Array ( [0] => {{Short description|Rescuer trained to extinguish fires and save people}} [1] => {{Other uses}} [2] => {{redirect-multi|2|Fireman|Firewoman}} [3] => {{Infobox Occupation [4] => | image= FiremenFightBurningBarn.jpg [5] => | caption= Firefighter team work together to contain a blazing barn [6] => | activity_sector= [[Rescue]], [[fire protection]], [[civil service]], [[public service]], [[public safety]] [7] => |synonyms= Fireman ({{abbr|PL:|plural}} firemen)
Firewoman ({{abbr|PL:|plural}} firewomen) [8] => | competencies= [9] => | formation= [10] => | employment_field= [11] => | related_occupation= [12] => | average_salary= [13] => }} [14] => [15] => A '''firefighter''' (or '''fire fighter''') is a [[first responder]] trained in [[firefighting]], primarily to control and extinguish [[fire]]s that threaten life and property, as well as to rescue persons from confinement or dangerous situations. Male firefighters are sometimes referred to as '''firemen''' (and, less commonly, female firefighters as '''firewomen''').{{Cite web|url=https://www.express.co.uk/news/uk/899938/BBC-sexism-cartoon-firefighter-fireman-hey-duggee-dany-cotton|title=BBC in sexism row over cartoon hippo in Hey Duggee who wants to be a fireman|first=Michael|last=Knowles|date=January 4, 2018|website=Express.co.uk}}{{Cite web|url=https://www.standard.co.uk/news/uk/london-fire-brigade-accuses-bbc-of-sexism-over-use-of-term-fireman-in-children-s-show-hey-duggee-a3730511.html|title=London Fire Brigade accuses BBC of sexism over use of term 'fireman' in children's show Hey Duggee|first=Martin|last=Coulter|date=January 3, 2018|website=www.standard.co.uk}} [16] => [17] => The [[Fire department|fire service]], also known in some countries as the fire brigade or [[fire department]], is one of the three main [[emergency service]]s. From [[urban area]]s to aboard [[ship]]s, firefighters have become ubiquitous around the world. [18] => [19] => The skills required for safe operations are regularly practiced during training evaluations throughout a firefighter's career. Initial firefighting skills are normally taught through local, regional or state-approved fire academies or training courses.{{Cite web|url=http://publicsafetyelite.com/fire-academy/|title=Fire Academy|website=Public Safety Elite|access-date=2016-03-10}} Depending on the requirements of a department, additional skills and certifications may also be acquired at this time. [20] => [21] => Firefighters work closely with other emergency response agencies such as the [[police]] and [[emergency medical service]]. A firefighter's role may overlap with both. [[Fire investigation|Fire investigators]] or [[fire marshal]]s investigate the cause of a fire. If the fire was caused by [[arson]] or [[negligence]], their work will overlap with law enforcement. Firefighters may also provide some degree of [[emergency medical service]]. [22] => [23] => ==Duties== [24] => ===Fire suppression=== [25] => [[Image:Fire inside an abandoned convent in Massueville, Quebec, Canada.jpg|thumb|Firefighters had to focus their efforts on saving the adjacent church instead of this burning building, an abandoned convent in Massueville, Quebec, Canada]] [26] => [[File:Firefighter ladder slide.jpg|thumb|upright=0.6|Firefighter carrying out a ladder slide]] [27] => A fire burns due to the presence of three elements: [[fuel]], [[oxygen]] and heat. This is often referred to as the ''[[fire triangle]]''. Sometimes it is known as the ''[[fire tetrahedron]]'' if a fourth element is added: a chemical chain reaction which can help sustain certain types of fire. The aim of firefighting is to deprive the fire of at least one of those elements. Most commonly this is done by dousing the fire with water, though some fires require other methods such as foam or dry agents. Firefighters are equipped with a wide variety of equipment for this purpose that include ladder trucks, pumper trucks, tanker trucks, fire hose, and [[fire extinguisher]]s. [28] => [29] => ==== Structural firefighting ==== [30] => {{unreferenced section|date=August 2021}} [31] => {{overly detailed|date=November 2023}} [32] => :''See also [[:Category:Fire suppression|Fire suppression]] for other techniques.'' [33] => While sometimes fires can be limited to small areas of a structure, wider collateral damage due to smoke, water and burning embers is common. Utility shutoff (such as gas and electricity) is typically an early priority for arriving fire crews. In addition, forcible entry may be required in order to gain access into the structure. Specific procedures(NFPA 704){{Cite web |last=Hart |first=Jonathan |date=2021-11-05 |title=Hazardous Materials identification |url=https://www.nfpa.org/news-blogs-and-articles/blogs/2021/11/05/hazardous-materials-identification |access-date=2023-11-29 |website=www.nfpa.org}} and equipment are needed at a property where hazardous materials are being used or stored. Additionally, fighting fires in some structures may require additional training and firefighting tactics that are specific to that structure. For example, [https://www.cdc.gov/niosh/docs/video/2023-101/default.html row house fires] are a type of structure fire that require specific tactics to decrease risks. [34] => [35] => [[Structure fire]]s may be attacked with either "interior" or "exterior" resources, or both. Interior crews, using the "[[two in, two out]]" rule, may extend [[fire hose]] lines inside the building, find the fire and cool it with water. Exterior crews may direct water into windows and other openings, or against any nearby [[fuel]]s exposed to the initial fire. Hose streams directed into the interior through exterior wall apertures may conflict and jeopardize interior fire attack crews. [36] => [37] => Buildings that are made of flammable materials such as wood are different from building materials such as concrete. Generally, a "fire-resistant" building is designed to limit fire to a small area or floor. Other floors can be safe by preventing smoke inhalation and damage. All buildings suspected or on fire must be evacuated, regardless of fire rating. [38] => [39] => When fire departments respond to structure fires, the priorities are life safety, incident stabilization, and property conservation. Some tactics used to achieve positive results at a structure fire include scene size-up, door control, coordinated ventilation, and exterior attack prior to entry. [40] => [41] => When the first fire department arrives on-scene at a structure fire, scene size-up must occur to develop the appropriate strategy (offensive or defensive) and tactics.  With scene size-up, a risk assessment must also occur to determine the risks of making an interior fire attack.  When an incident's critical factors and the risk management plan indicate an offensive strategy, the incident commander will define the tactical objectives for entering the structure. Offensive incident action plans (tactics) are based on the standard offensive tactical priorities and their corresponding completion benchmarks. [42] => [43] => '''Firefighting priorities and tactics:''' [44] => [45] => The incident commander should consider these priorities and firefighting tactics at a structure fire: [46] => [47] => '''Incident Priorities''' [48] => [49] => ·       Life safety – primary and secondary "All Clear(s)" (A/C) [50] => [51] => ·       Property conservation – "Loss Stopped" (L/S) [52] => [53] => ·       Post fire control firefighter decontamination (Decon) [54] => [55] => ·       Customer Stabilization* – Short term [56] => [57] => *Customer stabilization refers to customer service that fire departments provide during an emergency. When a fire department responds to an emergency, two related priorities are life safety and stabilizing the incident. Part of this process is ensuring the customer's well-being from the time of dispatch until after the incident becomes stable. [58] => [59] => Some firefighting tactics may appear to be destructive, but often serve specific needs. For example, during [[Ventilation (firefighting)|ventilation]], firefighters are forced to either open holes in the roof or floors of a structure (called vertical ventilation), or open windows and walls (called horizontal ventilation) to remove smoke and heated gases from the interior of the structure. Such ventilation methods are also used to improve interior visibility to locate victims more quickly. Ventilation helps to preserve the life of trapped or unconscious individuals as it releases the poisonous gases from inside the structure. Vertical ventilation is vital to firefighter safety in the event of a [[flashover]] or [[backdraft]] scenario. Releasing the flammable gases through the roof eliminates the possibility of a backdraft, and the removal of heat can reduce the possibility of a flashover. Flashovers, due to their intense heat ({{convert|900|–|1200|°F|-1}}) and explosive temperaments, are commonly fatal to firefighter personnel. Precautionary methods, such as smashing a window, reveal backdraft situations before the firefighter enters the structure and is met with the circumstance head-on. Firefighter safety is the number one priority. [60] => [61] => Whenever possible during a structure fire, property is moved into the middle of a room and covered with a salvage cover, a heavy cloth-like tarp. Various steps such as retrieving and protecting valuables found during suppression or overhaul, evacuating water, and boarding windows and roofs can divert or prevent post-fire runoff. [62] => [63] => ====Wildland firefighting==== [64] => {{Main|Wildfire suppression}} [65] => [[Wildfire]]s (known in Australia as [[Bushfires in Australia|bushfires]]) require a unique set of strategies and tactics. In many countries such as Australia and the United States, these duties are mostly carried out by local [[Volunteer fire department|volunteer firefighters]]. Wildfires have some ecological role in allowing new plants to grow, therefore in some cases they will be left to burn.{{citation|title=Forest Fire in Canada|date=2008-06-05|url=http://fire.cfs.nrcan.gc.ca/questions-eng.php|archive-url=https://web.archive.org/web/20090530143903/http://fire.cfs.nrcan.gc.ca/questions-eng.php|url-status=dead|publisher=Natural Resources Canada|access-date=2009-05-01|archive-date=2009-05-30}} Priorities in fighting wildfires include preventing the loss of life and property as well as ecological damage. [66] => [67] => ==== Aircraft rescue and firefighting ==== [68] => {{Main|Aircraft rescue and firefighting}} [69] => [[Airport]]s employ specialist firefighters to deal with potential ground emergencies. Due to the mass casualty potential of an aviation emergency, the speed with which emergency response equipment and personnel arrive at the scene of the emergency is of paramount importance. When dealing with an emergency, the airport firefighters are tasked with rapidly securing the aircraft, its crew and its passengers from all hazards, particularly fire. Airport firefighters have advanced training in the application of firefighting foams, dry chemical and clean agents used to extinguish burning aviation fuel. [70] => [71] => === Rescue === [72] => [[File:Extrication exercise (1).jpg|thumb|right|A demonstration of a [[vehicle extrication]]]] [73] => Firefighters rescue persons from confinement or dangerous situations such as [[Structure fire|burning buildings]] and [[traffic collision|crashed vehicles.]] Complex, infrequent situations requiring specialized training and equipment include rescues from collapsed buildings and confined spaces. Many fire departments, including most in the United Kingdom, refer to themselves as a ''fire and rescue service'' for this reason. Large fire departments, such as the [[New York City Fire Department]] and [[London Fire Brigade]], have specialist teams for advanced technical rescue. As structure fires have been in decline for many years in developed countries such as the United States, rescues other than fires make up an increasing proportion of their firefighters' work. [74] => [75] => ===Emergency medical services=== [76] => Firefighters frequently provide some degree of [[Emergency medicine|emergency medical care]]. In some jurisdictions [[first aid]] is the only medical training that firefighters have, and medical calls are the sole responsibility of a separate [[emergency medical services]] (EMS) agency. Elsewhere, it is common for firefighters to respond to medical calls. The impetus for this is the growing demand in medical emergencies and the significant decline in fires.