Evaluating workplace protection factors (WPFs) of different firefighter PPE interface control measures for select volatile organic compounds (VOCs).

Structural firefighters are exposed to a complex set of contaminants and combustion byproducts, including volatile organic compounds (VOCs). Additionally, recent studies have found structural firefighters' skin may be exposed to multiple chemical compounds via permeation or penetration of chemical byproducts through or around personal protective equipment (PPE). This mannequin-based study evaluated the effectiveness of four different PPE conditions with varying contamination control measures (incorporating PPE interface design features and particulate blocking materials) to protect against ingress of several VOCs in a smoke exposure chamber. We also investigated the effectiveness of long-sleeve base layer clothing to provide additional protection against skin contamination. Outside gear air concentrations were measured from within the smoke exposure chamber at the breathing zone, abdomen, and thigh heights. Personal air concentrations were collected from mannequins under PPE at the same general heights and under the base layer at abdomen and thigh heights. Sampled contaminants included benzene, toluene, styrene, and naphthalene. Results suggest that VOCs can readily penetrate the ensembles. Workplace protection factors (WPFs) were near one for benzene and toluene and increased with increasing molecular weight of the contaminants. WPFs were generally lower under hoods and jackets compared to under pants. For all PPE conditions, the pants appeared to provide the greatest overall protection against ingress of VOCs, but this may be due in part to the lower air concentrations toward the floor (and cuffs of pants) relative to the thigh-height outside gear concentrations used in calculating the WPFs. Providing added interface control measures and adding particulate-blocking materials appeared to provide a protective benefit against less-volatile chemicals, like naphthalene and styrene.

Evaluating Exposure to VOCs and Naphthalene for Firefighters Wearing Different PPE Configurations through Measures in Air, Exhaled Breath, and Urine.

Firefighters are at an increased risk of cancer due to their occupational exposure to combustion byproducts, especially when those compounds penetrate the firefighter personal protective equipment (PPE) ensemble. This has led to questions about the impact of base layers (i.e., shorts vs. pants) under PPE ensembles. This study asked 23 firefighters to perform firefighting activities while wearing one of three different PPE ensembles with varying degrees of protection. Additionally, half of the firefighters unzipped their jackets after the scenario while the other half kept their jackets zipped for five additional minutes. Several volatile organic compound (VOC) and naphthalene air concentrations outside and inside of hoods, turnout jackets, and turnout pants were evaluated; biological (urinary and exhaled breath) samples were also collected. VOCs and naphthalene penetrated the three sampling areas (hoods, jackets, pants). Significant (p-value < 0.05) increases from pre- to post-fire for some metabolites of VOCs (e.g., benzene, toluene) and naphthalene were found. Firefighters wearing shorts and short sleeves absorbed higher amounts of certain compounds (p-value < 0.05), and the PPE designed with enhanced interface control features appeared to provide more protection from some compounds. These results suggest that firefighters can dermally absorb VOCs and naphthalene that penetrate the PPE ensemble.

Use of Preliminary Exposure Reduction Practices or Laundering to Mitigate Polycyclic Aromatic Hydrocarbon Contamination on Firefighter Personal Protective Equipment Ensembles.

