Nine ways to reduce risk from contaminated PPE

Emergency service staff need personal protective equipment to keep them safe but if the practices that go alongside it weaken their defences, then is it doing the right job? Over 200 people gathered in Manchester this week to suggest the answer to that is no.

John Lord is a passionate campaigner and advocate for safe, clean practices for firefighters that means they protect themselves when dealing with incidents and adopt a rigorous clean up routine in the immediate aftermath. He says that too many firefighters remove their kit and take the contaminants home with them, spreading what he calls the invisible risk to their loved ones.

It’s not a new problem but without continued vigorous campaigning and advocacy, the custom and practice will not change. A modern view on clean practices is on show at Horsham Fire Station in West Sussex, where the Fire Brigades Union Decon campaign is brought to life as the station separates dirty and clean zones so that the contaminated kit stays where it should, quite literally in the red zone.

John convened a conference at Cranfield University in November 2022 called The Invisible Risk. He wrote a review about that first appeared in the April 2023 issue of Emergency Services Times.

At the second conference gathering of firefighters mostly drawn from non-local authority fire and rescue services such as airports, industrial settings and defence, Dr Emily Watkins set out a series of simple actions to minimise exposure to toxic contaminants.

“The only way we move forward and reduce risks to firefighters through contaminated PPE is to change culture, be aware that change needs to happen and say why so people understand. We know how important it is to change and small changes together will make big difference.”

Dr Emily Watkins, University of Roehampton.

Number one on her list was to train differently. She questioned whether it’s necessary for firefighter training to use real smoke, suggesting using non-carbonaceous alternatives. She highlighted the cumulative exposure of trainers and their vulnerability to high levels of contaminants.

Moving on to talk about respiratory protection, she said it should be worn by all firefighters on the training ground. In a later presentation by Professor Anna Stec, she said that in one of her research studies, 84 per cent of firefighters reported that they often or sometimes attend fires without using RPE, with more than half citing habit as the reason for doing so.

Her third point focused on wearable technology to test physiology. While she advocated the benefits of tracking heart rate, temperature and other factors, she was sceptical about the way in which measurements are communicated contemporaneously from devices during active incident response. She said she was collecting data and testing devices with services to examine this in more detail.

Number four was simple: wear well fitted PPE and adopt sound removal, storage and cleaning habits the limit further exposure and spread of contaminants. This fits with number five, where the garments worn under protective firefighting gear should not be washed together with other family clothes at home to avoid contamination.

The way in which PPE is removed was the focus of number six. She asked firefighters to think about the way they remove their gear: removing gloves and exposing bare hands which then touch the tunic and other contaminated gear increases exposure and adopting a different sequence could be beneficial.

She said that by reducing physiological stress in the preparation for and recovery after an incident can create better conditions for a healthier life – and that includes hydration. She said that in her research she finds firefighters are almost always dehydrated and that this has adverse impacts on performance.

And she wrapped up her advice with number nine focused on lifestyle factors like exercise, eating and alcohol, “do everything in your power to reduce your risk.”

Health conditions among active and retired fire service personnel: an international survey is currently open for operational and non-operational staff to complete a 15 minute questionnaire about working history and various health factors. The results will be used to identify current health trends and focus future research and guidance on areas of need.