{{cite news|url=https://www.bostonglobe.com/ideas/2013/09/07/plenty-firefighters-but-where-are-fires/isCPrIPauX078UKHdixu0K/story.html|title=Plenty of firefighters, but where are the fires?|date=2013-09-07|newspaper=[[The Boston Globe]]|access-date=2017-09-22}} [77] => [78] => In such departments, firefighters are often certified as [[emergency medical technician]]s in order to deliver [[basic life support]], and more rarely as [[paramedics]] to deliver [[advanced life support]]. In the United Kingdom, where fire services and EMS are run separately, [[Fire service co-responder|fire service co-responding]] has been introduced more recently.{{cite web|url=http://www.london-fire.gov.uk/news/LatestNewsReleases_brigade-and-london-ambulance-service-team-up-for-life-saving-trial.asp#.WIpXBH2DEfI|title=News|website=www.london-fire.gov.uk|access-date=5 May 2018|url-status=live|archive-url=https://web.archive.org/web/20170813185751/http://www.london-fire.gov.uk/news/LatestNewsReleases_brigade-and-london-ambulance-service-team-up-for-life-saving-trial.asp#.WIpXBH2DEfI|archive-date=13 August 2017|df=dmy-all}} Another point of variation is whether the firefighters respond in a fire engine or a [[Nontransporting EMS vehicle|response car]].{{cite web|url=https://www.getsurrey.co.uk/news/surrey-news/surrey-firefighters-called-300-medical-11295803|title=Surrey firefighters called to almost 300 medical emergencies during co-responding trial|publisher=[[Surrey Advertiser]]|date=9 May 2016|access-date=3 September 2018}} [79] => [80] => === Hazardous materials === [81] => [[File:Decontamination after incident at Archway - geograph.org.uk - 108750.jpg|thumb|[[Decontamination]] after a chemical spill]] [82] => Fire departments are usually the lead agency that responds to [[Dangerous goods|hazardous materials]] incidents. Specialized firefighters, known as hazardous materials technicians, are trained in chemical identification, leak and spill control, and decontamination.{{Cite web |title=NFPA 1072 Hazardous Materials Technician |url=https://festi.ca/emergency/hazardous-materials/nfpa-1072-hazardous-materials-technician/ |access-date=2023-12-13 |website=festi.ca |language=en-CA}} [83] => [84] => ===Fire prevention=== [85] => [[File:FiremanPaffandElmo.jpg|thumb|right|upright=0.6|Firefighters frequently give fire prevention talks at schools and community events]] [86] => [87] => Fire departments frequently provide advice to the public on how to prevent fires in the home and work-place environments. Fire inspectors or fire marshals will directly inspect businesses to ensure they are up to the current building [[fire code]]s,{{cite web|url=https://www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards/detail?code=5000|title=NFPA 5000 Building Construction and Safety Code|website=National Fire Protection Association (NFPA)|access-date=8 July 2018}}{{cite web|url=https://www.iccsafe.org/codes-tech-support/codes/2018-i-codes/ifc/|title=Overview of the International Fire Code|website=International Code Council (ICC)|access-date=8 July 2018|date=2015-03-20}} which are enforced so that a building can sufficiently resist fire spread, potential hazards are located, and to ensure that occupants can be safely evacuated, commensurate with the risks involved. [88] => [89] => [[fire sprinkler|Fire suppression systems]] have a proven record for controlling and extinguishing unwanted fires. Many fire officials recommend that every building, including residences, have [[fire sprinkler]] systems.{{cite web|url=https://www.nfpa.org/Public-Education/Campaigns/Fire-Sprinkler-Initiative/Legislation-and-adoptions/Sprinkler-requirements|title=NFPA Fire Sprinkler Initiative|website=National Fire Protection Association (NFPA)|access-date=8 July 2018}} Correctly working sprinklers in a residence ''greatly'' reduce the risk of death from a fire.{{cite news|url=https://www.firehouse.com/home/article/12096404/research-shows-residential-sprinklers-save-lives|title=Research Shows Residential Sprinklers Save Lives|last1=Pollack|first1=Keshia|date=August 24, 2015|access-date=8 July 2018|publisher=SAGE Journal|last2=Frattaroli|first2=Shannon|issue=Fire and Worker Health and Safety|last3=Somers|first3=Scott}} With the small rooms typical of a residence, one or two sprinklers can cover most rooms. In the United States, the housing industry trade groups have lobbied at the State level to prevent the requirement for Fire Sprinklers in one or two family homes.{{cite news|url=https://www.propublica.org/article/the-fire-sprinkler-war-state-by-state|title=The Fire Sprinkler War, State by State|last1=Faturechi|first1=Robert|date=June 22, 2016|work=Propublica|access-date=8 July 2018}}{{cite web|url=https://www.nfpa.org/Public-Education/Campaigns/Fire-Sprinkler-Initiative/Legislation-and-adoptions/Anti-sprinkler-legislation|title=Anti-sprinkler legislation|website=National Fire Protection Association (NFPA)|access-date=8 July 2018}} [90] => [91] => Other methods of fire prevention are by directing efforts to reduce known hazardous conditions or by preventing dangerous acts before tragedy strikes. This is normally accomplished in many innovative ways such as conducting presentations, distributing safety brochures, providing news articles, writing [[public safety announcement]]s (PSA) or establishing meaningful displays in well-visited areas. Ensuring that each household has working [[smoke alarm]]s, is educated in the proper techniques of fire safety, has an evacuation route and rendezvous point is of top priority in [[public education]] for most fire prevention teams in almost all fire department localities. [92] => [93] => Fire investigators, who are experienced firefighters trained in fire cause determinism, are dispatched to fire scenes, in order to investigate and determine whether the fire was a result of an accident or intentional. Some fire investigators have full law enforcement powers to investigate and arrest suspected arsonists. [94] => [95] => ==Occupational health and safety== [96] => ===Direct risks=== [97] => ====Fires==== [98] => [[File:Firemen's Monument, Boston by John A Wilson- far.jpg|thumb|[[Firemen's Memorial (Boston)]] by [[John A. Wilson (sculptor)|John Wilson]]]] [99] => [[Image:Airport-firefighters-drill.jpg|thumb|right|Firefighters wearing [[Personal protective equipment|PPE]] tackle an aircraft fire during a drill at [[Dyess Air Force Base]] in [[Abilene, Texas]]]] [100] => To allow protection from the inherent risks of fighting fires, firefighters wear and carry protective and self-rescue equipment at all times. A [[self-contained breathing apparatus]] (SCBA) delivers air to the firefighter through a [[full face mask]] and is worn to protect against [[smoke inhalation]], toxic fumes, and super heated gases. A special device called a [[PASS device|Personal Alert Safety System]] (PASS) is commonly worn independently or as a part of the SCBA to alert others when a firefighter stops moving for a specified period of time or manually operates the device. The PASS device sounds an alarm that can assist another firefighter ([[firefighter assist and search team]] (FAST), or [[rapid intervention team]] (RIT), in locating the firefighter in distress. [101] => [102] => Firefighters often carry personal self-rescue [[rope]]s. The ropes are generally {{convert|30|ft}} long and can provide a firefighter (that has enough time to deploy the rope) a partially controlled exit out of an elevated window. Lack of a personal rescue rope is cited in the deaths of two New York City Firefighters, Lt. John Bellew and Lt. Curtis Meyran, who died after they jumped from the fourth floor of a burning apartment building in the Bronx. Of the four firefighters who jumped and survived, only one of them had a self-rescue rope. Since the incident, the Fire Department of New York City has issued self-rescue ropes to their firefighters.{{cite news |author=James Barron |url=https://www.nytimes.com/2005/01/24/nyregion/3-firefighters-die-in-blazes-in-brooklyn-and-bronx.html |title=3 Firefighters Die in Blazes in Brooklyn and Bronx |newspaper=[[The New York Times]] |date=January 24, 2005 }} [103] => [104] => [[Hyperthermia|Heat injury]] is a major issue for firefighters as they wear insulated clothing and cannot shed the heat generated from physical exertion. Early detection of heat issues is critical to stop dehydration and heat stress becoming fatal. Early onset of heat stress affects cognitive function which combined with operating in dangerous environment makes heat stress and dehydration a critical issue to monitor. Firefighter physiological status monitoring is showing promise in alerting EMS and commanders to the status of their people on the fire ground. Devices such as [[PASS device]] alert 10–20 seconds after a firefighter has stopped moving in a structure. Physiological status monitors measure a firefighter's vital sign status, fatigue and exertion levels and transmit this information over their voice radio. This technology allows a degree of early warning to physiological stress. These devicesZephyr Technologies [http://www.zephyr-technology.com/bioharness-bt.html BioHarness BT] {{webarchive|url=https://web.archive.org/web/20100407031009/http://www.zephyr-technology.com/bioharness-bt.html |date=2010-04-07 }} are similar to technology developed for [[Future Force Warrior]] and give a measure of exertion and fatigue. They also tell the people outside a building when they have stopped moving or fallen. This allows a supervisor to call in additional engines before the crew get exhausted and also gives an early warning to firefighters before they run out of air, as they may not be able to make voice calls over their radio. Current [[Occupational Safety and Health Administration|OSHA]] tables exist for heat injury and the allowable amount of work in a given environment based on temperature, humidity and solar loading.{{cite web|url=https://www.osha.gov/dts/osta/otm/otm_iii/otm_iii_4.html |title=OSHA Technical Manual (OTM) - Section III: Chapter IV: Heat Stress |publisher=Osha.gov |access-date=2012-12-10}} [105] => [106] => Firefighters are also at risk for developing [[rhabdomyolysis]]. Rhabdomyolysis is the breakdown of muscle tissue and has many causes including heat exposure, high core body temperature, and prolonged, intense exertion. Routine firefighter tasks, such as carrying extra weight of equipment and working in hot environments, can increase firefighters' risk for rhabdomyolysis.{{Cite web|publisher=NIOSH|date=2018-05-01|title=What structural fire fighters need to know about rhabdomyolysis.|url=https://www.cdc.gov/niosh/docs/2018-133/pdfs/2018-133.pdf?id=10.26616/NIOSHPUB2018133|doi=10.26616/nioshpub2018133|doi-access=free}}{{Cite web|date=2018-05-01|title=What wildland fire fighters need to know about rhabdomyolysis.|url=https://www.cdc.gov/niosh/docs/2018-131/pdfs/2018-131.pdf?id=10.26616/NIOSHPUB2018131|doi=10.26616/nioshpub2018131|doi-access=free}} [107] => [108] => ====Structural collapses==== [109] => Another leading cause of death during firefighting is [[structural collapse]] of a burning building (e.g. a wall, floor, ceiling, roof, or [[truss|truss system]]). Structural collapse, which often occurs without warning, may crush or trap firefighters inside the structure. To avoid loss of life, all on-duty firefighters should maintain two-way communication with the [[incident commander]] and be equipped with a [[PASS device|personal alert safety system device]] (PASS) on all fire scenes and maintain radio communication on all incidents.[[National Institute for Occupational Safety and Health]] Alert: [https://www.cdc.gov/niosh/99-146.html Preventing Injuries and Deaths of Fire Fighters due to Structural Collapse]. August 1999.[[National Institute for Occupational Safety and Health]] Alert: [https://www.cdc.gov/niosh/99-146.html Preventing Injuries and Deaths of Fire Fighters Due to Truss System Failures]. May 2005. [[Francis Brannigan]] was the founder and greatest contributor to this element of firefighter safety. [110] => [111] => ====Traffic collisions==== [112] => In the United States, 25% of fatalities of firefighters are caused by [[traffic collision]]s while responding to or returning from an incident. Other firefighters have been injured or killed by vehicles at the scene of a fire or emergency (Paulison 2005). A common measure fire departments have taken to prevent this is to require firefighters to wear a bright yellow reflective vest over their turnout coats if they have to work on a public road, to make them more visible to passing drivers.Federal Highway Administration DOT 23CFR634 Worker Visibility [113] => [114] => ====Violence==== [115] => Firefighters have occasionally been assaulted by members of the public while responding to calls. These kinds of attacks can cause firefighters to fear for their safety when responding to specific areas and may cause them to not have full focus on the situation which could result in injury to their selves or the patient.