Wildland Fire Fighting Safety and Health

Categories: At-risk populations, Cardiovascular Disease, Emergency response, Outdoor work, Personal protective equipment, Respiratory hazards

July 13th, 2012 4:40 pm ET - Corey Campbell and Liz Dalsey

Photo courtesy of Todd Wyckoff, New Jersey Forestry Services

Wildland fires continue to increase in the Western United States as hot, dry and windy conditions persist, resulting in an extended fire season and factors conducive to fires. Currently, drought conditions are prevalent in the West due to low snow-pack levels, below average rainfall, record setting temperatures and high winds, resulting in a greater than average number of fires this year. Since January 2012, over 32,000 fires have burned almost 3.3 million acres in the US. [NIFC, 2012a]. Additionally, in the last 50 years, there has been a general increase in the occurrence and severity of forest wildfires in the US, as over 5 million wildfires have burned over 206 million acres [NIFC, 2012b].
When wildland fires occur in the Wildland Urban Interface (WUI), the area where houses meet undeveloped land, they can easily become catastrophic because a large number of people, homes and structures are at-risk. When a fire ignites in these areas, a quick and aggressive response from wildland fire agencies and wildland fire fighters is required.
Wildland fire fighting can be a dangerous occupation. Over the past 10 years, over 200 fire fighters have died while participating in wildland fire suppression activities [USFA, 2001-2010]. These fatalities have occurred among federal, state and local fire fighters as well as private and military personnel. Although a variety of agencies track wildland fire fighter fatality data a national system for collecting data on non-fatal injuries and illnesses among wildland fire fighters does not exist. Research studies that evaluated injuries at specific fires show that the types of injuries that occurred while fighting fires and working in fire camps include falls, strains, burns, being struck-by-objects and vehicle-related incidents [Kiefer, 2004; Britton, 2010].
In 2010, there were approximately 34,000 federal workers employed in wildland fire suppression activities [Ryerson, 2011] and an unknown number of volunteer wildland fire fighters. Ensuring fire fighter safety during the challenging conditions encountered when responding to a wildland fire (rapid response, poor visibility, uncharacterized hazards, unfamiliarity with the environment, etc.) requires knowledge of hazards and commitment to safety by Incident Commanders, Fire Management and Safety Officers. Safety programs should be established that include employee training on safe work practices, recognition and reporting of hazards, appropriate personal protective equipment and frequent safety program evaluation.
Hazards that wildland fire fighters may encounter include:
Heat Stress
Fire fighters working in hot weather may experience heat stress (feeling hot, tired or fatigue, weakness, vertigo, headache, or nausea). Heat stress can progress into heat strain (physiologic changes such as e.g., increased core body temperature and heart rate) and, without appropriate intervention, can progress into heat-related illnesses (heat rash, cramps, exhaustion or heat stroke). Risk factors for heat-related illness include:

Strenuous work performed while fighting fires
High environmental heat load (temperature, humidity, air movement and radiant heat)
Personal risk factors (age, physical fitness, and existing medical conditions)
Dehydration from insufficient fluid intake
Insufficient acclimatization to heat
Sleep deprivation and fatigue
Burdensome personal protective equipment

How to Prevent and Reduce Heat Stress
Recommendations for Incident Commanders and Fire Managers

Provide training to fire fighters on recognizing, understanding and preventing heat stress
Reduce the physical demands of workers
Use relief fire fighters and/or assign extra fire fighters for physically demanding jobs
Schedule hot jobs for the cooler part of the day whenever possible
Acclimatize fire fighters by exposing them for progressively longer periods to hot work environments
Provide cool water or liquids to fire fighters
Provide rest periods in cooler areas with water breaks
Monitor fire fighters for signs of heat stress

Recommendations for Wildland Fire Fighters
When possible, fire fighters should avoid exposure to extreme heat, sun exposure and high humidity. When these exposures cannot be avoided, fire fighters should take the following steps to prevent heat stress:

Take more breaks in extreme heat and humidity
Take breaks in the shade or a cool area when possible
Drink water frequently. Drink enough water that you never become thirsty (about 1 cup every 15-20 minutes)
Avoid alcohol and drinks with large amounts of caffeine or sugar
Be aware that protective clothing or personal protective equipment may increase the risk of heat stress, particularly turnout-gear
Monitor your physical condition and that of your fellow fire fighters and notify emergency personnel if heat stress symptoms occur, stop working, notify emergency personnel immediately, move to a cooler area and begin cooling activities to reduce the body’s temperature

