An official website of the United States government 
Routine firefighting can expose firefighters to substantial cancer risk. A study in 2015 estimated that firefighters have a 14 percent increased lifetime cancer risk compared to the general public.
The decon challenge
Protective gear — pants, jackets, boots, gloves, facemasks, helmets and hoods — gets contaminated from emergency vehicle diesel exhaust and from toxic smoke arising from fire incidents. Exposure can occur from the off-gassing of toxins while removing gear post-fire or absorption through the skin from contact with dirty gear.
Using cleansing wipes on skin and field decontamination of dirty gear can significantly reduce these toxic exposures, but researchers have found that firefighters often don’t perform systematic decontamination procedures. The reasons for this vary but often relate to group norms, attitudes and perceived barriers.
The researchers’ hypothesis
Firefighters work in what researchers call high-reliability organizations, where the environment is high-risk and the organizational culture places emphasis on peer-support, teamwork and expertise. Group norms exert a very strong influence in that setting.
If firefighters believe that post-fire decontamination is effective, if they perceive their group of peers recognize the value of it, and if they can overcome any time or resource barriers to performing decontamination, then the researchers would expect to see an increase in post-fire decontamination behaviors.
The intervention
The program to increase decontamination behaviors relied on face-to-face presentations delivered by a member of the research team to audiences of 12-18 firefighters at a time. They presented it to 226 firefighters in the Palm Beach County and Boynton Beach Fire Departments (Florida).
The program had these parts:
- An overview of firefighter cancer risk (PowerPoint presentation, 5-7 minutes).
- Role of firefighter culture in addressing cancer risk. The messages were designed to show changing norms and culture, for example “clean gear as a badge of honor” (PowerPoint presentation, 7-8 minutes).
- Overcoming logistical barriers to decontamination. (PowerPoint presentation, 5-7 minutes).
- Overview of specially designed campaign materials available for use around fire stations. The messages promoted the seven steps to decontamination and the new norm of clean gear. (5 minutes)
- Videos showing the spread of toxins from bunker gear using invisible dye and highly respected firefighters talking about culture change and the decontamination process.
https://www.youtube.com/embed/UFzP1rQJWSQ
https://www.youtube.com/embed/m0u3S0T0hvI
Intervention takeaways
- Researchers measured a significant increase in firefighters’ intention to clean their gear following the presentation.
- Firefighter attitudes, perceived norms, and self-efficacy in overcoming barriers all showed substantial increases towards gear cleaning.
- A key element of the intervention was featuring highly respected firefighters delivering the principal messages and demonstrating the desired decontamination procedures. Peer influence in high reliability organizations like the fire service cannot be underestimated.
- The high occupational demands of the firefighters, who often were running 20 to 30 calls each day, made the reduction of barriers to decontamination behavior a key component in the intervention.
Key takeaway
An intervention that succeeds in increasing firefighters’ intention to perform post-fire decontamination procedures should result in decreased exposure to carcinogens and consequently a decrease in cancer risk from those exposures.
For more information on this study
- YouTube: Clean Gear as the New Badge of Honor. This video (25:25) demonstrates one approach to field decontamination. It gives firefighters many of the tools and knowledge they need to engage in field decontamination, as well as helping shift norms and attitudes toward clean gear.
- Firefighter Cancer Initiative Education Campaign. This site has the materials mentioned above and additional materials including posters used in the campaign, bumper stickers, standard operating guidelines implemented at fire departments in Florida, manuscripts, and additional videos developed by Palm Beach County Fire Rescue. (This site requires you to create an account but allows for download and non-commercial use of material.)
1Harrison, T.R., Yang, F., Morgan, S.E., Wendorf Muhamad, J., Talavera, E., Eaton, S., Niemczyk, N., Sheppard, V., Kobetz, E. (2018). The invisible danger of transferring toxins with bunker gear: a theory-based intervention to increase postfire decontamination to reduce cancer risk in firefighters. Journal of Health Communication, published online, 1-9. DOI: 10.1080/10810730.2018.1535633
Learn more about this research
Summary information for this article was provided by the NETC Library. You can find this article in our library.
This summary is for informational purposes only. As such, the content does not reflect any official positions, policies, or guidelines on behalf of the sender, the U.S. Fire Administration, FEMA, DHS, nor any other federal agencies, departments or contracting entities. Similarly, this summary does not represent in any manner an official endorsement or relationship to any private or public companies, organizations/associations, or any authors or individuals cited or websites associated within the article.
