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Suiting up for the Invisible Enemy

PPE’s Role in Saving Lives

On July 9th 2018, the US president signed legislation to track firefighters’ on-the-job exposure to cancer. Despite the lack of conclusive evidence to demonstrate a causal relationship between this profession and cancer, the initiative raised a red flag.

It’s clear that cancer-causing carcinogen contamination of firefighters remains a serious health and safety issue.  What can be done to address it?

There’s something in the air

Until the mid-1990s heart disease was the leading cause of firefighter deaths.

As building materials evolved to more complex glass, plastic and metal-material based structures, correlation between firefighting and higher cancer rates started to emerge. “Risk of Cancer Among Firefighters in California”, 1988–2007, was one of the first studies to examine firefighters’ exposure to types of leukemia, esophageal cancer and lung cancer.

More research brought to light a new and interesting hypothesis - that toxic chemicals released during the burning process were sometimes far more dangerous than the fires themselves.

Toxic air has been found to contain these carcinogens:

Aldehydes, known to cause immediate irritation of the eyes, nose, and throat, and lung inflammation when inhaled. Short-term effects include cough, shortness of breath, and chest pain.

Sulfur dioxide that causes severe irritation of the eyes, skin, upper respiratory tract, and mucous membranes.

Respirable particulates that can be inhaled into the deeper recesses of the lungs, the alveolar region. These particles carry absorbed and condensed toxic chemicals into the lungs.

Crystalline silica, known to cause silicosis, a noncancerous lung disease that affects lung function. OSHA classifies silica as a carcinogen.

The consequences of gear contamination

Only a couple of decades ago, firefighters were known as "smoke-eaters," and they wore their charred, soot-covered gear as a badge of honor. Dirty gear was perceived as a sign of experience. To their defense, cleaning gear had practical obstacles – there was little or no access to commercial-grade laundry equipment, a place for drying or a second set of turnout gear for the next shift.

But contaminated gear is now known to prolong exposure to unhealthy chemicals. Studies show that smoke poses both inhalation hazards as well as skin absorption hazards. A 2017 study by the University of Ottawa found that firefighters are exposed to certain harmful chemicals mainly via contact with their skin, rather than just by inhalation.

“Secondary contamination” begins after the firefighter leaves the hazard area, as harmful substances deposited on unprotected skin find their way in the bloodstream and into lungs. Continued exposure can also occur as the firefighter remains in contact with contaminated PPE, tools, apparatus seat and other items that were directly or indirectly exposure to fireground particles.

Even when firefighters wear a full set of protective gear, some areas remain vulnerable. The neck has been one of the primary areas for dermal exposure and a regular knitted hood only provides limited protection, a NIOSH study confirms.

Realistic expectations

Given the documented increase in cancer cases among firefighters, firefighter safety should be part of a fire safety ecosystem that comprises multiple key elements - including public education efforts, training resources, better PPE, more accessible cleaning, and better overall hygiene practices.

And prevention efforts need to be addressed both personally and organizationally.

Some of the already-proven strategies and practices to reduce contamination include these simple measures.

Pre-intervention measures

1.       Using PPE properly (this includes ensure that all interfaces are properly covered, such as having coat collars worn in the upright position and ear covers pulled down)

2.       Using SCBA throughout the duration of the intervention.

3.       Subjecting gear to preliminary exposure reduction at the scene, whenever possible, or at least removing gear immediately after leaving a fire.

4.       Transporting contaminated equipment in a separate gear or plastic bag and keeping it out of the apparatus cab or personal areas of a vehicle.

Post-fire measures

  • Off-loading PPE minutes before washing and not sooner, to avoid contaminating other areas.
  • Following good hygiene, cleaning exposed skin with wipes and using disposable examination gloves for handling dirty equipment.
  • Showering thoroughly.
  • Not taking contaminated gear home or storing it in personal areas.

The role of PPE

Next-generation protective equipment can also significantly and proactively reduce exposure to contaminants.

Fortunately, many of the current moisture barrier materials in the firefighter protective ensemble already block particulates. When combined with new, innovative materials and ensemble designs, the skin is better protected from toxic soot that enters the gaps in the ensemble and settles on the skin (at the jaw level, neck, wrists, waist, front torso, and lower legs).

The use of breathable materials and designs reduce the risk of heat stress by allowing body heat to be more easily released and thus, reduces the risk of heart attack. These have appropriate levels of physical strength and hazard resistance to preserve durability with expected repeated laundering that increasing with use.

We’ve discussed how to reduce carcinogen exposure and more in a recent webcast. Go check it out!

Honeywell has recently created an integrated particulate-shield design to address the most vulnerable areas of the body (helmet to hood to air mask, coat to pant, glove to coat sleeve, and boot to pant cuff).


The Honeywell Morning Pride Gear Shield package (Head Shield, Arm Shield, Core Shield, Leg Shield and Heat Release Liner) reduces particulate penetration of turnout gear when compared to a standard ensemble, while maintaining breathability and air circulation to prevent heat stress. The Heat-Release liner technology, with its patent-pending vent feature, allows for air trapped inside the liner to escape faster.

Interested in learning more about this amazing product? Click here to reach out to a Honeywell representative for more information.