Chronic health risks associated with firefighting continue to be documented and studied, however, the complexity of occupational exposures and the relationship between occupational exposure and contaminated personal protective equipment (PPE) remains unknown. Recent work has revealed that common PPE cleaning practices, which are becoming increasingly more common in the fire service, are not effective in removing certain contaminants, such as polycyclic aromatic hydrocarbons (PAHs), from PPE. To better understand the relationship between contaminated firefighter PPE and potential exposure to PAHs, and to gain further understanding of the efficacy of cleaning practices, we used a standardized fire exposure simulator that created repeatable conditions and measured PPE surface contamination levels via wipe sampling and filters attached to firefighter gear worn by standing mannequins. This study examined the effects of repeated (40 cycles) PPE cleaning (laundering and on-scene preliminary exposure reduction (PER) techniques) and repeated exposures on PAH concentration on different surfaces. Further exploration included examination of contamination breakthrough of turnout jackets (comparing outer shell and interior liner) and evaluation of off-gassing PAHs from used gear after different cleaning treatments. When compared by jacket closure type (zipper and hook and dee), total PAH concentration wiped from gear after exposure and cleanings showed no significant differences. Regression analysis indicated that there was no effect of repeated exposures on PAH contamination levels (all sampling sites combined; before fire 10, 20, and 40; after fire 1, 10, 20, and 40; p-value > 0.05). Both laundering and on-scene PER significantly reduced contamination levels on the exterior pants and helmets and were effective at reducing PAH contamination. The jacket outer shell had significantly higher PAH contamination than the jacket liner. Both laundering and wet soap PER methods (post-fire) are effective in reducing surface contamination and appear to prevent accumulation of contamination after repeated exposures. Semi-volatile PAHs deep within the fibers of bulky PPE are not effectively reduced via PER or machine laundering, therefore, permitting continued off-gassing of these compounds. Further research is needed to identify the most effective laundering methods for firefighter turnout gear that considers the broad spectrum of common contaminants.

Silicone passive sampling used to identify novel dermal chemical exposures of firefighters and assess PPE innovations.

A plethora of chemicals are released into the air during combustion events, including a class of compounds called polycyclic aromatic hydrocarbons (PAHs). PAHs have been implicated in increased risk of cancer and cardiovascular disease, both of which are disease endpoints of concern in structural firefighters. Current commercially available personal protective equipment (PPE) typically worn by structural firefighters during fire responses have gaps in interfaces between the ensemble elements (e.g., hood and jacket) that allow for ingress of contaminants and dermal exposure. This pilot study aims to use silicone passive sampling to assess improvements in dermal protection afforded by a novel configuration of PPE, which incorporates a one-piece liner to eliminate gaps in two critical interfaces between pieces of gear. The study compared protection against parent and alkylated PAHs between the one-piece liner PPE and the standard configuration of PPE with traditional firefighting jacket and pants. Mannequins (n = 16) dressed in the PPE ensembles were placed in a Fireground Exposure Simulator for 10 min, and exposed to smoke from a combusting couch. Silicone passive samplers were placed underneath PPE at vulnerable locations near interfaces in standard PPE, and in the chamber air, to measure PAHs and calculate the dermal protection provided by both types of PPE. Silicone passive sampling methodology and analyses using gas chromatography with mass-spectrometry proved to be well-suited for this intervention study, allowing for the calculation and comparison of worker protection factors for 51 detected PAHs. Paired comparisons of the two PPE configurations found greater sum 2-3 ring PAH exposure underneath the standard PPE than the intervention PPE at the neck and chest, and at the chest for 4-7 ring PAHs (respective p-values: 0.00113, 0.0145, and 0.0196). Mean worker protection factors of the intervention PPE were also greater than the standard PPE for 98% of PAHs at the neck and chest. Notably, the intervention PPE showed more than 30 times the protection compared to the standard PPE against two highly carcinogenic PAHs, dibenzo[a,l]pyrene and benzo[c]fluorene. Nine of the detected PAHs in this study have not been previously reported in fireground exposure studies, and 26 other chemicals (not PAHs) were detected using a large chemical screening method on a subset of the silicone samplers. Silicone passive sampling appears to be an effective means for measuring dermal exposure reduction to fireground smoke, providing evidence in this study that reducing gaps in PPE interfaces could be further pursued as an intervention to reduce dermal exposure to PAHs, among other chemicals.

Exposure Risks and Potential Control Measures for a Fire Behavior Lab Training Structure: Part B. Chemical Gas Concentrations.

