Two comments that I’ve heard in the fire stations recently, and you’ve probably heard similar comments in yours are, “I don’t care if I never respond to a structure fire again in my career if it means contracting issues down the road,” or “I’ll be glad if I never have to fill out another exposure form for a fire I’ve responded to!” Long fought battles with cancer that have ended with loss of life have begun to weigh heavy on firefighters. It seems the trend has continued to increase with no end in sight, and yet the one thing that has resonated in my mind is a quote one of my early mentors regularly used, “If We Keep Doing What We’re Doing, We’ll Keep Getting What We’ve Got!”
We’ve recently had a half dozen very serious battles with cancer over the past few years that has unfortunately taken the lives of two of our younger firefighters, and has left the others with minor to moderate damage from the side effects of cancer. Our trend has grown to a level of a new case of some form of cancer every 75 days. Other surrounding larger departments are experiencing a new case every 3 or so weeks. Many of our members look to early retirement after events like this, or at minimum begin to look more critical at how we manage the day to day dangers that we face. It raises the critical questions within our department as well as all of yours, 1) Are we raising the awareness of cancer and it’s causes within our department? 2) Are we implementing procedural changes to reduce exposure on the fireground? 3) Are we providing decon after recognizing the exposure? 4) Do we follow through with a QA process that evaluates whether we did what we said we wanted to do on scene for our people? I believe we do quite well with 1-3, but suffer greatly with #4 which defines clearly whether any or all of it is being put to practice. We must do better!
From a Chief’s perspective in a department where we do diligence to both inform and implement, I can honestly say that even still, we have members unaware of the level of toxic exposure they are subjected to on fires. Some look at it like it’s a crap shoot where eventually you’re going to roll “Snake Eyes!” a a former hazmat tech and instructor, I happen to think it’s far more scientific than that. Many are hearing for the first time about studies like the one out of Tucson Fire where they teamed up with Dr. Jeffrey Burgess from U of A to study exposure. For a three year period they tested their firefighters after every working fire to gather information regarding exposure levels for the transitional attack crews on the outside, the interior attack crews, and even the engineers pumping the fire. They consistently found significant levels of PAH’s (Polycyclic Aromatic Hydrocarbons), carcinogens like Benzine in their post fire blood draws, urinalysis, and breath testing, indicating that the toxins were penetrating their protection and entering their body. When our firefighters were told about this study they were curious why they have never heard this. We all have a responsibility to continually educate ourselves and our team on the hazards related to the job, as spoon feeding is for our youth. Many of our current decon-after-the-fire methods have come from this particular study. It begs the question, “Are we explaining, teaching, reinforcing with passion, and clarity in order to motivate and inspire change among our firefighters?”
It was just this kind of study that helped motivate me to come up with an even better solution to this increasing crisis. The knowledge from that Tucson study that exposure for every additional minute interior on a working fire led them to an absorbed amount of Benzene increased by approximately 1%. That a shower at two hours actually showed an increase absorption over the ones that could get a shower within the hour. And bagging our first set of turnouts for cleaning, using baby wipes to clean those vulnerable areas, and hand washing upon entry to rehab prior to replenishment all led to an increased reduction in absorption of toxicity into our body. They determined that these combined decon procedures could reduce the toxins absorbed into our firefighters by one third. So I began working on an effective fireground strategy that could work on reducing the other two thirds by minimizing the exposure.
First we must recognize why the strategy for decon after the fire is so valuable. 33% reduction in toxic exposure is a huge accomplishment for our industry. But it’s almost like putting the cart before the horse. It appears that we have been approaching the solution to this problem of exposure as if we accidentally became exposed and then realized, “We have to get this stuff off of us!” But once we realize it’s no accident, and that we knowingly expose our people again and again to the same “Toxic Bath” (IDLH Atmosphere) that exists with most every working fire, we become complicit, almost negligent if we continue without working on implementing change that will affect this trending curve upward. We must focus on that other two thirds that decon couldn’t remove. The amount of exposure is critical!
Change Must Come in the form of Tactics! We must put the horse before the cart, and begin to manage the exposure time and more importantly, the exposure amount. Two years ago I wrote an article in Fire Rescue 1 titled, “Combining Transitional Attack and Early Ventilation to Reduce Toxic Exposures.” It’s worth reading. What’s more interesting about the article and concept is how my plan has morphed since it published in March of 2020. While improving upon cancer prevention our department removed all gas powered fans on all engines to create space to fulfill our plans for clean cab, a proven method for contamination reduction, but this created a dilemma to implementing this new plan to reduce exposure. Without fans on those first arriving engines, we couldn’t delay our number one priority of “Rescue” while waiting on a ladder truck to arrive to perform early ventilation as described in the article. What fire crew would buy into those tactics? Then Covid 19 hit, training came to a fast halt, and I was faced with either giving up on honoring our fallen comrades that had succumb to this vicious demon, or adapting and overcoming. I had to come up with an alternative form of early ventilation to provide the effect I was proposing, but many of you can begin simply with the strategy laid out in my first article. We had to work on an alternative, and it came at a perfect time. We were looking into changing out our toxic class B foam and our 20 gallon tank of class A foam in search of a product that would work on both A and B and could be delivered using the same tank and in-line educator system.
