Brian Hesler describes the training needed to guide the cultural change required to improve firefighter health and wellbeing, post COVID-19
IN RECENT times, firefighter health has received increased media attention, and rightly so. COVID-19 has highlighted the risks that all essential workers face when performing their critical roles throughout a pandemic. Firefighters have been very much on the front line, changing roles to support the wider emergency services and ultimately putting themselves at a higher risk of infection.
More emphasis is now being placed on hygiene and disinfection, which will be one positive outcome of this pandemic. A significant cultural change has been a long time coming. It has taken us from firefighters wearing dirty kit as a badge of honour that proved their hard work and value, to understanding that clean and well maintained kit is essential. That kit must be supported by detailed and robust hygiene processes that mitigate every contact with contaminants.
Prior to COVID-19, media outlets were also reporting more regularly on the very real issue of the exposure of firefighters to carcinogens. Embedded carcinogens in any equipment can be absorbed by the firefighter, and the cancers mostly responsible for this higher risk are respiratory, gastrointestinal or ‘GI’(oral cavity, oesophageal, large intestine) and kidney.
Cancer has been highlighted in some scientific reports to be the leading cause of death among firefighters, with the International Association of Firefighters (IAFF) reporting that cancer caused nearly two out of three (61%) firefighter line of duty deaths between 2002 and 2017. The National Institute for Occupational Health and Safety (NIOSH) also found that in the US, firefighters had a 14% higher chance of dying of cancer compared to the general population.
The results of these reports need to be underpinned by robust medical research to reflect the landscape, culture, current standards and operational practices of UK fire and rescue services (FRSs). While these shocking statistics are relatively well known, not enough has been done to force a change. Manufacturers of medical and safety technology products have a responsibility to innovate solutions that support change.
To achieve this, Dräger’s Health for the Firefighter campaign complements its training programmes and also communicates the importance of detailed hygiene processes, from the handling and storage of masks and breathing apparatus equipment through to the subsequent cleaning of the kit after an incident has occurred. Training is the first and crucial step in guiding a cultural shift, and ultimately protects the health and wellbeing of firefighters.
Current training
It is important that training programmes reflect the fact that FRSs are the experts with the experience and understanding of what solutions are practical. It is therefore the role of product manufacturers to use technology, research and innovation to work with them as partners, helped by applied training to create a robust consistency in approach and provide a safe environment
for training.
Training has become even more important with the welcome reduction in fires over recent decades. When I was first operational in the 1970s and 80s, we would attend 2,500 to 3,000 incidents annually from one fire station. Thankfully, improved fire awareness, education and fire safety measures have reduced call outs by approximately 80%.
However, this also results in firefighters not gaining the frontline experience that they did previously, and therefore realistic fire training must be provided to ensure that firefighters are competent and confident in how they approach the wide range of scenarios with which they are faced.
COVID-19 has further heightened the importance of training, as some non operational firefighters have had to retrain and return to the front line to replace colleagues who are shielding, in isolation or simply supporting and protecting family members.
Dräger’s training is typically split into the three following areas:
Training systems
These encompass mobile or fixed training facilities that enable state of the art training, so that firefighters can experience real fires or extrication scenarios in a safe environment, including compartment fire behaviour training (CFBT). At Dräger, these include a vast portfolio of potential fire and rescue environments, including petrochemical plants, hospitals, schools, high rise buildings, vehicles, aircraft and underground stations.
Technical training
This type of training provides comprehensive knowhow on the maintenance and repair of equipment, from mechanical and electronic components through to cleaning and disinfection.
Fitness training
Equipment is provided here to help prepare firefighters for the physical challenges that come with the job, and ensure that they can be tested and monitored to improve their operational safety.
Training has come a long way from when it centred simply around exposure to hot temperatures, often referred to as ‘burn to learn’. It is now about much more than protecting a firefighter from becoming burnt, but rather teaching the science and behaviour of a fire and its contaminants, not only to support fire and rescue operations, but also to protect the firefighter’s own health.
Technology’s role
Hands free thermal imaging, firefighter location and remote physiological monitoring systems are all recent technologies that are being adopted.They are being used to make sure that firefighters are given as much information as possible before entering an incident, and that those on the outside are able to track and monitor a firefighter’s health in real time.
The benefits accruing from these technical advancements are evident and this makes training in their use a relatively easy ‘sell’. While COVID-19 is driving improvements in this regard, what is more difficult is helping FRSs realise that technical training on the cleaning and hygiene processes related to kit is just as important to firefighter health.
Consistent and robust hygiene processes are also related to technology. While manual cleaning of equipment is still generally the norm, there are many FRSs that are moving towards mechanical washing systems, which provide complete consistency in washing temperatures, the amount of detergent used, speed and temperature of drying – all of which can work together to disinfect contaminants and protect the longevity of the kit.
Training on and support around these systems encompasses the entire purchasing and use lifecycle, from helping to build business cases for procurement and logistical installation support, through to advice on the exact processes a firefighter should take when leaving a scene and returning to the station. Support also includes the ongoing maintenance of equipment and the quantity of stock required.
Future improvements
Despite the advances described, the UK is still behind other countries in terms of its hygiene and infection control practices.
The Netherlands and Sweden, for example, are two European countries which are leading the way in shifting the mindset and using mechanical washing equipment, supported by improved logistics for managing and tracking personal protective equipment (PPE) and respiratory protective equipment (RPE) more widely.
For these countries, stringent hygiene practices are commonplace and are not only related to fighting cancer or the current pandemic, but also to protecting firefighters and support staff from more day to day illnesses such as flu, common colds, cold sores and other communicable illnesses.
My role includes advising on these best practice examples and new equipment technologies. This involves working with our UK based manufacturing facility and R&D departments to ensure that they are designed with the firefighter in mind, as well as with FRSs, government and other key stakeholders to help drive improvements to further protect our crews.
With more than 115 years of experience in manufacturing advanced technology solutions for FRSs, Dräger has the experience and technological knowhow to support this necessary change in how we think about equipment, its cleaning, and ultimately how to apply technology and training to help make our firefighters safer
Brian Hesler is consultant and specialist advisor at Dräger Safety UK