{{Cite web|title=Rapid Response: Firefighters describe alarming moments during riots|url=https://www.firerescue1.com/firefighter-safety/articles/rapid-response-firefighters-describe-alarming-moments-during-riots-iftvQ2TdlzaaGo1W/|access-date=2020-12-05|website=FireRescue1|language=en}} Workplace violence{{Cite journal |last1=Murray |first1=Regan M. |last2=Davis |first2=Andrea L. |last3=Shepler |first3=Lauren J. |last4=Moore-Merrell |first4=Lori |last5=Troup |first5=William J. |last6=Allen |first6=Joseph A. |last7=Taylor |first7=Jennifer A. |date=2019-12-16 |title=A Systematic Review of Workplace Violence Against Emergency Medical Services Responders |journal=NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy |language=en |volume=29 |issue=4 |pages=487–503 |doi=10.1177/1048291119893388 |issn=1048-2911 |pmc=8594050 |pmid=31841060|bibcode=2020NewSo..29..487M }} consists of the mental and physical abuse sustained during on-duty activities. First Responders are the most likely to experience this type of violence and EMS even has a percentage range of 53-90% of calls that had an instance of Workplace violence. This type of violence is a major reason for burnout and depression in First Responders, while EMS deal more with people on a daily basis, ~18% Firefighters experience PTSD due to WPV and 60% had at least one call where they had feared for their life or questioned their safety.{{Cite journal |last=Setlack |first=Jennifer |date=2019-04-02 |title=Workplace violence and mental health of paramedics and firefighters |url=http://hdl.handle.net/1993/34347 |journal=University of Manitoba |hdl=1993/34347 |language=en}}{{Cite journal |last1=Murray |first1=Regan M. |last2=Davis |first2=Andrea L. |last3=Shepler |first3=Lauren J. |last4=Moore-Merrell |first4=Lori |last5=Troup |first5=William J. |last6=Allen |first6=Joseph A. |last7=Taylor |first7=Jennifer A. |date=February 2020 |title=A Systematic Review of Workplace Violence Against Emergency Medical Services Responders |journal=NEW SOLUTIONS: A Journal of Environmental and Occupational Health Policy |language=en |volume=29 |issue=4 |pages=487–503 |doi=10.1177/1048291119893388 |issn=1048-2911 |pmc=8594050 |pmid=31841060|bibcode=2020NewSo..29..487M }} [116] => [117] => ====Chemical exposure==== [118] => While firefighters are generally responsible for managing hazardous materials in the environment, there is a great deal of risks that they face by doing so.{{Cite journal |last1=Young |first1=Anna S. |last2=Hauser |first2=Russ |last3=James-Todd |first3=Tamarra M. |last4=Coull |first4=Brent A. |last5=Zhu |first5=Hongkai |last6=Kannan |first6=Kurunthachalam |last7=Specht |first7=Aaron J. |last8=Bliss |first8=Maya S. |last9=Allen |first9=Joseph G. |date=May 2021 |title=Impact of "healthier" materials interventions on dust concentrations of per- and polyfluoroalkyl substances, polybrominated diphenyl ethers, and organophosphate esters |url=|journal=Environment International |volume=150 |pages=106151 |doi=10.1016/j.envint.2020.106151 |pmid=33092866 |pmc=7940547 |issn=0160-4120}} [[Flame retardant]]s are chemical products that are utilized to slow down or stop the spread of a fire by reducing its intensity. While there are numerous benefits to flame retardant products in terms of the reduction of major fires, the components that make up these substances are extremely harmful.{{Cite journal |last1=Sim |first1=Wonjin |last2=Choi |first2=Sol |last3=Choo |first3=Gyojin |last4=Yang |first4=Mihee |last5=Park |first5=Ju-Hyun |last6=Oh |first6=Jeong-Eun |date=2021-03-05 |title=Organophosphate Flame Retardants and Perfluoroalkyl Substances in Drinking Water Treatment Plants from Korea: Occurrence and Human Exposure |journal=International Journal of Environmental Research and Public Health |language=en |volume=18 |issue=5 |pages=2645 |doi=10.3390/ijerph18052645 |pmid=33807996 |pmc=7967649 |issn=1660-4601 |doi-access=free }} [119] => [120] => The most concerning materials that make up these products are [[Per- and polyfluoroalkyl substances|PFAS]] chemicals. Studies linked PFAS exposure with health effects including major neurological defects and cancer. Long term exposure to these chemicals is a notable concern. [121] => [122] => While many hazardous chemicals sued in fire-fighting materials, such as penta-bromdiphenyl ether have already been banned by the government, they are almost immediately replaced by a new substance with similar harmful effects. After banning penta-bromodiphenyl ether, chlorinated tris, chloroalkyl phospahtes, halogenated aryl esters, and tetrabromophthalate dio diester were used instead.{{Cite journal |last1=Clarity |first1=Cassidy |last2=Trowbridge |first2=Jessica |last3=Gerona |first3=Roy |last4=Ona |first4=Katherine |last5=McMaster |first5=Michael |last6=Bessonneau |first6=Vincent |last7=Rudel |first7=Ruthann |last8=Buren |first8=Heather |last9=Morello-Frosch |first9=Rachel |date=December 2021 |title=Associations between polyfluoroalkyl substance and organophosphate flame retardant exposures and telomere length in a cohort of women firefighters and office workers in San Francisco |journal=Environmental Health |language=en |volume=20 |issue=1 |page=97 |doi=10.1186/s12940-021-00778-z |pmid=34454526 |pmc=8403436 |bibcode=2021EnvHe..20...97C |issn=1476-069X |doi-access=free }} While these chemicals are constantly changing with attempts to make it safer for the public, firefighters have constant, up-close exposure that can put them at increased risk. [123] => [124] => === During debris cleanup === [125] => {{Main|Occupational hazards of fire debris cleanup}} [126] => [[File:Three New York City fire fighters in front of burning building following September 11th terrorist attack (29318406842).jpg|thumb|Firefighters at [[World Trade Center site|Ground Zero]] during the [[September 11 attacks]]]] [127] => Once extinguished, fire debris cleanup poses several safety and health risks for workers.{{Cite web|url=https://www.cdc.gov/niosh/hhe/reports/pdfs/2018-0094-3355.pdf|title=Evaluation of fire debris cleanup employees' exposure to silica, asbestos, metals, and polyaromatic hydrocarbons|last1=Beaucham|first1=Catherine|last2=Eisenberg|first2=Judith|date=August 2019|website=U.S. [[National Institute for Occupational Safety and Health]]}}{{Cite web|url=https://www.dir.ca.gov/dosh/wildfire/worker-health-and-safety-during-fire-cleanup.html|title=Worker Safety and Health During Fire Cleanup|date=April 2019|website=[[California Division of Occupational Safety and Health]]|access-date=27 March 2020}} [128] => [129] => Many hazardous substances are commonly found in fire debris. [[Silicon dioxide|Silica]] can be found in concrete, roofing tiles, or it may be a naturally occurring element. Occupational exposures to silica dust can cause [[silicosis]], lung cancer, pulmonary tuberculosis, airway diseases, and some additional non-respiratory diseases.{{Cite journal|publisher=NIOSH|date=2017-05-13|title=Health effects of occupational exposure to respirable crystalline silica.|url=https://www.cdc.gov/niosh/docs/2002-129/default.html|language=en-us|doi=10.26616/NIOSHPUB2002129|website=U.S. National Institute for Occupational Safety and Health|doi-access=free}} Inhalation of [[asbestos]] can result in various diseases including [[asbestosis]], lung cancer, and [[mesothelioma]].{{CodeFedReg|29|1910|1001|}} Sources of metals exposure include burnt or melted electronics, cars, refrigerators, stoves, etc. Fire debris cleanup workers may be exposed to these metals or their combustion products in the air or on their skin. These metals may include [[beryllium]], [[cadmium]], [[chromium]], [[cobalt]], [[lead]], [[manganese]], [[nickel]], and many more. [[Polycyclic aromatic hydrocarbon|Polyaromatic hydrocarbons]] (PAHs), some of which are carcinogenic, come from the incomplete combustion of organic materials and are often found as a result of structural and wildland fires.IARC 2002 [130] => [131] => Safety hazards of fire cleanup include the risk of reignition of smoldering debris, [[electrocution]] from downed or exposed electrical lines or in instances where water has come into contact with electrical equipment. Structures that have been burned may be unstable and at risk of sudden collapse.{{cite web|url=https://www.cdc.gov/disasters/wildfires/cleanupworkers.html|title=Worker Safety During Fire Cleanup|date=27 December 2012|website=U.S. [[Centers for Disease Control and Prevention]]|access-date=25 March 2020}} [132] => [133] => Standard [[personal protective equipment]] for fire cleanup include [[hard hat]]s, [[goggles]] or safety glasses, heavy [[work glove]]s, [[earplug]]s or other [[Hearing protection device|hearing protection]], [[steel-toe boot]]s, and [[fall protection]] devices.{{Cite web|url=https://www.dir.ca.gov/dosh/wildfire/Protective-Equipment-During-Fire-Cleanup.html|title=Personal Protective Equipment During Fire Cleanup Operations|website=California Division of Occupational Safety and Health|access-date=2020-03-28}} Hazard controls for [[electrical injury]] include assuming all power lines are energized until confirmation they are de-energized, and grounding power lines to guard against electrical feedback, and using appropriate personal protective equipment. Proper respiratory protection can protect against hazardous substances. Proper ventilation of an area is an [[Engineering controls|engineering control]] that can be used to avoid or minimize exposure to hazardous substances. When ventilation is insufficient or dust cannot be avoided, personal protective equipment such as [[N95 respirator]]s can be used.{{Cite web|url=https://www.dir.ca.gov/dosh/fire_resp_protection.html|title=Respiratory Protection During Fire Cleanup|website=California Division of Occupational Safety and Health|access-date=2020-03-28}} [134] => [135] => ===Long-term risks=== [136] => ====Cardiovascular disease==== [137] => Firefighting has long been associated with poor [[cardiovascular]] outcomes. In the United States, the most common cause of on-duty fatalities for firefighters is sudden cardiac death, accounting for approximately 45% of on duty US firefighter deaths.{{cite journal|title=The New England Journal of Medicine", March 22, 2007, Accessed:July 17, 2011 |journal=New England Journal of Medicine |volume=356 |issue=12 |pages=1207–1215 |doi=10.1056/NEJMoa060357 |pmid=17377158 |year = 2007|last1 = Kales|first1 = Stefanos N.|last2=Soteriades |first2=Elpidoforos S. |last3=Christophi |first3=Costas A. |last4=Christiani |first4=David C. |citeseerx=10.1.1.495.4530 }} In addition to personal factors that may predispose an individual to [[coronary artery disease]] or other [[cardiovascular disease]]s, occupational exposures can significantly increase a firefighter's risk. Historically, the fire service blamed poor firefighter physical condition for being the primary cause of cardiovascular related deaths. However, over the last 20 years, studies and research has indicated the toxic gasses put fire service personnel at significantly higher risk for cardiovascular related conditions and death. For instance, [[carbon monoxide]], present in nearly all fire environments, and [[hydrogen cyanide]], formed during the combustion of paper, cotton, plastics, and other substances containing [[carbon]] and [[nitrogen]]. The substances inside of materials change during combustion, and their by-products can interfere with the transport of oxygen in the body. [[hypoxia (medical)|Hypoxia]] can then lead to heart injury. In addition, chronic exposure to [[Atmospheric particulate matter|particulate matter]] in smoke is associated with [[atherosclerosis]]. Noise exposures may contribute to [[hypertension]] and possibly ischemic heart disease. Other factors associated with firefighting, such as [[Stress (medicine)|stress]], [[heat stress]], and heavy physical exertion, also increase the risk of cardiovascular events.