Please allow me to paraphrase an affirmation I read recently: “There are men of a rough persuasion who are willing to take care of the kinds of situations that ordinary people can’t. They’re called soldiers.” This, in my mind describes the men and women of the emergency services who have dedicated their lives for their communities. And in doing so, often become afflicted by significant diseases – most notably cancer. To add irony to the situation, in the early 1990’s I recall reading a series of newspaper articles high-lighting unusual cancers Southern California firefighters were experiencing! The exclamation mark is placed to emphasize the fact that we as a profession had been aware of or suspected the health dangers associated with firefighting over thirty years ago. And yet researchers, trainers, individuals and now politicians are “discovering” those threats in 2022.
Some states were late to the conversation, but through the efforts of folks like Dr. Alberto Caban-Martinez at the University of Miami Hospital’s Sylvester Comprehensive Cancer Institute, the National Volunteer Fire Council (NVFC), the International Association of Fire Chiefs (IAFC) and the International Association of Firefighters (IAFF) inroads are being made. Through their efforts and those of other organizations and thousands of individuals across the United States, we are beginning to get a handle on the situation. Strategies are being established and now the tactics are being drawn up. If you or your department hasn’t done so already, now is the time to develop an action plan enabling you to transmit the “under control” someday hopefully soon. That may sound a bit naïve – because I’ve been told I’m a glass half-full kinda’ guy – but every journey begins with a step.
If you’re like me, normally you wouldn’t sit down to read reports for pleasure, but for the sake of your survivability, I urge you to take a few minutes to read the Lavender Ribbon Report Update (https://www.nvfc.org/lrr/) (LRRU) by the NVFC and IAFC. Once you get past all the recognitions and introductory pages – let’s face it most firefighters just want the “facts ma’am” – it’s pretty straight forward and provides firefighters and the basic tools to begin a lifetime of self-preservation.
In the interest of brevity and keeping the conversation short, below are seven habits or practices that all firefighters and fire departments can live with. Many are included in the LRRU, while some have been translated and/or collected from colleagues.
Habit 1. Advocate for yourself.
Citing budget constraints, local governments or hiring authorities often take a less costly route to firefighter health care. Research your options. Get informed. Know your rights.
Communicate with your colleagues and if you have an opportunity to influence bulk coverage costs or contracts…share. Push for annual physicals that include cancer screening.
Don’t rely on others to make decisions for your health.
Habit 2. Always wear appropriate PPE including your SCBA.
While our bunker gear is often viewed as a badge of courage many wannabes wish they could wear, it is critical to choose and use the gear appropriate for the job. Should we bunker-out for medical calls? Probably not unless the emergency entails operations in an IDLH atmosphere.
Remember, always use the most appropriate tool(s) for the job at hand.
When considering SCBA use, a quick phrase may be in order – “When in doubt, pack out!” Understand how it works. Know its limitations and use it. If you or your department doesn’t have a strict SCBA use rule – and enforces it – you are doing yourself, your family and your team a disservice. While discussing bunker gear, bring the topic full-circle by adopting – and enforcing – a no bunker gear in the station policy. The New York Safety Officers Association prints “No Bunkers Allowed in Station” posters for their members, which serves the greater good at a reasonable cost.
Habit 3. Always wash hands and contaminated areas after each medical call.
Never smoke/vape or eat after leaving hot zone until you have deconned. Nuf’ said.
Habit 4. Don’t use contaminated hoods.
Hoods showed up in the firefighter’s toolbox in the late-70’s and early 80’s. Initially, early adopters of the practice were sometimes ridiculed by their teammates. But as forward-thinkers began to realize the value of normally-formed ears, the experimental use of the hood became a universal practice. Unfortunately, as firefighters-will-be-firefighters who reveled in showing how busy and bad their company was would use and re-use the same, stank hood week after week until their colleagues began to search for the foul smell often thought to be a dead rodent in the station walls.
Not only will wearing clean hoods prevent a funky odor from following you around, more importantly it will reduce unnecessary exposure to carcinogens and other hazards from entering your system through your head, neck and face – thus helping to prolong your health. When the job is done remove the hood from around your neck. Encourage your department to establish a hood replacement and secondary hood program. If that is not possible or supported, invest a few bucks in your health and buy a second (or third) hood.
Habit 5. Gross decon immediately following the event.
As soon as personnel and/or companies are released from conducting duties in IDLH zones, personnel should begin the important action of removing the initial layer(s) of debris, combustion products and other substances from their gear. Initially focus on cleansing the head, face, neck and hands. Removing helmets, gloves, hoods and SCBAs following debridement, then bunker gear in a top down, systematic process will help to ensure complete outer layer decontamination. Don’t forget to follow local and/or state hazardous products containment requirements as well.
Habit 6. Take a shower within an hour of exposure and shower before leaving the station.
Does that mean you need to bring at least two uniform changes to duty? Yes.
That may mean a need to change to a less expensive duty uniform and save the glitz and glamor (Class A’s?) for the July 4th and Christmas parades. In the scheme of things, uniforms are cheap – replacing firefighters is not.
Consider investing in station washers and dryers (commercial or industrial grade) to ensure whatever methyl-ethyl bad stuff you picked up at a call doesn’t mix with your family’s home laundry. An alternative is leasing the equipment or contracting with a commercial laundry service. There is power in numbers, so a service for several stations and/or departments is much cheaper than for one station.
Habit 7. Decon apparatus and equipment.
Fold into your routine after every call to wash and decontaminate exterior and interior compartments. When doing so, be sure to wear appropriate PPE. Pre-made decon kits are now offered by fire and emergency services equipment suppliers. If funding is an issue, do a little research and build decon kits for every response vehicle – including one for the safety officer’s rig. *
Although the points raised here seem to many as common sense, I am amazed at the number of individuals and departments that still operate on another planet: one hood per person, failure to wash bunkers (including helmets and liners) lacking at-the-scene decon practices and allowing boots and bunkers in the station….
The CDC reports in their studies that firefighters have a 14% increase of cancer over the general population’s mortality rate. And while the numbers differ depending on what study you read, we cannot as a profession escape the cold, hard truth that firefighting is an inherently danger job that comes with many risks including the propensity to experience cancer more so than the general population. Protect yourself and your family. Take a few steps to plug these steps and others into your daily practices. Save a life – your own.
* Decon kits can be easily built with items from your local hardware store.
- Decon bucket and lid
- 55gallon, 6 mil clear bags to contain off-gassing from contaminated gear
- Duct tape to seal the bags holding gear
- 14 oz spray bottle of PPE and turnout gear cleaner
- 8 oz bottle of gear cleaner sample to use in an extractor
- Field wipes to remove heavy metals from skin areas
- 1 qt spray bottle to clean equipment
- Short handle scrub brush to wash gear
- 10’ X 10’ tarpaulin
- 50’ of 5/8” hose
- Hose nozzle
- Adapter, 2.5” female X to .75” male