CANCER REDUCTION GUIDE
The focus of the Fairfax County Professional Firefighters and Paramedics Cancer Prevention Program is to promote the early recognition of potential contamination hazards, implement precautionary measures, reduce, and minimize the risk of exposure, and ensure that our members who are exposed to contaminants document their exposures. This program is an effort to combat the incidence of cancer among our membership.
Protecting the health and well-being of each member and his or her family is the highest priority of the Fairfax County Professional Firefighters and Paramedic IAFF Local 2068.
This document is directed to all members. It shall be adhered to by those who have the potential to be exposed to contaminants and carcinogens from firefighting operations, entering an IDLH, training evolutions and during routine tasks.
Barrier Protection: An interface device that provides physical protection from contact with potentially infectious fluids, chemicals, soot, or contaminants. These items include, but are not limited to latex gloves, filter masks, disposable Tyvek suits or PPE.
Best Practices: A method or technique that has been generally accepted as superior to any alternatives because it produces results that are superior to those achieved by other means or because it has become a standard way of doing things.
Carcinogens: A substance capable of causing cancer in living tissue.
Cleaning: The act of removing soiling and contaminants from ensembles or ensemble elements by mechanical, chemical, thermal, or combined processes.
Advanced Cleaning: NFPA 1851 defines advanced cleaning as a form of clothing care. This type of cleaning must be done at least once a year AND whenever gear is exposed to soiling at a fire. Advanced cleaning is the act of removing both soiling and contaminants generally associated with products of combustion.
Specialized Cleaning: This level of cleaning involves specific procedures and specialized cleaning agents and processes only conducted by an authorized and certified cleaning professional. Specialized cleaning is the act of removing hazardous materials, bodily fluids, or other forms of contamination.
Contaminants: A harmful substance(s) that adversely affects living organisms.
Cool Down Phase: The time frame post “knock-down” required for the structure and its contents to significantly reduce atmospheric toxic levels.
Decontamination: Preliminary exposure reduction for the purpose of reducing and preventing the spread of contamination. This is conducted on the incident scene and prior to other forms of required cleaning.
Direct Vehicle Exhaust Extraction System: A mechanical device (Plymovent) that collects and extracts harmful vehicle exhaust fumes.
Immediate Danger to Life or Health (IDLH): Any condition that would pose an immediate or delayed threat to life, cause irreversible adverse health effects, or interfere with an individual’s ability to escape unaided from a hazardous environment.
Occupational Disease: An illness or disease contracted through or aggravated by the performance of the duties, responsibilities, and functions of a fire department member, but not an ordinary disease of life to which the general population is exposed to outside of the employment.
Personal Decon: The process of removing or neutralizing contaminants that have accumulated on personnel.
Protective Measures: Elements of procedures, protective clothing, and equipment that when utilized correctly provide protection from risks.
Rehab: An intervention designed to mitigate the physical, psychological, and emotional stress of incident operations in order to sustain the member’s energy, improve and decrease the likelihood of on-scene injury or death.
Occupational Cancer poses the greatest risk to our members’ health and safety. It is the most dangerous and underemphasized threat we face as firefighters.
Multiple studies have revealed credible evidence for statistically higher rates of various types of cancers in firefighters compared to the general population.
Research has also demonstrated that modern day fires produce odorless and colorless gasses, chemicals, and toxins such as, but not limited to: Polycyclic Aromatic Hydrocarbons (PAH), Volatile Organic Compounds (VOCs), Carbon Monoxide (CO), and Hydrogen Cyanide (HCN).
As the most influential person in the company, it is the Company Officer’s responsibility to promote the appropriate attitude in cancer prevention. Leadership by example and setting clear expectations concerning cancer awareness, prevention, exposures reporting and the essential operational precautions that are necessary to minimize exposure to carcinogens and other toxins should be of the highest priority. It is in this position that Fairfax County Fire and Rescue Department empowers and expects our members to enforce the safe and appropriate actions of their entire crew.
It is the responsibility of each member to abide by these directives to lessen the potential of occupational exposures to carcinogens. It is imperative that members understand that not accepting these changes and failing to enhance their knowledge of these hazards will have a direct impact on their health.
Personal Protective Equipment
All personnel are issued two sets of Personal Protective Equipment (PPE) in the event their primary set is damaged or contaminated.
