robert tutterow
I think history will show that we are in the early stages of a fundamental change in how the fire service operates. The changes are going to be prompted by “exposure reduction controls.” Remember that term; it could become a common phrase.
It will impact operations, personal protective equipment (PPE), equipment, apparatus, fire station design, and budgets. The focus of this month’s column is on the budgetary aspect.
Operations will be impacted in that fires will be treated “somewhat” like hazmat scenes. The “somewhat” part is that PPE, where at all possible without a big negative impact on service delivery, will go through “advanced” cleaning after every exposure. This is after there has been an on-scene “preliminary reduction control” process completed—i.e., gross decontamination. For career departments, companies will be out of service until the firefighters have all showered following an exposure. WHAT? Yes, this will happen and is already standard protocol for some departments. Career departments routinely go out of service for training and other obligations. Company “move-ups” to cover while other companies are at working incidents or training activities will be extended a few minutes to allow for firefighter showering. Volunteer departments will also cover for other departments.
PPE
PPE will be impacted, as most departments, if they haven’t already, will have at least two sets of PPE per firefighter. For example, the Seattle (WA) Fire Department has already issued its firefighters three sets of PPE. PPE will be made of materials that are less likely to absorb contaminants and are easier to clean. PPE designs will also change to facilitate cleaning. For example, helmets will be more easily disassembled to facilitate cleaning. We have already seen the introduction of barrier hoods to minimize contamination to the head and neck area. At least one self-contained breathing apparatus manufacturer has introduced a new design that is easier to decontaminate. I’m sure the other manufacturers will follow suit.
Apparatus and Equipment
Equipment design and materials will change to make cleaning and decontamination easier. Cleaning supplies will come to market that are specifically designed to clean equipment. For example, there will be a resurgence of hose-washing machines. Special cleaning agents and processes will emerge that are suited for use in removing the products of combustion.
Apparatus cabs will become easier to decontaminate. Seat coverings and floor coverings will be made of materials that are readily decontaminated. The cab interior design will have smoother corners, rather than sharp recess corners, to make cleaning easier. And some day, we may even see power sources that do not use carcinogenic diesel fuel.
Stations
Many fire stations will be designed or renovated to minimize exposures. The concept of hot-warm-cool zones is already emerging. The hot zone is for contaminated PPE and equipment. The cold zone comprises the station’s living areas where no contamination should be present. The warm zone is the transition area between the hot and cold zones. Decontamination rooms, decontamination equipment, and dedicated PPE storage rooms will become part of basic design.
Costs and Savings
What will all this cost? The short answer is no one knows, but it will be a lot. But, it is important to keep in mind that a lot of exposure control can be accomplished through common-sense basic hygiene practices that have minimal costs.
What are the savings from all this change? Again, the short answer is no one knows. However, a recently released report by the Rand Corporation provided a perspective that must be included in such discussions. Prepared for the National Institute for Occupational Safety and Health (NIOSH), the report, “Understanding the Economic Benefit Associated with Research and Services at the National Institute for Occupational Safety and Health,” reviewed three case studies as an example of how NIOSH’s research and services provides overall savings. One of the case studies was titled, “Building and Disseminating Evidence on Firefighters’ Cancer Risk.” The report states that because of NIOSH’s work, stakeholders—i.e., firefighters—“have taken actions to reduce occupational exposure to remnants of carcinogenic materials burned in fires through the use of PPE and other control measures, including increasing the use of respirators during postfire overhaul operations.”
Without “getting into the weeds” of the report, a brief overview of its analysis included:
1. Identifying the target population; estimating the number of firefighters affected.
2. Estimating the reduction in exposure.
3. Estimating the number of avoided injuries, illnesses, and fatalities.
4. Monetizing the avoided injuries, illnesses, and fatalities.
The report estimated that using exposure-control measures “could reduce medical costs and productivity losses for firefighters by approximately $71 million per year, with benefits as high as $93 million per year and as low as $23 million, depending on assumptions made….” Furthermore, they said that by using “Value of Statistical Life” (VSL) instead of medical and productivity losses, the savings could be $1 billion.
Though the report was generated for NIOSH, it clearly shows that preventive measures can have a major impact in cost savings. Now, if we could just find a way to convince the stakeholders of the cost benefits of implementing exposure reduction control measures.
For information about the Rand study, visit http://bit.ly/2GTtF96.
ROBERT TUTTEROW retired as safety coordinator for the Charlotte (NC) Fire Department and is a member of the Fire Apparatus & Emergency Equipment editorial advisory board. His 34-year career includes 10 as a volunteer. He has been very active in the National Fire Protection Association through service on the Fire Service Section Executive Board and technical committees involved with safety, apparatus, and personal protective equipment. He is a founding member and president of the Fire Industry Education Resource Organization (F.I.E.R.O.).
