Fire Fighter Clothing Contamination and Cleaning Jeffrey O. Stull International Personnel Protection, Inc.

Important Questions How dangerous are fireground contaminants? Do these contaminants cause cancer or other long term health problems? What types of risks does dirty gear pose? Do cleaning processes remove contaminants? If I clean my PPE, will it be safe to use? What about biological exposures, like MRSA or EBOLA? Just how clean is clean?

Prior UL Research on FF Exposure Comprehensive study of firefighter exposure to smoke particulates Provided key findings associated with firefighter contamination Both staged and actual fires Firefighter exposure and PPE contamination levels

Glove Chemical Contamination

NIOSH FF Exposure Study Special report on research undertaken to highlight specific safety and health concern by NIOSH Showed elevated firefighter exposures to benzene/PAHs Specific fire service recommendations: develop new hoods

Key NIOSH Report Takeaway RECOMMENDATION: Study the effect of turnout hood designs and materials on dermal exposure and absorption of combustion products. The neck was the only skin site where we measured elevated levels of PAHs that were statistically significant (for round 1) and was also a possible site for dermal absorption of aromatic hydrocarbons (e.g., benzene). Providing better protection to the neck could reduce dermal absorption of combustion products.

IAFF Research on Turnout Clothing IAFF study to highlight fire fighter exposure to particulates Visually showed contamination pathways through turnout gear Demonstrated penetration of smoke particles to skin

IAFF Particle Exposure Study Approach: Full turnout ensemble evaluated in standardized military particle test Test subject exercised in chamber with particles tagged with fluorescent tracer Measurement: Ensemble removed; black light showed where particles penetrated

IAFF Study Visualization

Understanding Cleaning Effectiveness Most cleaning processes probably remove many contaminants However, not all contaminants removed with same efficiency Decontamination effectiveness rarely determined

Cleaning Instructions Lacking NFPA 1851 does not provide explicit cleaning procedures Contamination and soiling terms muddled No recognitions of need for different procedures Few parameters specified Specialized cleaning not defined Cleaning effectiveness is not evaluated Cleaning Preconditioning Wash Formulation Specified in NFPA 1971

Expectations and Capabilities

Key Themes for Change Current cleaning methods have evolved based on good practice, but are lacking a scientific basis Fireground decontamination is technically very challenging There is no simple, easy solution approach Awareness is critical to support credible approaches

Contamination Avoidance Teach personnel how to recognize contamination hazards Delineate hazard zones at emergency scene Designate HOT, WARM, and COLD zones Keep unprotected personnel away from contaminated areas

Wearing of PPE Select appropriate PPE Conduct thorough hazard assessment Ensure that selected PPE is properly integrated to provide needed level of protection Wear PPE according to manufacturer instructions Continue wearing PPE where hazards still remain

Contamination Reduction at Scene Integrate contamination control as part of member rehabilitation procedures Start cleaning as soon as possible after coming out of the emergency scene Perform appropriate forms of gross decontamination (cold weather?) Maintain protection until principal contamination is removed IFSI study shows effectiveness

Contaminated Item Handling Properly remove PPE at scene to avoid contamination transfer Isolate and bag contaminated PPE Provide clean clothing for personnel at scene Avoid transporting contaminated PPE in apparatus or personal vehicles Apply proper cleaning to other contaminated items

Cleaning and Decontamination Clean all contaminated items Other items: SCBA, boots, gloves, hoods, helmet textiles Subject contaminated items to proper cleaning Pick effective processes Ensure that items can be safely returned to service

Implementation of Best Practices Increase awareness Substantiate benefits from suggested improvements Incorporate findings into standards where possible

Key Proposed Changes to NFPA 1851 Systematic approach to cleaning and decontamination Preliminary exposure reduction Advanced cleaning after exposure Specialized cleaning when needed Increased guidance for how to conduct cleaning and decontamination Requirements for cleaning verification

Added Fire Service Guidance Specific recommended procedures: Machine selection/loading Sanitization of garments exposed to blood/body fluids Non-destructive analysis of garments for asbestos Cleaning guidelines for other elements

Use of Surrogates Samples Specific procedures for shipping, handling, and returning specimens and clothing

Validation Results for Different ISPs

Cleaning Verification Requirements Methods are being added to NFPA 1851 Proposed criteria Metals: 70% reduction (each metal) Organics: 50% reduction (average over group of chemicals) Proposed phased-in implementation (minimum of 2 years) Further testing validation efforts in progress Project will be continuing through July 2018

Overall Significance Steps have to be taken reduce contamination wherever possible (especially at the scene) PPE needs to be cleaned after every exposure More information is needed for establishing viable cleaning methods in fire service Cleaning capacity within fire service must be increased ISPs/industry should lead way with verified, improved cleaning Clothing manufacturers/material suppliers should actively address clothing solutions, consequences of frequent cleaning