Decon: Not Taking the Bad Stuff with You

BY WEBSTER MARSHALL

IN THIS ARTICLE, I am discussing Preliminary Exposure Reduction (PER) and the simplicity of the process that can be very impactful to our health and fire protection afforded by our personal protective equipment (PPE). For now, let’s call it decon.

In the fire service we hear constantly that the work we do could make us sick or kill us from all the exposures we face on the fireground. It is also a common conversation that we should reduce the levels of these contaminants to limit the risk of illness or possibly death. The risk of cancer or other chemical-related illness can be mitigated. The issue lies in one of two areas: a high dose exposure or a low to moderate exposure spread over a longer period. Look at it as one bad event or a career of smaller doses that build up against you and your body’s ability to fight off the exposure.

Why is exposure such an issue? Is it the chemicals themselves or is it a systemic issue interwoven within many areas of our job? Possible chemical exposure to a person in excellent health and possible exposure in a person with less than excellent health can have drastically different outcomes. Why is this not a cut-and-dry question? Doesn’t it stand to reason that if you are exposed to a chemical with known health impacts on humans, it should cause some sort of negative health effect no matter the person?

With all these questions, I think the answer is simple. Take a simple, concerted approach to taking care of yourself and your gear so we are all at the top of our game to be able to help the citizens when they call.

Is It Validated?

Since issues started to arise that fireground chemicals were dangerous to our health, there has been ongoing research to source out the root cause and provide suggestions and solutions. Your parents probably told you to take care of your things so they will last longer. This holds true with your fire gear.

When I started, my father taught us that taking care of the gear would not only make it last longer, but it would better protect us in the worst situations. This is even more important with all the changes to our PPE in durability—its ability to resist chemicals and oily substances. (If you have gear made with different finishes and coatings, you should have different expectations of durability, cleanability, and longevity.)

The research has ramped up significantly over the past decade or so. The Illinois Fire Service Institute has done extensive work to identify problems and processes to mitigate the issues surrounding fireground contaminants and initial decon (PER). There has been ongoing research at the University of Miami-Sylvester Institute on cancer in the fire service. Medical research outlines the issues in the body in great detail. It has also provided valid feedback on processes surrounding on-scene chemical absorption. North Carolina State University has conducted numerous projects to test our PPE as well as help establish suggested best practices.

With this research and more, how do we sift through it to find what works? Which process or information is most impactful? There is a large amount of valuable information to be had, but piecing it together can be confusing. Let’s try to simplify the process a bit.

Decon Process

There are many factors that play a role in the success of decon. First, what is the culture and industry feeling around the topic of decon? What is the buy-in? We have all heard of or participated in a decon process at one time or another. The effectiveness hinges not only on the practical competency but also on the attitude and effort of the participants. So, what are the barriers of entry for such a program?

The on-scene cleaning process can be simple and effective. Also, it should not be seen with the negative stigma based on your gear being wet or not being ready to respond to another emergency. Outside of severe cold weather, doesn’t water get on our gear when we fight fire anyway? The common misconception I have heard is that if I wet my gear in decon, I will get steamed the next time I go to a fire. (Little known secret: Bunker gear has a moisture barrier. Consider it the most expensive rain gear a person could have.) The other largest barrier is that it’s not what the fire service has done until more recent times. It has been spotty but is gaining prominence. It still has a way to go for further widespread acceptance.

The decon process can look different based on differing factors. For simplicity, let’s break the factors down by scene type, component type, contaminant type, weather, and resource availability.

Scene Type

Scenes include motor vehicle crashes, vehicle fires, structure fires, flammable liquids fires, wildland fires, special/ hazmat, and lithium-ion battery fires— and don’t forget the training ground. The scene type will give us an idea of the level of severity or difficulty for what we may be contaminated by in each emergency. If we look at this like we look at incident command and size-up, then we can identify the “usual suspects” that we may find in each fire.