Explore other articles
- Filter:
Supporting Women in Fire and EMS: The USFA Commitment
Learn about our professional development opportunities and resources to help departments keep women safe and healthy on the job.
Interdependent factors can influence WUI fire home survivability
Learn about research findings related to weather, terrain, building materials and property layout and actionable steps that communities can take to reduce wildfire-related loss.
New materials highlight row house firefighting safety
The National Institute for Occupational Safety and Health recently released a free fact sheet and poster that highlight tactics for fighting row house fires and areas for potential fire extension.
Post-wildfire recovery
Considerations and suggested resources to help communities rebuild and individuals to recover after a wildfire.
Serve Up Fire Safety in the Kitchen!™
This year's Fire Prevention Week (Oct. 4-10) campaign works to educate everyone about the simple but important actions they can take to keep themselves, and those around them, safe in the kitchen.
Include everyone in community wildfire preparedness
Pre-fire planning tips for wildfire to help ensure that your whole community's resilience is considered.
Preparedness Month and fire safety
Severe weather can happen at any time, in any part of the country. That's why it is important for your community to be ready for severe weather events and to understand the fire risks that can come with them.
Respiratory Protection Week 2020
The National Institute for Occupational Safety and Health has assembled informative webinars and other content to help you make the best decisions about respiratory protection and to keep you safe.
A pictograph is worth a thousand words
Our pictographs can help you reach everyone in your community with fire and life safety messages.
Hurricane Isaias shows why storm fire safety matters
Despite making landfall as a weak Category 1 hurricane, the wind and storm surge from Isaias caused significant fire safety problems for Ocean Isle Beach, North Carolina.
New graphics highlight wildland firefighter safety messaging
Graphics for wildland firefighters that depict the 10 Standard Firefighting Orders and 18 Watch Out Situations are available for download.
Minimizing the effects of wildfire smoke during COVID-19
Inform your community about these actionable steps they can take to minimize the respiratory effects of wildfire smoke.
Retrofitting homes with lower cost sprinkler technologies
USFA is working with the UL Firefighter Safety Research Institute on research to reduce home fire sprinkler retrofit complexities.
Doing the little things makes a difference in wildfire safety
Learn about simple and low-cost actions that homeowners can take to protect their homes from wildfire.
First responders: know your fire investigation role
This year's Arson Awareness Week (May 3-9) highlights the crucial role that first responders can play in a successful fire investigation.
Fire onboard: safety tips for boaters in your community
Resources you can use to make people in boating communities aware of onboard fire dangers and how to prevent boat and marina fires.
WUI fire evacuations: how national address point data helps
A national address point database can be of value to officials during wildfire evacuations by allowing for more precise mapping and improved information sharing.
Mitigating the risk and impact of assaults on EMS responders
The SAVER checklist helps departments assess and implement training, policies and practices to mitigate assaults on EMS responders.
Helping assaulted first responders during legal prosecutions
Recommendations to overcome common obstacles to the legal prosecution of people who assault first responders.
How organizational factors affect firefighter cancer screening
Having two or more health and safety officers influences the availability of firefighter cancer screening.
Teach your community about the dangers of fire
A recent survey shows that many in your community probably don't understand the life-threatening risks from heat and toxic smoke produced in a modern home fire.
Community paramedics helpful in treating home-bound patients
A community paramedicine program, integrated with an advanced illness management program, can be effective in treating frail, older adults in their homes.
Mitigating wildfire vulnerability: one community's success story
Learn how the Montecito Fire Protection District used a socio-ecological mitigation approach to successfully fight the Thomas Fire.
Medal of Valor ceremony recognizes two Kansas firefighters
U.S. Fire Administrator Keith Bryant attended the Public Safety Officer Medal of Valor ceremony at the White House on May 22, 2019.
Assessing cardiovascular disease risk with push-ups
Can a simple exercise like a push-up be an inexpensive way for fire departments to assess cardiovascular disease risk in firefighters?
Using nanotechnology to minimize fire damage
Nanotechnology, manufactured at scale and low cost while posing minimal health risks, may potentially point to a future with fewer fires that are less lethal and less damaging.
A better DC hot stick technology is on the way
New tool will help prevent first responder electrical injury.
Takeaways from a hoarding intervention strategy
A recent study of the City of Vancouver’s Hoarding Action Response Team provides key takeaways for fire departments.