Firefighters' or instructors' exposure to airborne chemicals during live-fire training may depend on fuels being burned, fuel orientation and participants' location within the structure. This study was designed to evaluate the impact of different control measures on exposure risk to combustion byproducts during fire dynamics training where fuel packages are mounted at or near the ceiling. These measures included substitution of training fuels (low density wood fiberboard, oriented strand board (OSB), pallets, particle board, plywood) and adoption of engineering controls such as changing the location of the instructor and students using the structure. Experiments were conducted for two different training durations: the typical six ventilation cycle (6-cycle) and a shorter three ventilation cycle (3-cycle) with a subset of training fuels. In Part A of this series, we characterized the fire dynamics within the structure, including the ability of each fuel to provide an environment that achieves the training objectives. Here, in Part B, airborne chemical concentrations are reported at the location where fire instructors would typically be operating. We hypothesized that utilizing a training fuel package with solid wood pallets would result in lower concentrations of airborne contaminants at the rear instructor location than wood-based sheet products containing additional resins and/or waxes. In the 6-cycle experiments (at the rear instructor location), OSB-fueled fires produced the highest median concentrations of benzene and 1,3 butadiene, plywood-fueled fires produced the highest total polycyclic aromatic hydrocarbon (PAH) concentrations, particle board-fueled fires produced the highest methyl isocyanate concentrations, and pallet-fueled fires produced the highest hydrogen chloride concentrations. All fuels other than particle board produced similarly high levels of formaldehyde at the rear instructor location. The OSB fuel package created the most consistent fire dynamics over 6-cycles, while fiberboard resulted in consistent fire dynamics only for the first three cycles. In the follow-on 3-cycle experiment, PAH, benzene, and aldehyde concentrations were similar for the OSB and fiberboard-fueled fires. Air sampling did not identify any clear differences between training fires from burning solid wood pallets and those that incorporate wood-based sheet products for this commonly employed fuel arrangement with fuels mounted high in the compartment. However, it was found that exposure can be reduced by moving firefighters and instructors lower in the compartment and/or by moving the instructor in charge of ventilation from the rear of the structure (where highest concentrations were consistently measured) to an outside position.

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.

Firefighters' urinary concentrations of VOC metabolites after controlled-residential and training fire responses.

INTRODUCTION: Firefighters are exposed to volatile organic compounds (VOCs) during structural fire responses and training fires, several of which (e.g., benzene, acrolein, styrene) are known or probable carcinogens. Exposure studies have found that firefighters can absorb chemicals like benzene even when self-contained breathing apparatus (SCBA) are worn, suggesting that dermal absorption contributes to potentially harmful exposures. However, few studies have characterized VOC metabolites in urine from firefighters. OBJECTIVES: We quantified VOC metabolites in firefighters' urine following live firefighting activity across two field studies. METHODS: In two separate controlled field studies, spot urine was collected before and 3 h after firefighters and firefighter students responded to simulated residential and training fires. Urine was also collected from instructors from the training fire study before the first and 3 h after the last training scenario for each day (instructors led three training scenarios per day). Samples were analyzed for metabolites of VOCs to which firefighters may be exposed. RESULTS: In the residential fire study, urinary metabolites of xylenes (2MHA), toluene (BzMA), and styrene (MADA) increased significantly (at 0.05 level) from pre- to post-fire. In the training fire study, MADA concentrations increased significantly from pre- to post-fire for both firefighter students and instructors. Urinary concentrations of benzene metabolites (MUCA and PhMA) increased significantly from pre- to post-fire for instructors, while metabolites of xylenes (3MHA+4MHA) and acrolein (3HPMA) increased significantly for firefighter students. The two highest MUCA concentrations measured post-shift from instructors exceeded the BEI of 500 µg/g creatinine. CONCLUSIONS: Some of the metabolites that were significantly elevated post-fire are known or probable human carcinogens (benzene, styrene, acrolein); thus, exposure to these compounds should be eliminated or reduced as much as possible through the hierarchy of controls. Given stringent use of SCBA, it appears that dermal exposure contributes in part to the levels measured here.

Airborne contamination during post-fire investigations: Hot, warm and cold scenes.

