On July 30, 2014, I attended a Stakeholder meeting on Emergency Response and Preparedness in Washington D.C. at the Department of Labor. Bill Perry, Acting Director of Standards and Guidelines led the meeting along with his team of Deputy Directors and Advisors.
Opening statements made by Andy Levinson, Deputy Assistant Director of Standards and Guidance referred to events of September 11th and the more recent fertilizer plant explosion in West, Texas. The introduction included information that one member of the West Fire Department worked at the plant and that a member of the Dallas Fire Department (career firefighter) responded and died at the scene. Mr. Levinson went on to say, “the City of West Fire Department knew what they had, but didn’t know how to properly respond, manage and mitigate the incident.” Incidents like these have led to the need for additional regulations for emergency personnel.
The US Fire Administration conducts an annual analysis called, Firefighter Fatalities Statistics and Reports. For the past 36 years they have tracked the number of firefighter fatalities. Twenty-two firefighters were killed during fire ground operations in 2012. In 2010, there were 2.33 firefighter fatalities per 100,000 fire incidents in the United States. Between 1977 and 2012 there were 4,410 on-duty firefighter fatalities. The data reflects an industry lacking standards and is clearly the most dangerous job in America. Much of the data comes from the US Fire Administration. There was also lengthy discussion of FEMA, NFPA and NIOSH 2012 firefighter fatality reports.
OSHA Focus Is On Emergency Workers, including:
• EMS (EMT & Paramedic)
• Rescue Technicians
• HazMat Technicians
• Law Enforcement
• Security Officers
• Urban Search/Rescue and other Specialty Teams
• Emergency Management Specialist, and
• Other associated personnel who work closely with emergency workers:
o Utility personnel
o Tow truck operators, and
o Possibly more Other Rationales for Considering New Standards
OSHA standards are out-of-date, or in conflict with industry consensus standards and those adopted by Department of Homeland Security (DHS) and Federal Emergency Management Agency (FEMA). These standards do not address the full range of hazards facing emergency responders. Current standards don’t reflect changes in personal protective equipment (PPE) or health and safety practices effectively. While the primary focus of OSHA was originally fire brigades, but with recent hurricanes, wildfire outbreaks, disaster response efforts and changes in the federal government’s response to emergency response and preparedness, there needs to be standards that reflect the issues that emergency responders are facing. Options for standards include, but are not limited to incorporation by reference, integration of provisions and compliance alternatives of NFPA 1500 (health and safety programs), NPFA 1800 (PPE) and NFPA 1900 (series apparatus and equipment).
Scope of Discussion Items
The scope of discussions covered included:
• Emergency phases,
• Incident scenarios,
• Categorization and flexibility
Emergency phases discussed the pros and cons of Emergency Response and Preparedness standards concentrating on preparing for emergencies such as pre-incident planning and training versus comprehensively covering all phases of emergency response, including operations. It was recommended early on that the title of this stakeholder meeting be changed to “Emergency Preparedness and Response” to better put things in order.
Incident scenarios focused on the causes of most Line of Duty Deaths (LODDs) and injuries. The first three LODD were brought up by OSHA. There were two other LODDs brought up by the audience and referred to as “The elephants in the room,” that brought the total to five LODDs of greatest concern.
1. Sudden cardiac arrest (SCA)
2. Vehicle collisions,
3. Offensive verses defensive operations
The term “cause of injury” refers to the action, lack of action, or circumstances that directly result in the fatal injury. The term “nature of injury” refers to the medical cause of the fatal injury or illness, which is often referred to as the physiological cause of death. A fatal injury is usually the result of a chain of events, the first of which is recorded as the cause .
Sudden Cardiac Arrest
Firefighting is extremely strenuous work and can be the most physically demanding of human activities. Out of the 45 firefighters (55.6 percent) that died as a result of stress or overexertion in 2012, 39 of those died due to heart attacks. OSHA stated, “firefighters die from cardiac arrest within two hours of overexertion.” Fitness for duty, wellness programs, no smoking rules and medical screenings will be closely looked at and possibly required with new standards.
According to US Fire Administration 2012, 18 firefighters died (22.2 percent) as the result of 14 vehicle crashes, six involving personal vehicles and six involving apparatus, and six from two separate incidents involving aircraft. Not only are Firefighter’s at higher risk en route to calls, but also while working accident scenes. One Texas firefighter recently lost his life at an accident scene during an ice storm when he fell off a bridge to avoid being hit by a car.