[[National Institute for Occupational Safety and Health]] Alert: [https://www.cdc.gov/niosh/docs/2007-133 Preventing Fire Fighter Fatalities Due to Heart Attacks and Other Sudden Cardiovascular Events.] July 2007. [138] => [139] => During fire suppression activities a firefighter can reach peak or near peak heart rates which can act as a trigger for a cardiac event. For example, [[tachycardia]] can cause plaque buildup to break loose and lodge itself is a small part of the heart causing [[myocardial infarction]], also known as a heart attack. This along with unhealthy habits and lack of exercise can be very hazardous to firefighter health.[University of Illinois] https://www.fsi.illinois.edu/documents{{dead link|date=October 2017 |bot=InternetArchiveBot |fix-attempted=yes }} /research/CardioChemRisksModernFF_InterimReport2016.pdf [140] => [141] => ====Cancer==== [142] => [[File:Sailors participate in a fire drill exercise aboard USS Bainbridge (DDG 96). (40730256683).jpg|thumb|Smoke can expose firefighters to a variety of carcinogens]] [143] => Cancer risk in the U.S. fire service is a topic of growing concern. Recent studies suggest that due to their exposure on the fireground, firefighters may be at an increased risk for certain types of cancer and other chronic diseases.{{Cite journal |last1=Daniels |first1=Robert D |last2=Kubale |first2=Travis L |last3=Yiin |first3=James H |last4=Dahm |first4=Matthew M |last5=Hales |first5=Thomas R |last6=Baris |first6=Dalsu |last7=Zahm |first7=Shelia H |last8=Beaumont |first8=James J |last9=Waters |first9=Kathleen M |last10=Pinkerton |first10=Lynne E |date=June 2014 |title=Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009) |journal=Occupational and Environmental Medicine |language=en |volume=71 |issue=6 |pages=388–397 |doi=10.1136/oemed-2013-101662 |issn=1351-0711 |pmc=4499779 |pmid=24142974}}{{Cite journal |last1=LeMasters |first1=Grace K. |last2=Genaidy |first2=Ash M. |last3=Succop |first3=Paul |last4=Deddens |first4=James |last5=Sobeih |first5=Tarek |last6=Barriera-Viruet |first6=Heriberto |last7=Dunning |first7=Kari |last8=Lockey |first8=James |date=November 2006 |title=Cancer Risk Among Firefighters: A Review and Meta-analysis of 32 Studies |url=http://journals.lww.com/00043764-200611000-00014 |journal=Journal of Occupational and Environmental Medicine |language=en |volume=48 |issue=11 |pages=1189–1202 |doi=10.1097/01.jom.0000246229.68697.90 |issn=1076-2752 |pmid=17099456 |s2cid=1659335}}{{Cite book |url=https://www.worldcat.org/oclc/1066415095 |title=Painting, Firefighting, and Shiftwork. |date=2010 |publisher= |others=International Agency for Research on Cancer |isbn=9789283215981 |location= |oclc=1066415095}}{{Cite journal |last1=Laroche |first1=Elena |last2=L'Espérance |first2=Sylvain |date=March 3, 2021 |title=Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews |journal=International Journal of Environmental Research and Public Health |language=en |volume=18 |issue=5 |pages=2519 |doi=10.3390/ijerph18052519 |issn=1660-4601 |pmc=7967542 |pmid=33802629 |doi-access=free}}{{Cite journal |last1=Hwang |first1=Jooyeon |last2=Xu |first2=Chao |last3=Agnew |first3=Robert J. |last4=Clifton |first4=Shari |last5=Malone |first5=Tara R. |date=January 2021 |title=Health Risks of Structural Firefighters from Exposure to Polycyclic Aromatic Hydrocarbons: A Systematic Review and Meta-Analysis |journal=International Journal of Environmental Research and Public Health |language=en |volume=18 |issue=8 |pages=4209 |doi=10.3390/ijerph18084209 |pmc=8071552 |pmid=33921138 |doi-access=free}}{{Cite journal |last1=Jalilian |first1=Hamed |last2=Ziaei |first2=Mansour |last3=Weiderpass |first3=Elisabete |last4=Rueegg |first4=Corina Silvia |last5=Khosravi |first5=Yahya |last6=Kjaerheim |first6=Kristina |date=November 15, 2019 |title=Cancer incidence and mortality among firefighters |journal=International Journal of Cancer |language=en |volume=145 |issue=10 |pages=2639–2646 |doi=10.1002/ijc.32199 |issn=0020-7136 |pmid=30737784 |s2cid=73451966|doi-access=free |hdl=10037/17313 |hdl-access=free }}{{Cite journal |last1=Soteriades |first1=Elpidoforos S |last2=Kim |first2=Jaeyoung |last3=Christophi |first3=Costas A |last4=Kales |first4=Stefanos N |date=November 1, 2019 |title=Cancer Incidence and Mortality in Firefighters: A State-of-the-Art Review and Meta-َAnalysis |url=http://journal.waocp.org/article_88817.html |journal=Asian Pacific Journal of Cancer Prevention |language=en |volume=20 |issue=11 |pages=3221–3231 |doi=10.31557/APJCP.2019.20.11.3221 |issn=2476-762X |pmc=7063017 |pmid=31759344}}{{Cite journal |last1=Casjens |first1=Swaantje |last2=Brüning |first2=Thomas |last3=Taeger |first3=Dirk |date=October 2020 |title=Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences |journal=International Archives of Occupational and Environmental Health |language=en |volume=93 |issue=7 |pages=839–852 |doi=10.1007/s00420-020-01539-0 |issn=0340-0131 |pmc=7452930 |pmid=32306177|bibcode=2020IAOEH..93..839C }}{{Cite journal |last1=Lee |first1=David J. |last2=Koru-Sengul |first2=Tulay |last3=Hernandez |first3=Monique N. |last4=Caban-Martinez |first4=Alberto J. |last5=McClure |first5=Laura A. |last6=Mackinnon |first6=Jill A. |last7=Kobetz |first7=Erin N. |date=April 2020 |title=Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014) |url=|journal=American Journal of Industrial Medicine |language=en |volume=63 |issue=4 |pages=285–299 |doi=10.1002/ajim.23086 |issn=0271-3586 |pmid=31930542 |s2cid=210191181}}{{Cite journal |last1=Pinkerton |first1=Lynne |last2=Bertke |first2=Stephen J |last3=Yiin |first3=James |last4=Dahm |first4=Matthew |last5=Kubale |first5=Travis |last6=Hales |first6=Thomas |last7=Purdue |first7=Mark |last8=Beaumont |first8=James J |last9=Daniels |first9=Robert |date=February 2020 |title=Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update |journal=Occupational and Environmental Medicine |language=en |volume=77 |issue=2 |pages=84–93 |doi=10.1136/oemed-2019-105962 |issn=1351-0711 |pmid=31896615 |pmc=10165610 |s2cid=209677270|doi-access=free }} Additionally, large international studies generally support the finding from U.S. studies that firefighters have elevated rates of cancer, with some variation by cancer site.{{Cite journal |last1=Ahn |first1=Yeon-Soon |last2=Jeong |first2=Kyoung-Sook |last3=Kim |first3=Kyoo-Sang |date=September 2012 |title=Cancer morbidity of professional emergency responders in Korea |url=http://oem.bmj.com/cgi/content/short/68/Suppl_1/A37-a|journal=American Journal of Industrial Medicine |language=en |volume=55 |issue=9 |pages=768–778 |doi=10.1002/ajim.22068 |pmid=22628010 |s2cid=41791288}}{{Cite journal |last1=Amadeo |first1=Brice |last2=Marchand |first2=Jean-Luc |last3=Moisan |first3=Frédéric |last4=Donnadieu |first4=Stéphane |last5=Coureau |first5=Gaëlle |last6=Mathoulin-Pélissier |first6=Simone |last7=Lembeye |first7=Christian |last8=Imbernon |first8=Ellen |last9=Brochard |first9=Patrick |date=2015 |title=French firefighter mortality: Analysis over a 30-year period |url=|journal=American Journal of Industrial Medicine |language=en |volume=58 |issue=4 |pages=437–443 |doi=10.1002/ajim.22434 |issn=1097-0274 |pmid=25708859}}{{Cite journal |last1=Glass |first1=D. C. |last2=Pircher |first2=S. |last3=Monaco |first3=A. Del |last4=Hoorn |first4=S. Vander |last5=Sim |first5=M. R. |date=November 1, 2016 |title=Mortality and cancer incidence in a cohort of male paid Australian firefighters |url=https://oem.bmj.com/content/73/11/761 |journal=Occupational and Environmental Medicine |language=en |volume=73 |issue=11 |pages=761–771 |doi=10.1136/oemed-2015-103467 |issn=1351-0711 |pmid=27456156 |s2cid=43114491}}{{Cite journal |last1=Glass |first1=Deborah C |last2=Del Monaco |first2=Anthony |last3=Pircher |first3=Sabine |last4=Vander Hoorn |first4=Stephen |last5=Sim |first5=Malcolm R |date=September 2017 |title=Mortality and cancer incidence among male volunteer Australian firefighters |url=https://oem.bmj.com/lookup/doi/10.1136/oemed-2016-104088 |journal=Occupational and Environmental Medicine |language=en |volume=74 |issue=9 |pages=628–638 |doi=10.1136/oemed-2016-104088 |issn=1351-0711 |pmid=28391245 |s2cid=32602571}}{{Cite journal |last1=Glass |first1=Deborah Catherine |last2=Del Monaco |first2=Anthony |last3=Pircher |first3=Sabine |last4=Vander Hoorn |first4=Stephen |last5=Sim |first5=Malcolm Ross |date=April 2019 |title=Mortality and cancer incidence among female Australian firefighters |url=https://pubmed.ncbi.nlm.nih.gov/30674605 |journal=Occupational and Environmental Medicine |volume=76 |issue=4 |pages=215–221 |doi=10.1136/oemed-2018-105336 |issn=1470-7926 |pmid=30674605 |s2cid=59226066}}{{Cite journal |last1=Harris |first1=M. Anne |last2=Kirkham |first2=Tracy L. |last3=MacLeod |first3=Jill S. |last4=Tjepkema |first4=Michael |last5=Peters |first5=Paul A. |last6=Demers |first6=Paul A. |date=October 2018 |title=Surveillance of cancer risks for firefighters, police, and armed forces among men in a Canadian census cohort |url=|journal=American Journal of Industrial Medicine |language=en |volume=61 |issue=10 |pages=815–823 |doi=10.1002/ajim.22891 |pmid=30073696 |s2cid=51905238}}{{Cite journal |last1=Kirstine Ugelvig Petersen |first1=Kajsa |last2=Pedersen |first2=Julie Elbaek |last3=Bonde |first3=Jens Peter |last4=Ebbehoej |first4=Niels Erik |last5=Hansen |first5=Johnni |date=April 2018 |title=Long-term follow-up for cancer incidence in a cohort of Danish firefighters |url=https://oem.bmj.com/lookup/doi/10.1136/oemed-2017-104660 |journal=Occupational and Environmental Medicine |language=en |volume=75 |issue=4 |pages=263–269 |doi=10.1136/oemed-2017-104660 |issn=1351-0711 |pmid=29055884 |s2cid=4395029}}{{Cite journal |last1=Petersen |first1=Kajsa Ugelvig |last2=Pedersen |first2=Julie Elbæk |last3=Bonde |first3=Jens Peter |last4=Ebbehøj |first4=Niels Erik |last5=Hansen |first5=Johnni |date=August 2018 |title=Mortality in a cohort of Danish firefighters; 1970–2014 |url=http://oem.bmj.com/cgi/content/short/74/Suppl_1/A110-b|journal=International Archives of Occupational and Environmental Health |language=en |volume=91 |issue=6 |pages=759–766 |doi=10.1007/s00420-018-1323-6 |issn=0340-0131 |pmid=29808435 |bibcode=2018IAOEH..91..759P |s2cid=44168738}}{{Cite journal |last1=Pukkala |first1=Eero |last2=Martinsen |first2=Jan Ivar |last3=Weiderpass |first3=Elisabete |last4=Kjaerheim |first4=Kristina |last5=Lynge |first5=Elsebeth |last6=Tryggvadottir |first6=Laufey |last7=Sparén |first7=Pär |last8=Demers |first8=Paul A |date=June 2014 |title=Cancer incidence among firefighters: 45 years of follow-up in five Nordic countries |url=https://oem.bmj.com/lookup/doi/10.1136/oemed-2013-101803 |journal=Occupational and Environmental Medicine |language=en |volume=71 |issue=6 |pages=398–404 |doi=10.1136/oemed-2013-101803 |issn=1351-0711 |pmid=24510539 |s2cid=24392558}} [144] => [145] => A 2015 retrospective [[longitudinal study]] showed that firefighters are at higher risk for certain types of [[cancer]]. Firefighters had [[mesothelioma]], which is caused by [[asbestos]] exposure, at twice the rate of the non-firefighting working population. Younger firefighters (under age 65) also developed [[bladder cancer]] and [[prostate cancer]] at higher rates than the general population. The risk of [[bladder cancer]] may be present in [[women in firefighting|female firefighters]], but research is inconclusive as of 2014.{{cite web |last=Daniels |first=Robert D. |date=17 December 2014 |title=Is There a Link Between Firefighting and Cancer? – Epidemiology in Action |url=http://blogs.cdc.gov/niosh-science-blog/2014/12/17/cancer-ff/ |access-date=6 January 2015 |publisher=National Institute for Occupational Safety and Health}}{{cite web |date=25 July 2014 |title=Study of Cancer among U.S. Fire Fighters |url=https://www.cdc.gov/niosh/firefighters/ffCancerStudy.html |access-date=6 January 2015 |publisher=National Institute for Occupational Safety and Health}} Preliminary research from 2015 on a large cohort of US firefighters showed a direct relationship between the number of hours spent fighting fires and [[lung cancer]] and [[leukemia]] mortality in firefighters. This link is a topic of continuing research in the medical community, as is cancer mortality in general among firefighters.