Wearing Personal Protective Equipment (PPE) as a first responder to a fire is imperative for the safety of the firefighter, however what side effects are there? Wearing Personal Protective Equipment (PPE) is essential, especially for those jobs that deal with emergency situations like fire. And while safety is the main reason why proper PPE should be worn, they are needed by firefighters to prevent them from inhaling hazardous fumes, toxins and debris that could harm their lungs and respiratory system. PPE for firefighters is extremely important so they can enter a house or building without suffering from burns or lung damage from smoke inhalation. Even in situations where these heroes have to engage in size-up or overhaul, wearing of PPE is also required so they won’t get seriously injured while doing their job. The trousers and bunker jackets are critical components of a firefighter’s PPE ensemble as it is made with different layers of fabric for optimal fire protection. To be specific, the trousers and bunker jackets are composed of an outer shell or layer, a moisture barrier, and the thermal layer. The outer and thermal layer protects the wearer from radiant heat, and it can also serve as protection from partial flame. While the moisture barrier serves as a protection from the sprayed water to prevent their bodies from getting soaked and save them from injuries due to steam burns. On the other hand, the gloves and boots that firefighters wear are made from fire-resistant materials to safeguard their hands from sharp objects, radiant heat, and other forms of danger that they might encounter during fire service. Furthermore, the helmet is the most recognisable equipment of a firefighter. And it is made from durable and fire-resistant materials to protect their head from extreme temperatures and falling debris. Likewise, it also prevents the firefighter from getting drenched from the sprayed water. Finally, the PPE also includes a face mask, an air pack, and an air cylinder so they can regulate air pressure and breathe clean air during firefighting operations. And in some situations, small editions such as a sealed off gear is also included so that the exhaled air will be used to cool the firefighter off. Lightweight PPE Your structural firefighting protective ensemble, aka your turnout gear or PPE, is a marvel of design engineering that meets its primary objective – protecting you from the thermal hazards of structural firefighting – extremely well. But are you aware of the risk to your health and well-being that also comes with working in your PPE? Heat stress – Denise Smith, Ph.D., is the Director of the First Responder Health and Safety Laboratory and a subject matter expert regarding heat stress and its effect on firefighter health and safety. In that role, she served as the principal investigator for the Science Medicine and Research & Technology for Emergency Responders (SMARTER) project, a study supported by the DHS/FEMA Grant Directorate for the Assistance to Firefighters Grant Program with a Fire Prevention and Safety Grant. Smith and her research team published the project’s key findings in 2015 with a paper titled, Effect of Heat Stress and Dehydration on Cardiovascular Function, in which they wrote: Firefighters are exposed to numerous life-threatening dangers, including high temperatures, flames, smoke, hazardous chemicals, and unstable structures. Despite these dangers, the physiological strain, specifically cardiovascular strain, associated with firefighting poses the greatest threat to the life and health of a firefighter [1]. Smith and her team found that working in their full structural ensemble and SCBA, firefighters put their bodies at risk of developing hyperthermia and dehydration, factors they dubbed the “Terrible Twins.” The development of the “Terrible Twins” leads to an increased strain on your cardiovascular system that can manifest itself in two ways: A sudden cardiac event, such as heart attack or stroke. Early onset of fatigue, causing slower work on your part, which can contribute to increased fire growth (because you’re working slower), which can in turn contribute to a greater risk of slips or falls as you struggle to get the job Steam burns – The increase in body heat being generated – and the body’s inability to adequately cool the firefighter through evaporation of perspiration – also presents another potential hazard to the firefighter: steam burns. In a research study initiated in 2015, the National Institute for Testing and Standards began looking at this risk. In the potential steam burn mechanism NIST is exploring, water vapor accumulates in a burning room, penetrates the firefighters’ protective clothing and collects in the layer of air between clothing and skin. Water vapor from human perspiration also increases the humidity in this air layer [2]. Your structural ensemble has three key layers of fabric: An outer shell (e.g., Kevlar, Nomex, PBI) that’s your first line of defense against flames and heat. A middle layer (moisture barrier) that repels liquids on one side but allows perspiration to evaporate Closest to your skin, a quilted thermal liner for insulation. That middle layer – the moisture barrier – is a two-way street, in that vapor (water/sweat in its gaseous form) can penetrate the barrier. During interior structural firefighting, there’s plenty of water vapor in the space because of the water you’re applying to the fire. Water vapor is also filling the space as a byproduct of combustion. All that water vapor in the air means a greater chance that it will find its way into relatively dry places, such as the air spaces between those three layers of PPE. Within those air spaces, there is a threshold moisture content, the dew point, at which the air space can no longer absorb moisture. When these interior air spaces within reach their dew points, any additional moisture entering those spaces begins condensing into liquid droplets on the skin. This transition from vapor to liquid releases heat and raises the temperature of the skin – not a desirable effect, given that the body is trying to shed excess heat. While the research into this phenomenon continues,