By Jeff Hall
The initial dispatch may come in as a medical call, a transportation accident or a vague request for the fire department to “check out” an unknown condition. In any event, fire service responses to confirmed or suspected radiological incidents are relatively rare. They can present as ordinary fire service calls and will most often involve responders with various degrees of hazmat training and wide-ranging operational roles. These incidents can be jarring or disorienting, even for dedicated hazmat crews.
Effective response depends on firefighters, regardless of role and technical training, operating from a shared set of radiation response principles. First-due companies must understand which principles are within their scope and when to apply them.
| READ MORE: The firefighter decon guide: Your playbook for reducing exposure and contamination
The radiological incident size-up
Before crews deploy monitoring equipment, a radiological response begins with a fundamental fireground principle: the size-up.
Starting with dispatch information, responding units should compile and assess relevant details about the setting, suspected radioactive material, special risks, standard operating procedures or guidelines and resource needs. Fixed facilities, including industrial and healthcare settings, often have radiation safety personnel who can provide critical intelligence and facility knowledge. They also tend to have tightly controlled conditions. Transportation incidents are usually more dynamic, with more unknowns and competing priorities such as traffic control or patient triage.
Whatever the context, prioritizing the initial size-up will enable crews to choose the best strategy and tactics for the situation.
Radioactive material as a hazard
Radioactivity begins with unstable atoms. As an unstable atom changes to a more stable state, it may release energy as particles or electromagnetic waves. That emitted energy is radiation.
Radiation can be ionizing or nonionizing. Nonionizing radiation, including microwaves and ultraviolet light, generally does not carry enough energy to remove tightly bound electrons from atoms and create ions. Although nonionizing radiation can still cause injury, it is not the radioactive-material hazard typically involved in a radiological emergency.
Ionizing radiation carries enough energy to remove electrons from atoms and molecules. In the body, that process can damage cells, tissue and DNA. The four forms of ionizing radiation that first responders may encounter are alpha particles, beta particles, neutron radiation and gamma rays:
- Alpha particles travel very short distances — typically inches — and cause the most biological damage when they enter the body through ingestion or a break in the skin barrier.
- Beta particles may travel substantially farther than alpha particles. They can damage skin and may cause internal injury if they enter the body.
- Neutron radiation is highly penetrating and is most often associated with nuclear reactors, criticality events and certain specialized sources. It can damage tissue through interactions with atoms in the body. Responders are unlikely to encounter hazardous neutron radiation outside nuclear or specialized facilities.
- Gamma rays are highly penetrating electromagnetic radiation emitted directly from an atom’s nucleus. They can pass through the body and deposit energy that damages cells, tissue and DNA. Gamma radiation itself does not leave residual contamination, although radioactive material that emits gamma rays can contaminate people or objects.
PPE and shielding
Structural firefighting turnout gear with SCBA is the most readily available and practical PPE for most firefighters in radiological emergencies. It can help protect firefighters from external contamination and inhalation of radioactive material, but it does not shield them from penetrating radiation. As such, it is important to understand the limitations of PPE protection.
- Alpha particles are stopped by the outer barrier of skin and common thin barriers such as sheets of paper.
- Beta particles can be shielded by materials such as plastic or aluminum.
- Gamma rays are best shielded by heavy materials like lead and concrete.
- Neutron particles are best reduced by materials with high hydrogen content, such as water.
Turnout gear can provide meaningful protection for alpha and beta particles. However, ordinary PPE provides no effective protection against gamma rays and neutron particles, so time, distance and appropriate shielding should be utilized.
The ALARA framework
As every firefighter should be able to recall from basic hazmat awareness and operations training, the ALARA framework — As Low As Reasonably Achievable (ALARA) — remains the cornerstone of responder safety during radiological incidents. Crews achieve ALARA by minimizing time near the source, maximizing distance and using effective shielding.
First-due companies without radiological monitoring training or capabilities can still utilize ALARA principles to prevent or minimize unnecessary exposure and contamination.
Radiation exposure vs. contamination
Additionally, we must keep in mind the difference between radiation exposure and contamination:
- Radiation exposure, also known as irradiation, occurs when the body receives radiation energy from an external source. An individual who is only exposed — or irradiated — will not pass on radioactive energy to others.
