Decon Procedures and Firefighter Health

Assessing the Skelleftea Model for the U.S. Fire Service

By Todd J. LeDuc

Of late, the American fire service has been discussing and focusing on occupational cancer exposure and potential mitigation strategies. Such mitigation strategies and prevention approaches have included numerous occupational changes: exhaust extraction systems, enhanced personal protective gear cleaning, hood and glove exchange programs, more thorough and aggressive decontamination approaches, and early detection and medical screenings. A National Institute of Occupational Safety & Health (NIOSH) study of more than 30,000 Philadelphia, San Francisco, and Chicago firefighters found elevated rates of certain cancers over general population control. The American fire service certainly may benefit from reviewing global fire service cancer practices, particularly in light of their aggressive practices aimed at a “well” firefighter from the point of contamination forward.

Reducing the Impact of Heat Stress within the Fire Service Industry

Evaluating key factors contributing to, and exacerbating, the heat stress risks within the fire service industry, readers can explore important preventative protocols to help alleviate the hazard.

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Sweden has adopted an approach to post-products of combustion exposure--very much like what has been common practice in the United States when it comes to decontamination of hazardous materials environments and exposure (see video below, "The Skelleftea Model.")The notion of hot, warm, and cold zones, and of gross and fine decontamination, are well-accepted in this operating environment. We know from continued research and evidenced-based data that exposure to products on combustion contaminate our personal protective equipment and, in many cases, our skin, being absorbed into our circulatory system.  As such, our approach to post-carcinogen exposure demands due diligence and accountability to ensure we remove as much of the carcinogenic product as early as possible.

This focus should be on the immediate brushing and, if possible, scrubbing of personal protective gear to remove decontamination. In addition, whenever possible, gross and fine decontamination on the fireground should be undertaken, including using body wipes. Firefighters should concentrate on areas of the body that have been demonstrated to have higher than normal rates of absorption, especially when overheated, thereby expand body pores. Areas of the body where large blood vessel are just below the surface--such as the carotids (neck), abdominal (thoracic) and femoral for the lower extremities--are areas that have large arterial blood supply and can absorb and circulate rapidly. Although awareness campaigns of “showering within the hour” have taken proactive steps towards decontamination, when logistically feasible aggressive measures should be taken as soon as possible to limit the amount of carcinogenic byproducts being absorbed into the bloodstream.

More thorough personal protective gear cleaning should be untaken as soon as possible, as well with extractors/gear washers and removal of any embedded carcinogenic products. Some departments have been swapping hood and gloves on scene to control contamination until they can receive appropriate cleaning, and issuing members clean replacements on-scene. Each department may have particular challenges when it comes to such an approach. The essence of this model is to control and remove as much carcinogenic exposure as soon as possible.

We all understand that firefighting has inherent risks associated with it. We also know  that we have occupational exposures to products of combustion that are linked to elevated rates of certain types of cancer when compared to general population controls. As such, it is incumbent on each of us to take proactive actions to decontaminate ourselves and our personal protective equipment. The early we can decontaminate thoroughly, the more we can mitigate our occupational cancer exposure and risks.

As evidence-based research continues to evolve, our understanding and response to further mitigation strategies will certainly continue to develop- in the meantime, take action to protect yourself!

Model Behavior - A simple way of minimizing firefighters’ exposure to hazardous chemicals on the job, after the job, and between jobs...

Into the unknown

As the Skellefteå Model focuses on unknown hazardous substances, the subject of combustion gases plays a major role in the program. Heat and flame may generate more than 400 different harmful substances, including benzene, dioxin, formaldehyde, polyaromatic hydrocarbons, and vinyl chloride – and that’s only from 7 common plastics. In a house fire, many more combustion gases are generated.

The firefighter may be exposed to these hazardous substances in three ways: inhalation, skin absorption, and swallowing.

