Health hazard evaluation report: HETA-99-0062-2804, Newark Fire Department, Newark, New Jersey.
Cincinnati, OH: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, HETA 99-0062-2804, 2000 Feb; :1-22
On December 22, 1998, the National Institute for Occupational Safety and Health (NIOSH) received a request for a health hazard evaluation (HHE) from the International Association of Fire Fighters (IAFF) on behalf of fire fighters from the Newark Fire Department (NFD) to assess the incident response procedures followed during a fire in a refuse waste-to-energy facility (American Ref-fuel) on December 17, 1998, in Newark, New Jersey. The IAFF indicated that several of the fire fighters responding to the incident were subsequently hospitalized due to smoke and chlorine gas inhalation. NIOSH investigators conducted a site visit to the NFD on April 12-13, 1999, and again on June 24, 1999. NIOSH personnel conducted private interviews with several NFD fire fighters who responded to the incident and reviewed several incident-related records provided by the NFD, including the departmentís standard operating procedures (SOPs) and medical records. Self-administered questionnaires were distributed to fire fighters who were not present on the days of the NIOSH investigation. In addition to the medical interviews and questionnaires, medical records were reviewed from five hospitals where the fire fighters received medical care, and from the occupational medicine provider for the NFD. NIOSH investigators also visited American Ref-fuel. On December 17, 1998, the NFD received a report of a fire in the refuse pit of American Ref-fuel. The fire was declared a hazardous materials incident as information became known that the fire had involved chlorine bleach cleaner which, according to the productís material safety data sheet, would liberate chlorine and phosgene as decomposition products. Fire fighters used the plantís showering facilities for decontamination purposes before all of the 37 responding fire fighters were sent to area hospitals for evaluation. The medical survey showed that most fire fighters at the scene experienced some degree of acute upper respiratory tract irritation, and many experienced lower respiratory tract irritation as well. Fifteen had persistent symptoms at 24 hours, and 13 had symptoms at the time of the NIOSH investigation. Based on the combustion of chlorine-containing cleaner, the fire fightersí exposures probably consisted primarily of irritant gases, such as chlorine and nitrogen trichloride. Medical records revealed that the treating physicians were aware that the fire fighters were exposed to chemicals at a fire and were concerned about the inhalation of toxic fumes and smoke. However, neither fire fighters nor treating physicians knew what specific toxins were present. The symptoms of the fire fighters were consistent in the different hospitals, however the diagnostic tests performed differed. The university based hospital performed the most diagnostic tests on the fire fighters. The other hospitals performed fewer tests, but this did not appear to result in a greater rate of adverse health outcomes. The elements leading to fire fighter exposures at the waste-to-energy plant on December 17, 1998, are complex and multi-factorial in nature. Clearly, fire fighters did encounter exposures to irritant gasses at the scene. The NFD approached the incident in fire mode, when in fact, a hazardous materials (HAZMAT) response approach would have been more appropriate. Most fire fighters suffered irritant symptoms that were the result of exposures to irritant gases at American Ref-fuel. For those fire fighters who had recovered at the time of the NIOSH investigation or did not develop symptoms, it is unlikely that this exposure will result in further health problems. Those who developed more significant respiratory symptoms were being evaluated by health care providers. Several recommendations are offered for improving fire fighter health and safety, including recommendations for better integration of fire fighter medical surveillance information with acute care occupational medicine providers, better personal protective equipment (PPE) usage, and filling gaps in HAZMAT coverage.
Region-2; Hazard-Confirmed; Fire-fighters; Fire-fighting; Fire-fighting-equipment; Fire-safety; Emergency-responders; Respiratory-irritants; Pulmonary-system-disorders; Respiratory-system-disorders; Chlorine-compounds; Personal-protective-equipment; Protective-equipment; Respiratory-protective-equipment; Self-contained-breathing-apparatus;
Author Keywords: Fire Protection; fire fighters; firefighters; incident command system; ICS; self-contained breathing apparatus; SCBA; hazardous materials