Don’t forget, there are always outliers that can be hidden among the so-called “normal” contaminants. Take a house fire, for example. We have a set of expectations in a residential fire and thus we can have a set of expectations when it comes to decon. Typically, we can expect certain levels of soot, smoke, insulation, and other building materials to keep things high level and simple. With these known factors and a little preplanning, we can have a system that works to lower our contaminant levels. These expectations and contaminant levels will vary from scene to scene but follow closely to what we understand of fuel classes (A, B, C, D, K) and how each of them burns. Through fire behavior, we can understand cleaning.

We can look at chemicals with respect to dose and time: How concentrated or difficult they are to remove and how long we were exposed to them can determine how difficult they can be to clean off. There are many new conversations about lithium-ion battery fires, for example, and how we don’t have all the answers yet. Cleaning at this level can be as simple as the old adage, “Dilution is the solution” (copious amounts of water). Until more information comes out, dilution of contaminants will reduce the possible exposure concentration.

One of the issues specific to lithium-ion battery fires is the possible acidic nature of the fire contaminants. Don’t jump off the deep end yet on these fires. While they should be a special consideration in a fire, it should come down to dose and time. If you have a room-and-contents fire and there is only one battery pack for a small radio control car or even a scooter, the likelihood of the battery producing adequate amounts of those concentrated chemicals to warrant an all-out hazmat response for battery fires is slim to none. Simply performing standard on-scene decon should suffice unless there is a persistent material or chemical noted that needs much more attention.

Component Type

Components include helmets, hoods, self-contained breathing apparatus (SCBA) with masks, coats, pants, uniforms, and skin. Each component of our gear has varying types of materials and construction. If we are only talking decon, then why is this important? We have to understand that a one-size- fits-all process is convenient but not realistic at times. We must manage our expectations of what decon should accomplish based on the differing materials of each piece of our PPE.

Look at PPE as a truck. When we wash and take care of our truck, we have many different components and ways to maintain the surfaces. The care we take in how our rig looks shows our company pride. It also shows we understand that there are different ways to clean (decon) tires, paint, windows, seats, aerial sections, etc. Our PPE is the same. The way we want to not scratch the paint on a rig when washing it is the same care needed in the decon process. It also allows us to have greater cleaning efficiency when we employ the right tools (i.e., brushes, nozzles, and soaps).

Take your coat and pants, for example. When decon is done on scene, a soft- bristle brush may have a higher cleaning ability than a stiff-bristle brush partly due to the ability of the fine bristles to get into the small areas of the fabric to loosen contaminants. The same can be said when deconning SCBA, helmets, and even boots. Understand that the different materials can have different abilities to hold contaminants. The expectation of “clean” on the fireground can be significant if we apply the correct process and tools. On scene, we can expect that we can reduce chemicals on hard surfaces than on textiles and leathers. While we can take PPE back and clean it thoroughly in a well-established wash process, we can significantly reduce our onscene exposures. Don’t take the scene with you any more than is absolutely necessary. Reduce the dose. Dilution is the solution.

Contaminant Type

Contaminants include soot, flammable liquids, biological, and special/hazmat. With many different forms and concentrations of contaminants found at each scene, how do we choose what to do to mitigate each one? Different types of contamination can require different techniques or tools.

If we take each scene type and break out the most common types of contamination we may see, then we have a start on our process for on-scene decon. Let’s take structural fire contamination at a high level into consideration. When we think of structure fire contamination, it’s soot and remnants of building materials in various states of decay and the water we used to suppress the fires. We can largely reduce these with a diligent rinse process and some brush scrubbing to help remove as much as possible on scene. The question then becomes, what is our removal efficiency for such materials? Further, how do we measure the success of our decon process?

For this conversation, let’s call these contaminants standard structure fire contamination. You can easily remove the standard fire contaminants and larger pieces at a decent efficiency. What is a “decent efficiency” of removal? Is it 80%, 60%, 50%? Some research has said up to 85% reduction, but largely we have lower efficiency due in part to the competency of the people conducting the process (how much have they practiced?) and the quality of the process/tools used (discussed later).

