Firefighter Autopsy Protocol - US Fire Administration - Federal ...

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■ Firefighter Autopsy Protocol ■ 23 ■ I: Background ■ table 4. specific chemical contaminants identified in various Fires 15 Compound 1(K) 1(K) 2(K) 3(O) 4(O) 5(K) 6(K) 6(O) Furan X X C 4 H 8 isomers X X Benzene X X X X X X X X Dimethylfuran X X Methyl methacrylane X X Toluene X X X X Furfural X X Xylene X X X Styrene X X X Pinenes X X X Limonene X X Indane X X X X Methylcyclopentane X X 2,4-Dimethyl-1-pentene X Ethyl benzene X X C 3 -Alkyl benzene X C 4 -Alkyl benzene X X n-Butane X Freon 11 X t-Butyl anisole X X Methyl naphthalene X X K-knockdown; O-overhaul Firefighters may be exposed to other particulate hazards. Chemical dusts, lead particles, and asbestos also may be encountered at fires and other responses. For example, though asbestos is principally an inhalation hazard, it can cling to protective clothing and be released when the responder is not wearing his or her SCBA. Similarly, lead and other toxic dusts can fill clothing pores and contaminate the firefighter’s skin after the incident. Firefighters also are subject to exposure to blood or other body fluids containing pathogens, particularly the Human Immunodeficiency Virus (HIV) or Acquired Immunodeficiency Syndrome (AIDS) virus, and Hepatitis B and C viruses. These viruses are extremely small in size and are transmitted by blood or other biological fluids. The risk is high since emergency patient care is a major function of many responses. The extrication of victims from automobile accidents and rescue of injured persons from fires and other incidents all involve the potential for this exposure. Even minute droplets of blood are capable of carrying thousands of virus that potentially can cause infection through mucous membrane contact or nonintact skin. Firefighters also face serious health threats from exposure to existing and nontraditional airborne pathogens that can be encountered in providing medical care or general interface with the public, including tuberculosis, sudden acquired respiratory syndrome (SARS), and more recently avian flu. Though these exposures may not be fatal, they can contribute to firefighter fatalities. 15 Noonan, Gary P., Judith A. Stobbe, Paul Keane, Richard M. Ronk, Scott A. Hendricks, Laurence D. Reed, and Robert L. McCarthy. Firesmoke: A Field Evaluation of Self-Contained Breathing Apparatus. NIOSH and U. S. Fire Administration, 1989.
■ Firefighter Autopsy Protocol ■ 24 ■ I: Background ■ An emerging concern for firefighters and other first responders is the potential lethality from exposure to chemical, biological, radiological, nuclear, and explosive (CBRNE) hazards. These hazards may take the form of chemical warfare agents, toxic industrial chemicals, biological agents that are both liquid and airborne, ionizing radiation, nuclear material, and explosives. Terrorism has become a real threat to firefighters and is likely to cause multiple casualties, including firefighters. Under the circumstances of a terrorism event, special provisions will be needed for the handling of first responder and civilian deaths. III.6 Burns Firefighters encounter flames, high heat, physical obstacles, and a number of other hazards in carrying out their response duties. Each hazard serves as an individual stressor on the firefighter that given its relative intensity, length of exposure, and the degree to which protection is provided, creates specific risks of injury, disease, or death. Particularly relevant to this report is structural firefighting, which the NFPA defines as “the activities of rescue, fire suppression, and property conservation in buildings, enclosed structures, vehicles, marine vessels, or like properties that are involved in a fire or emergency situation.” Structural firefighting is likely to expose firefighters to a range of thermal conditions when responding to a fire. While several researchers have attempted to classify these conditions, one system is shown in Figure 1, where the fireground is characterized in terms of level of thermal radiation (expressed in cal/cm 2 s) and the air temperature (expressed in degrees Celsius and degrees Fahrenheit). 16,17 Three possible structural firefighting situations are illustrated in this figure and are described below: ■ The Routine region describes conditions where one or two objects, such as a bed or waste basket, are burning in a room. The thermal radiation and the air temperatures are virtually the same as those encountered on a hot summer day. As shown in Figure 1, Routine conditions are accompanied by a thermal radiation range of 0.025 to 0.05 cal/cm2s and by air temperatures ranging from 68 to 140 °F (20 to 60 °C). Protective clothing for firefighters typically provides protection under these conditions, but excessive exposure times may create a burn injury situation. ■ The Ordinary region describes temperatures encountered in fighting a more serious fire or being next to a “flashover” room. Ordinary conditions are defined by a thermal range of 0.05 to 0.6 cal/cm2s, representing an air temperature range of 140 to 571 °F (300 °C). Under these conditions, protective clothing may allow sufficient time to extinguish the fire or to fight the fire until the nominal air supply is exhausted (usually less than 30 minutes). ■ The Emergency region describes conditions in a severe and unusual exposure, such as those caused inside a “flashover” room or the firefighter being next to a flame front. In Emergency conditions, the thermal load exceeds 0.3 cal/cm2s and temperatures exceed 571 °F. In such conditions, the function of firefighters’ clothing and equipment is simply to provide protection during the short time needed for an escape without serious injury. 16 Abbott, N. J. and S. Schulman. “Protection from Fire: Nonflammable Fabrics and Coatings.” Journal of Coated Fabrics, Vol. 6, July 1976, pp. 48-64. 17 Utech, H.P. “High Temperatures vs. Fire Equipment.” International Fire Chief, Vol. 39, 1973, pp. 26-27.
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