Firefighter’s cancer prevention checklist

Overview

Employers, supervisors and workers all play a role in taking responsibility for health and safety in the workplace. Understanding your duties, responsibilities and rights under Ontario’s Occupational Health and Safety Act (OHSA) is integral to ensuring all workers stay safe and healthy at work. The goal is to prevent workplace injuries, illnesses and deaths.

Purpose

The purpose of this checklist is to help Ontario’s fire service employers and workers increase their knowledge about measures to prevent exposure to contaminants, including those that cause cancers and other occupational illnesses. Fire services must take steps to minimize or prevent exposures, to keep their workplaces healthy and safe.

How to use this checklist

We encourage employers and workers of fire services to work through this checklist together. Using this self-audit tool, employers can identify opportunities to prevent or reduce exposure to cancer-causing contaminants and take steps to improve health and safety in the workplace.

You can read the Firefighter guidance notes for more information and materials.

Background

Routes of entry

The two major routes of entry for contaminants affecting firefighters are inhalation and skin absorption.

Inhalation

Inhalation exposure may occur by:

• not wearing a respiratory protection device during fire suppression, salvage, overhaul or investigations
• handling or cleaning soiled personal protective equipment (PPE) and other equipment without a respirator
• respirator leakage
  • facepiece problems including distortion, valves and deterioration
  • facepiece seal if the user is not clean shaven where the facepiece meets the skine
  • fit testing not conducted
• overbreathing while wearing a respirator during high workload

Skin absorption

Skin absorption exposure may occur by:

• unprotected skin due to improperly wearing PPE
• permeation through bunker gear, balaclava and gloves, resulting in contamination of neck, face, wrists, hands or groin
• handling or cleaning soiled PPE or other equipment without rubber gloves
• wearing contaminated PPE and clothing (wash them thoroughly and replace as needed)
• insufficient personal hygiene (not thoroughly washing or showering after fire)

As you work through the checklist, consider the measures and procedures that the fire service can implement to prevent the inhalation and skin absorption of contaminants.

Decontamination

Contaminants from fire suppression activities can be inhaled and absorbed through the skin. Soiled or contaminated ensembles and ensemble elements are a hazard to firefighters since soils and contaminants can be flammable, toxic, or carcinogenic. Additionally, soiled or contaminated ensemble elements can have reduced protective performance.

Firefighter bunker gear is designed for protection against heat at the fire scene. However, contaminants can penetrate through the bunker gear. The balaclava and gloves are of different construction than the bunker gear, potentially resulting in skin contamination at the face, neck, hands, and wrist. Contaminants detected in the groin area can come through the bunker pants zipper or waistline.

Routine cleaning of soiled equipment, apparatus and PPE items is important to reduce the risk of exposure.

Respirators must also be properly cleaned and sanitized. Filtering facepiece respirators (such as the N95 disposable mask) are not to be washed and must be disposed of after use.

After use, the following should be decontaminated to remove any residual contaminants:

• areas where PPE is washed
• equipment used for decontamination (such as extractors)
• shower facilities for workers

Checklist

Part A: programs

Respiratory protection program

A respiratory protection program protects workers from airborne contaminants.

Refer to Regulation 833 – Control of Exposure to Biological or Chemical Agents for the relevant occupational exposure limits, and requirements for the employer to develop written measures and procedures regarding the selection, care and use of respirators.

Refer to CAN/CSA-Z94.4-19, Selection, use, and care of respirators for guidance on the administration of an effective respiratory protection program in the workplace.

The table below contains recommended elements to be included in a respiratory protection program

Number	Respiratory protection program element	Is this element included in your program?
1	Program administration – the program is administered by a competent person	Yes/No Comments
2	Roles and responsibilities – the roles and responsibilities of the workplace parties are established	Yes/No Comments
3	Hazard situations – situations where respirators are required to be worn are identified	Yes/No Comments
4	Hazard assessment – potential airborne contaminants have been identified	Yes/No Comments
5	Respirator selection – appropriate respirators have been chosen based on the hazard assessment and requirements of Regulation 833	Yes/No Comments
6	Fit testing – worker fit testing occurs at least every two years	Yes/No Comments
7	Training – workers are trained on the use, care, storage, inspection, maintenance, cleaning, proper fitting, and limitations of the respirator, before first use	Yes/No Comments
8	Use, maintenance, storage – procedures are in place for the proper use, maintenance and storage of the respirators	Yes/No Comments
9	User screening – workers are screened to determine whether they are medically eligible to use a respirator	Yes/No Comments
10	Records and program evaluation – records are retained and the program is regularly evaluated to ensure it remains effective	Yes/No Comments

Air management program

An air management program ensures workers using self-contained breathing apparatus (SCBA) are provided with an adequate volume of safe air to breathe from safe cylinders and that the cylinders are stored and transported safely.

Refer to CSA Z180.1-19 Compressed breathing air and systems for guidance on the design, construction, commissioning, calibration, testing, operation and maintenance of components for compressed breathing air systems.

