Combining transitional attack and early ventilation to reduce toxic exposures

Each approach has been around for years, but is their combination the key to limiting firefighters’ exposure to cancer-causing agents?


By Kevin Maschue

“Structure assignment, heavy cancerous smoke and flames showing. Respond at your own risk on Fire Channel 2!”

Ever feel like that’s the message we should be presenting to our dispatched units – or is it not even on your radar? How many of your members or colleagues are contracting cancer, fighting for their lives and dying from it?

A firefighter engages in transitional attack training. (Photos/Mesa Fire and Medical Department)
A firefighter engages in transitional attack training. (Photos/Mesa Fire and Medical Department)

Toxicity in smoke is getting worse from modern materials. Cities and states are questioning their responsibility for covering our firefighters and supporting their families. The big question: Are WE, as firefighters, doing everything we can to protect our troops?

Current steps: A focus on decon post-fire

In its research, UL Firefighter Safety Research Institute has shown dangerous toxins making it through our turnout gear and being absorbed into our body. We, like many other departments, have begun working on decon procedures after the fire to reduce this absorption. If you were already aware of this research, are you doing anything different to protect your crew?

As firefighters are become more and more educated about the cancer risks they face every day, they are speaking up, voicing sentiments that essential boil down to this: “Give me one good reason why I should go interior to fight a fire when it’s clear I’m not protected for the exposure that will kill me over time!” And the message is beginning to spread amongst the troops.

Many departments are working on measures to prevent absorption once you’ve been exposed: gross decon showers, baby wipes in rehab for decontamination, mixtures/solutions for cleaning turnouts, removal of contaminated clothing, early showering, clean cabs and others methods, all with the focus on quick removal of any and all contaminants that have made their way to your skin. I can appreciate, as I’m sure you can, that we’re moving in a direction of improvement, and we should continue to brainstorm, develop and test more methods to prevent absorption of toxins.

Have you ever asked for an interior report and been told, “We have heavy smoke, moderate to heavy heat, we need ventilation,” and as Command, you withheld it because the fire wasn’t confirmed out? With every second and minute we withhold, we expose our firefighters to more and more cancer-causing material.

I love the fact that we are focused on how to remove that toxicity once it comes in contact with our people, but what steps can we take to reduce the toxicity levels even before they go inside?

Departmental changes based in research revelations

Five years ago, when I was promoted to battalion chief, one of my captains introduced me to studies by UL FSRI, National Institute of Standards and Technology (NIST) and the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF).

The moment I watched some of these videos, particularly the “Understanding the Modern Fire Environment” series, I realized there was no way I could command or fight fire the same way I had been for 26 years. The concepts of modern fire burning rates, toxicity increases, dangers of flashover and flow paths brought forward in the studies discussed in the videos were proving the reasons why line-of-duty death (LODD) rates were increasing while the number of structure fires nationally at the time was decreasing.

If you haven’t read the studies or watched videos about fire behavior and fireground tactics, you should. Here are four to get you started:

  1. Understanding the modern fire environment: flow paths, fuel and ventilation, Part 1
  2. Understanding the modern fire environment: flow paths, fuel and ventilation, Part 2
  3. Understanding the modern fire environment: flow paths, fuel and ventilation, Part 3
  4. NIST & UL Research on Fire Behavior and Fireground Tactics, Part 1

Inspired by these studies, a group of us at my department brought the idea forward to some of our department leaders, and we soon sought to bring about a committee to develop a plan for turning our ship around and changing the way we faced a firefight. There wasn’t a prepackage plan at the time, so as a committee, we had to develop one.

We tossed around the ideas presented by UL FSRI, NIST and ATF and settled on one UL FSRI presentation titled Tactical Considerations Web Series: Ep. 15 – Transitional Attack with Fire Showing Near Entry Point.

UL FSRI defined it as an initial exterior attack upon arrival, prior to making entry, and designed to cool the interior and reset the clock. We felt as a committee that the ability to successfully teach our 400 members transitional attack would be far easier and far more successful than attempting alternatives to avoid that dangerous flashover condition.

Four years later, after instituting this approach to firefighting, as well as implementing a 360-degree evaluation of the structure prior to entry that was also recommended, I can confidently say that as an organization, we have accomplished the objective to improve firefighter safety.

We have without question reduced the circumstances leading to near-miss situations and LODDs. In 4 years, I haven’t heard of an experienced rollover or flashover condition, and I’ve reviewed many of our departments’ working fires as part of a quality assurance program. We’ve also saved a tremendous amount of property in that I can’t remember the last time we went defensive on a house fire, and there’s no doubt these methods have provided us the opportunity for more successful and viable victim rescue when the situation has presented itself.

Combining concepts: Ventilation and transitional attack

Why do I mention this tactic of transitional attack? Because as an industry, we are faced with huge challenges to reducing the instances of cancer within the fire service. UL FSRI has dedicated many of its studies to analyzing the effects of the absorption of carcinogen PAHs and VOCs that have been able to penetrate our turnout gear and be absorbed into our body and finding solutions to that problem. Unfortunately, every fire scene is a hazmat exposure that we are incapable of wearing a vapor-proof, fully encapsulated Level A suit due to the fact they are plastic suits and can’t be exposed to fire.

