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Firefighter/EMT Safety, Health & Survival: Firefighter Cancers: Soot

April 15, 2009

Prolonged exposure to soot on the skin is a hazard. The groin area of the body has a very high rate of permeability, and this may lead to testicular and other cancers in firefighters. Fire chiefs should consider adopting an SOG that requires firefighters and other personnel to promptly take showers after exposure to smoke, change into clean clothing and bag or wash their dirty clothes.

Other best practices include washing turnout gear and protective hoods after exposure to smoke, storing the turnout gear in designated areas far away from sleeping and dining areas and cleaning the interior cab areas of emergency apparatus after a structure fire.

The SOG should also require routine cleaning, inspections and recordkeeping, per NFPA 1851.

A recent study at the University of Cincinnati, Academic Medical Center, compared cancer rates of British chimney sweeps (the chimney sweeps in the late 1800s were notorious for lack of bathing) with the chimney sweeps in Germany and Belgium (homes “exceedingly clean”) and Sweden (routinely took baths at the workplace at the end of each workday).

The UC study revealed:

The major cause of testicular (and possibly other types of) cancer in chimney sweeps and firefighters is probably PAHs (Polycyclic Aromatic Hydrocarbons) absorbed through skin persistently coated in soot and often hot, as a consequence of their occupation…

Chimney sweeps’ cancer in Britain was due to persistent contact of soot with the skin. These cancers were unknown in continental European sweeps.

Dr. Stuart Baxter, Jan. 22, 2009, UC seminar

Why testicular cancer? Dr. Baxter explained that soot from burning wood, polymers, plastics, oils and other substances contain the cancer-causing agent PAH. The groin area of our bodies has a very high permeability rate:

  • Scrotum: 300 permeability rate
  • Jaw angle: 93
  • Forehead: 43
  • Scalp: 25
  • Back: 12

Skin absorption also increases with temperature. Dr. Baxter’s hypothesis is sobering for firefighters.

A major cause of cancer in firefighters is PAH absorbed through the skin as a result of contact with soot, persistently and under hot conditions. The especially high permeability of the groin area results in increased testicular and possibly other types of cancer.

Dr. Stuart Baxter, Jan. 22, 2009, UC seminar

Fire Department Best Practice: PPE Cleaning

On March 21, 2003, Cincinnati Firefighter Oscar Armstrong III died in the line of duty during a structure fire. The Cincinnati Fire Department conducted an extensive investigation, in cooperation with IAFF Local 48, including a review of PPE cleaning practices.

The report included the following findings and recommendations regarding PPE (page 83):

4. Personal Protective Equipment Maintenance and Cleaning Technician

Relationship to the death of Oscar Armstrong
The personal protective equipment of the personnel involved in this incident had not been inspected, cleaned or maintained for 2 to 3 years. Since there is no record of cleaning or inspection it is assumed the time frame greatly exceeded the 6-month inspection and cleaning recommendation. It is impossible to know the condition of FF Armstrong’s PPE prior to destruction in the fire.

The protective coat in this incident was issued in January 2001 and manufactured in March of 1999. The protective pants in this incident had not been evaluated or cleaned since April 27, 2000. They were issued to FF Armstrong in January 2000. The date of manufacture of the turnout pants was May 1992. The turnout pants worn by FF Armstrong were in service for over 10 years without record of cleaning or inspection for 35 months prior to the incident.

Recommendations by the committee to limit similar occurrences:
Create a dedicated position responsible for the cleaning, maintenance, tracking and issuance of PPE. This position is essential in order to track personal protective equipment issuance, maintenance and cleaning. This individual will also perform routine inspections and perform minor repairs. Ensure that inspection, cleaning, and care of protective coat is in accordance with NFPA 1851 Standard on Selection, Care and Maintenance of Structural Fire Fighting Protective Ensembles. All PPE needs inspection and cleaning every 6 months regardless of use.”

For more information about firefighter cancer issues, visit the websites of the Firefighter Cancer Support Network and the IAFC’s Safety, Health & Survival Section.

Larry Bennett is a member of the Safety, Health & Survival Section and deputy director of Fire Science Education at the University of Cincinnati’s Fire Science and Emergency Management Department.

UC Seminar: Firefighter Cancers – Management Best Practices

On July 12, the UC Fire Science and Emergency Department will host a seminar focused on fire department best practices to avoid firefighter cancers. Dr. Baxter will be the keynote speaker at the seminar. In addition, Cincinnati Fire Department’s Health & Safety Officer, District Chief Ron Texter, will discuss the changes they’ve implemented since the LODD of Oscar Armstrong in 2003. Other speakers will share their best practices.

They will post the presentations at UC Officer Development Seminars. The seminar will be held at the College of Applied Science auditorium. Email Larry Bennett if you plan to attend or if you’d like to share your department’s best practices.