{{cite journal |vauthors=Daniels RD, Bertke S, Dahm MM, Yiin JH, Kubale TL, Hales TR, Baris D, Zahm SH, Beaumont JJ, Waters KM, Pinkerton LE |year=2015 |title=Exposure-response relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009) |journal=Occupational and Environmental Medicine |volume=72 |issue=10 |pages=699–706 |doi=10.1136/oemed-2014-102671 |pmc=4558385 |pmid=25673342}} [146] => [147] => In addition to [[Epidemiology|epidemiological]] studies, mechanistic studies have used [[biomarker]]s to investigate exposures' effects on biological changes that could be related to cancer development. Several of these studies have found evidence of [[DNA damage]], [[oxidative stress]], and [[Epigenetics|epigenetic]] changes related to firefighters' exposures.{{Cite journal |last1=Abreu |first1=Ana |last2=Costa |first2=Carla |last3=Pinho e Silva |first3=Susana |last4=Morais |first4=Simone |last5=do Carmo Pereira |first5=Maria |last6=Fernandes |first6=Adília |last7=Moraes de Andrade |first7=Vanessa |last8=Teixeira |first8=João Paulo |last9=Costa |first9=Solange |date=August 3, 2017 |title=Wood smoke exposure of Portuguese wildland firefighters: DNA and oxidative damage evaluation |url=|journal=Journal of Toxicology and Environmental Health, Part A |volume=80 |issue=13–15 |pages=596–604 |doi=10.1080/15287394.2017.1286896 |issn=1528-7394 |pmid=28524757 |bibcode=2017JTEHA..80..596A |hdl=10216/111908 |s2cid=205867973|hdl-access=free }}{{Cite journal |last1=Adetona |first1=Olorunfemi |last2=Simpson |first2=Christopher D |last3=Li |first3=Zheng |last4=Sjodin |first4=Andreas |last5=Calafat |first5=Antonia M |last6=Naeher |first6=Luke P |date=November 11, 2015 |title=Hydroxylated polycyclic aromatic hydrocarbons as biomarkers of exposure to wood smoke in wildland firefighters |url=|journal=Journal of Exposure Science & Environmental Epidemiology |volume=27 |issue=1 |pages=78–83 |doi=10.1038/jes.2015.75 |issn=1559-0631 |pmc=5140750 |pmid=26555473}}{{Cite journal |last1=Andersen |first1=Maria Helena Guerra |last2=Saber |first2=Anne Thoustrup |last3=Clausen |first3=Per Axel |last4=Pedersen |first4=Julie Elbæk |last5=Løhr |first5=Mille |last6=Kermanizadeh |first6=Ali |last7=Loft |first7=Steffen |last8=Ebbehøj |first8=Niels |last9=Hansen |first9=Åse Marie |last10=Pedersen |first10=Peter Bøgh |last11=Koponen |first11=Ismo Kalevi |date=February 24, 2018 |title=Association between polycyclic aromatic hydrocarbon exposure and peripheral blood mononuclear cell DNA damage in human volunteers during fire extinction exercises |url=https://academic.oup.com/mutage/article/33/1/105/4553087 |journal=Mutagenesis |language=en |volume=33 |issue=1 |pages=105–115 |doi=10.1093/mutage/gex021 |issn=0267-8357 |pmid=29045708|doi-access=free }}{{Cite journal |last1=Keir |first1=Jennifer L. A. |last2=Akhtar |first2=Umme S. |last3=Matschke |first3=David M. J. |last4=Kirkham |first4=Tracy L. |last5=Chan |first5=Hing Man |last6=Ayotte |first6=Pierre |last7=White |first7=Paul A. |last8=Blais |first8=Jules M. |date=November 7, 2017 |title=Elevated Exposures to Polycyclic Aromatic Hydrocarbons and Other Organic Mutagens in Ottawa Firefighters Participating in Emergency, On-Shift Fire Suppression |url=https://pubs.acs.org/doi/10.1021/acs.est.7b02850 |journal=Environmental Science & Technology |language=en |volume=51 |issue=21 |pages=12745–12755 |bibcode=2017EnST...5112745K |doi=10.1021/acs.est.7b02850 |issn=0013-936X |pmid=29043785}}{{Cite journal |last1=Hoppe-Jones |first1=C. |last2=Beitel |first2=S. |last3=Burgess |first3=J. L. |last4=Snyder |first4=S. |last5=Flahr |first5=L. |last6=Griffin |first6=S. |last7=Littau |first7=S. |last8=Jeong |first8=K. S. |last9=Zhou |first9=J. |last10=Gulotta |first10=J. |last11=Moore |first11=P. |date=April 1, 2018 |title=515 Use of urinary biomarkers and bioassays to evaluate chemical exposure and activation of cancer pathways in firefighters |url=https://oem.bmj.com/content/75/Suppl_2/A412.2 |journal=Occupational and Environmental Medicine |language=en |volume=75 |issue=Suppl 2 |pages=A412–A413 |doi=10.1136/oemed-2018-ICOHabstracts.1178 |issn=1351-0711 |s2cid=80490930|doi-access=free }}{{Cite journal |last1=Jeong |first1=Kyoung Sook |last2=Zhou |first2=Jin |last3=Griffin |first3=Stephanie C. |last4=Jacobs |first4=Elizabeth T. |last5=Dearmon-Moore |first5=Devi |last6=Zhai |first6=Jing |last7=Littau |first7=Sally R. |last8=Gulotta |first8=John |last9=Moore |first9=Paul |last10=Peate |first10=Wayne F. |last11=Richt |first11=Crystal M. |date=May 2018 |title=MicroRNA Changes in Firefighters |url=https://journals.lww.com/00043764-201805000-00009 |journal=Journal of Occupational & Environmental Medicine |language=en |volume=60 |issue=5 |pages=469–474 |doi=10.1097/JOM.0000000000001307 |issn=1076-2752 |pmc=5959213 |pmid=29465512}}{{Citation |last1=Oliveira |first1=M. |title=Levels of urinary biomarkers of exposure and potential genotoxic risks in firefighters |date=March 14, 2018 |url=|work=Occupational Safety and Hygiene VI |pages=267–271 |publisher=CRC Press |doi=10.1201/9781351008884-47 |isbn=978-1-351-00888-4 |last2=Delerue-Matos |first2=C. |last3=Morais |first3=S. |last4=Slezakova |first4=K. |last5=Pereira |first5=M.C. |last6=Fernandes |first6=A. |last7=Costa |first7=S. |last8=Teixeira |first8=J.P.}} [148] => [149] => Firefighters regularly encounter [[Carcinogen|carcinogenic materials]] and hazardous contaminants, which is thought to contribute to their excess cancer risk. Dozens of chemicals classified by the [[International Agency for Research on Cancer]] (IARC) as known or probable carcinogens have been identified on the fireground.{{Cite journal |last1=Marques |first1=M Matilde |last2=Berrington de Gonzalez |first2=Amy |last3=Beland |first3=Frederick A. |last4=Browne |first4=Patience |last5=Demers |first5=Paul A |last6=Lachenmeier |first6=Dirk W |last7=Bahadori |first7=Tina |last8=Barupal |first8=Dinesh K. |last9=Belpoggi |first9=Fiorella |last10=Comba |first10=Pietro |last11=Dai |first11=Min |date=June 2019 |title=Advisory Group recommendations on priorities for the IARC Monographs |url= |journal=The Lancet Oncology |language=en |volume=20 |issue=6 |pages=763–764 |doi=10.1016/S1470-2045(19)30246-3 |pmid=31005580 |s2cid=128350881}}{{Cite journal |last=IARC Working Group on the Evaluation of Carcinogenic Risks to Humans |date=2010 |title=Painting, firefighting, and shiftwork |journal=IARC Monographs on the Evaluation of Carcinogenic Risks to Humans |volume=98 |pages=9–764 |issn=1017-1606 |pmc=4781497 |pmid=21381544}} Several studies have documented airborne and/or dermal exposures to carcinogenic compounds during firefighting, as well as contamination on [[Bunker gear|turnout gear]] and other equipment worn by firefighters.{{Cite journal |first1=J. |last1=Jankovic |first2=W. |last2=Jones |first3=J. |last3=Burkhart |first4=G. |last4=Noonan |year=1991 |title=Environmental study of firefighters |url=|journal=Annals of Occupational Hygiene |volume=35 |issue=6 |pages=581–602 |doi=10.1093/annhyg/35.6.581 |pmid=1768008}}{{Cite journal |last1=Bolstad-Johnson |first1=Dawn M. |last2=Burgess |first2=Jefferey L. |last3=Crutchfield |first3=Clifton D. |last4=Storment |first4=Steve |last5=Gerkin |first5=Richard |last6=Wilson |first6=Jeffrey R. |date=September 2000 |title=Characterization of Firefighter Exposures During Fire Overhaul |url=|journal=AIHAJ - American Industrial Hygiene Association |language=en |volume=61 |issue=5 |pages=636–641 |doi=10.1080/15298660008984572 |issn=1529-8663 |pmid=11071414}}{{Cite journal |last1=Austin |first1=C. C. |last2=Wang |first2=D. |last3=Ecobichon |first3=D. J. |last4=Dussault |first4=G. |date=July 15, 2001 |title=Characterization of Volatile Organic Compounds in Smoke at Municipal Structural Fires |url=|journal=Journal of Toxicology and Environmental Health, Part A |language=en |volume=63 |issue=6 |pages=437–458 |doi=10.1080/152873901300343470 |issn=1528-7394 |pmid=11482799 |bibcode=2001JTEHA..63..437A |s2cid=36263955}}{{Cite journal |last1=Fent |first1=Kenneth W. |last2=Alexander |first2=Barbara |last3=Roberts |first3=Jennifer |last4=Robertson |first4=Shirley |last5=Toennis |first5=Christine |last6=Sammons |first6=Deborah |last7=Bertke |first7=Stephen |last8=Kerber |first8=Steve |last9=Smith |first9=Denise |last10=Horn |first10=Gavin |date=October 3, 2017 |title=Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures |journal=Journal of Occupational and Environmental Hygiene |language=en |volume=14 |issue=10 |pages=801–814 |doi=10.1080/15459624.2017.1334904 |issn=1545-9624 |pmid=28636458 |s2cid=44916370|doi-access=free |hdl=2142/101922 |hdl-access=free }}{{Cite journal |last1=Mayer |first1=Alexander C. |last2=Fent |first2=Kenneth W. |last3=Bertke |first3=Stephen |last4=Horn |first4=Gavin P. |last5=Smith |first5=Denise L. |last6=Kerber |first6=Steve |last7=La Guardia |first7=Mark J. |date=February 1, 2019 |title=Firefighter hood contamination: Efficiency of laundering to remove PAHs and FRs |journal=Journal of Occupational and Environmental Hygiene |language=en |volume=16 |issue=2 |pages=129–140 |doi=10.1080/15459624.2018.1540877 |issn=1545-9624 |pmc=8647047 |pmid=30427284}}  Some of these compounds have been shown to absorb into firefighters' bodies.{{Cite journal |last1=Beitel |first1=Shawn C. |last2=Flahr |first2=Leanne M. |last3=Hoppe-Jones |first3=Christiane |last4=Burgess |first4=Jefferey L. |last5=Littau |first5=Sally R. |last6=Gulotta |first6=John |last7=Moore |first7=Paul |last8=Wallentine |first8=Darin |last9=Snyder |first9=Shane A. |date=February 1, 2020 |title=Assessment of the toxicity of firefighter exposures using the PAH CALUX bioassay |journal=Environment International |language=en |volume=135 |pages=105207 |doi=10.1016/j.envint.2019.105207 |issn=0160-4120 |pmid=31812113 |s2cid=208870627|doi-access=free |hdl=10356/148860 |hdl-access=free }}{{Cite journal |last1=Fent |first1=Kenneth W. |last2=Toennis |first2=Christine |last3=Sammons |first3=Deborah |last4=Robertson |first4=Shirley |last5=Bertke |first5=Stephen |last6=Calafat |first6=Antonia M. |last7=Pleil |first7=Joachim D. |last8=Wallace |first8=M. Ariel Geer |last9=Kerber |first9=Steve |last10=Smith |first10=Denise |last11=Horn |first11=Gavin P. |date=March 2020 |title=Firefighters' absorption of PAHs and VOCs during controlled residential fires by job assignment and fire attack tactic |journal=Journal of Exposure Science & Environmental Epidemiology |language=en |volume=30 |issue=2 |pages=338–349 |doi=10.1038/s41370-019-0145-2 |issn=1559-0631 |pmc=7323473 |pmid=31175324}} [150] => [151] => In addition to chemical exposures, firefighters often work 24-hr shifts or longer, and may respond to emergencies at night. Night [[shift work]] has been classified as a probable human carcinogen by IARC.{{Cite web |title=IARC Monographs Volume 124: Night Shift Work – IARC |url=https://www.iarc.who.int/news-events/iarc-monographs-volume-124-night-shift-work/ |access-date=September 1, 2022 |website=www.iarc.who.int}} Some firefighters also work with [[Dangerous goods|hazardous materials]] and trained to control and clean up these dangerous materials, such as [[oil spill]]s and [[chemical accident]]s. As firefighters combat a fire and clean up hazardous materials, there is a risk of harmful chemicals coming in contact with their skin if it penetrates their [[personal protective equipment]] (PPE). In June 2022, IARC classified occupational exposure as a firefighter as "carcinogenic to humans."{{Cite journal |last1=Demers |first1=Paul A |last2=DeMarini |first2=David M |last3=Fent |first3=Kenneth W |last4=Glass |first4=Deborah C |last5=Hansen |first5=Johnni |last6=Adetona |first6=Olorunfemi |last7=Andersen |first7=Maria HG |last8=Freeman |first8=Laura E Beane |last9=Caban-Martinez |first9=Alberto J |last10=Daniels |first10=Robert D |last11=Driscoll |first11=Timothy R |date=July 1, 2022 |title=Carcinogenicity of occupational exposure as a firefighter |url= |journal=The Lancet Oncology |language=en |volume=23 |issue=8 |pages=985–986 |doi=10.1016/S1470-2045(22)00390-4 |issn=1470-2045 |pmid=35780778 |s2cid=250227232}} [152] => [153] => Firefighters are in addition to carcinogenic chemicals, firefighters can be exposed to [[radiation]] ([[alpha radiation]], [[beta radiation]], and [[gamma radiation]]).