What happened next was the development of the “Arizona Method for Cancer Reduction!” We landed on a new product called F500, an encapsulating agent. I’ve never seen anything in the firefighting business quite like this! I have linked some video on my website showing how it works, with some information on how you can reach out to them directly for a demo anywhere in the world. Initially when we were shown the product by the sales rep, it was explained how effective this agent would be on all class A, B, C, D, K and lithium batteries fires. The one rep was very impressive in how he demonstrated F500s capability of extinguishing quickly, cooling the surface immediately, and controlling that typical pesky burn back we experience as we would advance our hose within a hallway only to realize fire licking back up behind us. I listed to a Mayday video just the other day with a fire that did just that! This product puts it out for good, but seeing is believing. The other sales rep’s focus was on the chemistry behind this products ability to encapsulate the carbon molecule in order to not only remove the fuel, but the heat, two vital sides of the fire tetrahedron. Some was mentioned during their lecture about the toxic reduction aspect of this carbon encapsulating agent, but at first it didn’t sink in for most of us. We are visual learners, and so many of us were overwhelmed with the ability to extinguish large amounts of fire quickly, and missed the best part! When faced with adversity to my original plan of cancer reduction through early ventilation, the toxic reduction capability of F500 became my primary focus when developing this new method for Cancer Prevention.
Clemson University did an independent study of F500, meaning the manufacturer had nothing to do with the study. They created a system where they could burn toluene fuel in a pan and funnel the exhausting smoke upward so it passed through a misting system. One system was set up to mist the smoke with water and the other was set up to mist the smoke with a 3% solution of F500 since this was a class B fuel, and yet neither system was designed to extinguish the actual fire. The study was designed to show the visual improvement and toxic reduction effects while passively moving a toxic cloud of toluene smoke through both water and separately then through F 500. The water misting test had little effect on visual improvement as well as reducing the toxicity that passed through. That should come as no surprise to us, for a fog stream doesn’t change that we can’t see our hand in front of our face in a smoke filled house on fire. The F500 funnel improved visual acuity after passing through the mist by 68% and it acted as a scrubber and reduced the toxicity that was allowed to pass through the mist by 98.6%! There again, since many of us are visual learners, I’ve provided an easily understood chart that went along with the results. (See Below)
To me, this begged the question, “Why are we not using this product at 1% on all of our initial attack lines as prescribed by the manufacturer for Class A combustible fires?“ Hence the “Arizona Method” was born. Six years ago our department applied a change to our fire ground tactics that aligned ourselves with Modern Fire Tactics and Strategy. We developed and implemented the transitional attack system, or knock down of the fire from the exterior when found. This not only served as a great reset of the fire that rendered the interior attack far more safe, it was considered that water was now on the seat of the fire which allowed us immediate opportunity to begin a controlled coordinated ventilation from the entry point to the exhaust location where fire was found initially blowing out.
I know there are command officers that are reluctant to apply a fan for ventilation so early in the attack of the fire, but let’s be honest, the bad experiences you’ve had were few and the majority of time were related to poor or no management of the fan during ventilation. And let’s also be clear, what I’m describing here Is Not PPA. PPA does not apply a transitional attack from the outside first to knock down the fire, it applies a fan on the up wind side for you to follow in to the seat of the fire once an opening twice the size of the entry has been created. This is not that. The science put forth by NIST on Positive Pressure Ventilation states that once water has been put on the seat of the fire the occupancy can be opened up fully and completely ventilated more safely and effectively. So that was my theory two years ago with the original article, to pre-ventilate for 30 seconds prior to sending that first crew in through the front door, after of course the transitional attack had been made. But fans were removed, and like I said, an alternative method for ventilating had to be established.
We settled on F500 at 1% being utilized for the transitional attack, and encapsulation of that cloud of smoke in the area of origin. We followed that with an additional interior attack line with F 500 at 1% that began encapsulating the carbon upon entry. On most room and content house fires we encountered heavy smoke midway to the floor and moderate to heavy heat. We then hydraulically ventilate, a term I refer to as “Venting Forward,” as the crew make their way, while simultaneously searching, to the seat of the fire and continually flowing all the way into the room of origin and through the exhaust window for 15-20 seconds until the toxicity is mostly encapsulated and removed from the house. Twice the exhaust opening is not required since the fire has had a good portion of it’s energy removed.
When you envision this method being trained and implemented envision the Clemson study of the toxicity being washed or encapsulated out of the environment. Consider the reduced amount of PAH carcinogen exposure our firefighters then encounter. Consider the quick knock down. Consider the visual improvement aiding in quick and effective search and rescue. And consider venting forward to remove the toxicity quickly. Now we’re effecting toxic levels and exposure time, that other two thirds. If you don’t have the encapsulating F500, then apply the Arizona Method using water only and hydraulically “Vent Forward” as you make entry and make your way to the seat of the fire. Or use the original method I described with a transitional attack, early ventilation with a fan, and continued hydraulic ventilation until you reach the room of origin. Logically you are increasing that flow path towards the exhaust which will also hydraulically remove a good amount of the toxins produced by the fire, even if not scrubbed and encapsulated.
Continuing to fight fire the same traditional way we’ve been doing is a mistake. Fighting from the inside while entering the house from the unburned side, and exposing our people to the toxic bath of carcinogens is what will continue to place us in immediate danger, and increase our susceptibility to contract cancer. “If We Keep Doing What We’re Doing, We’ll Keep Getting What We’ve Got!” The “Arizona Method for Cancer Reduction,” is the solution!
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