Fire investigators may be occupationally exposed to many of the same compounds as the more widely studied fire suppression members of the fire service but are often tasked with working in a given exposure for longer periods ranging from hours to multiple days and may do so with limited personal protective equipment. In this study, we characterize the area air concentrations of contaminants during post-fire investigation of controlled residential fires with furnishings common to current bedroom, kitchen and living room fires in the United States. Area air sampling was conducted during different investigation phases including when investigations might be conducted immediately after fire suppression and extended out to 5 days after the fire. Airborne particulate over a wide range of dimensions, including sub-micron particles, were elevated to potentially unhealthy levels (based on air quality index) when averaged over a 60 min investigation period shortly after fire suppression with median PM2.5 levels over 100 µg/m3 (range 16-498 µg/m3) and median peak transient concentrations of 1,090 µg/m3 (range 200-23,700 µg/m3) during drywall removal or shoveling activities. Additionally, airborne aldehyde concentrations were elevated compared to volatile organic compounds with peak values of formaldehyde exceeding NIOSH ceiling limits during the earliest investigation periods (median 356 µg/m3, range: 140-775 µg/m3) and occasionally 1 day post-fire when the structure was boarded up before subsequent investigation activities. These results highlight the need to protect investigators' airways from particulates when fire investigation activities are conducted as well as during post-fire reconstruction activities. Additionally, vapor protection from formaldehyde should be strongly considered at least through investigations occurring 3 days after the fire and personal formaldehyde air monitoring is recommended during investigations.

Characterizing exposure to benzene, toluene, and naphthalene in firefighters wearing different types of new or laundered PPE.

The fire service has become more aware of the potential for adverse health outcomes due to occupational exposure to hazardous combustion byproducts. Because of these concerns, personal protective equipment (PPE) manufacturers have developed new protection concepts like particulate-blocking hoods to reduce firefighters' exposures. Additionally, fire departments have implemented exposure reduction interventions like routine laundering of PPE after fire responses. This study utilized a fireground exposure simulator (FES) with 24 firefighters performing firefighting activities on three consecutive days wearing one of three PPE ensembles (stratified by hood design and treatment of PPE): 1) new knit hood, new turnout jacket and new turnout pants 2) new particulate-blocking hood, new turnout jacket and new turnout pants or 3) laundered particulate-blocking hood, laundered turnout jacket and laundered turnout pants. As firefighters performed the firefighting activities, personal air sampling on the outside and inside the turnout jacket was conducted to quantify exposures to volatile organic compounds (VOCs) and naphthalene. Pre- and immediately post-fire exhaled breath samples were collected to characterize the absorption of VOCs. Benzene, toluene, and naphthalene were found to diffuse through and/or around the turnout jacket, as inside jacket benzene concentrations were often near levels reported outside the turnout jacket (9.7-11.7% median benzene reduction from outside the jacket to inside the jacket). The PPE ensemble did not appear to affect the level of contamination found inside the jacket for the compounds evaluated here. Benzene concentrations in exhaled breath increased significantly from pre to post-fire for all three groups (p-values < 0.05). The difference of pre-to post-fire benzene exhaled breath concentrations were positively associated with inside jacket and outside jacket benzene concentrations, even though self-contained breathing apparatus (SCBA) were worn during each response. This suggests the firefighters can absorb these compounds via the dermal route.

Characterizing exposures to flame retardants, dioxins, and furans among firefighters responding to controlled residential fires.

Firefighters may encounter items containing flame retardants (FRs), including organophosphate flame retardants (OPFRs) and polybrominated diphenyl ethers (PBDEs), during structure fires. This study utilized biological monitoring to characterize FR exposures in 36 firefighters assigned to interior, exterior, and overhaul job assignments, before and after responding to controlled residential fire scenarios. Firefighters provided four urine samples (pre-fire and 3-h, 6-h, and 12-h post-fire) and two serum samples (pre-fire and approximately 23-h post-fire). Urine samples were analyzed for OPFR metabolites, while serum samples were analyzed for PBDEs, brominated and chlorinated furans, and chlorinated dioxins. Urinary concentrations of diphenyl phosphate (DPhP), a metabolite of triphenyl phosphate (TPhP), bis(1,3-dichloro-2-propyl) phosphate (BDCPP), a metabolite of tris(1,3-dichloro-2-propyl) phosphate (TDCPP), and bis(2-chloroethyl) phosphate (BCEtP), a metabolite of tris(2-chloroethyl) phosphate (TCEP), increased from pre-fire to 3-hr and 6-hr post-fire collection, but only the DPhP increase was statistically significant at a 0.05 level. The 3-hr and 6-hr post-fire concentrations of DPhP and BDCPP, as well as the pre-fire concentration of BDCPP, were statistically significantly higher than general population levels. BDCPP pre-fire concentrations were statistically significantly higher in firefighters who previously participated in a scenario (within the past 12 days) than those who were responding to their first scenario as part of the study. Similarly, firefighters previously assigned to interior job assignments had higher pre-fire concentrations of BDCPP than those previously assigned to exterior job assignments. Pre-fire serum concentrations of 2,3,4,7,8-pentachlorodibenzofuran (23478-PeCDF), a known human carcinogen, were also statistically significantly above the general population levels. Of the PBDEs quantified, only decabromodiphenyl ether (BDE-209) pre- and post-fire serum concentrations were statistically significantly higher than the general population. These results suggest firefighters absorbed certain FRs while responding to fire scenarios.