{{cite journal |title=Painting, firefighting, and shiftwork |journal=IARC Monographs on the Evaluation of Carcinogenic Risks to Humans / World Health Organization, International Agency for Research on Cancer |volume=98 |pages=9–764 |year=2010 |pmid=21381544 |pmc=4781497|author1=IARC Working Group on the Evaluation of Carcinogenic Risks to Humans }} [154] => [155] => There are many types of firefighters. Most research on firefighters' cancer risk has involved structural or municipal career firefighters. [[Wildfire suppression|Wildland firefighters]] are specially trained firefighters tasked with controlling [[Wildfire|forest fires]]. They frequently create fire lines, which are swathes of cut-down trees and dug-up grass placed in the path of the fire. This is designed to deprive the fire of fuel. Wildland firefighting is a physically demanding job with many acute hazards. Wildland firefighters may hike several miles while carrying heavy equipment during the wildfire season, which has increased in duration over time, especially in the western United States. Unlike structural firefighters, wildland firefighters typically do not wear [[Respirator|respiratory protection]], and may inhale [[Particulates|particulate]] and other compounds emitted by the wildfires. They also use [[Controlled burn|prescribed fires]] to burn potential fire fuel under controlled conditions.{{Cite web |title=Firefighters : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics |url=https://www.bls.gov/ooh/protective-service/firefighters.htm#tab-2 |access-date=February 1, 2022 |website=www.bls.gov |language=en-us}} To examine cancer risk for wildland firefighters, a risk assessment was conducted using an exposure-response relationship for risk of lung cancer mortality and measured particulate matter exposure from smoke at wildfires. This study concluded that wildland firefighters could have an increased risk of lung cancer mortality.{{Cite journal |last1=Navarro |first1=Kathleen M. |last2=Kleinman |first2=Michael T. |last3=Mackay |first3=Chris E. |last4=Reinhardt |first4=Timothy E. |last5=Balmes |first5=John R. |last6=Broyles |first6=George A. |last7=Ottmar |first7=Roger D. |last8=Naher |first8=Luke P. |last9=Domitrovich |first9=Joseph W. |date=June 2019 |title=Wildland firefighter smoke exposure and risk of lung cancer and cardiovascular disease mortality |url= |journal=Environmental Research |language=en |volume=173 |pages=462–468 |bibcode=2019ER....173..462N |doi=10.1016/j.envres.2019.03.060 |pmid=30981117 |s2cid=108987257}} The research on cancer for other subspecialty groups of firefighters is limited, but a recent study of fire instructors in Australia found an exposure-response relationship between training exposures and cancer incidence.{{Cite journal |last1=Glass |first1=D. C. |last2=Del Monaco |first2=A. |last3=Pircher |first3=S. |last4=Vander Hoorn |first4=S. |last5=Sim |first5=M. R. |date=October 2016 |title=Mortality and cancer incidence at a fire training college |journal=Occupational Medicine (Oxford, England) |volume=66 |issue=7 |pages=536–542 |doi=10.1093/occmed/kqw079 |issn=1471-8405 |pmid=27371948|doi-access=free }} [156] => [157] => Due to the lack of central and comprehensive sources of data, research on cancer rates amongst firefighters has been challenging.{{Cite journal |last1=Tsai |first1=Rebecca J. |last2=Luckhaupt |first2=Sara E. |last3=Schumacher |first3=Pam |last4=Cress |first4=Rosemary D. |last5=Deapen |first5=Dennis M. |last6=Calvert |first6=Geoffrey M. |date=May 6, 2015 |title=Risk of cancer among firefighters in California, 1988-2007 |url=|journal=American Journal of Industrial Medicine |volume=58 |issue=7 |pages=715–729 |doi=10.1002/ajim.22466 |issn=0271-3586 |pmc=4527530 |pmid=25943908}}{{Cite journal |last1=Lee |first1=David J. |last2=Koru-Sengul |first2=Tulay |last3=Hernandez |first3=Monique N. |last4=Caban-Martinez |first4=Alberto J. |last5=McClure |first5=Laura A. |last6=Mackinnon |first6=Jill A. |last7=Kobetz |first7=Erin N. |date=April 2020 |title=Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014) |url=https://pubmed.ncbi.nlm.nih.gov/31930542 |journal=American Journal of Industrial Medicine |volume=63 |issue=4 |pages=285–299 |doi=10.1002/ajim.23086 |issn=1097-0274 |pmid=31930542 |s2cid=210191181}}{{Cite journal |last1=Ma |first1=Fangchao |last2=Fleming |first2=Lora E. |last3=Lee |first3=David J. |last4=Trapido |first4=Edward |last5=Gerace |first5=Terence A. |date=September 2006 |title=Cancer incidence in Florida professional firefighters, 1981 to 1999 |url=https://pubmed.ncbi.nlm.nih.gov/16966954 |journal=Journal of Occupational and Environmental Medicine |volume=48 |issue=9 |pages=883–888 |doi=10.1097/01.jom.0000235862.12518.04 |issn=1076-2752 |pmid=16966954 |s2cid=45179842}} On July 7, 2018, Congress passed the Firefighter Cancer Registry Act of 2018 requiring the [[Centers for Disease Control and Prevention]] to create the [[National Firefighter Registry]] designed to collect data on cancer rates among U.S. firefighters.{{Cite web |title=Firefighter Cancer Registry Act of 2018 (2018 - H.R. 931) |url=https://www.govtrack.us/congress/bills/115/hr931 |access-date=May 9, 2022 |website=GovTrack.us |language=en}}{{Cite web |date=2022-09-19 |title=National Firefighter Registry |url=https://www.cdc.gov/niosh/firefighters/registry.html |access-date=2022-11-08 |website=U.S. National Institute for Occupational Safety and Health |language=en-us}}{{Cite web |title=The National Firefighter Registry: An update on the plan to track firefighter cancer |url=https://www.firerescue1.com/cancer/articles/the-national-firefighter-registry-an-update-on-the-plan-to-track-firefighter-cancer-NQ5oPnbOKPDtfWiO/ |url-status=live |archive-url=https://web.archive.org/web/20220407003328/https://www.firerescue1.com/cancer/articles/the-national-firefighter-registry-an-update-on-the-plan-to-track-firefighter-cancer-NQ5oPnbOKPDtfWiO/ |archive-date=April 7, 2022 |access-date=September 30, 2022 |website=FireRescue1 |date=17 March 2022 |language=en}} [158] => [159] => ====Mental stress==== [160] => As with other emergency workers, firefighters may witness traumatic scenes during their careers. They are thus more vulnerable than most people to certain mental health issues such as [[post-traumatic stress disorder]]{{cite news |url= https://www.theguardian.com/public-leaders-network/2017/aug/23/mental-health-fire-service-government-cuts-grenfell-firefighters-charity |title= Fire fighters' battle with PTSD: "Every day is an anxious day" |date= 23 August 2017 |access-date= 22 September 2017 |newspaper= [[The Guardian]]}}{{Cite journal|last1=Berger|first1=William|last2=Coutinho|first2=Evandro Silva Freire|last3=Figueira|first3=Ivan|last4=Marques-Portella|first4=Carla|last5=Luz|first5=Mariana Pires|last6=Neylan|first6=Thomas C.|last7=Marmar|first7=Charles R.|last8=Mendlowicz|first8=Mauro Vitor|date=2012-06-01|title=Rescuers at risk: a systematic review and meta-regression analysis of the worldwide current prevalence and correlates of PTSD in rescue workers|journal=Social Psychiatry and Psychiatric Epidemiology|language=en|volume=47|issue=6|pages=1001–1011|doi=10.1007/s00127-011-0408-2|pmid=21681455|issn=0933-7954|pmc=3974968}} and suicidal thoughts and behaviors.{{Cite journal|last1=Stanley|first1=Ian H.|last2=Hom|first2=Melanie A.|last3=Joiner|first3=Thomas E.|title=A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics|journal=Clinical Psychology Review|volume=44|pages=25–44|doi=10.1016/j.cpr.2015.12.002|pmid=26719976|year=2016|doi-access=free}}{{Cite journal|last1=Stanley|first1=Ian H.|last2=Hom|first2=Melanie A.|last3=Hagan|first3=Christopher R.|last4=Joiner|first4=Thomas E.|title=Career prevalence and correlates of suicidal thoughts and behaviors among firefighters|journal=Journal of Affective Disorders|volume=187|pages=163–171|doi=10.1016/j.jad.2015.08.007|pmid=26339926|year=2015}} Among women in the US, the occupations with the highest suicide rates are police and firefighters, with a rate of 14.1 per 100 000, according to the National Center for Injury Prevention and Control, CDC.{{Cite journal|last=Lindahl|first=Björn|title= Why are suicide rates higher for farmers and firefighters than for librarians? |url= http://www.nordiclabourjournal.org/nyheter/news-2016/article.2016-10-09.4724251880/|journal=Nordic Labour Journal}} Chronic stress over time attributes to symptoms that affect first responders, such as anxiousness, irritability, nervousness, memory and concentration problems can occur overtime which can lead to anxiety and depression. Mental stress can have long lasting affects on the brain.{{Cite news|url=https://www.firehouse.com/safety-health/article/12152154/health-wellness-how-firefighters-can-manage-stress|title=Health & Wellness: How Firefighters Can Manage Stress|work=Firehouse|access-date=2018-09-11|language=en}} A 2014 report from the National Fallen Firefighters Foundation found that a fire department is three times more likely to experience a suicide in a given year than a line-of-duty death.{{Cite news|url=https://www.usatoday.com/story/news/2015/01/15/stress-takes-heavy-toll-on-firefighters-experts-say/21830649/|title=Stress takes heavy toll on firefighters, experts say|work=USA TODAY|access-date=2018-09-11|language=en}} Mental stress of the job can lead to substance abuse and alcohol abuse as ways of coping with the stress.{{Cite web|url=https://www.nfpa.org/news-and-research/publications/nfpa-journal/2014/may-june-2014/features/special-report-firefighter-behavioral-health|title=Special report: Firefighter behavioral health - NFPA Journal|website=www.nfpa.org|language=en|access-date=2018-09-11}} The mental stress of fire fighting has many different causes. There are those they see on duty and also what they miss by being on duty. Firefighters schedules fluctuate by district. There are stations where fire fighters work 48 hours on and 48 hours off, whereas some allow 24 hours on and 72 hours off.{{Cite web|url=https://www.firerescue1.com/exclusives-1/articles/9-sources-of-firefighter-stress-o2KNDn8vMYZTq2FB/|title=9 sources of firefighter stress|website=FireRescue1|date=9 February 2015 |language=en|access-date=2019-11-26}} The mental impact of missing a child's first steps or a ballet recital can take a heavy impact on first responders. There is also the stress of being on opposite shifts as a spouse or being away from family. [161] => [162] => When not on the scene of an emergency, firefighters remain on call at [[fire station]]s, where they eat, sleep, and perform other duties during their shifts. Hence, [[Shift work sleep disorder|sleep disruption]] is another occupational hazard that they may encounter at their job. [163] => [164] => ====Occupational hearing loss==== [165] => Another long-term risk factor from firefighting is exposure to high levels of sound, which can cause [[noise-induced hearing loss]] (NIHL) and [[tinnitus]].{{cite journal |last1=Hong |first1=O. |last2=Samo |first2=D.G. |title= Hazardous Decibels: Hearing Health of Firefighters |journal= Workplace Health & Safety|date=1 August 2007 |volume=55 |issue=8 |pages=313–319 |doi= 10.1177/216507990705500803|pmid=17847625 |s2cid=36850759 |doi-access=free }}{{cite journal |last1=Tubbs |first1=R.L. |title= Noise and Hearing Loss in Firefighting |journal= Occupational Medicine |date=1995 |volume=10 |issue=4 |pages=843–885 |pmid=8903753 |url= https://www.ncbi.nlm.nih.gov/labs/articles/8903753/}} NIHL affects sound frequencies between 3,000 and 6,000 Hertz first, then with more frequent exposure, will spread to more frequencies. Many consonants will be more difficult to hear or inaudible with NIHL because of the higher frequencies effected, which results in poorer communication. NIHL is caused by exposure to sound levels at or above 85dBA according to [[National Institute for Occupational Safety and Health|NIOSH]] and at or above 90dBA according to [[Occupational Safety and Health Administration|OSHA]]. [[A-weighting|dBA]] represents A-weighted decibels. dBA is used for measuring sound levels relating to occupational sound exposure since it attempts to mimic the sensitivity of the human ear to different frequencies of sound. OSHA uses a 5-dBA exchange rate, which means that for every 5dBA increase in sound from 90dBA, the acceptable exposure time before a risk of permanent hearing loss occurs decreases by half (starting with 8 hours acceptable exposure time at 90dBA). NIOSH uses a 3-dBA exchange rate starting at 8 hours acceptable exposure time at 85dBA. [166] => [167] => The time of exposure required to potentially cause damage depends on the level of sound exposed to.