Research should inspire positive action

Research should inspire positive action

The uk firefighter Contamination Survey was conducted between November 2019 and February 2020. This valuable research and the resulting report “Contamination of UK firefighters personal protective equipment and workplaces” published in January 2023 which provides comprehensive insight into the subject and will hopefully inspire positive action to protect firefighters not only in the UK but around the world. All serving UK firefighters were eligible to take part in the survey, which comprised 64 questions. A total of 10,649 responses were included for analysis, accounting for roughly 24% of the UK’s firefighting workforce.  

The entire report written by A. M. Wolffe Taylor,  Anna Clinton, Andrew Robinson, Louis Turrell, Anna A.Stec plus all references and supplementary documents can be studied here nature.com/articles/s41598-022-25741-x but for this article, and for the benefit of FME readers, we have chosen to briefly set the scene from the Introduction and Abstract and reproduce the Conclusions: 

Introduction

Firefighters are directly exposed to potentially large quantities of toxins on a regular basis when attending fires. This puts firefighters at an increased risk of developing adverse health outcomes and emphasises the importance of managing those risks by implementing controls which protect against exposure. Personal protective equipment (PPE) is one of the most important control measures for firefighters as it is often impossible to implement higher-level controls in the dynamic and transient working conditions presented by fire incidents and where firefighters are (necessarily) in close proximity to exposure sources.

Currently, there is no UK standard which requires firefighters’ PPE to protect against chemical or biological agents (i.e. particulates, fire gases etc.), remaining an area in need of further research and development. In other countries, such research/development has led to innovations such as particle-blocking fire hoods, which have been adopted in the USA. 

The UK Firefighter Contamination Survey assesses firefighters’ experiences and behaviours on a range of topics including health (cancer and mental health), PPE contamination/decontamination practices, and culture/habits and training. This manuscript also explores firefighters’ capacity for occupational exposure to fire contaminants through their PPE (i.e. PPE provision, maintenance, storage, fit etc.) and workplace.  The Survey also provides information on firefighters’ PPE provision, decontamination, and storage practices.

Conclusions

The UK Firefighter Contamination Survey uncovered considerable variation in terms of PPE provision, cleaning and storage in UK Fire and Rescue Services. Several practices which increase the risk of direct contaminant exposure and/or cross-contamination were found to be prevalent amongst surveyed firefighters. 

As such, the survey identified several opportunities for immediate intervention:

  • Policies concerning the use of RPE should be revised and better enforced. Firefighters should wear RPE at all fires, including during pre- and post-fire tasks. Different levels of protection may be required depending on the task/fire, thus adequate RPE should be available at all times.
  • Firefighters in managerial roles should set an example to more junior colleagues in terms of adhering to PPE/workplace maintenance and decontamination practices.
  • To prevent the passage of contaminants from fire incidents back to stations/homes, PPE and workwear should be de-robed on-site of the incident, before firefighters re-enter the appliance cab.
  • Contaminated PPE/workwear should be:

1.Bagged in disposable plastic bags on-site before being placed in any (fire and rescue service) vehicle in order to contain off-gassing/surface contaminants and then stored in a designated area of the appliance/vehicle, or preferably collected by professional cleaning services  on-site.

2. All personnel who may have been contaminated at the incident, whether involved in firefighting activity or not, should undergo a process of personal decontamination before changing into clean workwear, such that only ever clean PPE/workwear makes contact with the interior of the appliance/vehicle cab.

  • PPE storage and cleaning policies should prevent firefighters from cleaning PPE at home and/or transporting contaminated PPE in personal vehicles.
  • Review of current policy for the decontamination of vehicles shows existing policy to be inadequate. FRSs should review their policy and develop suitable and sufficient decontamination procedures.
  • The decontamination of appliance/vehicle interiors should be carried out in accordance with those improved procedures and should be conducted after every fire incident (however small) or other incidents where contamination is suspected.
  • Storage of clean/ bagged dirty PPE also requires proper separation in order to prevent cross contamination, e.g. through enforcing clean/dirty zones in the station.
  • Where PPE cannot or has not been collected on-site at an incident, dirty and bagged PPE should be sent for professional decontamination as soon as possible after every incident to ensure thorough removal of contaminants. This requires re-evaluating the policies and provisions concerning supplies of pooled PPE stock, PPE fit, and the length of the professional cleaning service.
  • Regular training/ message-reinforcement on the health effects of contaminant exposure and/or best decontamination practices may raise firefighters’ awareness of cross contamination and serve to reduce the prevalence of practices such as storing fire gloves within other items of PPE, laundering fire hoods in home washing machines etc.
  • Finally, standardisation is required in order to ensure effective decontamination practices. Promoting high-quality, nationally consistent policy on minimising exposures to fire toxins will help to reduce the incidence of occupational diseases and cancers in UK firefighters.