The table below contains recommended elements to be included in an air management program

Number	Air management program element (CSA Z180.1-19)	Is this element included in your program?
11	Monitoring of air levels during SCBA use – procedures are in place to ensure workers regularly monitor their air levels while using SCBA to prevent an out-of-air situation	Yes/No Comments
12	Filling of cylinders – procedures are in place to fill cylinders safely with clean air that meets the purity requirements in CSA Z180.1-19	Yes/No Comments
13	Cylinder replacement – procedures are in place to ensure cylinders are replaced as recommended by the manufacturer	Yes/No Comments
14	Secure transportation of cylinders – when transported in vehicles, cylinders are secured against tipping, falling or damage	Yes/No Comments
15	Secure storage of cylinders – cylinders are stored securely to prevent tipping, falling or damage	Yes/No Comments
16	Hydrostatic testing of cylinders – procedures are in place to ensure cylinders receive hydrostatic testing every five years	Yes/No Comments

Part B: work practices – scene/fire training ground

On the fireground or fire training ground, PPE protects firefighters from contaminants. In order to be effective, PPE must be worn properly and at all times when exposure can occur.

Some best practices for using and decontaminating PPE at the scene are listed below. The goal is to decrease worker exposure to contaminants by:

• using appropriate PPE
• limiting the spread of contaminants through a combination of personal hygiene practices
• cleaning gear on the fire ground (gross decontamination)
• isolation of contaminated PPE

One example of gross decontamination would be using water from a hose to remove visible contaminants from bunker gear and other equipment.

Bagging soiled gear at the scene is a good practice to reduce exposure to firefighters during transportation from the fire scene to the assigned fire hall for cleaning. Bagging soiled bunker gear at the scene will also prevent unnecessary contamination of the interior crew compartment of the apparatus and personal vehicles.

As Low As Reasonably Achievable (ALARA)

The ‘As Low As Reasonably Achievable’ (ALARA) principle should apply to all activities. The ALARA principle recognizes that although it may not be possible to reduce exposures to zero, efforts should be made to reduce workplace exposures as much as necessary to limit harm.

Part C: work practices – fire hall

Laundry rooms and laundry areas

If a ventilated laundry room is available, the laundry room should be kept under slight negative pressure at more than 1 cubic foot per minute (cfm)/square foot to prevent the spread of contaminants from soiled gear to the rest of the workplace. If there is no laundry room, the laundry area should be located away from bunker gear air dryers, clean bunker gear storage areas and other occupied areas, so as not to expose workers nearby or contaminate clean gear.

Laundering and drying bunker gear

To prevent damage to bunker gear, the manufacturer’s recommendations should be followed.

Refer to NFPA 1851 Standard on Selection, Care, and Maintenance of Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting for guidance on laundering bunker gear.

Wash/dry temperatures should be less than 40° Celsius. Detergent within a pH range between 6 to 10.5 should be used.

Extractors are commonly used for routine cleaning of bunker gear outer shell, bunker gear inner lining, balaclava, and gloves. The g-force of extractors should not exceed 100 grams for all elements.

Gear air dryers are commonly used for drying clean bunker gear.

Showering

Taking a shower with soap and water is encouraged as soon as possible after a fire call to remove contaminants on the skin, which can be absorbed into the body. If a shower is not available, washing of any potentially exposed skin (such as the face, neck, wrists and hands) is encouraged after a fire call.

Clean versus dirty areas

Bunker gear should be kept in restricted areas of the fire hall and should never enter the living areas. A combination of signage and markings on the floor can help separate clean areas from dirty areas.

Storing clean bunker gear on the apparatus floor

If the apparatus floor is not equipped with a direct local exhaust system from the tailpipes of vehicles, then exhaust emissions from the apparatus can be captured by general mechanical ventilation at 20,000 cubic foot per minute (cfm) (or more) per operating truck and 100 cubic foot per minute (cfm)/horsepower for diesel-fuelled vehicles. If the apparatus floor has only natural ventilation, then clean bunker gear should not be stored on the apparatus floor to prevent contamination of clean gear with diesel soot.

Part D: inspection of personal protective equipment

Personal protective equipment (PPE) protects workers from contaminants. Personal protective equipment needs to be maintained in good condition in order to provide protection. Regular inspection of the various PPE elements should be conducted to ensure they are in good condition. Where PPE is found to require repair or cleaning, it should be removed from service and clearly identified as being out of service.

Refer to CAN/CSA-Z94.4-19, Selection, use, and care of respirators for guidance on respirator inspections.

Refer to NFPA 1851 Standard on Selection, Care, and Maintenance of Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting for guidance on inspecting these items.

The table below discusses PPE training

Number	Personal protective equipment practice	Yes/No
78	Workers receive training in use, removal, disposal, cleaning, inspection and limitations of PPE	Yes/No Comments

Part E: use of personal protection equipment during decontamination activities

Proper PPE should be worn to protect workers from contaminants while they are handling soiled equipment or decontaminating surfaces.

When in the laundry room area, soiled bunker gear must be handled while wearing appropriate personal protective equipment such as disposable coveralls, safety glasses, rubber gloves, and N95 masks to prevent exposure via inhalation and skin absorption during laundering activities.

After laundering soiled gear, appropriate PPE should be worn while decontaminating the surfaces of the laundry room/area and extractor.

Some examples of PPE that could be used for various tasks are included in the checklist below – this list is not exhaustive and there may be other tasks in your fire hall that require PPE.

Further information

Purchasing equipment

When purchasing new apparatus, hose or other equipment, consider ease of cleaning. For example, non-porous crew compartment seats are easier to clean than fabric.

Cancer prevention resources

Visit Ontario’s Ministry of Health website for more cancer prevention information and resources.