ppe
Clean your kit Dermal absorption of toxic chemicals on PPE is elevating firefighters’ risk of developing cancer, according to a new study from the University of Central Lancashire in the UK. But what can be done to minimise this risk? Lotte Debell looks at research and initiatives from around the world and the challenges faced by fire services in getting to grips with the cancer threat.
C
ancer is the leading cause of death for firefighters. A search of the IAFF line-of-duty death database for cancer brings up 1,762 names. The organisation’s Fallen Firefighter Memorial Wall of Honour, erected more than 30 years ago in Colorado to honour firefighters from the US and Canada, has more than 7,600 names in total. 190 names were added in 2017. 167 were deaths caused by cancer. In fact, cancer accounts for more than 60% of the names added in the last five years. Study after study has shown that firefighters are at an increased risk of developing cancer because of the toxins they are exposed to on the job. But for many firefighters it doesn’t take a study to tell them what they already know – that too many of their colleagues have died from, or are fighting, cancer. The studies point to exposures to toxic compounds during fire suppression as the reason for a firefighter’s elevated risk of developing cancer. But what is becoming clearer as more research is coming out is how this exposure is happening. Whereas for a long time, the focus had been on inhalation, current research suggests dermal absorption is the main culprit – and this raises serious questions about how firefighters can protect themselves from this potentially deadly occupational hazard. The most recent study to provide evidence of the dangers of dermal absorption of chemicals from combustion was conducted by the University of Central Lancashire in the UK[1]. Published in February 2018 in Nature’s Scientific Reports, it is the first study of its kind in the country and links a firefighter’s increased risk of cancer to ‘dangerously high levels of harmful chemicals’ on their PPE after exposure to smoke from a fire. It also highlighted the need for government intervention and regulation for the long-term health protection of firefighters. Astonishingly, despite the growing evidence, firefighting is not currently considered a high-risk occupation in Europe. Following a meeting at the European Parliament to discuss fire toxicity and firefighter health, the study’s lead researcher Professor Anna Stec – who has been arguing for years that the risks are much higher than anyone in the fire service acknowledged – realised that more data was required to demonstrate firefighters’ exposure to carcinogenic chemicals.
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"We know that firefighters are exposed to a cocktail of acute toxins – those that have an immediate effect – as well as chronic toxins, which have a long-term effect. Within chronic toxins, not a lot of research has been carried out." For this reason, the study focused exclusively on PAHs (polycyclic aromatic hydrocarbons), specifically on 16 that are classed as either carcinogenic, potentially carcinogenic or possibly carcinogenic by the US. "Acute toxins will depend on the fire conditions and fuel for any given fire, but soot is carbon and everything contains carbon. So, we decided to focus on soot because it is always present and it sticks to everything. Soot is a build-up of PAHs." While conversations about exposure have tended to focus on inhalation, Stec took a different route. Since the use of breathing apparatus should limit the inhalation risk, and with studies from the US showing the presence of particulates under firefighters’ clothing, the UCLAN team homed in on clothing contamination and potential exposure on the skin. They also looked at PPE cleaning methods – or lack of them – and their effectiveness. This is really one of the key issues. If PPE is contaminated with carcinogens and is not cleaned effectively or indeed at all between incidents, the chemicals on those garments can cause repeated exposures for the firefighters who wear them, as well as potentially contaminating vehicles and anything else they touch. Working with 136 firefighters from two fire stations during training scenarios, researchers took pre- and post-event wipe samples from firefighters’ skin and PPE as well as from their workspace and fire engines, taking account of differences in PPE storage methods between the two stations. They looked at various roles, from instructors to trainees, and most, if not all, had carcinogens on their clothing and skin. "When we calculated the cancer risk to firefighters within 30 to 40 years of exposure to these contaminants on their clothing – and not washing that clothing – it is very high," said Stec. In fact, she says, it is as much as 350 times higher than the level that would prompt government intervention in the US. "Many firefighters have told us that they don’t have the facility to clean their kit at the station, so they either take it home to wash it or don’t wash it at all. And they often leave it in rooms close to their offices and sleeping areas. Most fire services in
Professor Anna Stec, lead researcher on the UCLAN study.
Dirty gear is still regarded as a badge of honour by some fireighters, but awareness of the health risks is now on the increase. (Shutterstock)
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