Evaluation of exposures and health effects in fire fighters following response to a chemical fire.

""The Health Hazard Evaluation Program received a request concerning occupational health concerns among fire fighters who participated in a fire response at a chemical manufacturer and distributor. Fire fighters extinguished an active fire in a chemical disposal vat. It was unclear what was in the vat and directly involved in the fire. Some of fire fighters involved in the response reported becoming ill inside the building, and others became ill upon leaving the building. While most responding fire fighters fully recovered, some had persistent symptoms they associated with their participation in the chemical fire response. We conducted two site visits during which all fire fighters from this department who responded to the chemical fire were invited to participate. We conducted confidential medical interviews, and we reviewed medical records and departmental incident reports, fire department standard operating procedures, chemical manufacturer chemical inventory records, and fire fighters' spirometry results. During the second visit, we administered a health questionnaire, performed spirometry and other breathing tests on fire fighters, and consulted with the fire department's occupational health provider who performed the department's annual and the post-fire response spirometry testing. Based on available information, we could not determine the exact exposures fire fighters encountered during the response. Many fire fighters reported symptoms that started while on scene at the chemical fire or shortly afterwards. The most common immediate symptoms reported were a dry cough shortness of breath, fatigue, and throat irritation. Some fire fighters had continued symptoms during our second visit. Our spirometry testing found one fire fighter with abnormal results. We determined that the fire department's action of performing spirometry after the response was appropriate due to the predominance of reported respiratory symptoms. However, future spirometry testing and the existing medical monitoring program can be improved. We recommended the fire department (1) audit practices and procedures regarding chemical fire responses and HAZMAT situations, (2) ensure standard operating procedures for chemical fire responses and HAZMAT situations comply with National Fire Protection Agency - NIOSHTIC-2NIOSH no. 20055840Recommended citation: NIOSH [2019]. Evaluation of exposures and health effects in fire fighters following response to a chemical fire. By Eisenberg J, Harvey RR, Feldmann KD. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Hazard Evaluation Report 2018-0080-3350, https://www .cdc.gov/niosh/hhe/reports/pdfs/2018-0080-3350.pdf.2019627