Firefighter Hygiene Needs Better Conditions
Why firefighter hygiene often falls short despite measurable contaminant exposure - and what needs to change at an organisational level.
Through our work with fire services, we have visited numerous fire stations across Austria in recent years. Our impression: decontamination does not yet have the priority in everyday operations that the issue actually requires.
After a fire, vehicles and equipment need to be made operational again, breathing apparatus must be serviced and countless other tasks have to be completed. All of this takes place under time pressure, physical strain and exhaustion. For volunteer fire departments in particular, the regular working day often resumes shortly afterwards. Under these conditions, the effort required for consistent decontamination can easily become a deterrent.
We regularly experience ourselves how easily fire residues are carried beyond the incident scene: after visiting a fire station, our own clothes can smell strongly of smoke. This clearly demonstrates that combustion products have long since left the original fire scene and are being carried into other areas.
But we are only visitors. The central question is: What does contaminant exposure actually look like for firefighters?
One fire training exercise - measurable PAH uptake
In 2023, Koslitz et al. examined nine firefighters during realistic flashover exercises at a fire training facility.
All participants wore full PPE and self-contained breathing apparatus. Urine samples were collected before the exercise and approximately two, six and 14 hours afterwards. The researchers measured 1-hydroxypyrene (1-OHP), an established biomarker for the uptake of polycyclic aromatic hydrocarbons, or PAHs.
The results:
The mean concentration increased temporarily to approximately five times the baseline level after the exercise. The highest individual value measured was 5,31 µg/L.
In five of the nine firefighters, creatinine-adjusted values after the exercise exceeded the respective reference values for the general population, in some cases by up to eight times. In two non-smokers, the Biological Exposure Index of 2.5 µg/L used in the study was also exceeded.
The authors reached a clear conclusion: even with full PPE and respiratory protection, significant PAH uptake was measurable after the fire training exercise.
Health effects of PAH exposure
PAHs are formed during incomplete combustion. Some substances within this group are carcinogenic. A single elevated measurement does not, of course, mean that a disease will develop. But firefighters are not exposed to these substances only once during their lifetime.
Since 2022, the International Agency for Research on Cancer, IARC, has classified occupational exposure as a firefighter as carcinogenic to humans, Group 1. IARC found sufficient evidence for mesothelioma and bladder cancer.
PAHs are only one part of the potential exposure. Fire smoke can contain numerous other hazardous substances.
The key question is therefore not whether decontamination makes sense. The question is how it can actually work in everyday fire service operations.
The problem must not be left to individual firefighters
In conversations with firefighters, we repeatedly notice that firefighter hygiene is sometimes viewed negatively. That is understandable.
Responsibility is too often shifted onto the individual: be more careful, work more cleanly, change clothes faster, clean more thoroughly. What remains in the end is mainly a bad conscience - which can create resistance to the entire subject.
But if firefighters are expected to handle contaminated PPE and equipment consistently, suitable conditions must first be created. Our demand is therefore not for more individual responsibility, but for better conditions for firefighter hygiene in Austria.
In practical terms, this means:
Plan and retrofit fire stations accordingly. Clean and contaminated areas must be physically and organisationally separated. Contaminated PPE should not have to pass through clean areas.
Provide time for decontamination. Post-incident work does not end once technical operational readiness has been restored. Handling contaminated PPE and equipment requires dedicated time and personnel.
Explain the background. Firefighters need to understand which substances can be produced during fires, how contamination is transferred and how these substances can enter the body.
Train decontamination procedures in practice. Removing, separating, packaging, transporting, cleaning, decontaminating and storing equipment must become established routines rather than something improvised after an incident.
Define clear responsibilities. Who does what, when and with which equipment? These questions need to be answered before an incident occurs.
Provide efficient technology. Decontamination methods must be realistic to integrate into everyday fire service operations. If decontamination is complicated, slow or labour-intensive, it will inevitably lose out under time pressure.
One of the main reasons we developed our Oxy3 decontamination system was to contribute a technical solution to the problem: one that requires no structural modifications, is mobile and quickly available, easy to use, and demonstrably highly effective. It was developed for the treatment of suitable PPE, equipment, operational materials and vehicle interiors, with a particular focus on reducing PAHs. It does not replace the required pre-cleaning or washing process, but complements it with an additional decontamination step.
Technology alone cannot solve the problem either: if we take contaminant exposure among firefighters seriously, we need to make consistent decontamination practically feasible, allow sufficient time for it and make it an established part of fire service organisation.
Source: Koslitz S. et al. (2023), Biomonitoring of polycyclic aromatic hydrocarbons in firefighters at fire training facilities and in employees at respiratory protection and hose workshops, Frontiers in Public Health 11, 1277812. DOI: 10.3389/fpubh.2023.1277812.
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