Prevention of Inhalation Injuries

In the emergency response professions there are many examples of inhalation exposures to combustion gases and even chemicals.

Excellent examples of the dangers of inhalation exposures to combustion gases are numerous. The February 27, 1975 fire in New York City at a New York Telephone Company is noteworthy because of the approximately 239 firefighters who required medical treatment on the day of the fire many of them developed chronic health problems in the ensuing months and years. Soon after the fire dozens of those firefighters developed several types of cancer including throat and larynx cancers. Many of those firefighter victims met a premature death as a result of the acute exposure at the fire to gases emanating from burning plastics and wire insulation.

It is also a well-known fact that many fire victims die as a result of inhaling toxic gases such as carbon monoxide and even hydrogen cyanide. In the average structure fire smoke many toxic compounds are generated with poisonous and carcinogenic qualities. In addition to those poisonous and chemical asphyxiants listed above the following gases are also evolved at nearly every fire as a result of our chemical world;

Hydrogen Chloride
Hydrogen Fluoride
Nitrogen oxides
Strong irritant
Poison, irritant, carcinogenic
Poisonous and asphxiant
Poisonous, caused by decomposing refrigerants
Poison, cause lung edema
Poison, irritant, caused by burning plastics

Chemical Fires

Chemical fires are equally as dangerous. A 1969 fire at a Fort Lauderdale, Florida fertilizer facility also has destroyed the lives of numerous firefighters and their families. Many forms of cancer started showing up in the firefighters several years after their exposures at this fire. The 1960's were the days when self-contained breathing apparatus were not used very often even if they were available. The firefighters did not wear any scba's the day of the fire and now their cancers can be traced to the incident at the fertilizer company. Through research by the local union it was found that the company had 39 compounds in which a dozen could be linked to cancer. Not surprisingly, the group of firefighters who fought the toxic fire has a rate of cancer that is 15%, nearly 6 times the normal cancer rate.

In a recent local fire that involved the combustion of the metal zinc at a casting company two firefighters developed metal fume sickness as a result of their inhalation to the zinc fumes. Despite several warnings to "mask-up" two of the three firefighters who entered the smoke-charged building did so without the protection their scba's afford. The third firefighter masked-up immediately upon entering the building and consequently did not develop any symptoms. Even though the exposed firefighters went to the hospital for an evaluation after the fire, later in the day they developed the symptoms of headaches, metallic taste in their mouths, and elevated body temperature, which is consistent with metal fume fever. This type of illness is usually transient (symptoms generally pass within 2 or 3 days) but can be life threatening if the exposure is great enough.

What do all of these inhalation exposures have in common? They were all preventable! Adequate use of scba's may have prevented the dire consequences that followed these incidents. Many departments stress the dangers of smoke and hazardous atmospheres and the use of protective equipment and even have standard operating guidelines or procedures in place to prevent responders from becoming victims yet these exposures continue to happen. As an industry, we have to change our approach to these situations. Prevention is the key!

Odor Investigations

Generally speaking, no exposure to combustion products is safe but when we respond to odor investigations we confront a dilemma; if we mask-up we will not be able to "sniff-out" the source of the odor and if we do sniff-out the source we may become over-exposed. Over-exposure is likely especially on investigations involving the toxic products of combustion and also with chemicals.

Odor investigations are common responses and in an article by FDNY's Battalion Chief Frank C. Montagna it is stressed that they should be investigated fully. Chief Montagna states that the common causes for odor investigations are;

  • food on the stove or in the oven
  • combustion materials in wastebaskets or even in bathtubs, sinks, or toilets
  • faulty flues
  • clothes dryers, washers, dishwashers
  • light ballasts
  • combustion materials that were placed in closets or too close to other materials