279 Association of Personal Protective Equipment Use and Maintenance with Burn Injury: A Pilot Survey of Firefighters

Abstract

Thermal injury remains a persistent occupational hazard for both volunteer and career firefighters. While advances in personal protective equipment (PPE) offer improved safety and reported rates of compliance are high, injuries still occur. The purpose of this pilot project was to investigate the correlation between PPE use and damage with injury characteristics. A structured questionnaire was distributed to a convenience sample of firefighters undergoing initial outpatient evaluation in a burn clinic. Data were collected regarding fire experience, incident circumstances and extent of injury sustained, as well as PPE use and post-injury damage and PPE integrity monitoring history. Chi-square tests were used to evaluate the relationship between PPE use, damage and monitoring with injury. There were 45 respondents included in this analysis. Firefighters were on average 31.8 ± 7.5 years with 10.8 ± 8.9 mean years of experience (range 1-32 years). The majority of respondents identified as career firefighters (72.4%). Injuries were sustained primarily in structure fires (93.3%), and 22.0% were in a training setting. Ears were the most commonly burned area (n=25) followed by arms, hands, and wrists. Nearly all injuries were small (< 5% TBSA) and managed in an outpatient setting. Only one patient requiring grafting, though 60.0% reported missing at least one shift. The majority reported use of most PPE elements at the time of injury, although more than 25% indicated not using suspenders. Eight individuals had not been sized for PPE in the last two years, two of whom indicated never having been properly sized. Although ear burns were not significantly associated with use of helmets or earflaps, there was a significant association with helmet damage (p = 0.04), with a trend toward significance for visible gear damage (p = 0.05) and hood damage (p = 0.09). Arm burns were significantly associated with visibly damaged gear (p = 0.003), damaged gloves (p = 0.012), and damaged coats (p < 0.001). Given the association of PPE damage and injury identified in this pilot study, further training directed towards improved frequency of resizing and inspection of PPE post-injury may be warranted. These findings necessitate further investigation, which is planned via more extensive questionnaire distribution within the firefighting community. Further significant associations may be revealed within a larger sample size. Thermal injury will continue to be an occupational hazard for firefighters. Better understanding of associated factors can help target training and prevention strategies to mitigate risk.