When a massive, five-alarm fire engulfed an apartment complex in Prospect Heights in July, swallowing swaths of synthetic materials in its wake, fire Chief Drew Smith said he was determined to keep his crew safe.
“There are no timeouts in firefighting like there are in sports, when you can blow the whistle during a game. So, you have to make these decisions in a matter of seconds,” Smith recalled recently.
“We were not making any progress, even though we kept adding more resources, so at the one-hour point, I knew we had to pull everyone out, and I sounded the air-horn signal,” he said.
The blaze left 500 residents homeless and caused an estimated $10 million in damages, as well as minor injuries to a firefighter and two residents. Investigators ruled it an accidental fire started by an 11-year-old with a lighter.
What remains unknown is how many of the 200 firefighters at the scene strictly followed cancer prevention and safety protocols, which advise them to wear air masks, even after a fire is extinguished, and to follow a decontamination regimen to rid their bodies and gear of harmful toxins.
An afternoon breeze fed the fire, which spread rapidly because of the mansard roof design of the 1970s-era apartment complex. Some of the dozens of firefighters who had been on the scene for hours were no longer wearing their self-contained breathing apparatus, despite the shrouds of black smoke that could be seen and smelled from miles away.
Many firefighters have said that following prevention protocols designed to protect them can become a secondary priority when dealing with often high-stakes pressures to save lives in an emergency and extinguish blazes quickly.
The issue of wearing air masks is one example of the ongoing work to change the culture at many fire departments across the country, including Prospect Heights, amid the debate over cancer and its link to firefighters.
Smith recalled an era from decades past when some of his fellow firefighters refrained from wearing air masks unless a particular scene “was really bad.”
“Now, we’re of the position to never take it off,” Smith said of the masks. “More and more guys are afraid of getting cancer. … It’s become very personal, and people are trying to do the right thing.”
Protecting a firefighter
Protective clothing and equipment are designed to protect a firefighter from extreme heat, but not against direct exposure to toxic material. Even when worn correctly, skin contamination inevitably occurs. Here’s a look at steps a firefighter can take to mitigate cancer risk.
Following cleaning of outside equipment, firefighters should take off their hoods as soon as possible after an incident to stop further exposure to contaminants. Firefighters shouldn’t re-wear a dirty hood — they should have a second hood or clean one available.
Breathing apparatus and mask
Should be worn during the entire incident, through decontamination of outside equipment. After incident, firefighters should clean the mask and breathing apparatus with soapy water and a brush while it is still assembled.
Gloves need to be cleaned after each exposure. The first decontamination should happen at the site of the fire and a more thorough cleaning back at the station. Outer equipment should be sealed up or stored separately when taken back to avoid contact with harmful particles or chemicals.
Turnout coat and pants
These also need to be cleaned after each exposure. Additionally, dirty turnout pants and coats shouldn’t be stored in parts of a fire station where firefighters eat or sleep because contaminants could spread.
Both inside and outside of boots need to be cleaned following exposure.
Clothing and hygiene
A firefighter should clean soot from exposed parts of his or her body, especially the head, neck and hands at the site of the incident. When back at the station, firefighters should “shower within the hour” before deep cleaning other equipment and change clothes as well.
Sources: Fire Service Occupational Cancer Alliance; International Association of Fire Chiefs
To be sure, fire departments in the Chicago area and beyond are facing a herculean task to transform a deeply entrenched firefighter culture, said Gavin Horn, a researcher with the Illinois Fire Service Institute for the University of Illinois at Urbana-Champaign. The institute is the state’s fire academy that conducts fire science research and provides training and educational programs for firefighters.
But the efforts to encourage cancer prevention protocols are starting to find success among many departments, especially with younger firefighters, Horn said.
“These days, a lot of firefighter conversations I hear are about how ‘clean is the new cool,’” Horn said, adding, “Being covered in soot is no longer a badge of honor for firefighters.”
Prevention efforts also have been strengthened in recent years to keep firefighters safe while on the job, countering the old adage that the fire service represents “150 years of tradition unimpeded by progress,” Horn said.
For example, many firefighters now are aware of the need to follow a decontamination routine while on the scene, scouring their skin and gear of toxins as rapidly as possible rather than waiting until they return to the firehouse, he said.
WATCH: Battling a massive blaze — and taking preventive measures after
In Prospect Heights, firefighters are required to have a spare set of gear to prevent them from re-wearing dirty clothing, while baby wipes and garbage bags are placed in the department’s trucks to ensure crews can start a decontamination regimen directly at the scene, Smith said.
