Spring Fire Department Cancer Reduction Initiative PDF

Manual Name: Spring Fire Department Policies & Procedures Document Title: Cancer Reduction Initiative Chief’s Signature: Document Number: SFD.002 Date: 11/27/17 Revision Number: 01 PURPOSE Numerous studies have proven that firefighters are at greater risk of contracting many cancers because of the...

Manual Name: Spring Fire Department Policies & Procedures Document Title: Cancer Reduction Initiative Chief’s Signature: Document Number: SFD.002 Date: 11/27/17 Revision Number: 01 PURPOSE Numerous studies have proven that firefighters are at greater risk of contracting many cancers because of their assigned duties. These studies have shown that proper use of the PPE, SCBA and a gross decontamination process are beneficial in limiting the duration of fire fighter exposure to toxic carcinogens. The Spring Fire Department is committed to the overall health of employees. The Spring Fire Department recognizes the increased risk of cancer associated with firefighting activities. In an effort to provide a safe and healthy work environment, the Spring Fire Department has created the following guideline and best practices document to reduce the cancer risk to its members. This guideline will provide the member with the process to follow before, during and after the firefight. SCOPE All Spring Fire Department personnel are responsible for knowing and complying with this procedure. REVIEW The Fire Chief or designee is responsible for reviewing this guideline annually and assuring its accuracy. DEFINITIONS Apparatus Decontamination Bag: A bag containing the needed items for gross decontamination on scene. It will be provided and stored on the apparatus in the front left compartment. CycleSauna: Device that is designed to remove toxins form our bodies that may have been absorbed during firefighting duties. The device contains an infrared medical grade heater that combined with mild exercise will coax a quick and profuse sweat without raising core body temperature. Gross Decontamination: The physical process of reducing and preventing the spread of contaminants from persons and equipment. This is to be done on the fireground while personnel are still in donned PPE, breathing from the SCBA. To accomplish gross decontamination on the fireground the use of a pre-connected handline or booster line shall be used. IDLH atmosphere: An atmosphere which is immediately dangerous to life and health. This atmosphere is likely to cause death or immediate or delayed permanent adverse health effects or prevent escape from such an environment. Personal Protective Ensemble (PPE): Department issued structural firefighting helmet, hood, coat, pants, boots, and gloves. Self-contained breathing apparatus (SCBA) is also part of the ensemble and is to be worn anytime a member enters an IDLH or is deemed necessary by the company officer. Page 1 of 6 Manual Name: Spring Fire Department Policies & Procedures Document Title: Cancer Reduction Initiative Chief’s Signature: Document Number: SFD.002 Date: 11/27/17 Revision Number: 01 Self-contained breathing apparatus (SCBA): a device worn by rescue workers, firefighters, and others to provide breathable air in an immediately dangerous to life or health atmosphere (IDLH) PROCEDURE The member must understand that if they are to reduce their exposure to occupational cancer causing atmospheres, the responsibility starts with them. Personal responsibility is the cornerstone for members to ensure their exposure is reduced. Firefighters must understand this increased risk. Even though cancer prevention is still evolving, it’s well accepted that your chances of developing cancer are affected by your lifestyle choices. Below are some simple changes that can make a big difference: 1. 2. 3. 4. 5. 6. 7. 8. Don’t use tobacco Eat a healthy diet Maintain a healthy weight and be physically active Protect yourself from the sun Get immunized Avoid risky behaviors Get regular medical care/medical screenings Moderate use of alcohol Apparatus Decontamination Bag 1. 2. 3. 4. 5. (8) 60-gallon trash bag (4) packets of Inspire pre-moistened quick clean body cleaning wipes (1) small bottle of dawn soap (1) small soft bristled brush (1) box of medical gloves Use of SCBA Mask Filters 1. The filters provided by the Spring Fire Department are the only filters allowed to be used during approved overhaul operations. 2. The SCBA mask filters and adapters will be carried by the on-duty district chief. The filters and adapters will be issued to crews that are overhauling the fireground. After completion of overhaul, all filters and adapters will be returned to the district chief for disposal of the filters and cleaning of the adapters. 3. The 4-gas detector must monitor the atmosphere to ensure no presence of HCN or CO. When no presence of HCN or CO is detected, use of the SCBA mask filters is acceptable. Fire Scene Operations 1. Anytime a member is in an IDLH environment, they must breathe air from a SCBA, no exceptions. Anytime a member is in an environment that is without CO and has an ample Page 2 of 6 Manual Name: Spring Fire Department Policies & Procedures Document Title: Cancer Reduction Initiative Chief’s Signature: 2. 3. 4. 5. 6. 7. 