Firefighter hemodynamic responses to different fire training environments.

Firefighting is associated with an increased risk for a cardiovascular (CV) event, likely due to increased CV strain. The increase in CV strain during firefighting can be attributed to the interaction of several factors such as the strenuous physical demand, sympathetic nervous system activation, increased thermal burden, and the environmental exposure to smoke pollutants. Characterizing the impact of varying thermal burden and pollutant exposure on hemodynamics may help understand the CV burden experienced during firefighting. The purpose of this study was to examine the hemodynamic response of firefighters to training environments created by pallets and straw; oriented strand board (OSB); or simulated fire/smoke (fog). Twenty-three firefighters had brachial blood pressure measured and central blood pressure and hemodynamics estimated from the pressure waveform at baseline, and immediately and 30 minutes after each scenario. The training environment did not influence the hemodynamic response over time (interaction, p > 0.05); however, OSB scenarios resulted in higher pulse wave velocity and blood pressure (environment, p < 0.05). In conclusion, conducting OSB training scenarios appears to create the largest arterial burden in firefighters compared to other scenarios in this study. Environmental thermal burden in combination with the strenuous exercise, and psychological and environmental stress placed on firefighters should be considered when designing fire training scenarios and evaluating CV risk.

Effects of firefighting hood design, laundering and doffing on smoke protection, heat stress and wearability.

Firefighter hoods must provide protection from elevated temperatures and products of combustion (e.g. particulate) while simultaneously being wearable (comfortable and not interfering with firefighting activities). The purpose of this study was to quantify the impact of (1) hood design (traditional knit hood vs particulate-blocking hood), (2) repeated laundering, and (3) hood removal method (traditional vs overhead doffing) on (a) protection from soot contamination on the neck, (b) heat stress and (c) wearability measures. Using a fireground exposure simulator, 24 firefighters performed firefighting activities in realistic smoke and heat conditions using a new knit hood, new particulate-blocking hood and laundered particulate-blocking hood. Overall, soot contamination levels measured from neck skin were lower when wearing the laundered particulate-blocking hoods compared to new knit hoods, and when using the overhead hood removal process. No significant differences in skin temperature, core temperature, heart rate or wearability measures were found between the hood conditions. Practitioner Summary: The addition of a particulate-blocking layer to firefighters' traditional two-ply hood was found to reduce the PAH contamination reaching the neck but did not affect heat stress measurements or thermal perceptions. Modifying the process for hood removal resulted in a larger reduction in neck skin contamination than design modification. Abbreviations: ANOVA: analysis of variance; B: new particulate-blocking hood and PPE (PPE configuration); FES: fireground exposure simulator; GI: gastrointestinal; K: new knit hood and PPE (PPE configuration); L: laundered particulate-blocking hood and PPE (PPE configuration); LOD: limit of detection; MLE: maximum likelihood estimation; NFPA: National fire protection association; PAH: polycyclic aromatic hydrocarbon; PPE: personal protective equipment; SCBA: self-contained breathing apparatus; THL: total heat loss; TPP: thermal protective performance.

Impact of Repeated Exposure and Cleaning on Protective Properties of Structural Firefighting Turnout Gear.