  • Inhalation is simple to understand: if respiratory protection is not worn – even for a very short time – the firefighter will inevitably breathe in airborne materials.
  • Skin absorption can be deceptive. Not only is any opening in the turnout gear a possible entry point for contaminants, but just touching your skin with a dirty glove is a certain way of letting foreign materials reach the skin. This is particularly important when it comes to removing soiled clothing and equipment after the job. Add to this that chemicals commonly are absorbed more readily by warm and sweaty skin.
  • Swallowing hazardous materials can happen when not wearing any respiratory protection, or momentarily removing the respirator. Most ingestion happens after a job is finished, when the firefighter perhaps has some food to eat, enjoys a sweet or a bubble gum, takes a drink, or smokes. Bottles, dishes, packaging, and one’s own fingers may be contaminated. Furthermore, just swallowing saliva may ‘activate’ harmless substances into hazardous ones.

These three means of entry into the body are insidious. The absence of detectable characteristics in many hazards may lead to failure to wear personal protection when it is needed.

Some firefighters may resort to simple but largely ineffectual practices, such as breathing through the nose in the belief that the nose hairs will filter out airborne hazards (false), hold one’s breath or try to breathe less (counterproductive), or breathing into the elbow or collar (useless).

It’s in the mix

One problem in firefighting situations is that not only may there be unknown contaminants present, but often more than one. One chemical blending with another can cause far greater damage than each substance on its own. As mentioned, a contaminant may be harmless unmixed, but might become harmful when mixed with saliva. The combined effects of more than one chemical can be graded as follows:

  • No effect.
  • Added effect (each substance adds its own harmful effect).
  • Counteractive effect (the substances cancel each other out).
  • Synergistic effect (the combined effect is greater than that of each chemical).
Click here to read full article...

Impact of Fire Suit Ensembles on Firefighter PAH Exposures as Assessed by Skin Deposition and Urinary Biomarkers
Håkan Wingfors Jenny Rattfelt Nyholm Roger Magnusson Cecilia Hammar Wijkmark


Over the past 10 years, a number of safety measures for reducing firefighters’ exposure to combustion particles have been introduced in Sweden. The most important measure was the reduction in the time firefighters wear suits and handle contaminated equipment after turn-outs involving smoke diving. This study was divided into two parts, those being to investigate the level of protection obtained by multiple garment layers and to assess exposure during a standardized smoke diving exercise. First, realistic work protection factors (WPFs) were calculated by comparing air concentrations of the full suite of gaseous and particle-bound polycyclic aromatic hydrocarbons (PAHs) inside and outside structural ensembles, including jacket and thick base layer, during a tough fire extinguishing exercise using wood as the fuel. Second, during a standardized smoke diving exercise, exposure was assessed by measuring PAH skin deposition and levels of eight urinary PAH metabolites in 20 volunteer student firefighters before and after the exercise. The average WPF for the sum of 22 PAHs was 146 ± 33 suggesting a relatively high protective capacity but also indicating a substantial enrichment of contaminants with a risk of prolonged dermal exposure. Accordingly, in the second exercise, the median levels of skin-deposited Σ14-PAHs and urinary 1-hydroxypyrene significantly increased 5-fold (21 to 99 ng/wipe) and 8-fold (0.14 to 1.1 µmol mol−1 creatinine), respectively, post exposure. Among the PAH metabolites investigated, 1-hydroxypyrene proved to be the most useful indicator of exposure, with significantly elevated urinary levels at both 6 h and 20 h after the exercise and with the strongest correlation to dermal exposure. Metabolites from two-ring and three-ring PAHs were eliminated faster while levels of 3-hydroxy-benzo[a]pyrene did not meet the detection criteria. The results from correlation studies indicated that dermal uptake was a major route of exposure in accordance with previous findings. To summarize, this study shows that some of the newly adopted protective measures were correctly implemented, and should continue to be followed and be more widely adopted.

The Push For Clean PPE And Healthy Fire Fighters
In the past decades, firefighters have been glorified for their tough and dirty exteriors that demonstrate their heroic efforts to fight fires and save lives.Soot covered turn out gear often served as a badge of honor, illustrating how courageous these men and woman are in their day to day job.

Recent research, however, has suggested that the fire flames are not the only battles our fire fighters are fighting. One other unforeseen battle is cancer.