8. Document Number: SFD.002 Date: 11/27/17 Revision Number: 01 level of oxygen (such as may be typical within a gas-monitored overhaul environment) the use of an SFD issued cartridge system and SCBA mask adapter may be utilized. The use of the SCBA shall always be considered the best respiratory protection, with the implementation of the cartridge system at the discretion of the incident commander. The breathing of air from the SCBA or from the department issued SCBA mask filter must be from the initial attack to the finish of overhaul. During the use of the cartridge system, appropriate electronic means shall continually monitor the air quality of the work environment. The incident commander should take workload and climatic conditions into consideration when making the determination. Once the incident has been stabilized and demobilization operations begin, the apparatus operator should retrieve the apparatus decontamination bag for the needed supplies. The decontamination bag and related supplies should be placed in a readily available area so the contaminated members can access the needed supplies. Gross decontamination of Personal Protective Equipment (PPE) is needed to remove as much soot and particulate as possible. Gross decontamination is required anytime your PPE may have been exposed to products of combustion or other contaminants, or if the company officer or incident commander deems necessary. During the gross decontamination process, the member must ensure that they are still breathing air from the SCBA while the gross decontamination is occurring. The removing of your SCBA regulator from your mask while being decontaminated is counterproductive in keeping the contaminants out of your lungs and off your face. The preferred method to decontaminate is to use an apparatus booster line at pump pressure with a fog nozzle on a power cone setting. Rinse at a downward angle from top to bottom. If the member is covered in large particulates and the temperature is not conducive for wet gross decontamination, use the provided bristle brush to remove debris and contaminants. After gross decontamination, the member will not re-enter the IDLH atmosphere. The incident commander must ensure that overhaul is completed prior to the last firefighter being gross deconned. The member will remove all PPE and place it into the heavy-duty trash bag provided in the apparatus decontamination bag. All contaminated gear, including coat, pants, hood, helmet, mask, gloves, and boots shall be placed in the heavy-duty trash bag. The bag should be placed outside of the passenger compartment. Use wet personal decontamination wipes to remove as much soot as possible from the head, neck, jaw, throat, underarms, and hands immediately while on scene. Decontamination of your body is necessary prior to eating or drinking at rehab while on scene. Use the soap provided in the apparatus decontamination bag for decontaminating your hands and face prior to eating. Depending on the severity of the incident and the exposure of contaminants to the first arriving crew(s), the incident commander should consider calling for additional resources to assist in the overhaul process. Releasing the crews that were exposed for the longest amount of time to the contaminants and have worked the longest in PPE will allow them to begin the decontamination process and rid themselves of the cancer-causing carcinogens and toxins they were exposed to during firefighting operations. Each incident must be evaluated on a case by case basis depending on the severity of the exposure. The final decision rests with the incident commander. Page 3 of 6 Manual Name: Spring Fire Department Policies & Procedures Document Title: Cancer Reduction Initiative Chief’s Signature: Document Number: SFD.002 Date: 11/27/17 Revision Number: 01 9. Upon arrival, back at the fire station, and prior to taking a shower, open the turnout bag, and let the turnouts off-gas outside the fire station. Remove your contaminated gear from the heavy-duty trash bag and place into the gear extractor. Wearing of medical gloves is necessary to reduce your exposure of contaminants getting onto your skin or into your body via your hands. 10. Decontaminate the apparatus interior. All members must ensure that the area is adequately ventilated and you are wearing medical gloves while wiping down all surfaces. Leave fire apparatus windows down, and use an apparatus bay floor fan to ventilate/dry the interior of the apparatus. 11. After arriving back at the station, each member shall do at least 15 minutes, but not to exceed 20 minutes in the CycleSauna decontamination unit. This must be done after handling contaminated PPE, but prior to showering. It is recommended you change into a loose-fitting t-shirt, shorts and tennis shoes for the exercise time. This part of the decontamination process will allow you to produce a detoxifying sweat, assisting in removing cancer causing carcinogens from your body. Refer to SFD.060 (CycleSauna) guideline for settings and additional procedures for the unit. 12. Shower thoroughly after your CycleSauna detoxification session. 13. Place your second set of gear into service ensuring that you have all required equipment for an emergency response. Clean thoroughly your helmet and boots before making them part of the second set ensemble. Overhaul The primary emphasis during post-fire operations should be the safety of all personnel operating on the fire scene. When crews exit the structure as soon as possible, they allow for the chemicals to dissipate naturally and their overall exposure will be reduced. An additional benefit of timely crew removal, is that it will allow the Harris County Fire Marshal’s office to gather information before a scene is further disturbed by overhaul. As a best practice, the most contaminated crews should be sent home first for detoxification, showering and change of clothing to remove the toxic products of combustion that accumulate during firefighting operations. 1. During the structural cooling off period, the incident commander can develop an overhaul plan that includes the identification of safety issues like holes in floors or unstable walls/roofs and the establishment of hot, warm, and cold zones. 