Respiratory Diseases and the Fire Service, Report Issued

The United States Fire Administration (USFA), in partnership with the International Association of Fire Fighters (IAFF), announced the release of Respiratory Diseases and the Fire Service, a report discussing the findings of a long-term study intended to examine and improve the occupational health of firefighters. Link to Report HERE

“Respiratory diseases remain a significant health issue for firefighters and other emergency responders,” said IAFF General President Harold A. Schaitberger. “Respiratory effects due to firefighter occupational exposure are a concern affecting the fire service throughout the United States.” The goal of this project was to research the long-term effects and post-exposure mitigation of occupational respiratory exposure to firefighters and develop a report based on this research.

This effort involved renowned experts in the field of pulmonary medicine. The study will assist in recognizing and quantifying the impact of respiratory exposure, and the development of mitigation strategies and programs for firefighters, their families, and fire departments. The manual was written for fire fighters and emergency medical responders, a group of individuals who face special occupational risks of respiratory diseases due to fire ground exposures and their direct interaction and contact with the public. Respiratory diseases in fire fighters have been an area of concern and focus for the International Association of Fire Fighters and others for several decades.

Although medical progress has led to improvements in the diagnosis and treatment of respiratory diseases, prevention remains the best method of decreasing the number of such diseases and related deaths. Understanding diseases of the respiratory system, identifying respiratory disease-causing agents, and avoiding exposure to these agents are key in preventing respiratory diseases.

Excerpt from Introduction: Respiratory diseases remain a significant health issue for fire fighters and emergency responders, as well as civilians. Respiratory disease is the number three killer in North America, exceeded only by heart disease and cancer, and is responsible for one in six deaths. The American Respiratory Association estimates that more than 35 million Americans are living with chronic respiratory diseases such as asthma or chronic obstructive pulmonary diseases (COPD) including emphysema and chronic bronchitis.

Fire fighters work hard each and every day, proudly protecting and serving our citizens by answering the call for help — a call to save lives. That call may be to suppress fire and save lives jeopardized by smoke and flame. It may be a response to a hazardous materials incident, a structural collapse or other special operations event. The response may be for emergency medical assistance and transport to the hospital, with potential exposures to a host of infectious disease. Fire fighters have little idea about the identity of many of the materials they are exposed to or the health hazards of such exposures — whether they are chemical, biological or particulates.

Nevertheless, fire fighters and emergency medical responders continue to respond to the scene and work immediately to save lives and reduce property damage without regard to the potential health hazards that may exist. A fire emergency has no engineering controls or occupational safety and health standards to reduce the effect of irritating, asphyxiating or toxic gases, aerosols, chemicals or particulates.

It is an uncontrollable environment that is fought by fire fighters using heavy, bulky and often times inadequate personal protective equipment and clothing. An occupational disease takes years to develop. It is the result of a career of responding to fires and hazardous materials incidents; it is caused by breathing toxic smoke, fumes, biological agents, and particulate matter on the job; and it is the response to continuous medical runs or extricating victims at accidents. Some health effects are immediate while others may take years and even decades to develop and because some respiratory diseases develop over time, it’s impossible to say, “This specific emergency response caused my disease,” yet fire fighters continue to get sick and die from occupationally caused respiratory diseases.

Variability in exposures among fire fighters can be great; however, a number of exposures are commonly found in many fire scenarios. The common combustion products encountered by fire fighters that present respiratory disease hazards include but are not limited to: acrylonitrile, asbestos, arsenic, benzene, benzo(a)pyrene and other polycyclic hydrocarbons (PAHs), cadmium, chlorophenols, chromium, diesel fumes, carbon monoxide, dioxins, ethylene oxide, formaldehyde, orthotoluide, polychlorinated biphenyls and vinyl chloride. Also, findings from fire fighters monitored during the overhaulphase (fire is extinguished, clean-up begins and where respiratory protection is not usually available) of structural fires indicates that short-term exposure levels are exceeded for acrolein, benzene, carbon monoxide, formaldehyde, glutaraldehyde, nitrogen dioxide and sulfur dioxide as well as soots and particulates.

They are often exposed in their fire stations to significant levels of diesel particulate from the operation of the diesel fueled fire apparatus. Fire fighters are routinely exposed to respirable particulate matter consisting of liquids, hydrocarbons, soots, diesel fumes, dusts, acids from aerosols, and smoke. Health effects are known to be produced not just by the particulates themselves, but also by certain chemicals adsorbed onto the particulates. Further, the mixture of hazardous chemicals is different at every fire and the synergistic effects of these substances are largely unknown.

Respiratory Diseases and the Fire Service is available from the IAFF website (PDF, 6.1 Mb).

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