Health Beat--The "Smoldering" and "Flying" Hazards, Part 2

By: Mary Jane Dittmar, Senior Associate Editor

In addition to brain cancer and carbon monoxide poisoning (discussed in Part 1), recent research has shown that failure to wear adequate respiratory protection during overhaul and other nonfirefighting operations can lead to respiratory distress and even respiratory failure. Contaminated air is even more threatening to individuals with chronic heart and lung conditions.

A Norwegian study, conducted 11 years ago and published in the American Journal of Respiratory and Critical Care Medicine, found a connection between asbestos exposure and a high risk of severe breathlessness and asthma. The study observed 2,819 subjects. Almost a third of them had been exposed to dust and fumes in the workplace. The study found an association between dust/fume exposure and respiratory problems in between 5.7 percent and 19.3 percent of the study participants and a link between an exposure and asthma in 14.4 percent.¹

The 9-11-01 World Trade Center disaster reinforced quite vividly the message that health hazards are inherent in fire and other emergency disaster environments. On analysis, it can be seen that many of these dangers lurk in many of the environments to which you respond routinely.

Let's look at some of the most commonly encountered contaminants, carcinogens, and other harmful substances, a good number of which are derived from building construction materials.

According to the New York Committee for Occupational Safety and Health (NYCOSH), these hazardous substances include cement and drywall dust; airborne particles of burned plastic, including polyvinyl chloride (PVC); and asbestos.² Because these are substances to which all responders at one time or another are exposed in structure and vehicle fires, structure collapses, and natural disasters--even though the information on contaminants and the recommendations for protecting responders were directed at those in the vicinity of the World Trade Center operations at the time the information was released-- they are also relevant for other emergencies and disasters that present similar dangers for responders.

The NYCOSH document explains that cement and drywall dust generally contain crystalline silica and that inhaling silica dust can cause silicosis or other potentially fatal lung diseases. Cement dust can irritate the respiratory system or aggravate asthma and chronic bronchitis. The same is true for airborne particles of burned plastics used in insulation, conduits, furniture, and other items. All dusts, in fact, may cause asthma or bronchitis and other respiratory problems, irritate eyes, or cause allergic skin reactions.

In addition, working or conducting an investigation in confined or restricted areas without wearing adequate respiratory and body protection may also expose you to flammables or explosives released from ruptured gas lines or storage containers, thereby subjecting you to the ill effects of carbon monoxide, including possible asphyxiation or an oxygen deficiency. Gases also can irritate the eyes, nose, throat, or lungs. (2)

In addition, any emergency scene poses the threat of exposure to communicable diseases. You must make sure that infected blood or other bodily fluids do not enter your body through your eyes, nose, mouth, or an unprotected (uncovered) cut, scratch, or break in your skin. (2)

Keep in mind also that you must protect your food, beverage containers, smoking materials, and other personal items from contaminants that might be on your clothing and in your immediate environment.

Precautions
The NYCOSH precautions with regard to dust exposure include the following:

Prevent dust/ash from becoming airborne by wetting it with water before disturbing it. Do not sweep or handle it when dry. Dust is hazardous when it is airborne. It doesn't take much to make it airborne. Simply walking by the dust can do it. Note: If the dust might contain asbestos or some other hazardous substances, it should be tested before cleanup is attempted. Only those adequately trained to clean up the hazardous materials should do the work.
Do not vacuum dust with equipment that does not have HEPA filters.
Wear a respirator that provides eye protection (or goggles).
Have available sufficient supplies of respirator cleaning supplies and replacement cartridges or replacement respirators. Make sure the respirator protects from the specific air contaminants to which you are exposed. Make sure it fits properly and that its seal is not compromised by fire. Note: A dust mask is not a respirator and does not protect from asbestos, silica, or other hazardous particulates.
For incidents involving high-rises, use rubberized masks with screw-in particulate P-100 or R-100 HEPA cartridges (not N-100). Disposable respirator seats may not be sturdy enough for these conditions. Replace respirator cartridges once a shift at minimum, or when it becomes difficult to breathe through them.
If several blocks from the disaster site, where dust/ash is the main air contaminant, the respirator should be rated N-, P-, or R-100. Replaceable cartridges are preferred; disposable respirators rated N-, P-, or R-100 are acceptable if they can be protected from conditions that comrpomise the seals.
Respirators that protect from dust cannot protect for oxygen deficiency or flammable and toxic gases. Test the air in an unventilated area where toxic or flammable gases may be present before entering. No one who has not been trained and certified in confined-space entry should enter an area where these hazards may be present.
Wear protective clothing so you can change out of your work clothes before returning home. Bag your work clothes, and wash them separately from your personal laundry to prevent contamination. Entering your vehicle or home while wearing your dusty work clothes will contaminate these areas.
Use universal precautions to protect yourself against bloodborne diseases.
Since you may ingest toxic materials that are on your clothing, in your hair, or on your skin when you eat, wash before doing anything that could result in ingestion. If washing water is not available, use moist towelettes.

Note: After preparing this column, the following came to my attention. According to the FEMA/USFA Web site database on line-of-duty deaths, two fatalities were recently attributed to smoke inhalation. In one instance, a 51-year-old Fall River (MA) Fire Department district fire chief was commanding a major structure fire under heavy smoke conditions on September 19. He complained of breathing difficulties after inhaling toxic and noxious gases and fumes. He consulted medical professionals. His condition worsened. He died of acute respiratory distress syndrome in the hospital on October 24.

On November 4, a 39-year-old volunteer firefighter with the Northern Wayne Fire Company in Lakewood, Pennsylvania, died of carbon monoxide poisoning caused by smoke inhalation during interior operations at a structure fire.

Next time: A relatively new respiratory disease.

References

"Dust on the Job Can Be Tough on the Lungs," HealthScoutNews, HealthCentral.com, Oct. 23, 2002.
"World Trade Center Catastrophe Worker Health Fact Sheet," New York Committee for Occupational Safety and Health, September 11, 2001.
Is there a health issue your department has faced recently? Has your organization adopted a new health policy? Has concern over health matters increased in your department? Let us hear from you. Send your comments to maryjd@pennwell.com.
Mary Jane Dittmar is senior associate editor of Fire Engineering magazine. Before joining the magazine in 1991, she served as editor of a trade magazine in the health/nutrition market and held various positions in the educational and medical advertising fields. She has a bachelor's degree in English/journalism and a master's degree in communication arts.