2. SCBA or a department issued SCBA mask filter with adapter is mandatory to be used for any work performed inside the structure for duration of overhaul. Monitor fatigue, hydrate, and cool crew members. 3. Fire investigators can begin interviews and investigation outside the structure during the structural cooling off period. Equipment Cleaning Page 4 of 6 Manual Name: Spring Fire Department Policies & Procedures Document Title: Cancer Reduction Initiative Chief’s Signature: Document Number: SFD.002 Date: 11/27/17 Revision Number: 01 SCBA facemasks and tools are exposed to the same products of combustion as turnout gear. They are contaminated any time they are exposed to a smoky atmosphere, including, but not limited to, structure fires, car fires, dumpster fires, training fires or burnt food on the stove. If not properly cleaned, contaminated equipment will continue to expose personnel to carcinogens long after the fire. 1. Gross decontamination of equipment should be done at the scene. 2. Fire hose should be transported back to the station by a utility vehicle, or on the apparatus if it can be properly secured. The passenger compartment should be avoided. 3. Any time contact is made with the contaminated equipment at the scene or while cleaning, proper PPE that will limit dermal absorption should be used. 4. Contaminated equipment should be grossly decontaminated first on scene and then placed back into the compartment for transporting back to the station. Keeping it out of the passenger compartment of the apparatus prevents cross-contamination of the apparatus cab. 5. Equipment must be cleaned in a location that will allow for proper cleaning without further exposure to personnel or living quarters. The equipment should be cleaned per manufacturer recommendations. Most hand tools can be cleaned with mild soap and water. Scrub with a soft to medium bristled brush and rise with garden hose. 6. Gas powered equipment can be wiped free of smoke, soot, and debris with wet towels. SCBA and Facemask Cleaning 1. The cylinder needs to be removed from the backpack for proper cleaning. It should be washed with warm, soapy water and thoroughly rinsed, making sure to clean all components of the cylinder. After cleaning, the cylinder valve should be cracked open to blow out any moisture that has collected in the valve opening. 2. Masks should be cleaned inside and out to remove all contaminants and sanitized prior to being placed back in service. 3. The backpack (minus cylinder) should be thoroughly cleaned in accordance to the manufacturers recommendation. Warm soapy water, sponge and soft bristled brush should be used, with care taken to make sure water is not directly applied to electronics, i.e. pack alert. Hose Cleaning 1. Contaminated hose should be cleaned per NFPA 1962 Standard for Inspection, Care and Use of Fire Hose, Couplings, and Nozzles and the Service Testing of Fire Hose. 2. It is recommended to remove the harmful materials and contaminants with a gross decontamination of the hose while on the fire ground. Roll the hose on scene and place in a safe location for transporting, but not in the apparatus cab. 3. Upon returning to the station fill a large bucket with mild, soapy water. The water should be ambient temperature. Using a long-handled, medium to hard bristled broom/brush, scrub the entire length of the hose. 4. Turn the hose over to the opposite side and scrub. Page 5 of 6 Manual Name: Spring Fire Department Policies & Procedures Document Title: Cancer Reduction Initiative Chief’s Signature: Document Number: SFD.002 Date: 11/27/17 Revision Number: 01 5. Using the garden hose, completely rinse the soap from the hose on both sides. 6. The hose can be re-loaded wet or if spare hose is available and the officer deems it best to load replacement hose, replacement hose can be loaded and the wet hose dried. Ensure if the hose is left out to dry that it is not placed in direct sunlight. Apparatus Decontamination and Cleaning 1. All apparatus cabs, compartments, and equipment should be cleaned weekly and decontaminated after every incident or training that involved contaminants. 2. Parking upwind, keeping windows closed and heaters and air conditioners off during fireground operations will minimize airborne contaminants from entering the cab. 3. All cleaning can be done utilizing cleaning solutions, designated rags, mop buckets, brushes, and disinfectants. 4. Apparatus cab cleaning should be done in a top-down cleaning method followed by disinfecting. Special attention should be paid to computers, radios, seats, steering wheel, floorboards, and headsets. Disinfecting is intended to prevent the spread of contagious illnesses such as C Diff, MRSA, staph, etc. 5. All cloth surfaces should be cleaned using a shop vac. 6. Remove all equipment and use the top-down method to clean apparatus compartments. All equipment should be cleaned prior to being placed back on the apparatus. 7. After cleaning is complete ensure all rags, mops and other items used are washed in the washing machine. Make sure all mop buckets are rinsed out and cleaned for the next use. Wash your hands, face and neck or shower. Station Best Practices 1. Never have the apparatus motor running inside the bay with the bay doors closed. Apparatus should be pulled onto the front or rear slab anytime the motor is running. 2. Apparatus power tools shall be started and idled outside the bay during routine checks and cleaning. 3. Keep PPE out of living and sleeping quarters. 4. Keep PPE in a gear bag and out of your vehicle’s interior compartment. The use of a tool box in a pick-up is preferred or a trunk for equipped vehicles. 5. Wash your hands thoroughly and consistently throughout your time at the station. 6. Always wash your hands prior to eating meals or preparing food. Page 6 of 6