Fatigue
Fire fighters can also experience physical and mental fatigue during a wildland fire due to strenuous work activity, high altitudes, long and irregular work shifts, lack of sleep and/or quality sleep, improper nutrition and unpredictable and stressful events. Fatigue and stress can increase the risk of injury, accidents and poor health. Studies show that working 12 hours or more per day is associated with a 37% increased risk of injury [Dembe, 2005].
How to Prevent and Reduce Fatigue:

Allow enough time to sleep after shift work and on days off
Avoid heavy foods before sleeping
Reduce intake of caffeine and other stimulants several hours before sleeping
Ensure fluid and nutritional needs are met and that work/rest cycles are implemented to prevent unnecessary fatigue among both fire fighters and fire managers

Injuries
Wildland fire fighters are also exposed to a variety of hazards that may put them at risk of both fatal and non-fatal injuries while on the job. Hazards wildland fire fighters may encounter include:

Slips, trips and falls
Burns, including sun-burns
Scrapes and cuts from tools and equipment, such as chain-saws
Struck-by partially burned trees, other objects in the forest or vehicles (e.g. fire equipment, ATVs, etc.)
Contact with plant irritants and sensitizers (e.g., poison ivy, thorns)
Snake/animal bites
Injuries sustained in crashes of vehicles/airplanes/helicopters
Electrocution from downed power lines and lightning storms
Unstable building structures

Recommendations to Reduce Injuries:

Ensure fire fighters are informed of potential hazards, how to avoid them and the need to report all occupational injuries/illnesses and unsafe conditions
Establish and implement LCES (lookouts, communication, escape routes and safety zones) before fire fighting begins
Ensure fire fighters receive training on safe response to emergencies and to always be aware of the potential to be caught in a burnover
Establish and enforce standard operating procedures for operating motor vehicles and wearing seat belts (restraints)
Ensure all wildland fire fighters wear wildland personal protective equipment that is compliant with the National Fire Protection Association (NFPA) Standard on Protective Clothing and Equipment for Wildland Fire Fighting (1977)

Respiratory Hazards from Smoke, Ash and Debris
Smoke and dust from a wildland fire can be composed of a variety of inhalation health hazards, including gases, such as carbon monoxide, sulfur dioxide and formaldehyde, and particulates, including ash and silica [Austin, 2008] [Reinhardt and Ottmar, 2004] [Harrison, et al 1995]. Structural fires that occur during a wildland fire may generate additional hazardous contaminants from the many materials present in homes and buildings. For example, car batteries or mercury light bulbs present in homes and buildings, especially older buildings have a greater potential to contain asbestos and lead. Incident Commanders, Fire Managers and fire fighters should always be aware of the risk for smoke inhalation, the potential hazards associated with ash and the precautions that should be taken to prevent and reduce exposure.
Recommendations to Limit Exposure to Smoke, Ash and Debris:

Utilize fire operations procedures that reduce smoke exposure, such as:
- rotating crews through areas of heavy smoke
- avoiding downwind fire fighting, whenever possible
- minimizing mop-up whenever possible
- using equipment rather than people in holding areas, when possible
Locate camps and Incident Command Posts in areas that are upwind of the fire and not prone to inversions
Use protective clothing and equipment to avoid skin contact with ash
Thoroughly wet areas to reduce ash and dust generation
Ensure fire fighters are trained on the risks of smoke inhalation and exposure to ash and how to reduce their risk of exposure

Cardiac-related Events
Fire fighters are also at risk for heart attacks, strokes and other cardiac related events while fighting wildland fires.
Recommendations to Reduce the Risk of a Cardiac-related Event:

Ensure fire fighters maintain good physical fitness and aerobic and muscular endurance training
Implement a pre-employment medical screening and medical examination program, including exercise stress tests following standard medical guidelines for all fire fighters
Implement a comprehensive wellness and fitness program for fire fighters consistent with NFPA 1583, Standard on Health-Related Fitness Programs For Fire Fighters (see http://www.nfpa.org/aboutthecodes/AboutTheCodes.asp?DocNum=1583 )
Fire fighters should participate in pre-placement and annual medical examinations and physical performance (physical ability) evaluations before engaging in fire response activities

Wildland fire fighting can be a dangerous occupation. These men and women place themselves in harms way to protect the lives and property of those living in the affected areas. Following the recommendations above and using the additional resources below can help protect fire fighters from the hazards associated with wildland fire fighting. We would like to hear from those involved in wildland fire fighting. Have you experienced any of the issues we discuss in this blog? Are there any unique issues with the current fires? Let us know if there are areas we have not covered in this blog that might be helpful to you.
Corey Campbell and Liz Dalsey
Ms. Campbell is an Occupational Safety and Health Specialist in the NIOSH Western States Office
Ms. Dalsey is a Health Communication Specialist in the NIOSH Western States Office
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