Untitled Web Page s1

LESSON 27 PROTECTION FROM HAZARDOUS MATERIALS OUTLINE Objectives Introduction Health Hazards Exposure Levels Types of Personal Protective Equipment Lessons Learned Key Terms Review Questions Endnotes Suggested Readings CLASS ASSIGNMENT Prior to this lesson: Read Firefighter's Handbook, Chapter 27, pages 781-800 Length: 2 hours, 40 minutes Equipment/Supplies: Course outline Transparency masters--Chapter 27 PowerPoint Presentation--Chapter 27 Overhead projector, slide projector, or LCD display Samples of PPE for HAZMAT incidents OBJECTIVES After completing this lesson, students should be able to:  Describe the causes of harm.  Explain the health hazards associated with chemical releases.  Discuss various chemical-related health terms.  Identify the various levels of PPE.  Demonstrate the use of SCBA and other respiratory protection at chemical releases.  Demonstrate the use of firefighting protective clothing at chemical releases.  Explain the signs and symptoms of heat stress. INTRODUCTION Firefighter's Handbook, page 783 Time: 15 minutes Key Points

 PPE takes on many different shapes and versions.  When dealing with hazardous materials, these configurations are endless.

 The failure to use PPE, or using it improperly, may cause an individual injury or have fatal effects.

 The best protection for the first responder, above all else, is to use the self-contained breathing apparatus (SCBA).

 Firefighter turnout gear offers limited protection against some chemicals, but it is not intended for use at a chemical spill response.

 As the need to be in the hazard area increases, so does the need for the proper PPE.

 In general, HAZMAT technicians and specialists wear chemical-protective clothing.

 Persons trained at the Operations level may be required to don chemical-protective clothing to perform decontamination operations or other patient-related decontamination operations. HEALTH HAZARDS Firefighter's Handbook, pages 783-788 Time: 45 minutes Key Points Toxicology

 Toxicology is the study of poisons and their effects on the body.

 The focus of industrial hygienists is the chemical hazards that exist within an industrial facility.

 When dealing with emergency situations, information is needed quickly. A quick consultation with an industrial hygienist may make the incident easier to resolve. Types of Exposures

 There are two types of exposures: acute and chronic. Both types can have serious health effects.

 Typically, there is little damage or effect noted after an acute exposure.

 This one-time exposure is not harmful for most people, nor would it cause any long-term effects. Types of Hazards

 As with the IMS, several methods are used to identify possible hazards at a chemical release.  The most common method in use today is known by the acronym TRACEM:

 Thermal.

 Radiation.

 Asphyxiation.

 Chemical.

 Etiological.

 Mechanical.

 Much like the risk-based response theory, the use of TRACEM assigns a chemical to a risk category so that tactical decisions can be based on that classification. Categories of Health Hazards

 One of the most commonly used terms relating to health hazards is carcinogen, which refers to a material with cancer-causing potential.

 The American Conference of Governmental Industrial Hygienists (ACGIH) provides health and safety information regarding chemical exposures, specifically cancer information.

 The American Chemical Society estimates that there are 10.8 million chemicals on the earth, of which only twenty-six have been identified as known cancer-causing agents.

 According to the ACGIH, there are an additional 126 suspected cancer-causing agents.

 Firefighters are exposed to a large number of chemicals, many of them known cancer- causing agents, but if firefighters wear their SCBA these exposures are unlikely to cause problems.

 Another term that is commonly used is irritant, which is self-explanatory.

 An irritant is not corrosive but mimics the effects of a corrosive material in that it can cause irritation of the eyes and possibly the respiratory tract.

 Sensitizer is a term that is used to describe a chemical that causes an effect that is, in reality, an allergic reaction.

 Some chemicals only affect one or more organs and are described as target organ hazards, while others may affect an entire body system, such as the central nervous system.

 The effects depend on the individual dose, concentration, and length of exposure.

 The four primary routes of exposure are: respiratory, absorption, ingestion, and injection.  Gases, vapors, and solid materials such as dust and other particles can affect the respiratory system.

 When dealing with respiratory hazards, there are two categories of asphyxiants: simple and chemical.

 Simple asphyxiants merely exclude the oxygen from the air and push it out of the area.

 Normal oxygen levels are 20.9 percent in air. The human body starts to develop difficulty breathing at less than 19 percent.

 Serious problems start to occur at less than 16.5 percent oxygen.

 If the concentrations of simple asphyxiants are high enough, death could result.