Firefighter decon challenges? Try a communication intervention.
Learn about a communication intervention strategy designed by researchers to increase post-fire decontamination behaviors in firefighters.
Firefighter decon challenges: knowledge versus practice
Understanding firefighter beliefs related to decontaminating bunker gear is an essential first step to reduce exposure risks.
Dual dispatch to cardiac arrest: can it save lives?
Dual dispatch of EMT-trained firefighters shortens response time and increases survival chance for out-of-hospital cardiac arrest patients.
Waking children with maternal voice smoke alarms
A new study from Nationwide Children's Hospital shows that maternal voice smoke alarms are more effective in waking children than conventional tone alarms.
How one homeowner saved his house from the Carr Fire
Learn about wildfire mitigation measures one California homeowner took during construction and maintained over the years to make his home fire-resilient.
EMS Mobile Integrated Health during disaster response
How one community's MIH providers assisted with patient care during severe flooding.
Training helps EMS workers identify human trafficking signs
Learn about the key components of a human trafficking training and awareness program for EMS workers.
Reducing airborne contaminant exposure with fireground tactics
New study provides valuable insights into fireground exposure risks and ways to mitigate them.
Smoke alarm messaging: Facebook ads versus phone calls
Study shows automated calls were more successful than Facebook ads in getting residents to request a free smoke alarm install.
Fire and life safety concerns in peer-to-peer lodging
Fire departments and communities around the U.S. are starting to recognize and address the unique fire safety concerns that peer-to-peer lodgings, like Airbnb, present.
Circuit training impact on volunteer firefighters’ cardiovascular health
About 20 percent of volunteer firefighters meet the VO2 max fitness level recommended by NFPA 1582. So how might volunteer firefighters best improve their cardiovascular fitness? A study published this year explored how circuit training may help.
Mitigating fireground injury risks: Suggested interventions
Firefighting poses many hazards that come in a wide variety of work settings. A recent study focused on the scope and nature of fireground injuries to determine what steps fire departments can take to better mitigate hazards posed by certain risks.
Home fire safety canvassing: Achieving better results
Planning a home canvassing event? These research-based tips can help you to win maximum neighborhood participation.
Firefighter burnout and workplace safety
Are firefighters who show symptoms of burnout less likely to follow safety procedures? A team of researchers recently set out to learn if burnout impacted a firefighter’s ability to follow required safe work practices.
New Firefighter Cancer Registry will help to monitor cancer incidents
The voluntary registry will include the number and type of fires each firefighter attended.
Study reveals successful smoke alarm installation partnership
Find out what happened when Maricopa County, Arizona firefighters partnered with nurses from a home visiting program to get smoke alarms into homes of the “hard-to-reach.”
Fire sprinkler tax incentives for small businesses
Fire service officials: Here’s some news that you can share with local small business owners to encourage them to install fire sprinklers.
EMS prehospital documentation accuracy: Can body-worn cameras help?
This article discusses the results of a pilot study where EMS providers used body-worn cameras to see if they could help to improve the accuracy of their prehospital documentation.
Factors that contribute to preventable firefighter deaths
A recent study highlights the importance of SOPs in preventing firefighter fatalities.
Clear boarding creates a ”no ply“ zone
There’s a new alternative to plywood for boarding up vacant and abandoned buildings that can help prevent arson: clear board.
Clean gear is the new badge of honor
This article looks at firefighter perceptions of dirty gear and how Palm Beach County Fire Rescue promoted organizational resilience to combat the risk of firefighter cancer from dirty gear.
Clean your PPE and skin post-fire to reduce chemical exposure risk
Firefighting activities can lead to chemical contamination. This article presents research findings on cleaning personal protective equipment and skin to reduce chemical exposures.
Transforming cardiac emergency care with drone delivery of AEDs
Preliminary studies suggest that medical drones may make a life-saving difference in providing emergency care to cardiac arrest patients, especially those in a rural setting.
Turnout times: How important is time of day?
Research findings from a recent study into how station design of dormitory location and the time of day of the emergency affect turnout times.
The effect of repeated exposure trauma on firefighters
This article details findings from a research project that studied the impact of repeated exposure trauma on firefighters.
New report offers insights for emergency responders on chlorine releases
Multiagency chlorine release experiments were conducted in part to help emergency responders meet the planning, tactical and operational challenges of a catastrophic Toxic Inhalation Hazard release.