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THE ROANOKE FIRE-EMS CANCER PROJECT

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Roanoke Fire-EMS

on 18 August 2016

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Transcript of THE ROANOKE FIRE-EMS CANCER PROJECT

THe silent Threat

Goal
Impact
Post-Incident Operations
Follow-up approach to reducing exposure
to carcinogens.
SIGNIFICANCE
“Cancer is the most dangerous and unrecognized threat to the health and
safety of our nation’s firefighters.”

Mission
to reduce the exposure to known cancerous causing agents, thereby reducing the occurrence of cancer
for all Roanoke Fire-EMS members to understand the cancer risk associated with firefighting, and actively engage in cancer prevention through awareness, behavior, and action, making it a priority to improve the health of the individual and organization
YOUR RISK
Testicular cancer
Latency Period
How Carcinogens Enter Your Body
Anatomy of Smoke
Pre-Incident Strategies
Incident Operations
Personal Hygiene
Documentation
Decontamination
Proper Use of PPE
Cancer has impacted Roanoke Fire-EMS significantly and continues to be an overwhelming concern. It is a priority of the department to provide you with the proper training and tools. It is
your
responsibility to utilize the training and tools to protect yourself and your crew.
Firefightercancersupport.org
102%
Multiple myeloma
53%
Non-Hodgkin’s
lymphoma
51%
Skin cancer
39%
Prostate cancer
28%
Malignant melanoma
31%
You don’t care today because
of the ‘latency period’.

The time between the exposure and the appearance of malignancies.
What Is Cancer?
Your Attitude
Utilize Diesel Exhaust Systems
These systems are designed to reduce contaminants in the breathing air in the apparatus area and prevent them from entering the living areas.
Your choices directly impact your health

Be the leader in positive change

There are no do overs
Comprehensive medical exams that are regular, increase the chances of detection, treatment, and survival

They reduce the cost of overall healthcare expenses
Reduce your exposure before the incident occurs
Ways to reduce your exposure during the incident
Medical Screening
What Is Your Role?
Personal Protective Equipment
The dept is trying to secure funding for a secondary set of turn-out gear that allows time for proper cleaning between incidents.

In the mean time, gross decon gear and utilize 2nd hood and gloves.
Storage and wearing of turn-out gear, other than on fire calls, training, and within the apparatus bay is strictly forbidden.
Turn-Out Gear Storage
Turn-Out Gear Transportation
Transportation of turn-out gear in large black trash bags for travel between stations

Turn-out gear is not to go home


Cleaning & Maintaining
Personal Protective Equipment
Personnel will ensure that PPE will be rid of
soot, dirt, and toxins via turnout gear extractor
as soon as possible after an event
Clean the cab of apparatus, tools, SCBA's, and other equipment.


Cessation of tobacco products
Tobacco Use
Properly utilizing all personal protective equipment while operating in the IDLH, no exceptions.
Masks will not be removed until salvage and overhaul operations are complete. Even if
HCN readings are below 5ppm and CO below 35ppm, as microscopic particulates, such as asbestos, are still floating in the air.
Apparatus will remain out of service until personnel are able to shower and don clean clothing.
Apparatus will remain out of service until equipment, tools, and personal protective equipment is properly decontaminated and cleaned
Decontamination
Documenting exposures that are unusual

Follow-up with medical evaluation if necessary

Roanoke Fire-EMS tracks all exposures through Imagetrend and Red Alert
Extractors
Utilize turnout gear extractors at Stations 1, 2, 5, & 7 to clean gear after an event.

Smaller extractors to be ordered soon.

Brain cancer
31%
Colon Cancer
21%
Leukemia
14%
Cancer is the uncontrolled growth of abnormal cells in the body.
Exposures to various toxins cause the body to stop producing normal cells.

Old cells do not die and cells grow out of control forming a tumor, or mass of mutated cells.
The latency period can be 20 years or more.
5 Main Categories of Cancer
Develop in the brain and spinal cord