When PPE is exposed to products of combustion with or without obvious signs of contamination (soot) the contaminated PPE shall be bagged in department provided clear plastic bags. Once bagged, the Personal Protective Equipment Center (PPEC) must be notified. This can be done by emailing [email protected] * It is important to notify the PPEC as soon as possible to prevent damage of the PPE *
PPE shall be stored in an area of the station not to be contaminated by direct diesel exhaust. The second set of PPE shall be stored in a gear bag also not in direct contact with diesel exhaust.
Modern fires grow at a faster rate and produce toxic smoke because of the plastics and synthetic materials found in all occupancy types, vehicles, and dumpsters.
A false impression exists that simply wearing PPE is sufficient to limit exposure to most cancer-causing agents encountered on the incident scene; IT DOES NOT.
The use of Self-Contained Breathing Apparatus (SCBA) during ALL stages of the incident, proper PPE decontamination, the use of cleaning wipes to remove contaminants on the skin and showering within the hour (or as soon as possible) can reduce your chances of developing occupational cancer.
On an Incident
SCBA (on-air) shall be worn during the entire operational phase of an incident to include salvage, overhaul, and the investigative phase. All members should monitor exterior conditions and where SCBA when conditions dictate (this includes drivers operating at the pump panel and any other member operating on the incident scene).
**Atmospheric monitoring to identify levels of toxic gases (or oxygen depletion) in a structure should NOT be used to decide if dropping SCBA is appropriate. **
Decontamination of PPE utilizing the Apparatus Decon-Kit shall be initiated upon exiting the IDLH and prior to entering the rehab area.
Wet decontamination is the preferred method (Appendix A).
Dry decontamination is utilized when this procedure might be detrimental or create additional safety concerns such as in cold inclement weather. (Appendix A).
Contaminated PPE shall be placed in the department provided clear plastic bags and stored in an exterior compartment while returning to the station. ALL members must do this to prevent the continuation of exposure and to help maintain a clean cab.
Prior to eating or drinking ALL members shall utilize wet cleaning wipes to remove as much soot as possible from the head, neck, throat, jaw, hands, and underarms.
Whenever possible, crews exposed to the greatest contamination shall remain out of service when leaving the incident scene. Fill-in companies shall remain in place until crews complete the required PPE decontamination, take a shower, and put on clean uniforms. Delaying these tasks allows toxins to remain in contact with the skin longer and poses an increased health risk.
Contaminated PPE shall not be worn in the rehab area.
The rehab area shall be in an area free from vehicle exhaust, smoke, or other obvious contaminants.
Food and drink in the rehab area shall only be consumed after PPE decontamination and the completion of hand and face washing.
Members shall comply with all department policies and requirements of incident scene rehab.
Portable decontamination kits shall be utilized on the incident scene to reduce potential exposure to cariogenic soot and particulates. Each kit contains the following:
- Wet cleansing wipes
- Cleaning solution
- Scrub brush
- Clear trash bags
- Wash clothes/towels
- Hose, nozzle and adapter
Cleaning SCBA, Hose, Tools and Equipment
- Barrier protection shall be utilized when cleaning any contaminated item.
- SCBA shall be decontaminated utilizing the dry or wet method prior to placing back into the cab.
- Transport SCBA back to quarters in a plastic bag if further Decon is required.
- Contaminated hose shall NOT be transported back to quarters inside the apparatus cab.
- It is recommended to “dry” brush the hose utilizing a soft/medium bristle brush.
- Utilize soapy water and a brush to clean contaminated hose.
- Tools and equipment shall be cleaned utilizing soap and water prior to being returned to the apparatus.
Upon Return to the station from an incident
- Perform a comprehensive decontamination of PPE, SCBA, tools, equipment and apparatus. Utilize barrier protection and protective measures.
- Thoroughly clean SCBA and facemask; inside and out. (Appendix B)
- Utilize a second set of PPE until the contaminated set is returned from advanced cleaning.
- Decontaminate all tools and equipment to include the compartments where these are stored. Utilize barrier protection and protective measures.
- Thoroughly clean the apparatus. Wash the exterior as well as the interior crew compartment of the apparatus, seats, seat belts, and SCBA brackets. Use a wet technique inside to reduce the spread of dust and contaminants.
- Windows on apparatus shall be in the open position for at least one hour after the incident to allow the escape of vapors and gasses (weather permitting).
- Contaminated work uniform, to include station work shoes shall not be worn in living quarters, common areas or station offices.
- Change out of the contaminated work uniform and wash as soon as possible.
- Shower as soon as possible (within an hour), thoroughly wash paying attention to the head, neck, throat, jaw, underarm, behind knees and groin area.