In reading through several of those studies and their results, I believe there is a sound solution for drastically reducing our exposure to fireground toxicity prior to entry into the burning structure. Specifically, I believe the solution lies in the combination of early ventilation and transitional attack.

In the 2019 article “Effect of Firefighting Intervention on Occupant Tenability During a Residential Fire,” by Steve Kerber of UL FSRI and other researchers from UL, IFSI and NIOSH, the researchers discuss how water application is associated with a rapid drop in temperatures that affect the gas and thermal absorption by any potential victim located in proximity to the seat of the fire.

Another article, “Firefighters’ absorption of PAHs and VOCs during controlled residential fires by job assignment,” also co-authored by Kerber and other researchers, points out that there is no reduction in the toxicity level within the structure when comparing transitional attack to interior attack. However, the absorption of PAHs was increased with the firefighters going interior to fight the fire, and it seemed to be related it to the increased skin temperatures and transdermal absorption rates.

This is why I believe we need to go beyond the transitional attack we have more recently been doing, and focus on implementing early ventilation prior to entry to prevent exposure to these highly concentrated atmospheres of cancer-causing toxicity. This approach is being used more and more, both nationally and globally. The preliminary conversations I’ve had with departments that have been using this technique for fire safety reasons say it’s a no-brainer for aiding in toxic exposure reduction.

These tactics have not been studied by UL as of yet in direct conjunction with the reduction of absorption of these PAHs and VOCs or cancer reduction, but until those studies take place, I urge crews to let logic be our reason for making these fireground adjustments.

Department members perform a transitional attack on the backside of an apartment as they were getting ready to make entry through the front. Firefighters encountered thick smoke as they were making entry – a great time for early ventilation. (Photos/Mesa Fire and Medical Department)
Department members perform a transitional attack on the backside of an apartment as they were getting ready to make entry through the front. Firefighters encountered thick smoke as they were making entry – a great time for early ventilation. (Photos/Mesa Fire and Medical Department)

Breaking it down: Understand the reasoning

Think of it in simplistic, non-scientific terms. We enter an occupancy on fire where we are experiencing moderate to high heat with heavy smoke. We are exposing our people to a pressure cooker of chemical toxicity.

When temperature increases, pressure increases in a closed container. When we enter that container in full turnouts and SCBA, our body is at a lower temperature and pressure, which creates a natural tendency to equalize within the fire atmosphere. We have felt it on many occasions drive us to the floor, and some of us have even experienced pressure changes within our ears during those moments of high heat and higher pressure.

The logic and hypothesis would be that at that precise moment, those pressures are forcing toxic chemicals into our bodies through our pores at a much more rapid rate than if the container was not under these high temperatures and full of toxic smoke to the floor.

Studies by UL have shown that when exposed to high temperatures and heavy smoke, our body temperature increases. Firefighters exert themselves, causing them to sweat more profusely, and our absorption rate increases when placed in that toxic environment. Toxins like benzene (PAH), a known carcinogen, has been found in post-fire urinalysis as well as breath testing during a few of the UL studies previously mentioned.

Further, the Tucson Fire Department recently teamed up with Dr. Jeff Burgess at the University of Arizona and determined as part of their study that those toxins found present in a urinalysis post-fire increased 1% with every additional minute of exposure.

I’m suggesting that as command officers, we should consider working toward reducing this exposure from occurring in the first place, by using a combination attack from the exterior when possible, followed by early ventilation with PPV prior to entry. If we can force fresh air through the entry to the exhaust prior to exposing them to it, then it stands to reason that we will decrease firefighters’ exposure to toxins.

I’m very much aware, through vetting this tactic and talking to other departments currently using it, that there were initial concerns. We’ve all had experiences at one point or another where a fan was left on unsupervised and the house began to reignite, but that’s not the tactic in discussion here. The concept alone makes sense when properly applied and ventilation is controlled and supervised. It’s not rocket science, or a major change to what many of us are already doing, but there are a few factors that will need to be developed, taught and trained on in order to carry out this coordinated attack in a safe and effective manner.

Start the change process now

Unfortunately, when we develop cancer, it’s typically from exposure 15 to 20 years ago, and so the changes we are making today may not be recognized for many years. I’m sure more research will be conducted on this in the future, but until then, it’s essential that we start making changes now, to protect ourselves and our crews. And I believe one key step is to focus on transitional attack and early ventilation to help minimize firefighter exposure to toxins.

 

About the author

Kevin Maschue is the planning and research deputy chief for the Mesa (Arizona) Fire and Medical Department. He has 32 years in the fire service with a wide array of experience ranging from firefighter, engineer, paramedic and captain, and has held special teams certifications for hazmat, technical rescue and ARFF. Maschue has spent much of his career as a lead instructor in these specialties as well as in EMS as an ACLS instructor. Maschue has been a battalion chief for Mesa for the past 6 years, responsible for assisting in developing and managing their battalion level training and quality assurance program.

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