begin in the skin or tissues that line
the internal organs


Carcinomas
Sarcomas
develop in the bone, cartilage, fat,
muscle or other connective tissues
begins in the blood and bone marrow
Leukemia
starts in the immune system
Lymphomas
Central Nervous System Cancers
Inhalation
Dermal absorption
The skin is highly absorptive, and is the body’s second
largest organ
The permeability, or the ability of the skin to absorb,
increases with temperature, for every 5 degree increase in
skin temperature, absorption increases 400%.
Leukemia's
Lymphomas
Plantar Foot Arch
1%
Palm of Hand
6%
Back
12%
Forehead
43%
Jaw
93%
Scrotum /Groin
300%
Absorption
Rates
Toxins in Fire Smoke
CO, HCN, HCl, Nitrogen, Formaldehyde, Phosgene, Benzene, Polyvinyl chloride
Carbon Monoxide
Hydrogen Cyanide
(HCN)
Colorless gas whose odor is unrecognizable to 40% of the general public. It's odor is masked when we deal with the gas during a fire.
Colorless and odorless gas that is lighter than air and is present whenever combustion is taking place.
Rates & Statistics
Hydrogen Chloride
Bromomethane (methyl bromide)
Acetic acid
Methyl Chloride (Chloromethane)
Methyl Bromide (bromomethane)
Polyvinyl Chloride (PVC)
Soot (scrotum)
Mineral oil
Formaldehyde
Polyvinyl Chloride (PVC)
Benzene
Polyvinyl Chloride (PVC)
Benzene
Bromomethane (Methyl Bromide)
Polyvinyl Chloride
Oxides of Nitrogen
Hydrogen Chloride
Methyl Bromide
Acetic Acid
Soot
Other Long Term health Effects
of smoke toxins
Pulmonary Edema
Chronic Bronchitis
Fibrosis
Emphysema
Neurological/ CNS
Kidney disease/failure
Reproductive disorders
HCN: Is just one by product in smoke. Materials that give off HCN also give off many other carcinogens.
If the firefighters that died from cancer were added to the yearly LODD totals the figure would exceed 800 per year.... Firefighter Cancer Support Network

What are the numbers in
our
Dept?

Being downwind of a fire whether its brush, trash, vehicle, or structure fire without SCBA.
Smoke enters through airway, into the lungs, then the alveolis' and finally into blood stream.
4 Gas meters are set to alarm at 35ppm
Lighter than air
Formaldehyde
2-3ppm causes nasal irritation, 20-30ppm diff breathing, 50-100ppm serious injury

Watery eyes and itchy skin

Plastics, resins, preservatives

Heavier than air

Leukemia, Brain Cancer, Lymphoma
Oxides of Nitrogen
IDLH 20ppm

Affects the Cerebral Ventricular System "CVS" and Respiratory system

Will cause pulmonary edema- up to 2L in lungs

Delayed onset of up to 6 hours afterexposure
Gross decon before leaving the scene of turnout gear, SCBA, and tools.
Utilize "Rescue Wipes" to remove debris and soot from skin while on scene.

Remove hoods as soon as possible

Leave the fire debris at the fire.
Sunscreen
Utilize the individual sun screen packets, provided in the decon bucket, to protect yourself during training and incidents of long duration from UV rays.
Apparatus will
stay out of service when clearing
the fire ground until the following
criteria are met:
Cancers covered in the State of Virginia
Leukemia or pancreatic
Prostate
Rectal
Throat
Ovarian
Breast
Code of VA 65.2-402
Fiberglass Insulation
Carpet
Seat Cushion
PVC Pipe
Consistent 30+ppm of HCN
Maxes out at 49.9ppm of HCN
CO at 132ppm
HCN at 33.5ppm, peaked at 48ppm
All while not actively burning

HCN maxed out at 49.9ppm
CO at 128ppm
Meter was only exposed for
approximately 2 seconds
While burning
HCN at 26.5ppm
CO at 160ppm
Smoldering
HCN at 30ppm
CO at 430ppm
*Note: Our monitors max out HCN at 49.9PPM
Apparatus Placement
Make an attempt to place apparatus
upwind of smoke flow to keep operators of "Hot Zone".
Wear SCBA and mask even when operating around exterior of the structure.
Operators may be in position that wearing SCBA is necessary
Advance Auto Fire 2015
They are 100% source capture when used.....
Sources of Carcinogens
Polyvinyl Chloride / Vinyl chloride
(PVC)
PVC pipe
Wire covering
Toys
Shoes/ Clothing
Furniture
Upholstery
Cushions
Flooring
Door/ Window casings
Electronics
Formaldehyde
Resins
Plastics
Preservatives
Insulation
Dying agents
Clothing
Plywood
Particle board
Benzene
Synthetic fibers
Plastics
Resins
Rubber Lubricants
Dyes
Detergents
Pesticides
SOOT
Arsenic
Wood Preservatives
Alloy strengthening (car batteries)
LED's
Cadmium
Ni CAD Batteries
Color pigments
TV's
PVC
Chromium
Stainless steel
Cars
Chrome plating
*All 3 of these are highly carcinogenic*

Hydrogen Chloride
Rubber production
Production of PVC
Used to make
Hydrochloric Acid
used in photographic, textile,
rubber, and food prep
products

Bromoethane
Methyl bromide
Mainly in fumigation and pesticides
Acetic Acid
Solvent industrial process
Perfumes
Synthetic Fibers and textiles
Inks
Dyes
Manufacturing of Rubber
Methyl Chloride
Foam insulation
Aerosol propellants
Wood
Coal
Plastics
Silicone
Old refrigerators
Several studies have linked increased levels of CO in the blood to myocardial injury
There is evidence that post-incident heart attacks and sudden cardiac death is linked to CO exposure
Ultraviolet Rays Versus Your Skin
Full transcript