In the Station
- Utilize the direct vehicle exhaust extraction system (Plymovent) to reduce the exposure to diesel exhaust.
- Shall not be worn or brought into living quarters, common areas or station offices.
- Dirty or contaminated tools or equipment shall not be brought into living quarters, common areas or station offices.
- PPE should be stored in an area not in direct contact with diesel exhaust or in direct sunlight.
- Food or drink shall not be consumed in any contaminated work area or dirty environment.
- Refrigerators and ice machines shall not be located within an area of direct contact with diesel exhaust.
Direct Vehicle Exhaust Extraction System (Plymovent)
National and international studies have indicated that vehicle exhaust emissions are directly associated with certain cancers. The World Health Organization has classified diesel exhaust as a Group 1 carcinogen, which means it is known to cause cancer in humans. Additionally, exposure to diesel exhaust can cause headaches, dizziness, and irritation to the eyes, nose and throat. Diesel exhaust particulates are small enough to be inhaled and deposit in the lungs and lower respiratory system.
- The direct vehicle exhaust extraction system (Plymovent) when utilized correctly will reduce potential exposure.
- The use of the direct vehicle exhaust extraction system is mandatory.
- The P lymovent exhaust hose shall be attached to the vehicle’s exhaust pipe prior to entering the station and remain attached.
- The system is not used for the purpose of checking apparatus with the engine running inside.
- After initial start of the engine, move slowly outside allowing for the exhaust hose to safely disengage and retract.
- Upon returning, stop prior to entering the station.
O Attach the exhaust hose and secure it to the vehicle’s exhaust pipe.
O Enter the station slowly.
Additionally, best practices have been identified to reduce the emission of vehicle exhaust into the station, these include:
- Open apparatus bay garage doors before starting vehicles.
- Apparatus shall not be allowed to idle inside the station.
- Apparatus operations shall be at an absolute minimum in the fire station.
- Apparatus bay doors shall be closed while vehicles idle outside and in close proximity of the station.
- Tools and equipment check shall be completed while the vehicle’s engine is not running.
- Apparatus bay doors shall be left open, when weather conditions permit, for at least 10 minutes following the operations of the vehicles.
- Keep all doors leading from the apparatus bay to stairwells, living quarters, kitchen, offices, or other areas doors closed and sealed.
- Ensure automatic door closing devices are operational on all doors leading into the apparatus bay.
- Weather stripping or similar material on doors leading to the apparatus bay shall be inspected to ensure integrity in preventing diesel exhaust infiltration.
Daily Apparatus Checks
The direct vehicle exhaust extraction system shall not be utilized for the purpose of checking apparatus with the engine running inside.
Gas powered equipment shall be operated outside of the apparatus bay at a distance far enough to prevent fumes from entering the facility.
Tools and Equipment shall not be checked with the vehicle’s engine running.
Apparatus bay doors shall be closed while the vehicle is running or shall be moved away from the station to ensure that exhaust fumes are not entering the station.
Other Best Practices
Contaminated PPE or work uniforms shall not be brought home to launder.
Do not transport PPE inside the vehicle passenger compartment. Utilize issued gear bags and place it in the trunk or exterior compartment. Limit the time that PPE remains inside the vehicle, particularly in hot weather.
After washing contaminated uniform/clothing, run a wash-cycle empty to remove any lasting particulates.
Use sunscreen or sunblock to reduce ultraviolet radiation exposure.
Do not use any tobacco products to include electronic cigarettes or hookahs.
Limit alcohol intake.
Maintain a regular exercise program.
Evaluate your health with a yearly medical examination.
Research studies have repeatedly reported statistically higher rates of various types of cancers in firefighters compared to the general population. The University of Cincinnati published a meta-analysis of 32 studies of cancer among firefighters. Based on the analysis, there was a significantly increased risk among firefighters for several cancers, including multiple myeloma, non- Hodgkin’s lymphoma, prostate, and testicular cancers.
The Fairfax County Fire and Rescue Department provides annual medical examinations to uniformed career personnel as directed in NFPA 1582 (2022ed.) Standard on Comprehensive Occupational Medical Program for Fire Departments.
Medical evaluations and subsequent follow-up with a private medical professional are imperative. Early detection and treatment have proven to result in a favorable outcome.
Exposure Reporting/Record Keeping
Occupational disease(s) such as cancer can take years to develop. Because cancer develops over time, it’s impossible to say which specific emergency response caused a member’s disease. It is incumbent upon all members to document their exposures on the FRD Hazardous Materials and/or Suppression