{{cite web|title=NIOSH/Criteria for a Recommended Standard--Occupational Noise Exposure, 1998|url=http://www.nonoise.org/hearing/criteria/criteria.htm|website=www.nonoise.org}} The most common causes of excessive sound exposure are sirens, transportation to and from fires, fire alarms, and work tools. Traveling in an emergency vehicle has shown to expose a person to between 103 and 114dBA of sound. According to OSHA, exposure at this level is acceptable for between 17 and 78 minutes{{cite web|title=Noise exposure computation - 1910.95 App A {{!}} Occupational Safety and Health Administration|url=https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=9736|website=www.osha.gov|language=en-us}} and according to NIOSH is acceptable for between 35 seconds and 7.5 minutes over a 24-hour day before permanent hearing loss can occur. This time period considers that no other high level sound exposure occurs in that 24-hour time frame. Sirens often output about 120 dBA, which according to OSHA, 7.5 minutes of exposure is needed and according to NIOSH, 9 seconds of exposure is needed in a 24-hour time period before permanent hearing loss can occur. In addition to high sound levels, another risk factor for hearing disorders is the co-exposure to chemicals that are [[Ototoxicity|ototoxic]].{{Cite journal|last=Johnson|first=Ann-Christin and Morata, Thais|date=2010|title=Occupational exposure to chemicals and hearing impairment. The Nordic Expert Group for Criteria Documentation of Health Risks from Chemicals. 44 (4): 177.|url=https://gupea.ub.gu.se/bitstream/2077/23240/1/gupea_2077_23240_1.pdf|journal=Arbete och Hälsa|volume=44|pages=177}} [168] => [169] => The average day of work for a firefighter can often be under the sound exposure limit for both OSHA and NIOSH. While the average day of sound exposure as a firefighter is often under the limit, firefighters can be exposed to [[Impulse noise (audio)|impulse noise]], which has a very low acceptable time exposure before permanent hearing damage can occur due to the high intensity and short duration. [170] => [171] => There are also high rates of hearing loss, often NIHL, in firefighters, which increases with age and number of years working as a firefighter.{{cite journal|last1=Taxini|first1=Carla|last2=Guida|first2=Heraldo|title=Firefighters' noise exposure: A literature review|journal=International Archives of Otorhinolaryngology|date=6 January 2014|volume=17|issue=1|pages=080–084|doi=10.7162/S1809-97772013000100014|pmid=25991998|pmc=4423242}} [[Hearing conservation program|Hearing loss prevention programs]] have been implemented in multiple stations and have shown to help lower the rate of firefighters with NIHL. Other attempts have been made to lower sound exposures for firefighters, such as enclosing the cabs of the firetrucks to lower the siren exposure while driving. NFPA (National Fire Protection Association) is responsible for occupational health programs and standards in firefighters which discusses what hearing sensitivity is required to work as a firefighter, but also enforces baseline (initial) and annual hearing tests (based on OSHA hearing maintenance regulations). While NIHL can be a risk that occurs from working as a firefighter, NIHL can also be a safety concern for communicating while doing the job as communicating with coworkers and victims is essential for safety. [[Hearing protection|Hearing protection devices]] have been used by firefighters in the United States. Earmuffs are the most commonly used hearing protection device (HPD) as they are the most easy to put on correctly in a quick manner. Multiple fire departments have used HPDs that have communication devices built in, allowing firefighters to speak with each other at safe, but audible sound levels, while lowering the hazardous sound levels around them. [172] => [173] => == Types of coverage and workload == [174] => {{see also|Volunteer fire department|Retained firefighter}} [175] => In a country with a comprehensive fire service, fire departments must be able to send firefighters to emergencies at any hour of day or night, to arrive on the scene within minutes. In urban areas, this means that full-time paid firefighters usually have [[shift work]], with some providing cover each night. On the other hand, it may not be practical to employ full-time firefighters in villages and isolated small towns, where their services may not be required for days at a time. For this reason, many fire departments have firefighters who spend long periods on call to respond to infrequent emergencies; they may have regular jobs outside of firefighting.{{cite web |url = https://www.fireservice.co.uk/recruitment/retained-firefighters/ |title = Retained Firefighters |year= |publisher = UK Fire Service Resources Ltd |location= |archive-url=https://web.archive.org/web/20210812105021/https://www.fireservice.co.uk/recruitment/retained-firefighters/ |archive-date=12 August 2021 |url-status=live |access-date = 12 August 2021 |quote= }}{{cite web |url = https://www.prospects.ac.uk/job-profiles/firefighter |title = Job Profile - Firefighter |year= |publisher = JISC (Joint Information Systems Committee) |location= Bristol, England|archive-url=https://web.archive.org/web/20210827163618/https://www.prospects.ac.uk/job-profiles/firefighter |archive-date=27 August 2021 |url-status=live |access-date = 12 August 2021 |quote= }} [176] => [177] => Whether they are paid or not varies by country. In the United States and Germany, [[volunteer fire department]]s provide most of the cover in rural areas. In the United Kingdom and Ireland,{{cite web |url = https://gradireland.com/careers-advice/job-descriptions/firefighter |title = Firefighter |year= |publisher = GradIreland (GTI Ireland) |location= Dublin, Ireland|archive-url=https://web.archive.org/web/20210812105030/https://gradireland.com/careers-advice/job-descriptions/firefighter |archive-date=12 August 2021 |url-status=live |access-date = 12 August 2021 |quote= }} by contrast, actual volunteers are rare. Instead, "[[retained firefighter]]s" are paid for responding to incidents, along with a small salary for spending long periods of time on call. The combined fire services of the United Kingdom retain around 18,000 retained firefighters alongside their wholetime colleagues. In both the UK and Ireland retained firefighters make up the majority of active firefighting personnel. Their training, qualifications, and range of possible deployments, are all comparable to wholetime firefighters. Retained firefighters are required to live or work within a set radius of their assigned fire station - in the United Kingdom this is usually {{convert|1|mi}}, and in Ireland {{convert|2|mi}}. [178] => [179] => ==Firefighting around the world== [180] => {{Further|Firefighting worldwide|Fire department ranks by country}} [181] => [[File:BSPP section Bastille Day 2008.jpg|thumb|The [[Paris Fire Brigade]] is a [[French Army]] unit which serves as the fire service for [[Paris]] and certain sites of national strategic importance.]] [182] => [[File:mtlfirechiefs.jpg|thumb|Firefighters tackling a blaze in [[Montreal, Canada]]]] [183] => [[File:Indonesian fire fighters during a traffic accident.jpg|thumb|[[Indonesia]]n fire fighters handling a [[traffic accident]] in [[Jakarta]]]] [184] => A key difference between many countries' fire services is what the balance is between full-time and volunteer (or on-call) firefighters. In the [[United States]] and [[United Kingdom]], large metropolitan fire departments are almost entirely made up of full-time firefighters. On the other hand, in [[Germany]] and [[Austria]],{{Cite web|url=https://www.bundesfeuerwehrverband.at/oebfv/|archive-url=https://web.archive.org/web/20081228111522/http://www.bundesfeuerwehrverband.at/oebfv/index.php?id=154|url-status=dead|title=Organisation – ÖBFV|archive-date=December 28, 2008}} volunteers play a substantial role even in the largest fire departments, including Berlin's, which serves a population of 3.6 million. Regardless of how this balance works, a common feature is that smaller urban areas have a mix of full-time and volunteer/on-call firefighters. This is known in the United States as a [[combination fire department]]. In [[Chile]] and [[Peru]], all firefighters are volunteers.{{cite news|url=https://www.bbc.co.uk/news/world-latin-america-27186801|title=Chile's firefighters in spotlight after Valparaiso blaze |date=2014-04-29|access-date=2019-07-17|work=BBC News}} [185] => [186] => Another point of variation is how the fire services are organized. Some countries like the [[Czech Republic]], [[Israel]] and [[New Zealand]] have a single national fire service. Others like Australia, the United Kingdom and France organize fire services based on regions or sub-national states. In the United States, Austria, Germany and [[Canada]], fire departments are run at a municipal level. [187] => [188] => Atypically, [[Singapore]] and many parts of [[Switzerland]] have [[Compulsory Fire Service|fire service conscription]].{{Cite web |url=http://www.swissfire.ch/fileadmin/swissfire/Der%20SFV/Factsheet_Feuerwehr_2015_d.pdf |title=Die Schweizer Feuerwehren |access-date=2016-08-23 |archive-url=https://web.archive.org/web/20180128134257/http://www.swissfire.ch/fileadmin/swissfire/Der%20SFV/Factsheet_Feuerwehr_2015_d.pdf |archive-date=2018-01-28 |url-status=dead }}{{Cite web |url=http://www.scdf.gov.sg/content/scdf_internet/en/general/about-us.html |title=SCDF Website - GENERAL: About Us |access-date=2018-08-28 |archive-url=https://web.archive.org/web/20161228102845/http://www.scdf.gov.sg/content/scdf_internet/en/general/about-us.html |archive-date=2016-12-28 |url-status=dead }} In Germany, conscription can also be used if a village does not have a functioning fire service. Other unusual arrangements are seen in [[Denmark]], where most fire services are run by private companies, and in France, where two of the country's fire services (the [[Paris Fire Brigade]] and the [[Marseille Naval Fire Battalion]]) are part of the armed forces; similarly, the national fire service of Monaco is part of the [[Military of Monaco]] and maintains an armoury of [[Sidearm (weapon)|sidearms]] for use by firefighters during civil defence operations. [189] => [190] => Another way in which a firefighter's work varies around the world is the nature of firefighting equipment and tactics. For example, American fire departments make heavier use of [[Fire engine#Aerial apparatus|aerial appliances]], and are often split between engine and ladder companies. In Europe, where the size and usefulness of aerial appliances are often limited by narrow streets, they are only used for rescues, and firefighters can rotate between working on an engine and an aerial appliance. [191] => {{cite web|url=https://www.fireapparatusmagazine.com/articles/print/volume-21/issue-6/features/fire-apparatus-united-states-vs-europe.html|title=United States vs. Europe|publisher=Fire Apparatus|date=2016-06-07|access-date=2019-07-17}}{{cite web|url=https://www.fireengineering.com/articles/2008/06/fire-commentary-european-firefighting-operations.html|title=Fire Commentary: European Firefighting Operations|publisher=Fire Engineering|date=2008-06-12|access-date=2019-07-17}} A final point in variation is how involved firefighters are in [[emergency medical services]]. [192] => [193] => ==Communication and command structure== [194] => [[Image:NSWFB112.jpg|thumb|[[Fire and Rescue NSW|New South Wales Fire Brigade]] station officer (red helmet) and firefighters (yellow helmets), Australia]] [195] => [196] => The expedient and accurate handling of fire alarms or calls are significant factors in the successful outcome of any incident. Fire department communications play a critical role in that successful outcome. Fire department communications include the methods by which the public can notify the communications center of an emergency, the methods by which the center can notify the proper fire fighting forces, and the methods by which information is exchanged at the scene. One method is to use a [[megaphone]] to communicate. [197] => [198] => A telecommunicator (often referred to as a [[000 (emergency telephone number)|000 Operator]] in Australia{{Cite web|url=http://www.triplezero.gov.au/|title=Emergency Management in Australia - Triple Zero (000)|date=July 27, 2010|archive-url=https://web.archive.org/web/20100727122723/http://www.triplezero.gov.au/|archive-date=2010-07-27}}) has a role different from but just as important as other emergency personnel. The telecommunicator must process calls from unknown and unseen individuals, usually calling under stressful conditions. He/she must be able to obtain complete, reliable information from the caller and prioritize requests for assistance. It is the dispatcher's responsibility to bring order to chaos. [199] => [200] => While some fire departments are large enough to utilize their own telecommunication dispatcher, most rural and small areas rely on a central dispatcher to provide handling of fire, rescue, and police services. [201] => [202] => Firefighters are trained to use [[Telecommunication|communications]] equipment to receive alarms, give and receive commands, request assistance, and report on conditions. Since firefighters from different agencies routinely provide mutual aid to each other, and routinely operate at incidents where other emergency services are present, it is essential to have structures in place to establish a unified chain of command, and share information between agencies. The U.S. [[Federal Emergency Management Agency]] (FEMA) has established a National Incident Management System.