If we continue this conversation with other contaminants such as with a flammable liquid fire, how do we decon after that situation? Are we more apt to clean during that fire than the structure fire? If so, why? Culturally speaking, the fire service has not wholeheartedly latched onto decon, but maybe it should be made more of a priority. We look very closely to hazardous materials contamination like fuels, oils, battery acids, etc. But have we ever thought that some of those same chemicals are found in the structure fire contaminants? Looking more closely at these other fires requires additional steps or multiple run throughs of our decon process to lessen the contamination.

What about biological? Does your department have materials available on scene or on your rigs to handle biological contamination of your gear? For example, what are you doing for decon of gear after a particularly bloody call for a vehicle extrication? This can be handled as a start by performing gross decon on scene but with the additional need of a cleaning agent suitable for cleaning our PPE that will not damage the components but kill the biological contamination.

Finally, what about special chemicals or hazmat contaminants? Can we clean them and is it a situation where we need to gross decon to dilute the chemicals and remove the gear from the wearer to limit time in exposure altogether? Weigh the risk/benefit of leaving someone in gear to clean it off vs. removing the gear after a simple decon process if the chemical is deemed to be more of an immediate danger.

The world in which we work is becoming even more difficult to manage, and with the advent of more complicated materials we must protect ourselves from, our process must meet these needs as well. Lithium-ion battery fires are the new hot topic, and there are a few issues there as well. The batteries release potentially high levels of fluorine compounds and acids, depending on the state of charge, chemistry, etc. Note the products of combustion are a special hazard. Also note that having a small cell from a toy car does not produce the volume of contaminants as a larger mobility battery or a car battery. Base contamination evaluations and the risk assessment on the mass or quantity. It’s possible that the other contaminants could pose more risk.

Weather: Hot, Cold, Rain, or Snow

There has been much debate on decon with regard to weather, especially bitterly cold weather. With such weather comes the possibility of ice and at the base of all of this should be the best interest of the wearer of the gear. If decon places personnel in a precarious spot or risks exposing them to another issue such as a cold emergency or injury potential from making more ice, then it may be best to accomplish decon back in quarters.

Is decon always just water spray, or are there other alternatives? There are some, but they may yield a lower efficiency of removal. In the case of extreme weather, the best method may be a gross removal with a dry brush and taking care of the rest in a better climate-controlled environment. Weigh this with our continuous scene size-up and simply looking out for your fellow firefighters.

For decon in hot weather, the issue becomes time in gear and the rehab potential. Coordinate with operating crews to accomplish a workable system. Forecast the need early so crews don’t have to wait to clean off.

Resource Availability

Resources include decon tools, soaps, and willing attitudes. What tools do you have available, and how effective is what you currently use? Decon is not a costly process and can be scaled up or down as you or your department sees fit. Something as simple as a soft-bristle truck-wash-style brush and low-pressure line with the ability to have a medium fog pattern to rinse off will suffice. You can get as complicated as you wish, but these are the basics. Add soap or some cleaner that is deemed safe by the manufacturer to not damage your gear.

There are many other items like static shower devices, decon soap foam eductors and brush system, CAFS options, and many different decon-style soaps that can be used for initial decon. The tools and the process need to be built into your standard operating procedures and fit your department.

The final issue is the willingness and attitude of personnel to complete the process of decon. Understand that there may be opposition, but this is another opportunity to educate and get buy-in from those who may be skeptical.

The Process

The process is nothing new. Relate it to the exclusion zones we put on hazmat: hot, warm, and cold. The hot zone is most contaminated and, if we perform it properly, the cold zone is the least contaminated. Wait, shouldn’t the cold zone be no contamination? Realistically, we will not achieve that level of clean. We just want cleaner than before to get us home to finish the job with our detailed cleaning in an extractor, for example.

Figure 1 is an example of a decon organization matrix from the Fire Fighter Cancer Foundation. You can apply it to your department and make it your own. It is a simple process and a step in the right direction to take care of our own and to have a lasting impact on someone’s life.

**Figure 1.** Firefighter Contamination Reduction Matrix

WEBSTER MARSHALL is research chair for the Fire Fighter Cancer Foundation and a lieutenant in Gwinnett County (GA) Fire and Emergency Services.