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

2. 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?

3. 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

4. Glove Chemical Contamination

5. 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

6. 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.

7. 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

8. 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

9. IAFF Study Visualization

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

11. 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

12. Expectations and Capabilities

13. 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

14. 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

15. 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

16. 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

17. 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

18. 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

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

20. 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

21. 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

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

24. Validation Results for Different ISPs

25. 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

26. 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