UC study looks at how firefighters clean their gear to reduce cancer risk

Researchers in occupational health partner with first responders to improve decontamination technique after fires

Anthony Calvillo watched his father keep thousands of people safe over the years as a firefighter with the Cleveland Fire Service. After shadowing a hazmat team in high school, it sparked an idea that eventually led to him studying occupational health at the University of Cincinnati, so he could figure out how to, in turn, help heroes like his dad.

As a student within UC’s Department of Environmental Health, he began working with researchers and fire departments throughout Greater Cincinnati and the state of Ohio to determine if washing gear in only water was as effective as using soap and water or other cleaning techniques. The results, published in the Journal of Occupational and Environmental Hygiene, uncovered that sole use of water wasn’t cutting it.   

“Firefighters are exposed to toxic environments when they go into burning structures, with chemicals entering the body through multiple routes, including inhalation and skin absorption,” says Calvillo, who graduated in 2018 from the occupational hygiene master’s program in environmental health. He is the lead author on the study.

“When structure fires occur, furnishings and other synthetic household materials emit toxic fumes and have the potential to lead to serious health impacts,” says Tiina Reponen, PhD, professor of environmental health. “Known as polycyclic aromatic hydrocarbons, or PAHs, these chemicals are released when materials burn, and several are considered to be cancer-causing. This kind of exposure puts (firefighters) at higher risk for cancer, and this is becoming more well-documented in recent years.”

Reponen is also director of UC’s Education and Research Center (ERC), one of the university’s longest-running grants that supports training and research in the fields of occupational health and safety. The work of the ERC encompasses students and faculty from three UC colleges and has spent the past several years with a focus on various work-related exposures among firefighters, such as heat stress, ultrafine particles and PAHs.

“Since there has been a lot of publicity about the increased risk of cancer, I think many fire departments want to clean their gear after fires, but we don’t really know how well it works,” says Reponen.

Kenny Schroeder, a lieutenant and medic with the Independence Fire District in Northern Kentucky, had similar concerns. After attending a conference on firefighters and cancer risk, presented by the National Fallen Firefighters Foundation, which also cited UC’s 2006 research, he also wanted to incorporate proper decontamination methods for his department. He contacted UC and was eventually connected with Calvillo to participate in the study. 

Kenny Schroeder, Independence Fire District

Kenny Schroeder outside the Independence Fire District station.

While previous studies evaluated the efficiency of soap and water decontamination (up to 85% effective) and dry brushing of gear (24% effective in removing contaminants), Calvillo and UC researchers were not aware of studies testing water-only decontaminations. 

“Many fire departments had implemented water-only decontamination procedures because it requires less time and supplies than other methods,” says Calvillo. “However, no studies to date have evaluated the efficiency of water only procedures.”

father putting fire helmet on young son

Anthony Calvillo as a child, trying on his dad's helmet. His father, Angelo Calvillo, has been with the City of Cleveland Fire Service for over 25 years, and inspired Anthony's research.

The study used firefighting turnout gear that had recently been in live structure fires. Data collection occurred in two different cities with the help of the Cleveland and Independence Fire Departments. The firefighting gear sampled from the study all came from live structure fires— a total of 24 suits and two fire hoods were sampled for PAHs before and after contamination.

To collect the data, Calvillo turned to his father again, the Chief of Fire for City of Cleveland, Angelo Calvillo, spending two weeks at home “essentially being on call.” “My dad would listen to the scanner for the specific type of fire that would be a fit for the study,” (Anthony) Calvillo says. 

They lucked out and within two weeks’ time received word on two fires, both in the middle of the day, when Anthony could go and take samples of firefighters’ gear before and after their water decontamination. 

The study found that when the samples were averaged, water-only cleaning did not consistently or greatly reduce the PAH contaminants on the firefighter gear. In fact, in one sample set, taken from a Rescue from Fire team, actually resulted in an increase in carcinogens, concluding for Calvillo and the team that water-only decontamination is not an effective technique. The median total PAH increased across all the samples by 42% after water-only decontamination.

“Our results show that the water-only decontamination is not an efficient method to remove contamination from firefighter turnout gear,” notes Calvillo. “This was most evident with the most contaminated gear. While it is not likely that water increased the contamination level, it likely did not remove much or any contamination from the gear. The observed increase between pre- and post-wipes could be explained by the disparate locations from which the samples were collected.”

Calvillo says at first the results surprised him, “but really in hindsight, knowing soap is a surfactant, it made sense that using soap-and-water technique would be a much more efficient way of cleaning and decontaminating the gear.”

Video link: https://www.youtube.com/embed/HOlDI1JhxeU?rel=0

Although the authors acknowledge the limitations of such a small study, they recommend that fire departments adopt a soap-and-water decontamination method in place of water only.  As for the two departments involved in the study, they have already adopted the new process for their gear after structure fires. 

“It wasn’t a hard sell,” says Schroeder.

Soap and water bucket

Now, they have been provided buckets, scrub brushes and hoses for every fire apparatus to allow for decontamination onsite, thanks to a donation from (859)BoardUp, an organization that assists with services for fire, water and storm damage.

Independence Fire Chief Scott Breeze says partner departments across Northern Kentucky’s seven counties have also worked to develop a standard operating procedure for soap-and-water decontamination onsite. If it’s too cold or wet onsite, they perform a dry decontamination and bag the gear to be washed later. They can also launder the gear, but a full set can cost up to $ 2,500 each and have a lifespan of 10 years, says Breeze. (NFPA 1851 mandates a lifespan of gear no longer than 10 years.)

While Independence isn’t large enough to have a dedicated safety engineer as departments like Cincinnati or Cleveland do, Schroeder has taken it upon himself to keep up on the research and be mindful of safety precautions that can help his department. 

“Attending conferences like the one put on by the Fallen Firefighters group was really eye opening, especially to learn UC had provided some of the leading research in this area,” he says.

“We used to think the most dangerous part of firefighting was to protect ourselves while battling a blaze, while fighting the fire. But now we know what happens before and after the fire is just as important.”

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Featured image at top and others of Independence Fire District by Colleen Kelley, video by LIsa Ventre / UC Creative Services.