Last year, the Fire Industry Education Resource Organization (F.I.E.R.O.), in conjunction with North Carolina State University, conducted a national survey to help provide background information to enable a research study on heat strain suffered by firefighters.
The research project will not be completed for another couple of years, but the survey provided an interesting look (probably for the first time) at what we wear when responding to and mitigating emergency incidents.
Almost 3,500 firefighters responded to the survey—if you were one, thank you. Here is a brief description of the demographics. Of the respondents, 55 percent were career firefighters, 21 percent were from combination departments, 20 percent were volunteers, and four percent were other (government, military, etc.). The ranks of the respondents were 41 percent firefighter, 32 percent company officer, 20 percent chief officer, and seven percent other (administrative, etc.). The geographic region of the participants was heavily Northeast (25 percent) and Southeast (25 percent). The North Central had 14 percent, with the Northwest, Southwest, South Central, and Midatlantic each having between five and nine percent. From that geographic distribution, 79 percent said they worked in a hot and humid environment. This was followed by 13 percent saying they worked in a hot and dry environment, and the rest saying they worked in either a temperate/humid or temperate/dry environment.
The most common type of working fire encountered was a single-family dwelling (90 percent). One of the more interesting results of the survey was what firefighters say is the most physically demanding activity they perform. Eleven different activities were listed, and the top three of search and rescue, nozzle operator, and carrying hose up the stairs were closely grouped at the top. Not far back were vertical ventilation, backing up the nozzle operator, and providing slack to the nozzle operator. Overhaul and vehicle extrication finished ahead of horizontal ventilation, hydrant operator, and salvage.
DURING THE RESPONSE
It was no surprise to learn that most firefighters wear long pants and a short-sleeved T-shirt under their turnout gear (45 percent). This was followed by 26 percent who wore shorts and long-sleeved shirts. One question was about where personal protective equipment (PPE) is stored prior to a response. Next to the vehicle was the highest response with 37 percent, followed by in the apparatus at 29 percent, then on a rack or in a locker at 20 percent, and 12 percent keep it in their personal vehicle—probably volunteer firefighters. Eighty-two percent of the respondents said the PPE was not stored in a climate-controlled environment. (This leads to increased heat strain.) Seventy-five percent of the firefighters indicated they felt the cooling effects of the cab air-conditioning. Of this 75 percent, the impact of the cooling ranged from a little bit to very much.
The answers about what you don before getting into the apparatus were fairly consistent. Pants and boots are donned by 90 percent, coats are donned by 79 percent, and the hood (around the neck) by 78 percent. It was interesting to note that nine percent don their helmets. Wearing a helmet during response is not a good practice. Doing so can contribute to an injury in an apparatus collision because they are top heavy and not designed as crash helmets like those worn by race car drivers. Sixty-nine percent say they don their self-contained breathing apparatus (SCBA) during the response. Are they seated and buckled?
One of the more popular questions was what is worn or carried by the firefighter in addition to his head-to-toe PPE. Nineteen different items were included in the list. More than 50 percent of the firefighters listed the following (listed in order of popularity): flashlight, portable radio, webbing, wire cutters, door chocks, multitool, and knife. All these items, though needed, add weight and increase heat strain.
When asked how many times they reenter a structure before going to rehab, 40 percent said once and 40 percent said twice. Only nine percent said three times, and eight percent said none. The 45-minute duration air cylinder was used by 61 percent of the respondents, 34 percent used 30-minute cylinders, and five percent used 60-minute cylinders.
While on the scene, firefighters indicated they were actively involved in firefighting 32 percent of the time, doing other physical activity 38 percent of the time, and waiting/resting 30 percent of the time. Surprisingly, only 49 percent of respondents said they remove the SCBA, face piece, helmet, hood, gloves, and coat during rehab. Of that group, 37 percent indicated they also pulled their pants down over their boots.
A huge contributor to heat strain was revealed when it became known that full PPE (excluding SCBA) is being worn during overhaul by more than 97 percent of the firefighters. Unfortunately, only 84 percent wear their SCBA during overhaul. There must be a better way to address what is worn during overhaul. The thermal protection required for overhaul is not nearly as high as the thermal protection needed for fire attack. SCBA use during overhaul should be at 100 percent.
Finally, 47 percent of the firefighters indicated that they had suffered from heat exhaustion, heat stress, or a heat-related condition. When asked what they were doing at the time, the highest response was firefighting. This was followed by overhaul. Not surprising, many indicated they experienced this on very hot and humid days.
Hopefully, the data gathered from this survey will help in developing better PPE to reduce heat strain. There is also an opportunity for fire departments to look at what they do operationally to reduce heat strain. Firefighters wear structural PPE to almost all nonemergency-medical-service-related calls, most of which do not involve working fires. There must be an alternative set of PPE, or the current structural PPE needs to be modified through redesign or by introducing new products to reduce the burden of heat-related illnesses and deaths.
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.).