Firefighters also have to bag their dirty garments in the garbage bags before they’re allowed to return to the fire house, since they are prohibited from wearing soiled garments in the living areas of the fire house, he said.
The preventive measures underscore some of the efforts to change the firefighting culture.
“If it smells ‘macho,’ it’s bad news,” Smith said, adding, “I don’t know if we can prevent firefighters from getting cancer, but we can reduce exposure to getting it, just like heart disease.”
At the Elgin Fire Department, Chief Dave Schmidt said his firefighters now are required to follow a gross decontamination process on the scene that involves using baby wipes to cleanse exposed areas of their bodies, such as the neck, throat and armpits.
Similar to Prospect Heights, Elgin firefighters have to remove dirty gear and pack it into sealed bags, which are stored on the trucks in an enclosed area away from the crew to ensure toxins on the garments do not become airborne or rub onto the seats of trucks, Schmidt said.
When firefighters return to the station, they also have to shower immediately, he said.
“We don’t even want anyone to grab a water bottle out of the refrigerator until they have washed up and we know they’re clean,” Schmidt said.
The department also has purchased special washers and dryers, and it is moving toward providing its firefighters with a second set of gear to ensure they’re not re-wearing a uniform covered in toxins, Schmidt said.
At the Illinois Firefighters Association, a nonprofit that provides educational programs and other support services for firefighters across the state, including volunteer departments, president John Swan said the organization’s recent kickoff of the Go Green Clean campaign, which is meant to prevent cancer among firefighters, highlights 11 best preventive practices for departments.
The recommendations include using full protective equipment throughout an incident, even after a fire has been extinguished, and during the salvage and overhaul process on the scene. Firefighters also are encouraged to begin immediate decontamination at the scene of a fire, using soap, water and a brush, if weather conditions allow, Swan said.
As the complex science behind the issue continues to evolve, fire departments have relied on some studies to change protocols regarding the use of air masks meant to protect a firefighter’s airways.
Firefighters and other rescue workers now are required to wear the mask until a supervisor at the scene of a fire determines the environment is safe enough for them to remove the device, said Patrick Gratzianna, deputy chief of the Palatine Fire Department, one of the many departments that assisted Prospect Heights during the recent apartment fire.
The requirement exists because the air masks are designed to provide breathable air and prevent firefighters from inhaling toxic fumes on the scene, Gratzianna said.
Firefighters also have to break for mandatory “rehab” after they’ve typically gone through two oxygen canisters since the breathing apparatus provides roughly 20 minutes to a half-hour of breathable air, Gratzianna said.
“Working with a mask on can be bothersome, and it takes time to put on a new one, but they do what they’re designed to do,” Gratzianna said. “An officer assigned to a crew on the scene needs to understand the value and importance of wearing (a mask) by example.”
Sources of toxic smoke
In previous decades, homes consisted of simple components — wood, textiles, metal and glass. Today, synthetic materials — complex plastics, industrial polymers and chemical coatings — mean home fires now burn faster and hotter and produce thick, toxic smoke. Here’s a look at the gases released when common bedroom items are set on fire.
Known to cause cancer, those exposed to this sweet-smelling chemical can experience skin, eye and throat irritation. Redness and blisters could also develop on skin.
This carcinogen may cause leukemia and other cancers. Exposure can cause eye pain, sore throat, difficulty breathing and blurred vision.
This cancer hazard can also be highly irritating to the eyes, nose and throat.
Sources: “Firefighter exposure to smoke particulates” by Underwriters Laboratories; American Cancer Society; Occupational Safety and Health Administration; Fire Service Occupational Cancer Alliance
Concerted cancer prevention efforts at fire departments are commendable, but they also should be accompanied by annual medical screenings, said Dr. Jyoti D. Patel, a professor of medicine in the hematology and oncology department at University of Chicago Medicine.
Patel, who specializes in treating lung cancer patients, said she frequently sees firefighters with the disease who have never smoked and have no family history of cancer.
She said that while doctors today often still can’t be sure if a firefighter’s cancer is related to his or her work duties, they do understand firefighters have to put themselves in dangerous situations that “many of us never go into.”
“One hundred percent of the firefighters I have treated look back and say they are incredulous that years ago, some of them never even used a mask,” Patel said. “I’m glad fire departments are now looking at prevention efforts, but I’m of the opinion that it’s not as simple as just using baby wipes and developing better equipment.”