Fire EMS, Firefighting

Cyanide: Fire Smoke’s Other “Toxic Twin”

Issue 12 and Volume 164.

By ALAN H. HALL, M.D. and ROB SCHNEPP On December 2, 2010, the International Association of Fire Chiefs and the International Association of Fire Fighters launched an educational campaign called “The Silent Killer” ( to emphasize the hazards of occupational exposure to carbon monoxide (CO) and to reduce the known risk factors that can kill or injure firefighters. This campaign is highly laudable and can do a great deal toward increasing awareness of the hazards of CO on the fireground and the necessity for proper wearing and use of respiratory protection and air discipline. What this campaign does not emphasize is the significant role of the other “toxic twin” in fire smoke: cyanide (CN-). This review was performed to emphasize the role of cyanide in the acute toxicity of smoke inhalation and its probable role in line-of-duty deaths (LODDs) and sudden cardiac illness. This article is intended to accomplish two…

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