COVID-19 has greatly impacted the fire service as it has for every other aspect of daily life. This insidious virus has claimed many lives and sickened many others while stressing fire and EMS services alike. This has required adjustments to the realities of our new normal as we move forward. There have been many news conferences, public health announcements and a slew of newly implemented policies based largely on guidance from the Center for Diesel Control (CDC) related to COVID-19.
This has catapulted health and hygiene into the firefighter conscious like never before. This can be seen both on and off the fire ground. This heightened awareness coupled with municipalities desire to protect their first responders provides a unique opportunity for the fire service to change organizational habits to better protect firefighters. In the past several months fire departments have purchased new equipment and issued policies and procedures aimed at better protecting their members from COVID-19. While this opportunity for change comes due to the COVID-19 pandemic, many of these measures will also protect firefighters from another disease that has been ravaging the fire service for decades. That other disease is cancer.
Let’s briefly review some recent cancer data:
In September 2018, the International Association of Firefighters (IAFF) held their annual Fallen Firefighter Memorial in beautiful Colorado Springs. During the somber ceremony the IAFF added 249 names to the Memorial Wall of Honor including several friends of mine from the FDNY. In total 164 of the 249 names added to the Fallen Fire Fighter Memorial Wall of Honor were firefighters who died due to occupational cancer. Further, 65 percent of the members added to the Wall of Honor between 2002 and 2018 died from occupational cancer. These are sobering numbers. And this is likely only the tip of the iceberg with actual numbers likely much higher since these numbers only represent most career firefighters and do not include volunteer firefighters.
Tragically, firefighter related cancers have been killing firefighters for decades with change to the fire service in many areas slow to take place and with almost no sense of urgency. This is a moment in time where we can make changes that defend and guard against COVID-19 which also having a synergistic benefit to combating cancer in the fire service. This can lead to accelerated change.
This dreadful pandemic provides an opportunity for fire departments to accelerate change of organizational habits to further improve on contamination reduction efforts by implementing mutually beneficial polices that minimize the risk posed by COVID and cancer.
My advice, use this opportunity wisely.
What follows is a list of mutually beneficial initiatives that can be used as force multipliers to help change organizational habits. These initiatives can minimize all forms of cross contamination that can risk the lives of firefighters. We must use this moment in time while COVID is on the minds of firefighters and administrators to introduce, implement, or simply produce better marketing and training campaigns aimed at increasing awareness and training of our firefighters.
Mutually beneficial to COVID and Cancer risk management
Hand washing - Policies and procedures explaining the benefits of hand washing after an exposure have been an important and basic part of any contamination reduction strategy. A renewed emphasis on hand washing with soap and water for 20 seconds using video messages and posting signs in the apparatus bay and near sinks can serve as an omnipresent reminder for members of the importance of this simple but important task.
Portable hand washing stations - this is a good opportunity to purchase or build portable hand washing stations for use at training academies. These are ideal for times when it would be difficult for the fire fighters to shower or otherwise wash their hands in a timely manner. Their portability allows them to be close by for use following the training. Don’t forget to include mirrors so firefighters can see any visible contamination they might have otherwise missed. (See Photo 1)
(Photo 1) Newly acquired hand washing station positioned nearby during a recent tactical evolution at the FDNY Fire Academy (The Rock). Five of these hand washing stations were designed and built internally by members of the FDNY Facilities unit at the request of the Bureau of Training. These hand washing stations will better protect members of the FDNY during training evolution.
Showering and changing into clean station wear - Similar to hand washing, showering and clean station wear are basic tenants of a contamination reduction strategy. New policies, the installation of showering facilities, or simply cleaning out the unused shower stall that has long been used as storage closet instead of its original purpose may be all that is necessary.
Washing shoes and boots – during the pandemic, fire departments have enacted policies and distributed “boot washing or dipping stations” to require the washing of shoes and boots prior to entering the station. This policy and the required equipment purchases were made to prevent cross contamination of COVID 19. Since washing your shoes and boots is also an important way to minimize cross contamination of fire ground contamination, this is an opportunity to remind firefighters of the importance of maintaining their boots and their station shoes contamination free to best keep the firehouse contamination free. It is also an opportunity to advocate for separate footwear for station use only. Separate footwear for station use would prevent cross contamination from footwear used while on the scene of a call.
Hood cleaning and use – During the pandemic, some departments have authorized the use of the hood as a temporary face covering while on scene of a fire response and not operating (standing by). Clean hoods are the only type of hoods that should be considered for use at any time and for any purpose. The message of clean hoods must be part of the message for use as a face covering and is also beneficial for reducing cancer risk. Now is a good time to begin a wash your hood Sunday program or advocate for a second hood to better ensure this important piece of PPE that is in constant contact with your skin is maintained contamination free.
Clean SCBA’s - It is important to keep our firefighter equipment clean and ready to use. This includes our breathing apparatus. While all equipment must be cleaned following use, during the pandemic, some departments have implemented an additional layer of “advanced cleaning” for the SCBA. This is accomplished using soap and water or through the use of a dedicated SCBA washer machine. Both methods are equally valid and further ensure the SCBA is clean and contamination free. Adding an additional “advanced cleaning” can ensure a detailed cleaning is preformed that may not always take place following use. This can simply be done by adding this requirement as part of the scheduled maintenance of the SCBA.
Laundering of bunker gear – During the pandemic many departments have placed a greater emphasis on ensuring the continuation or enhancing of their bunker gear laundering programs. Others have used this as an opportunity to implement on scene decon policies, purchase washers (extractors) and gear dryers, and add bunker gear laundering and inspection by an Independent Service Provider (ISP). These are prudent steps considering that regularly cleaning your bunker gear can minimize the cross contamination and spread of fire ground contaminants as well as a host of other undesirable contamination such as a virus. NPFA standards include regular cleaning and maintenance of bunker gear as well as advanced cleanings by an ISP. The most current versions of NFPA standards also include “preliminary exposure reduction” to provide for an on scene preliminary exposure reduction. This may be accomplished through on scene decon.
Enhanced apparatus cleaning procedures – COVID-19 has placed a spotlight on the cleaning of our apparatus, especially the inside of our apparatus. The exterior of our apparatus has long been keep clean as a sure sign of company pride. However, a new look at the cleaning practices of the inside has led to the implementation of advance cleaning policies aimed specifically at killing COVID-19. However, this is also a good time to evaluate our cleaning policies of the inside the rig, the storage of dirty equipment, the positioning of apparatus on scene of a working fire (later arriving or non essential apparatus can be positioned upwind and out of the smoke), and other simple steps that can to minimize contamination.
Keeping the Firehouse clean and healthy – Keeping firefighters healthy by keeping COVID-19 out of the firehouse has been a top priority since the start of the pandemic. Likewise, an evaluation of other practices that may affect firefighter health should be viewed in a similar context, to keep contaminants out of the firehouse. Proper storage of bunker gear, diesel exhaust capture systems, clearly marked and defined areas where bunker gear is not allowed and air filtration system are some of the initiatives that should be evaluated to ensure we are doing all we can to keep all harmful contaminants out of the firehouse.
Medicals and testing - Testing for COVID-19 and antibodies has been a priority for many fire departments. Ideally, this is part of an overall robust plan to ensure long term firefighter health. This should include yearly medicals for firefighters as well as screening for certain cancers and annual flu vaccinations. Many illnesses and disease can be detected and treated early with yearly medicals. Early detection increases the likelihood of a positive outcome. The pandemic provides the opportunity to evaluate and enhance (if necessary) early medical evaluations to best ensure the long term heath of our firefighters.