 Chemical asphyxiants, in contrast, cause a chemical reaction within the body and will not allow it to use the readily available oxygen.

 The most common chemical asphyxiant is carbon monoxide (CO).

 Because hemoglobin has an attraction for CO about 225 times that of oxygen, it will not allow the oxygen molecules to bind with the blood, causing severe health consequences.

 The other common route of entry is via skin absorption, because the skin is the body's largest organ.

 The number of chemicals that are toxic by skin absorption is relatively low, but precautions should nonetheless be taken to minimize contact with them.

 The only way to provide skin protection is to wear the proper protective clothing that will not allow the chemicals to get onto the skin.

 The other route of entry is ingestion, which is more common than one would think.

 One other route of exposure is injection, although it is not considered to be one of the major routes.

 The most common material that people are exposed to is body fluids, or what is referred to as bloodborne pathogens.

 Factors that affect the rate of exposure, regardless of the route, are basic items such as temperature, pulse, and respiratory rate.

 The damage that chemicals create is based on the following equation: Effect 5 Dose 1 Concentration 1 Time. EXPOSURE LEVELS Firefighter's Handbook, pages 788-790 Time: 30 minutes Key Points

 In industry, monitoring for exposures is commonplace and is usually a preventive action, but in the emergency services it can be an afterthought.

 The key to preventing exposures is to monitor for hazardous materials and to wear the appropriate PPE.

 OSHA is the one key agency involved with exposure values.

 The ACGIH is a group that advocates worker safety and conducts a lot of studies regarding chemical exposures.

 The National Institute of Occupational Safety and Health (NIOSH), a research arm of OSHA, issues recommendations for exposure levels.

 The exposure values are based on the tolerances of an average male and are created for industrial applications.

 The exposure values are typically based on an 8-hour day, 40-hour workweek with a 16-hour break between exposures.

 The most common exposure values are expressed in ppm, but for some materials (typically solids) the values may be expressed as mg/m3.

 The values are generally for a period of time, usually 8 hours.

 OSHA refers to this 8-hour exposure value as the permissible exposure limit (PEL).

 The ACGIH refers to this 8-hour exposure value as the threshold limit value (TLV).

 In some cases these exposure values are called time-weighted averages (TWAs), and they may be expressed as the OSHA-TWA or the ACGIH-TWA.

 NIOSH issues recommended exposure limits (RELs), which are for a 10-hour day, 40-hour workweek.

 Other values listed for chemicals include the ceiling levels, referred to as the PEL-C or TLV- C.

 Safety organizations may attach a ceiling level to an exposure value, which is the highest level that an employee can be exposed to, regardless of what the end average is.

 Another exposure value is the short-term exposure limit (STEL).  This value is assigned to a 15-minute exposure.

 An employee can be exposed at this level for fifteen minutes, and then is required to take an hour break from the exposure.

 The last value can be confusing because it is called the immediately dangerous to life or health (IDLH) value.

 This is the value of the maximum airborne concentration that an individual could escape from and not suffer any adverse effects.

 Other values that a responder may see are called lethal doses (LD50) or lethal concentrations (LC50).

 The LD is for solids and liquids, and the LC is for gases.

 The 50 attached to the LD or LC means 50 percent of the exposed population.

 It is generally recommended for emergency responders to use the TLVs or PELs as the point as which SCBA should be utilized. TYPES OF PERSONAL PROTECTIVE EQUIPMENT Firefighter's Handbook, pages 790-799 Time: 60 minutes Key Points

 The most common type of PPE for the firefighter is turnout gear (TOG).

 Firefighter TOG is not certified for chemical contact, nor should it be used for chemical protection. Self-Contained Breathing Apparatus

 SCBA offers a protection factor of 10,000. This means a person wearing SCBA has a survivability rating 10,000 times greater than a person who is not wearing SCBA.

 The SCBA must be fitted properly to the person and must be a positive-pressure device.

 When determining the use of SCBA, one has to consider the time it takes to enter the hazard area, the working time, time to leave the area, and time to be decontaminated and undressed.

 Some teams and persons who deal with waste sites may use supplied air respirators (SARs).

 Some response teams use air-purifying respirators (APRs) for minor spills.

 With terrorism and blood-borne pathogen issues becoming more commonplace, however, there will be an increased use of APRs.  APRs also require fit testing just like the SCBA to ensure that the respirator fits and will offer the wearer protection.

