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Patient Care

Cleaning Up the Cab  

A “clean cab” apparatus is designed to facilitate a clean, healthy, and safe environment by reducing exposures to occupational contaminants found in emergency activities. The philosophy applies to all emergency vehicles, including transport, suppression, command, and support units. 

This is a different way of thinking and has meant a big change in designing fire-suppression units. As a culture, the fire service is a bit resistant to change, especially of this scale. The overall goal is reducing the exposure to contaminants proven to cause cancer among firefighters. In other words, this is a commitment to protect providers’ lives in the same way they’ve dedicated theirs to protecting others. 

Emergency responders must understand there are risk factors associated with our profession. Some we can control (lifestyle and environment), and others we cannot (family and age). We now know the occupational exposures associated with our profession contribute to a higher risk of cancer. It is also known that the materials firefighters are exposed to today are more toxic than ever before. There are higher rates of foams, plastics, resin coatings, and flame retardants used in construction of buildings, vehicles, and furnishings. Because of this the burn rates are faster, hotter, and produce more toxic byproducts. 

Other than the firehouse, firefighters and emergency medical personnel spend most of their days in the cabs of their apparatus. It is within this environment, as well as the station, that change needs to happen. These environments must stay clean and safe. The misconception that the only time firefighters may be at risk is when they are in a fire must change. We now know that exposures can occur while donning gear, in the apparatus responding to and from the scene, outside the structure in the hot zone, during maintenance and cleaning, and in rehab. 

The other misconception about how an exposure takes place must be addressed as well: We now know the routes of exposure are not only through inhalation but also through dermal exposure and ingestion. Just protecting our respiratory systems is no longer acceptable. 

When designing the interior cab of the apparatus, keep decontamination in mind:

  • Use as many smooth surfaces as possible; 
  • Keep electronics high up to facilitate floor washing; 
  • Use nonabsorbent surfaces such as vinyl for the seats with few to no seams, if possible; 
  • Don’t store firefighting equipment in the cab: no SCBAs, no irons, no TICs, etc. The exception is bunker gear that has been cleaned in accordance with department policy and manufacturer recommendations;
  • The cab should have adequate lighting for nighttime operations and for decontamination efforts;
  • Use a two-color flashlight system: one color for hazardous environments (orange) and one for non-IDLH (immediately dangerous to life and health) operations (yellow); 
  • Policy should require the cleaning/decontamination of the cab once per month. Work with manufacturers to incorporate 30-day reminders to perform a full and thorough cleaning of the apparatus interior; 
  • As you put the truck in pump, the windows may go up if in the down position;
  • The air conditioning system will go into recirculation mode so as not to pull in contaminated air. Use specialized filtration systems for the cab proven to clean the air;
  • Use seamless smooth flooring systems that allow for easy decon/washdown where available;
  • Use lighter-colored interiors to easily identify dirt and particulates;
  • If your department decides to use a spray-on liner, choose a grit size that will allow for easy wiping and cleaning.

Also keep decontamination in mind when designing the exterior of the apparatus:

  • Equipment that will help facilitate decontamination includes a booster reel or garden hose outlet on the truck (a reducer may be used). Keep in mind that decon of a firefighter should not be performed with high-pressure lines;
  • Have a compartment that houses standard tools and equipment to be brought into most fires: SCBAs, flashlights, thermal imaging cameras, gas meters, and irons. This area can also serve as a rally point for firefighters and officers to get on the same page by sharing the IAP;
  • Designate compartment space to store contaminated gear outside the cab;
  • Designate compartment space for decon equipment;
  • Diesel exhaust is a known carcinogen. Incorporate vertical exhaust to minimize the exposure to personnel on scene and/or exhaust removal systems.

This design may have been around for some time in some organizations. But for a lot of us it’s a new concept, and some may struggle with acceptance. I encourage you to take whatever steps you can to improve the health, safety, and well-being of those for whom you’re responsible.

—Frank Babinec

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