- Contamination occurs when the radioactive source becomes deposited in or on the body. An individual who is contaminated can emit radiation to others until the source is either removed or has enough time to decay to a non-radioactive isotope.
All firefighters with suspected exposures or contamination events should be medically monitored and documented per their organizational protocols.
Where the first-due company makes the difference
The first-due company at a radiological incident is typically not a dedicated hazmat crew, and they likely do not have access to specialized monitoring equipment. It is also very possible that the initial dispatch does not adequately indicate the involvement of suspected radiological materials. Nevertheless, basic fireground principles form the basis for successful mitigation once additional resources arrive.
First-due companies should focus on the following actions and considerations:
- Establish command: Initiating the Incident Command System is the foundation for accountability and managing resources. The first-due or first-arriving company does not need to be the hazmat team to successfully establish firm command and control early in an incident.
- Conduct a thorough size-up: From a safe position, gather as much information as possible about the scene. Identify people who can provide specialized information about the incident, facility layout and potential risks. Look for placards, labels, signs, containers and packages. When it can be done safely, take photos or record information from a distance for hazmat teams and subject-matter experts.
- Set up a perimeter: Clearly define the boundaries of the hot, warm and cold zones. Deny entry to individuals without clear emergency response roles. This prevents loss of accountability and unnecessary exposure for both civilians and responders. Utilize the Emergency Response Guidebook (ERG) and any other vetted sources to set up initial zones and perimeters. [Download: Where does the red zone really begin?]
- Identify incident priorities: After a thorough size-up, the company may find that a suspected radiation hazard is the only clearly identified hazard with no other detected emergency needs. And it is also possible that a radiation hazard can be just one part of a larger incident with other operational demands such as fire suppression, structural collapse or mass casualties. Base incident priorities on the totality of the incident.
- Get into rescue mode: The U.S. Environmental Protection Agency’s 2017 Protective Action Guide Manual for radiological incidents stipulates that a 25 rem exposure limit is a reasonable threshold for lifesaving operations. The manual also states that responders must “have full knowledge of the associated risks prior to initiating emergency action and receive medical evaluations after such exposure.” In addition, the IAEA Manual for First Responders to a Radiological Emergency states, “In principle, no dose restrictions are recommended for life saving if, and only if, the benefit to others clearly is more important than the rescuer’s own risk.” In general, responders should not withhold lifesaving measures solely due to radioactive exposure or contamination.
- Monitor the radiation levels: The first-due company likely does not have specialized radiation monitoring equipment and may have limited or no formal training in monitoring techniques. Hazmat teams should have the capability to monitor for alpha, beta and gamma radiation types. Background radiation is present everywhere on earth and levels vary by geographic location. Potential radiation exposure must be evaluated against background radiation and the characteristics of any packaging or containers. Elevated readings on a detector do not always mean that the level of emitted radiation is dangerous. Hazmat teams will characterize radiation, so check in with those teams and do not panic just because there are readings.
- Prepare to decon: While the first-due company may not be the hazmat team, it may very well be involved in patient or personnel decontamination later in the incident if company members are trained to the hazmat operations level. In contrast to traditional wet chemical decontamination, many organizations utilize dry decontamination methods for radiation particles. Dry methods are often preferred because they make it easier to contain contamination instead of creating radioactive runoff. Note: Non-hazmat companies will need to be sufficiently briefed by decontamination and hazmat teams on dry methods and the suspected radiation types in the incident.
Final thoughts
Radiological emergencies may be uncommon, but the fundamental responsibilities of the first-due company remain familiar. Strong command, a thorough size-up, basic radiation safety principles, and sound risk-benefit decisions can support the response until specialized resources arrive.
First-due firefighters do not need to be radiation experts; they need to recognize the hazard, understand their capabilities and limitations and continue doing their basic fireground tasks well.
ABOUT THE AUTHOR
Jeff Hall is a company officer and hazmat instructor who serves on his department’s hazmat response team. With a Master of Public Health specializing in industrial hygiene from the University of Alabama at Birmingham, Hall has conducted research on various health and safety topics related to the fire service. Hall is particularly interested in and committed to the continued development of special operations within the fire service.
