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, DHHS (NIOSH) Publication No. 2004-115, 2004 Jan; :1-27
Fire fighting continues to be one of the more hazardous industries in this country. The occupational environment for fire fighters is somewhat unique: exposures are varied, often high, and intermittent. They occur in circumstances of extreme physical and mental stress where the only means of exposure control is self-contained breathing apparatus (5CBAs). Exposures can include smoke and particulate matter, carbon monoxide (CO), nitrogen dioxide (N02), hydrogen chloride, hydrogen cyanide, sulfur dioxide (502) / sulfuric acid, acrolein, formaldehyde and acetaldehyde, benzene and many other organic chemicals, and any chemicals that might be located at the fire scene. Many of these exposures cause acute effects, but others may cause chronic effects, such as respiratory health effects and decreased lung function from repeated smoke exposures or cancer from repeated exposures to diesel exhaust, benzene, polycyclic aromatic hydrocarbons (PAHs), asbestos, or formaldehyde. A high potential exists for burns, acute trauma, and musculoskeletal injuries. Communicable diseases are becoming a major concern, especially blood-borne pathogens and tuberculosis (TB). Other health effects associated with fire fighters are cardiovascular disease, reproductive hazards, hearing loss, and occupational stress. A detailed summary of these exposures and health effects can be found in Occupational Medicine: State of the Art Reviews: Fire Fighters' Safety and Health. The 30 Health Hazard Evaluations (HHEs) summarized in this document are grouped into the following six categories: 1. Respiratory health effects and safety and health programs and procedures. 2. Diesel exhaust exposures. 3. Forest fire-fighting. 4. Chemical diseases. 5. Communicable diseases. 6. Other. Along with conducting fire-fighting HHEs, the Hazard Evaluations and Technical Assistance Branch (HETAB) began a project under the Fire Fighter Fatality Investigation and Prevention Program (FFFI&PP) during fiscal year (FY) 1998 to investigate line-of-duty cardiovascular fatalities suffered by fire fighters. Approximately 45 fire fighters suffer fatal heart attacks each year, and NIOSH is investigating these fatalities to generate hypotheses for prevention and intervention activities. Each investigation includes an assessment of the physiologic and psycho logic demands of the job, workplace organization factors, and individual risk factors. Each investigation results in a succinct report for the affected fire department as well as the country's fire service and is included as part of the larger annual report. From 1998 to 2001, 62 investigative reports have been completed, with an additional 13 pending completion. These reports have been distributed to more than 30,000 fire departments representing more than 1 million fire fighters. They are also available on the NIOSH fire fighter Web site <a href="https://www.cdc.gov/niosh/fire/"target="_blank" >https://www.cdc.gov/niosh/fire/</a>. One peer-reviewed journal article has been published, and seven presentations have been given at national meetings. Finally, as an expert of cardiovascular disease (CVD) among those employed in the fire service, one program member was invited to become a member of the National Fire Protection Association (NFPA) Standard 1582, Medical Requirements of Fire Fighters and Information for Fire Department Physicians.