created in a flashover chamber by continuously adding household materials to a smoldering fire. The sampling train was the same for both the standard and high-exposure environments; however, the facepiece was sealed to the mannequin head in the high-exposure environments. In the standard overhaul environment, the CBRN canister effectively reduced the level of exposure for most contaminants, while in the high-exposure overhaul exposure setting in-mask acetaldehyde and formaldehyde were detected. In both exposure settings, the SCBA prevented almost all exposure, and therefore remains the recommended respiratory protection during overhaul.

Evaluation of Interventions to Reduce Firefighter Exposures

OBJECTIVE

Evaluate the effectiveness of firefighter exposure reduction interventions.

METHODS

Fireground interventions included use of self-contained breathing apparatus by engineers, entry team wash down, contaminated equipment isolation, and personnel showering and washing of gear upon return to station. Urinary polycyclic aromatic hydrocarbon metabolites (PAH-OHs) were measured after structural fire responses before and after intervention implementation. Separately, infrared sauna use following live-fire training was compared to standard postfire care in a randomized trial.

RESULTS

The fireground interventions significantly reduced mean total urinary postfire PAH-OHs in engineers (-40.4%, 95%CI -63.9%, -2.3%) and firefighters (-36.2%, 95%CI -56.7%, -6.0%) but not captains (-11.3% 95%CI -39.4%, 29.9%). Sauna treatment non-significantly reduced total mean PAH-OHs by -43.5% (95%CI -68.8%, 2.2%).

CONCLUSIONS

The selected fireground interventions reduced urinary PAH-OHs in engineers and firefighters. Further evaluation of infrared sauna treatment is needed.