The US fire service has become acutely aware of the need to clean PPE after fires. However, there is concern that damage from repeated cleaning may impact critical protection from fireground risk. Using a protocol that included repeated simulated fireground exposures (between 0 and 40 cycles) and/or repeated cleaning with techniques common in the fire service, we found that several important protective properties of NFPA 1971 compliant turnout gear are significantly changed. Outer shell and thermal liner tear strength showed a statistically significant reduction when laundered as compared to wet or dry decontamination. Larger changes in outer shell tear strength resulted when the coat closure incorporated hook & dee clasps as compared with garments using zippered closures. Total Heat Loss (THL) was reduced for all samples that underwent any form of cleaning while Thermal Protective Performance (TPP) was only increased in the gear that was laundered. These results suggest that some important protective properties of bunker gear can be decreased after repeated exposure/cleaning cycles relative to their levels when tested in a new condition. For the specific materials tested, outer shell trap tear strength in the fill direction and seam strength dropped below NFPA 1971 requirements after 40 laundering cycles. The findings for this study may have utility for setting preconditions for the measurement of certain performance properties in future editions of NFPA 1971.

Impact of select PPE design elements and repeated laundering in firefighter protection from smoke exposure.

As the Fire Service becomes more aware of the potential health effects from occupational exposure to hazardous contaminants, personal protective equipment (PPE) manufacturers, and fire departments have responded by developing and implementing improved means of firefighter protection, including more frequent laundering of PPE after exposures. While laboratory testing of new PPE designs and the effect of laundering on PPE fabric provides a useful way to evaluate these approaches, laboratory scale testing does not necessarily translate to full garment protection. Utilizing a fireground smoke exposure simulator, along with air and/or filter-substrate sampling for polycyclic aromatic hydrocarbons (PAHs) and benzene, this pilot study tested the chemical-protective capabilities of firefighting PPE of different designs (knit hood vs. particulate-blocking hood, turnout jacket with zipper closure vs. hook & dee closure), including the impact of repeatedly exposing and cleaning (through laundering or decontamination on-scene) PPE 40 times. Overall, PAH contamination on filters under hoods in the neck region were higher (median PAHs = 14.7 µg) than samples taken under jackets in the chest region (median PAHs = 7.05 µg). PAH levels measured under particulate-blocking hoods were lower than levels found under knit hoods. Similarly, zippered closures were found to provide a greater reduction in PAHs compared to hook & dee closures. However, neither design element completely eliminated contaminant ingress. Measurements for benzene under turnout jackets were similar to ambient chamber air concentrations, indicating little to no attenuation from the PPE. The effect of laundering or on-scene decontamination on contaminant breakthrough appeared to depend on the type of contaminant. Benzene breakthrough was negatively associated with laundering, while PAH breakthrough was positively associated. More research is needed to identify PPE features that reduce breakthrough, how targeted changes impact exposures, and how fireground exposures relate to biological absorption of contaminants.

Flame retardants, dioxins, and furans in air and on firefighters' protective ensembles during controlled residential firefighting.

INTRODUCTION: Structure fires that involve modern furnishings may emit brominated flame retardants (BFRs) and organophosphate flame retardants (OPFRs), as well as brominated and chlorinated dioxins and furans, into the environment. OBJECTIVES: The goal of this study was to quantify the airborne and personal protective equipment (PPE) contamination levels of these compounds during controlled residential fires in the U.S., and to evaluate gross-decontamination measures. METHODS: Bulk-sampling was done to confirm the presence of flame retardants (FRs) in the furnishings used in 12 controlled residential structure fires. Area air samples were collected during the fires and PPE wipe samples were collected from the firefighters' turnout jackets and gloves after firefighting. For each fire, half of the jackets were decontaminated and the other half were not. RESULTS: Of the BFRs and OPFRs measured in air during the fire period, decabromodiphenyl ether (BDE-209) and triphenyl phosphate (TPP) were the most abundant, with medians of 15.6 and 408 µg/m3, respectively, and were also detected during overhaul. These and several other BFRs and OPFRs were measured on PPE. Some gloves had contaminant levels exceeding 100 ng/cm2 and were generally more contaminated than jackets. Air and surface levels of the brominated furans appeared to be higher than the chlorinated dioxins and furans. Routine gross decontamination appeared to reduce many of the BFR contaminants, but results for the OPFRs were mixed. CONCLUSIONS: Structure fires are likely to result in a variety of FRs, dioxins, and furans into the environment, leading to PPE contamination for those working on the fireground. Firefighters should wear self-contained breathing apparatus during all phases of the response and launder or decontaminate their PPE (including gloves) after fire events.