Offensive vs Defensive Operations
Interior offensive operations conducted when defensive operations are warranted were of interest to OSHA. For example, in Dallas, Texas, 2013, an incident commander ordered troops back into a building that not only had been declared a defensive operation, but had heavy master streams pounding the building for several hours, in addition to a previous collapse. Firefighters were not only injured, but Stan Wilson a brother firefighter died. Poor decision making that leads to LODD cannot continue. Interior approach may not be warranted unless an immediate threat to life exists. “You can’t call it defensive and then engage the fire,” one participant explained. OSHA wants to make a difference for emergency personnel and they can do this, but only with standards that require employers to take care in protecting personnel. “Until we regulate, things won’t change and people will die,” said another participant. We have an opportunity to help write the future and get involved in writing these standards.
It seems to be a common opinion that firefighters are exposed to carcinogens on a regular basis. For example, once a fire is out, we remove our heavy gear and SCBA. Contaminates rise with heat, but once a fire cools (about the time we remove our mask) contaminates fall into a firefighters breathing zone. Overhaul/ demolition duties also create exposures to carbon monoxide, lead, asbestos and crystalline silica. These hazards are a recipe for cancer. 29 Code of Federal Regulations (CFR) for General industry and Construction industry standards protect workers from these hazards, but firefighters need the training, information and standards too. In addition, carcinogens may not have acute health effects that can be seen immediately. Cancer is the most probable chronic health effect of exposure to these health hazards, but the problem is, the exposure is buried in the past under many years of fighting fire with no documentation of exposures. Firefighters are dying at alarming rates from cancer. As a young rookie myself, coming off air early was seen as a “macho man” subculture approach to a firefighter’s work ethic. I remember looking up at my mentors thinking they were cool, because they could take the smoke better than me. Only now after becoming an OSHA instructor did I realize the risk. It was stated by one participant that, “more firefighters died from cancer related complications from 911 than the number of firefighters that were actually killed during the September 11th attacks.”
Mental disease and suicides caused by exposure to critical incidents and violence was also addressed. Emergency workers consistently manage the critical incidents, violence and now terrorism of our population. A Phoenix Fire Department representative stated, “They had as many as eighteen suicides of firefighters in the last several years.” Possibly more aggressive Critical Incident Stress Management could be an answer, but OSHA seems determined to get to the bottom of this issue. It was summarized as firefighters across America are in desperate need of direction and they are not getting it because there are no mandatory standards to protect them.
Emergency Categorization and Flexibility
Emergency Categorization looked at industrial fire brigades (NFPA 600) which contains different provisions for defensive exterior and offensive interior operations, but fire department (NFPA 1710 and 1720) contain no such categorizations. NFPA are only guidance documents and not enforceable. This issue was heavily and lively debated twice during the incident scenarios and emergency categorization. The flexibility discussion focused on considerations and flexibility that may need to be built in for state OSHA plans that cover municipal firefighters, including volunteers.
Other Topics Discussed
You have to have enough people there to pull off the job so “typing” a fire department, based on capabilities was discussed. Typing would include information as to what kind of incidents a fire department can manage. Adequate risk assessment and size up was debated as, one participant said “The City of Houston’s last firefighter died from lack of adequate size up.”
Also discussed was; Candidates Physical Ability Test (CPAT), Rapid Intervention Teams (RIT) teams, personnel accountability, incident command, modeling the National Incident Management System (NIMS) structure, two-man apparatus inefficiency, lack of rules, and lack of training, as well as the need for situational awareness training.
Reporting was also addressed as “we don’t really know how many fire departments there really are in America,” said one OSHA advisor. The NFPA, FEMA and State Plans have numbers of departments, but none of the numbers match. “We have people fighting fire that really have no experience or training and we don’t know about them until they die,” said a participant. A recent US Fire Administration report stated that 75% of fire departments in the nation are volunteer.
Lack of tactical skills, complacency issues, driver engineers with no commercial driver license (CDL) because firefighters were exempted years ago were added to the list OSHA is considering. “We have people driving emergency vehicles that we won’t let drive big rigs on the road,” a participant shared.
Another issue addressed mutual aid agreements that allow volunteer organizations to oversee paid professionals operating inside their jurisdiction. This alone puts paid professionals at a higher risk because some volunteer training requirements can be practically non-existent. Requirements for training evolved into a lively discussion ending with minimum training requirements that are the same for both professional and volunteer. There was a discussion on the cost to implement these rules which would force some volunteer departments to go away.
When balanced against safety, it was an easy choice to make. “Get the standards right and let the chips fall where they may,” said a participant. Personnel safety appeared to win over no standards to protect the most dangerous jobs in America. All this and more adds up to OSHA Standards are coming for Emergency Personnel.
I left the meeting with the impression that everything is on the table, but when I contacted OSHA requesting an email where we could send in information, they said, they are taking everything discussed into consideration and moving forward. I suppose the only way to share your opinion now is to contact your congressman.