{{cite web|url=http://www.fema.gov/pdf/emergency/nims/NIMS_core.pdf|title=National Incident Management System|date=December 2008|publisher=U.S. Department of Homeland Security}} One component of this system is the [[Incident Command System]]. [203] => [204] => All [[radio communication]] in the United States is under authorization from the [[Federal Communications Commission]] (FCC); as such, fire departments that operate radio equipment must have radio licenses from the FCC. [205] => [206] => [[Ten codes]] were popular in the early days of radio equipment because of poor transmission and reception. Advances in modern radio technology have reduced the need for ten-codes and many departments have converted to simple English (clear text). [207] => [208] => ===Ranks=== [209] => {{Main|Fire department ranks by country}} [210] => Many firefighters are sworn members with command structures similar to the [[military]] or [[police]]. They do not usually have general [[Police|police powers]] (although some firefighters in the [[United States]] have limited police powers, like [[fire police]] departments), though certain fire safety officials (such as [[fire marshal]]s or [[fire safety inspector]]s) do possess extensive police powers in connection with their work of enforcement and control in regulatory and emergency situations. In some countries fire fighters carry, or have access to, firearms, including some US fire marshals, and the [[Corps des Sapeurs-Pompiers]] of Monaco which is a military unit providing civilian fire cover. [211] => [212] => The nomenclature of firefighting varies from country to country. The basic unit of firefighters is known as a "company" in many countries, including the United States, with its members typically working on the same engine. A "crew" or "platoon" is a subdivision of a company who work on the same shift. In British and Commonwealth fire services the firefighters of each station are more typically organised around a "watch" pattern, with several watches (usually four) working on a shift basis, as a separate "crew" for each engine or specialist appliance at that station.{{Cite web|url=http://www.humbersidefire.gov.uk/careers/becoming-a-firefighter/shift-patterns|title=Humberside Fire and Rescue Service: Shift patterns}} [213] => [214] => ==Firefighter equipment== [215] => {{Main|Glossary of firefighting equipment}} [216] => [217] => {{gallery [218] => |TurkishFirefighterMOPP4.jpeg|Turkish firefighters in [[MOPP (protective gear)|MOPP]] 4 level protective gear during an exercise held at [[Incirlik Air Base]], [[Turkey]] [219] => |TFS fire equipment.jpg|[[Toronto Fire Services|Toronto firefighters]] prepare their equipment [220] => |03262012Demonstraciones_rescate_erum_fabian_acuña137.JPG|A firefighter using a hydraulic cutter during a demonstration [221] => |Aa RN firefighter 01.jpg|[[Royal Navy|British sailors]] in firefighting gear on [[HMS Illustrious (R06)]], [[Liverpool]], 25 October 2009 [222] => }} [223] => A partial list of some equipment typically used by firefighters: [224] => * Hand tools, such as [225] => ** Flat-head and pick-head [[axe]] [226] => ** [[Pike pole]] [227] => ** [[Halligan bar]] [228] => ** [[Flashlight]] [229] => ** [[Spanner wrench]] [230] => ** Circular ("K-12"), Cutters Edge and chain saws [231] => ** [[Hydraulic rescue tools]] such as spreaders, cutters, and rams [232] => * [[Personal protective equipment]] ("PPE") designed to withstand water and high temperatures, such as [233] => ** [[Bunker gear]], including turnout jacket and pants [234] => ** [[SCBA|Self-contained breathing apparatus (SCBA)]] [235] => ** [[Firefighter's helmet|Helmet]], face mask and visor; climbing helmets [236] => ** [[Safety boots]], gloves, and [[Nomex]] and Carbon flash hoods [237] => ** [[PASS device|Personal alert safety system (PASS) device]] [238] => * Handheld radio, pager, or other communication devices [239] => * [[Thermal imaging camera (firefighting)|Thermal imaging camera]] [240] => * [[Gas detector]] [241] => [242] => ==History== [243] => {{Broader|History of firefighting}} [244] => [[Image:Old firefighters.jpg|right|thumb|A picture of American firefighters in the 1770s]] [245] => [[File:Vancouver firemen responding to a fire alarm.jpg|thumb|Vancouver firemen responding to a fire alarm, Vancouver, British Columbia, Canada. Photograph taken by W.J. Carpenter in 1910.]] [246] => [247] => Although people have fought fires since there have been valuable things to burn, the first instance of organized professionals combating structural fires occurred in [248] => [[ancient Egypt]]. Likewise, fire fighters of the [[Roman Republic]] existed solely as privately organized and funded groups that operated more similarly to a business than a public service; however, during the [[Principate]] period, [[Augustus]] revolutionized firefighting by calling for the creation of a fire guard that was trained, paid, and equipped by the state, thereby commissioning the first truly public and professional firefighting service. Known as the [[Vigiles]], they were organised into cohorts, serving as a [[Roman timekeeping#Watches of the night|night watch]] and city [[police]] force in addition to their firefighting duties. [249] => [250] => The earliest American fire departments were volunteers, including the volunteer fire company in [[New Amsterdam]], now known as [[New York (state)|New York]].Essentials of Firefighting Fire companies were composed of citizens who volunteered their time to help protect the community. As time progressed and new towns were established throughout the region, there was a sharp increase in the number of volunteer departments. [251] => [252] => In 1853, the [[Cincinnati Fire & EMS Department|first career fire department]] in the United States was established in [[Cincinnati, Ohio]], followed four years later by [[St. Louis Fire Department]]. Large cities began establishing paid, full-time staff in order to try to facilitate greater call volume. [253] => [254] => City fire departments draw their funding directly from city taxes and share the same budget as other public works like the [[police department]] and [[trash collection|trash service]]s. The primary difference between municipality departments and city departments is the funding source. Municipal fire departments do not share their budget with any other service and are considered to be private entities within a jurisdiction. This means that they have their own taxes that feed into their budgeting needs. City fire departments report to the mayor, whereas municipal departments are accountable to elected board officials who help maintain and run the department along with the chief officer staff.{{Cite web |last=rogerwaters3320 |date=2021-04-16 |title=The Difference Between a Fire Department and a Fire District. |url=https://firefighterconnection.com/the-difference-between-a-fire-department-and-a-fire-district/ |access-date=2023-12-13 |language=en-US}} [255] => [256] => ==Fundraisers== [257] => Funds for firefighting equipment may be raised by the firefighters themselves, especially in the case of volunteer organizations.{{Cite web|url=https://www.nvfc.org/volunteer-voices-fundraising-ideas-for-local-fire-departments/|title=Volunteer Voices: Fundraising Ideas for Local Fire Departments|date=October 7, 2019}} Events such as [[pancake breakfast]]s and [[chili con carne|chili feed]]s are common in the United States.{{Cite web|url=https://www.tracyfirefighters.org/pancake-breakfast/|title=Pancake Breakfast – Tracy Firefighters Association}}{{Cite web|url=https://www.bhpioneer.com/local_news/longtime-deadwood-firefighter-to-be-honored-at-annual-chili-feed-sunday/article_04ade58a-dec9-11e8-927d-4f2e521bbc2a.html|title=Longtime Deadwood firefighter to be honored at annual chili feed Sunday|first=Jaci Conrad Pearson Black Hills|last=Pioneer|website=Black Hills Pioneer|date=2 November 2018 }} Social events are used to raise money include dances, [[fair]]s, and [[car wash]]es. [258] => [259] => ==See also== [260] => [261] => * {{annotated link|Firefighting apparatus}} [262] => * {{annotated link|Firefighter arson}} [263] => *[[United States Air Force Fire Protection|USAF Firefighting]] [264] => * {{annotated link|Incident Command System}} [265] => * {{annotated link|Index of firefighting articles}} [266] => * {{annotated link|International Firefighters' Day}} [267] => * {{annotated link|Rescue}} [268] => * {{annotated link|Smokejumper}} [269] => * {{annotated link|Women in firefighting}} [270] => [271] => ==References== [272] => {{Reflist|30em}} [273] => [274] => ==External links== [275] => {{Wiktionary}} [276] => {{Commons}} [277] => * Fact Sheet for [https://www.cdc.gov/coronavirus/2019-ncov/community/organizations/firefighter-EMS.html?deliveryName=FCP_2_USCDC_10_4-DM26650 Firefighters and EMS providers] regarding risks for exposure to [[Coronavirus disease 2019|COVID-19]], [[Centers for Disease Control and Prevention]]. [278] => [279] => {{Fire fighting}} [280] => {{Fire services by country}} [281] => {{Fire}} [282] => [283] => {{Authority control}} [284] => [285] => [[Category:Firefighters| ]] [286] => [[Category:Occupational safety and health]] [287] => [[Category:Protective service occupations]] [] => )
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Firefighter

A firefighter is a highly trained individual whose primary role is to extinguish and prevent fires, as well as provide emergency medical services. They are part of a specialized profession that serves to protect lives and property from the destructive forces of fire.

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They are part of a specialized profession that serves to protect lives and property from the destructive forces of fire. The Wikipedia page on firefighters provides a comprehensive overview of their duties, training, equipment, and history. It explains that firefighters not only respond to fire emergencies but also handle other types of emergencies, such as rescuing people from accidents or hazardous situations. They often work closely with other emergency service providers, such as police and paramedics, to ensure public safety. The page details the various tasks and responsibilities of firefighters, including fire suppression, search and rescue, providing emergency medical care, and conducting fire investigations. It also highlights the risks and challenges involved in firefighting, such as exposure to hazardous materials, extreme temperatures, and physical exertion. The training section of the page explains the rigorous training process that firefighters undergo to develop their necessary skills and knowledge. It covers aspects such as fire behavior, safety procedures, operation of firefighting equipment, and even physical fitness. Additionally, the article discusses the equipment used by firefighters, including protective clothing, tools, and vehicles. It explains the different types of fire engines and specialized equipment used to combat specific types of fires and emergencies. The history section provides a historical overview of firefighting, dating back to ancient civilizations. It explores the evolution of firefighting techniques and equipment, highlighting key developments and landmark events in the field. Overall, the Wikipedia page on firefighters is a comprehensive resource that provides a wealth of information on this vital profession. It serves as a valuable reference for anyone seeking to understand the role and responsibilities of firefighters in society.

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