Being a firefighter can be harmful to one’s health, and this comes as no surprise to anyone. Firefighters are asked to work in hazardous environments that are never exactly alike and are probably foreign regarding specifics because of structural layout and fire conditions.
Knowing this should inspire those with the ability to do so to take as much action as possible to protect firefighters even though the level of unpredictability can be high. But through study, proper equipment, and healthy choices, the unnecessary risks can be eliminated and the rest minimized. Firefighter wellness must also include mental as well as physical programs that improve firefighters’ resilience to the by-products of the job.
Smoke is fuel. It comprises particulates, aerosols, and gases (solids, liquids, and gases). Besides the fuel, the smoke is very harmful to firefighters’ health with respect to the cardiovascular system and as a carcinogen. Besides carbon embers and ash, the particulates will most likely contain some form of asbestos as well as silica. Both have been proven to be cancer-causing. The gases generated by the contents found in most new buildings also contain carcinogens such as benzene. Working in high-heat environments causes additional health hazards. Providing protection for firefighters involves more than getting the best possible equipment. There must be training and education to go with well-written policies and procedures that must be followed.
Leadership in an organization will determine the course the department will take. Those chiefs and officers who truly put their people first will set the proper example and do what is necessary to establish the proper culture. That will include clear direction on risk management and risk taking. This is not to imply that departments must be only defensive if they want to protect firefighters. People sign up for the job with the understanding that there will be certain risks. These should be calculated and based on savable situations. Besides the obvious need to risk a lot to save people, there must be calculated actions that manage risks where there is value worth saving. Sometimes the least risky action for firefighters is putting the fire out.
Back to the personal protective equipment (PPE) for firefighters. There needs to be an understanding of what the ensemble can protect against and what is beyond the gear’s capabilities. Starting with the self-contained breathing apparatus (SCBA), all members, from top to bottom, must know what SCBA will protect and where risks are presented. There is no question that SCBA have greatly improved with each new generation. But, as with any tool, knowledge of its capabilities is important. SCBA will protect the respiratory system but will not prevent absorption of toxins through the skin. The SCBA, outside of the face piece, is often the least frequently cleaned and decontaminated part of the PPE. The actual polycarbonate face piece is subject to failure at lower temperatures than the rest of the unit. The face piece can have small cracks that are not easily visible. Members must be educated on the benefits and weaknesses and the proper way to check the unit completely.
Bunker pants and coats offer great protection but are not all-encompassing. Once again, members must know what the gear can and cannot do. There are requirements for heat and moisture protection. This occasionally can give the impression that firefighters have a “superman costume” so they can get to anywhere in the fire. If it were only that easy. While the heat protection is great, it is the strongest part of the entire ensemble. Helmets, hoods, gloves, boots, and SCBA do not have the same protection against heat. In addition, the bunkers do not protect the body against many of the toxins, as the gases can penetrate the material and get absorbed through the skin. Knowing the limitations is critical in training and educating firefighters. Best practices in decontamination must also be part of the regular and routine maintenance policies and procedures. Studies have shown that gross decon on the scene can remove the clear majority of contamination. This protects the firefighter immediately and prevents toxins from being placed in the apparatus or returned to the station. Packaging of the PPE in a bag for transport can also minimize exposures. The entire protection package is as good as it can possibly be, but there are limitations. A failure to understand this will result in unnecessary risk to firefighters and expose them to toxins and carcinogens that have proven to be harmful to the health of humans.
To best take advantage of the protective clothing offered to today’s firefighters, physical fitness must be a priority. Being as heathy and fit as possible allows firefighters to gain the most benefits from the outstanding equipment that is part of the overall protective program. This wellness involves looking at the entire package, which will include the obvious physical capabilities of strength and aerobic capacity. It must also look at nutrition, hydration, and rest. The cells of the body—all of them—require oxygen, water, and glucose to properly function. Tired, dehydrated, or undernourished firefighters cannot function at optimum performance and cannot match their protection. Physically healthy firefighters will better withstand the assault on their bodies from hostile fire conditions and will recover more quickly. This will include the short-term recovery from doing hard work and in the cases where injuries are incurred. Those who are serious about protecting firefighters must get serious about physical health and conditioning.
Mental health is also important. First, being in the right state of mind allows firefighters to do the best job that they can and the one that the citizens deserve. They need to be focused on the job at hand and have minimum distractions. This is not always easy, as there are many factors that come into play. It can include issues both on and off duty. It is not possible to maintain the ideal mental condition day in and day out over a long career. Therefore, it is important for everyone to pay attention—and even more important for supervisors to be engaged. But this is only one aspect of mental health. There is more and more information becoming available about the wear and tear this job has on the brain. This article cannot even begin to scratch the surface regarding the materials that are available to consider when evaluating mental health. Suffice to say that a good organization that cares about its people will stay engaged with the research being conducted and will consider actions that help firefighters maintain their mental well-being.
Protecting firefighters goes way beyond burns, strains, sprains, and broken bones. The number one killer of firefighters is cardiac events. This could be overtaken by cancer now that it has been directly correlated to firefighter health. We can add mental health issues to the equation. Good equipment, quality training and education, and sound policies and procedures are needed. Today, firefighters must be protected from all forms of assault. To accomplish this, individuals and departments must stay current on the latest developments that are designed to protect firefighters. Leaders must lead and set the right course of action and present the proper example. If firefighters are really the most valuable resources that a department has, then this must be demonstrated by action, not just words. Look at the total package and make sure that firefighters can focus on their job—not whether they are at risk unnecessarily.
RICHARD MARINUCCI is the executive director of the Fire Department Safety Officers Association (FDSOA). He retired as chief of the Farmington Hills (MI) Fire Department in 2008, a position he had held since 1984. He is a Fire Apparatus & Emergency Equipment and Fire Engineering Editorial Advisory Board member, a past president of the International Association of Fire Chiefs (IAFC), and past chairman of the Commission on Chief Fire Officer Designation. In 1999, he served as acting chief operating officer of the U.S. Fire Administration for seven months. He has a master’s degree and three bachelor’s degrees in fire science and administration and has taught extensively.