Last year I moved my family to the Valley of the Sun in Phoenix. Let me tell you, it’s HOT here! As I write this, it is 106 degrees outside; with 22% humidity, it feels like 108. I am grateful to be sitting in an air-conditioned house, but I am thinking about our firefighters across the West battling wildfires in these conditions. Also, many of you operate in urban settings where the effects of heat and high humidity are amplified. If you are a company officer or incident commander, you must understand how to prevent heat-related illness—for yourself and your crew members.
Understanding Heat-Related Illness
Heat-related illness can occur anytime we are exerting ourselves or are in an extremely hot environment. When you add the presence of personal protective equipment (PPE), the risk factors grow.
Heat exhaustion is typically what we see when a firefighter experiences a heat emergency. This condition is the result of heat strain that exceeds the body’s ability to cope and negative health effects begin to develop. The extreme result of heat strain is heat stroke; this is a serious medical condition that requires immediate action. Heat stroke can lead to serious complications and is deadly if not reversed.
Incident commanders (ICs) must take proactive approaches in dealing with heat stress in order to prevent injuries. There are numerous factors that contribute to heat illness potential, including:
• Length of emergency operations
• Amount of physical exertion by firefighters
• Climatic conditions
• Ability of the IC to monitor workers
Heat illness prevention begins far before you’re on scene worrying about whether your firefighters are getting overheated. It starts with a department-wide heat illness prevention program. And that includes two necessary components: 1) solid policies for implementing illness prevention, and 2) a training program that educates all members on heat-related injury and prevention. It’s one thing to have policies on a shelf and another thing entirely to make sure they are implemented. Basically, your policy needs to match your practice, and your practice needs to match your policy.
Equally important is training. Each new member of your department needs heat illness prevention training prior to working in PPE and in a potentially high-heat environment. All members need refresher training annually, typically just prior to the “heat” season in your area. Teach members about acclimatization and encourage them to get used to the heat before they perform exhausting work (I know that can sometimes be difficult). Encourage members to remain hydrated and prepare for their duty shift by hydrating on their off-duty days. Coach supervisors and company officers to be on the lookout for the signs and symptoms of heat-related illness in their crews and to monitor them throughout the work day.
The second component to heat-related illness prevention is action by supervisors in the field. During high-heat conditions, ICs and supervisors need to provide shorter work periods and increase rest time.
Typically we employ the “two bottle” rule to determine the maximum amount of work time that a firefighter can be expected to perform: After working through the air supply of two SCBA bottles the firefighter rotates through incident rehabilitation (rehab). During extreme exertion or extreme climatic conditions, however, the IC should consider dropping down to a “one bottle” rule. This will require setting up rehab early and calling additional alarms to have access to adequate personnel to perform the work.
In extended operations (those lasting more than two hours or going into additional operational periods) crew rehabilitation and rotation will be even more critical. The IC must consider how to provide adequate shade, drinking water, sports drinks and even food. Ongoing medical evaluation of the firefighters in rehab must also occur.
On large incidents the IC may not be close enough to monitor individual crews and their condition. That’s where the incident management system comes into play. Establish safety officers and division or group supervisors and conduct personnel accountability reports (PARs) to ensure adequate monitoring of crew work/rest cycles and general well-being. Remember: The IC has a responsibility to provide this level of care and concern for all members operating on the emergency ground.
During periods of high heat or other contributing weather and work factors, heat illness prevention must be an incident priority. Organizations must prepare for these operations in advance. A heat illness prevention training program, as well as a culture that supports providing incident rehabilitation during emergency operations, are essential to maintaining the health and well-being of your crews. Providing the logistical support necessary to maintain this type of worker safety is sometimes difficult; however, it is much more economical to provide this level of support than to pay for the consequences of not providing it. One worker’s compensation injury (or worse) can far outweigh the cost of proactively providing heat-related illness and injury prevention through policy, training and in-the-field practice.