 Problems with SCBA include the extra weight, fatigue, lack of visibility, lack of mobility, contribution to heat stress, the need to refill the air supply, and other limiting factors.

 The users of SCBA and chemical protective clothing need to be medically-cleared to function with this type of PPE. Chemical Protective Clothing

 There are four basic levels of chemical protective clothing, but these levels are broken down into further components.

 Both OSHA and the EPA use Level A, B, C, and D, with Level A being the highest level of chemical protection.

 Some of the suits that are NFPA certified do come close to these levels, but there are a couple of chemicals that they are not to be used with.

 Chemical compatibility is based on the permeation of a chemical through the fabric of the suit.

 Level A protective clothing is thought of as providing the highest level of protection against chemical exposure.

 It is a fully encapsulated suit, and sometimes it is called an encapsulated suit instead of a Level A suit.

 The requirement to use Level A suits is when a firefighter is entering an atmosphere above the IDLH value and the chemical is toxic by skin absorption.

 The Level A garment typically consists of the following components:

 Encapsulated suit with attached gastight gloves and boots.

 Inner and outer gloves.

 Hard hat.

 Communication system.

 Cooling system.

 SCBA.

 PBI/NOMEX coveralls.

 Overboots.  Within the Level B family, there is a lot of variety in suit types.

 Although the EPA and OSHA acknowledge two basic types, a large number of styles are available.

 The encapsulated style of Level B suits is similar to the Level A style, but does not have attached gloves, nor is it vapor tight.

 The Level B encapsulated suit is the workhorse of HAZMAT teams, and is the most common suit used.

 The encapsulated Level B suit is sometimes referred to as the Bubble B or a B plus suit.

 A Level B suit ensemble consists of the following components:

 Level B suit.

 Hard hat.

 SCBA.

 Communication system.

 Outer boots.

 NOMEX/PBI coveralls.

 A Level C suit incorporates the use of an air-purifying respirator within the ensemble.

 A Level C suit can be a coverall or a two-piece garment.

 A Level C suit is used where splashes occur but where respiratory hazards are minimal and are covered by the use of an APR.

 A Level C garment consists of these components:

 Level C suit.

 Air-purifying respirator.

 Hard hat.

 Outer boots.

 NOMEX/PBI coveralls.

 A Level D suit is actually regular working clothing.  The Level D suit provides no chemical protection, but it does offer protection against other workplace hazards.

 Level D protective clothing consists of these items:

 Work clothes.

 Hard hat.

 Chemical/work gloves.

 Safety glasses.

 Safety shoes/boots.

 The two basic types of high-temperature clothing are: proximity and fire-entry gear.

 The most common uses for this type of gear is in airport firefighting and flammable liquid firefighting.

 Proximity gear is named for the ability to allow the wearer to get close to the burning liquid.

 It offers protection for temperatures up to 300°F to 400°F.

 Fire-entry gear is designed to allow the wearer to enter a fully involved fire area for a period of 30 to 60 seconds over the life of the suit.

 Fire-entry gear can be used in temperatures ranging up to 2000°F.

 When dealing with cryogenics, the responder must wear protective clothing that protects the wearer against very cold temperatures.

 Responders should take precautions to prevent against cold stress, and hypothermia.

 Wearing clothing in layers can offer some additional protection.

 There are four basic limitations to protective clothing and they apply across the board from EMS infection control gear, to firefighter TOG, to the fully encapsulated Level A suit.

 The four major issues are: heat stress, mobility, visibility, and communications problems.

 Heat stress can lead to heat stroke, a condition that is almost always fatal.

 The progression of heat stress is dependent on the amount of work being performed and the physical ability of the responders. WRAP-UP Time: 10 minutes Key Points

 The use of protective clothing is important for the various hazards that responders may face.

 The absolute minimum should be SCBA, which offers a high level of protection.

 The decision to use chemical-protective clothing is not an easy one because many factors must be examined prior to its use.

 With the heat stress that accompanies the wearing of chemical-protective clothing, rescuers should be in good physical condition and must hydrate frequently.

 It is for these reasons that responders must use effective risk assessment to determine the true hazard, and then dress for the hazard. Assignment

 Read Chapter 28 in Firefighter's Handbook, pages 801-834

 Optional: Complete Firefighter's Handbook Workbook, Chapter 28 Instructor Preparation PowerPoint Presentation--Chapter 28 Transparency masters--Chapter 28 Overhead projector, slide projector, or LCD display HAZMAT placards, ERG book, and MSDS samples