Combustion by-products are pollutants that firefighters are exposed to when encountering fires. These contaminants include benzene, formaldehyde and even asbestos, which are known or suspected to cause cancer. In 2013, the U.S. Fire Administration (USFA) and National Institute for Occupational Safety and Healthy (NIOSH) announced that their multi-year study of a group of 29,993 U.S. firefighters concluded that they are at higher risk of cancers of the digestive, oral, respiratory, and urinary systems when compared to the general population. Although many of these exposures are inevitable in this field, there are unnecessary exposures that can and should be eliminated to reduce the overall risk. One way to do this is through the proper washing and drying of personal protective equipment (PPE).

Turnout gear becomes heavily saturated with carcinogens after an encounter with fire. The contaminants are not only on the outside of the gear, they become embedded in the fibers of the material. Firefighters take extra precautions not to inhale harmful toxins during the line of duty, however, they overlook that these hazardous particles are left with them on their PPE to be absorbed through the skin or ingested.

Podab Inc., a commercial laundry manufacturer based in Sweden, has exclusively partnered with the organization ‘Healthy Firefighters’ to aid in the prevention of carcinogenic exposures through proper washing, drying, and handling of contaminated gear. Stefan Magnusson, the founder of ‘Healthy Firefighters’ and a firefighter himself, has developed a method of disposing dirty PPE through properly extracting and containing it immediately after an exposure so that it can be washed and dried promptly upon arrival to the station. He emphasizes that for this procedure to be effective, washing and drying must be done with equipment that can clean and dry it quickly enough so that it can be re-used again as soon as possible.

Stefan said, “The heavy duty turnout gear is absolutely essential to keep firefighters safe, however, it is important to realize that after attending an incident the PPE can also act as a potential danger. Soot and other particles can contaminate the garments, making them a health hazard for our firefighters. In order to prevent this contamination, PPE should be removed immediately after every operation and washed and dried in a timely manner.”

Podab presents a complete range of washing and drying equipment that has been developed in cooperation with Healthy Firefighters. It has developed the FC20 Protective Gear Drying Cabinet specifically to dry turnout gear. This cabinet was the first drying cabinet on the market with the unique ability to dry PPE from the inside and outside by directing hot air through its hangers, significantly cutting drying time.

The FC20 bears a crucial component to the decontamination of PPE. Fire stations across the globe will be more likely to wash their gear if they can have it dry and ready to re-use as soon as possible. Damp turnout gear can be just as dangerous as dirty gear. If gear isn’t fully dried, the moisture left can turn into steam during a fire and subject the firefighter to burns. Any moisture left in the gear can also mold or mildew. The FC20 cabinet is equipped with humidity tracking system (HTS) that measures the level of humidity every second to determine exactly when textiles are dry, eliminating any risk of dampness.

These cabinets are a predominant feature in fire stations across Sweden. By spreading awareness about the importance of clean PPE, Podab and ‘Healthy Firefighters’ hope to aid in the prevention of cancer in our firefighters worldwide. Our mission is to help protect the men and women who protect us.

International Fire Fighter

The Silent Killer - Firefighter Cancer
The National Fallen Firefighters Foundation has released a cancer awareness and prevention video. This shows the importance of keeping your gear clean and decontaminated!


"The Skelleftea model" is the
Healthy Firefighters method for reducing the risk that firefighters are exposed to hazardous substances.

Watch the video below to view how Podab and Healthy Firefighters are working together to support this cause.

Check out our latest news article in 
International Fire Fighter!

Now introducing our partnership with Healthy Firefighters


Working together to minimize the exposure of hazardous substances through advanced washing and drying equipment.
Click here to read more about Healthy Firefighters

(B&C Technologies)
We will attend and have cabinets
on display at B&C Technologies sales meeting,
for their Distributors, in June

PPE Fire Turnout Gear Drying Cabinet
TexCare 2012 in Frankfurt
May 05-09 2012

We had our Drying Cabinet on display at the FDIC in Indianapolis in our distributor B&C Technologies booth. We appreciate everyone who stopped by, and we are looking forward to supply you with the best drying cabinets in the market. 
FDIC - Indianapolis 2011
Fire Departments Instructors Conference
March 21 - 26


Here is a copy of an information page that was mailed out to companies in the fire Industry before FDIC.



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