Culture and awareness of occupational health risks amongst UK firefighters

Abstract

Firefighters are exposed to toxic chemicals not only from the fire incidents they attend, but also from their contaminated station and/or personal protective equipment (PPE). Little is currently known about firefighters’ awareness, attitudes, and behaviours towards contaminants which was assessed in the UK firefighter contamination survey. Results revealed that lack of training on fire effluents and their health outcomes are strongly associated with increased fire smoke/contaminant exposure. Notably, untrained firefighters were at least twice as likely to: never clean personal protective equipment (PPE) (Crude Odds Ratio, OR 2.0, 1.5–2.7), infrequently send their PPE for professional cleaning (OR 2.0, 1.6–2.4), remain in the workwear (t-shirt etc.) worn while attending a fire incident (OR up to 3.6, 2.3–5.6), and indicate that cleaning at fire stations is not taken seriously (OR 2.4, 2.2–2.6). Firefighters personally viewing contamination as a “badge of honour” (BoH) were at least twice as likely to: remain in contaminated PPE after fire incidents (OR 2.3, 1.4–3.9), eat with sooty hands (OR 2.2, 1.9–2.5), notice soot in the nose/throat (OR 3.7, 2.7–5.2), and smell fire smoke on the body for more than a day after incidents (OR 2.0, 1.6–2.4). They were also more likely to indicate that cleaning at fire stations is not taken seriously (OR 2.5, 2.2–2.9) and that fire stations smell of smoke always/most of the time (OR 2.3, 2.0–2.6). Strong links were also found between belief in the BoH and never cleaning PPE (OR 1.9, 1.4–2.7), and eating while wearing contaminated PPE (OR 1.8, 1.5–2.2).

Contamination of UK firefighters personal protective equipment and workplaces

“…These significant associations may plausibly be explained by senior firefighters attending incidents in supervisory (rather than active firefighting) roles, where PPE does not become visibly contaminated and is therefore not cleaned. Long-serving, or incident-active firefighters may also have become desensitized to the threat of contamination or may not have received up-to-date training concerning the latest scientific evidence regarding the health effects of contaminant exposure 23 .…”

Cancer incidence amongst UK firefighters

“…Tackling the "badge of honour" attitude within the UK Fire and Rescue Service may also help to promote adherence to decontamination procedures. This attitude refers to the outdated belief that heavily soiled/contaminated PPE should be celebrated as a symbol of hard-work and dedication among firefighters 15 . The survey found that 16% of firefighters still hold this belief, while 46% believe that others do.…”

“…Although not significantly associated with an increased risk of cancer, this attitude was positively associated with proxies of fire toxin exposure which were found to be significantly associated with cancer e.g. eating while wearing PPE and staying in PPE for an extended amount of time after an incident (explored further in Wolffe et al 2023 15 ). Similarly, training on fire contaminants and their health outcomes may also help promote compliance with decontamination procedures.…”

“…), contamination and decontamination practices, PPE (provision, maintenance, cleaning, storage, fit etc.) 8 , attitude/culture, awareness and training 15 .This manuscript presents links between firefighters' occupational exposure to fire toxins and their risk of developing cancer.…”

“…), contamination and decontamination practices, PPE (provision, maintenance, cleaning, storage, fit etc.) 8 , attitude/culture, awareness and training 15 .…”