Protection

What PPE is required to protect me from smallpox exposure?

The employer shall have adopted the requirements contained in NFPA 1581,

Standard on Fire Department Infection Control Program and universal emergency

medical precautions shall be practiced.

 

The CDC Also known as the Centers for Disease Control and Prevention - A United States government agency that seeks to promote health and quality of life by preventing and controlling disease, injury, and disability. has recommended using N95 mask for anyone caring for a smallpox patient. However, this recommendation is based on the experience of hospital workers in a controlled setting that is unlike the uncontrolled environment in which fire fighters and emergency responders work. These differences raise the concern that N95 masks may not offer adequate protection to fire fighters and emergency medical responders. Similar concerns were raised with the anthrax terrorist attacks. These concerns prompted the IAFF to send a letter to NIOSH The National Institute for Occupational Safety and Health in October 2001 requesting recommendations for the selection of protective clothing and equipment for response to incidents involving suspected biologic agents. In response to this request, the CDC and NIOSH released recommendations for the selection and use of protective clothing and equipment when responding to suspected biologic agent incidents, including smallpox.

 

The employer shall implement the following NIOSH recommendations:

 

  • Fire fighter turnout gear should not be worn when responding to suspected biologic agent incidents because appropriate decontamination procedures may damage some of the protective fabrics.

    • NOTE: The IAFF recognizes that fire fighters initially responding to an incident may not know it is a WMD Weapons of Mass Destruction event involving a biological agent and will be in their turnout gear. If the incident involved the aerosol release of the smallpox virus, clothing should be removed, properly bagged and either decontaminated with a non-chlorinated anti-viral product or disposed.  

  

  • Incident Scenario 1: Suspected biologic agent, dissemination of suspected agent by letter or package, letter or package can be easily bagged, and an aerosol generating device was not used.

    • NIOSH PPE Personal protective equipment Recommendation: Full face respirator with a P100 filter or a power air purifying respirator (PAPR) with a high efficiency particulate air (HEPA) filter. Also use disposable hooded coveralls, gloves, and foot coverings (Level C).

  

  • Incident Scenario 2: Suspected biologic agent, aerosol is no longer being generated, splash hazard may exist. (Exposure would be from contaminated surfaces or individuals.)

    • NIOSH PPE Recommendation: NIOSH approved SCBA Self-contained breathing apparatus with Level B* protective suit.

  

  • Incident Scenario 3: Suspected biologic agent, dissemination via aerosol device is still occurring or has stopped but there is no information on the duration of dissemination or exposure concentration.

    • NIOSH PPE Recommendation: NIOSH approved SCBA with Level A* protective suit.

  

  • Decontamination:

    • Follow decontamination sequences currently used for hazardous materials incidents as appropriate to the level of PPE employed.

    • Equipment can be decontaminated with soap and water and 0.5% hypochlorite solution (one part household bleach to 10 parts water).

    • After taking off gear, emergency response employees should shower using copious quantities of soap and water.

 

*NOTE:  The traditional EPA Environmental Protection Agency/OSHA Occupational Safety & Health Administration levels A, B, C, and D classifications used for hazardous materials ensembles do not accurately describe the protective ability of ensembles for WMD protection. The federal government and the first responder community, through the InterAgency Board for Equipment Standardization and InterOperability now recognize that protective ensembles must not use these classifications.  

 

Where NIOSH recommends a “Level A protective suit,” protective garments from the following options should be selected:

 

  • NFPA 1991 Standard on Vapor-Protective Ensembles for Hazardous Materials Emergencies Ensembles with Optional Chemical/Biological Terrorism Protection. Include full-body, totally-encapsulating suits with gloves and footwear that provides a high level of protection against hazardous chemicals in accordance with NFPA 1991 and chemical and biological agents in accordance with the optional NFPA 1991 chemical/biological terrorism protection requirements. Respiratory protection is provided by a self-contained breathing apparatus (SCBA).

 

  • NFPA 1994 Standard on Protective Ensembles for Chemical/Biological Terrorism Incidents Class 1 Ensembles. Include full-body, totally encapsulating suit with gloves and footwear that provides highest level of protection against chemical and biological agents in accordance with the Class 1 requirement of NFPA 1994. Respiratory protection is provided by a self-contained breathing apparatus. A Class 1 ensemble is used to protect fire and emergency services personnel at chemical/biological terrorism incidents where the identity or concentration of the vapor or liquid agent is unknown, or where it is necessary to provide vapor protection, or where liquid contact is expected and no direct skin contact can be permitted as exposure of personnel at these levels will result in the substantial possibility of immediate death, immediate serious incapacitation, or the ability to escape will be severely impaired.

 

  • NFPA 1994 Standard on Protective Ensembles for Chemical/Biological Terrorism Incidents Class 2 Ensembles. Include full-body, encapsulating suit option only, with gloves and footwear that provides an intermediate level of protection against chemical and biological agents in accordance with the Class 2 requirements for NFPA 1994. Respiratory protection is provided by a self-contained breathing apparatus (SCBA).  A Class 2 ensemble is used to protect fire and emergency services personnel at chemical/biological terrorism incidents where it is necessary to provide sufficient vapor protection for the intended operation, where direct contact of liquid droplets is probable, and where victims are not ambulatory but symptomatic.

 

Where NIOSH recommends a “Level B protective suit,” protective garments from the following options should be selected:

 

  • NFPA 1994 Standard on Protective Ensembles for Chemical/Biological Terrorism Incidents Class 2 Ensembles. Include non-encapsulating suit option with gloves and footwear that provides an intermediate level of protection against chemical and biological agents in accordance with the Class 2 requirements for NFPA 1994. Respiratory protection is provided by a self-contained breathing apparatus (SCBA).

 

  • NFPA 1992 Standard on Liquid Splash-Protective Ensembles and Clothing for Hazardous Materials Emergencies Ensembles. Include full-body, totally-encapsulating or non-encapsulating suits with gloves and footwear that provides a high level of protection against liquid splash from hazardous chemicals. Respiratory protection is provided by a self-contained breathing apparatus (SCBA).

 

Where NIOSH recommends a “Level C protective suit,” protective garments from the following option should be selected:

 

  • NFPA 1994 Standard on Protective Ensembles for Chemical/Biological Terrorism Incidents Class 3 Ensembles. Include non-encapsulating suit option with gloves and footwear that provides an intermediate level of protection against chemical and biological agents in accordance with the Class 3 requirements for NFPA 1994. Respiratory protection is provided by a self-contained breathing apparatus (SCBA).  A Class 3 ensemble is used to protect fire and emergency services personnel at chemical/biological terrorism incidents where it is necessary to provide sufficient liquid protection for the intended operation, where direct contact of liquid droplets is possible, and where victims are impaired but ambulatory.

 

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