Development of Fireground Exposure Simulator (FES) Prop for PPE Testing and Evaluation.

Research on the performance of personal protective equipment (PPE) for the Fire Service is challenged by the ability to repeatedly and feasibly test new designs, interventions and wear trials in realistic conditions that appropriately simulate end use environments. To support firefighter PPE research and firefighter PPE acclimation/training, a multidisciplinary team has developed a low cost, easily replicable approach for simulating conditions commonly encountered by firefighters operating on the interior of a residential structure fire. The testing enclosure can be used with either stationary mannequins or firefighters conducting typical fireground activities, providing a method to study a wide range of PPE and physiological studies as well as training activities that may support developing new technologies and standardized testing opportunities. Environmental gas concentrations and firefighters' local temperatures were measured during trials and compared to data collected from simulated fireground activities and fireground responses with good agreement.

Management of Firefighters' Chemical & Cardiovascular Exposure Risks on the Fireground.

The fire service research community around the world has focused substantial resources on reducing firefighter risk for sudden cardiac events and chemical exposures that may lead to cancer. Research presented here summarizes important lessons learned from a full-scale residential Fire Study that allowed quantification of the risks as well as the effectiveness of interventions to reduce those risks. To address fireground exposure concerns, personal protective equipment (PPE) and administrative controls exist. But, these controls are not always straightforward to apply. Leadership and management concerns with ongoing implementation of these controls are introduced and opportunities for change management are discussed. While research provides a solid basis upon which to institute policy and practice, fireground leadership and management is critical to ensure appropriate implementation.

Firefighters' absorption of PAHs and VOCs during controlled residential fires by job assignment and fire attack tactic.

To better understand the absorption of combustion byproducts during firefighting, we performed biological monitoring (breath and urine) on firefighters who responded to controlled residential fires and examined the results by job assignment and fire attack tactic. Urine was analyzed for metabolites of polycyclic aromatic hydrocarbons (PAHs) and breath was analyzed for volatile organic compounds (VOCs) including benzene. Median concentrations of PAH metabolites in urine increased from pre-firefighting to 3-h post firefighting for all job assignments. This change was greatest for firefighters assigned to attack and search with 2.3, 5.6, 3.9, and 1.4-fold median increases in pyrene, phenanthrene, naphthalene, and fluorene metabolites. Median exhaled breath concentrations of benzene increased 2-fold for attack and search firefighters (p < 0.01) and 1.4-fold for outside vent firefighters (p = 0.02). Compared to interior attack, transitional attack resulted in 50% less uptake of pyrene (p = 0.09), 36% less uptake phenanthrene (p = 0.052), and 20% less uptake of fluorene (p < 0.01). Dermal absorption likely contributed to firefighters' exposures in this study. Firefighters' exposures will vary by job assignment and can be reduced by employing a transitional fire attack when feasible.

Electrocardiographic Responses Following Live-Fire Firefighting Drills.

OBJECTIVE: Firefighting-related environmental and physiological factors associated with cardiovascular strain may promote arrhythmias and myocardial ischemia, which induce sudden cardiac events (SCE) in susceptible individuals. The present study evaluated electrocardiographic (ECG) changes that may reflect increased SCE risk following simulated live-firefighting. METHODS: Using a repeated measures design, ECG tracings from 32 firefighters were recorded 12-hours post-firefighting in a residential structure and compared with a 12-hour control period. RESULTS: Ventricular arrhythmias were present in 20%, and ST segment changes indicative of myocardial ischemia in 16%, of firefighters 12-hours post-firefighting that were not detected in the control period. CONCLUSION: Live-firefighting induces significant ECG changes that include ventricular arrhythmias and ST segment changes, which may reflect myocardial ischemia. The implications of such ECG changes explaining increased cardiovascular risk in firefighters warrants further research.