In Conclusion...
The goal of decreasing the risk of exposure to contaminants to firefighters, thus decreasing the risk for cancer, took seven months of research, investigations, and data analysis. Moving the project through phases of observing effects on living organisms to identifying contaminants in wash water to devising a method of collecting contaminants in real time to the use of XRF and ICP-MS spectrometers to see how washing bunker gear removes elements was lengthy but very worthwhile. Results show the more rinse cycles done to the suit does indeed wash off more carcinogens than we had previously thought, potentially decreasing the risk of cancer among firefighters. The most effective and time-efficient way of lowering the risk is to wash the bunker gear two times instead of once, with a third and fourth rinse even more effective, if time and money allows.
The conclusion that we came to based on the data we gathered during our experiments was that there would be a significant reduction of contaminants if we were to wash and rinse the bunker gear at least twice in a designated washing machine with special detergent. This is supported by the significant decrease in the concentration of elements we tested from unwashed straps to straps that were cleaned at least once, then more decreased after the second rinse. The reduction in the concentrations of the elements would support that if less contaminants are on the gear, then the firefighters who wear the gear would not be exposed to as many contaminants, which in turn would reduce their risk of cancer since these contaminants are found to be carcinogenic. The elements that we tested for include Arsenic, Uranium, Lead, Mercury, Antimony, Vanadium, Chromium, Aluminum and many others.
The data we collected did not always show a significant decrease after the first rinse, but there was a significant decrease after the second rinse. Our data shows that the total concentration and individual element concentrations decreased as the number of washes increased. However, the biggest decrease in concentration was between the first and second wash, therefore leading us to the conclusion that we should rinse the bunker gear at least twice.
We also collected one hundred firefighters’ opinions that it typically takes more than one wash or shower to clean off the smell from their clothing and body. The qualitative response from the firefighters supports our hypothesis that cleaning the gear more than once provides a more thorough cleaning.
Our overall hypothesis is the following: If bunker gear is cleaned with water during gross decontamination and goes through a wash and rinse cycle two or more times in a commercially-designed machine, there will be far fewer contaminants present with each cycle. The risk of cancer will be reduced when bunker gear is cleaned in this way.
We broke our experiment up into five different stages or experiments, each of which built on the knowledge we gained from the original experiment plus the kinds of experiments done by researchers before us.
Our first experiment was to use a spectrophotometer to evaluate contaminants in fire engines as a health risk to firefighters. We took the wash water from the fire engine seats and ran it through a spectrophotometer. Our first hypothesis is if the rinse water from cleaning seats inside the fire engine is found to contain contaminants by the use of a spectrophotometer, then firefighters will be considered at greater risk for exposure when bunker gear is placed inside engine trucks or vehicles after being in a fire. We identified multiple peaks on the results, but were not always able to correlate it to specific elements or contaminants. We recorded our findings, but the uncertainty in the results taught us that we needed to find a university with better instruments to help us measure the elements.
Our second experiment looked into the effect of contaminants on living organisms. In this experiment, we placed Daphnia magna into spring water and counted their heartbeats and rate of death. We compared this to placing the Daphnia into contaminated water, and repeated the experiment. We found that the Daphnia died sooner in the contaminated water, and the lower the wash count was (i.e. first wash), the sooner they died. This supported our hypothesis that if contaminants found in the rinse water are used in a bioassay experiment on the invertebrate Daphnia magna, then the risk of harm to the living organism will increase with the concentration of contaminated water.
The third experiment was the engineering portion of our experiment. We got together with firefighter, Abi Morales, and obtained a decommissioned bunker gear, and got permission to cut it up. The thought was that we could make small straps from the bunker gear, so that they could be attached to firefighters’ gear when they went into fires, and we would obtain a sample of the contaminants they were exposed to. Our problem statement for this engineering project was to have straps made which would attach and detach well to firefighters’ gear, would not interfere in their ability to fight fire and be safe, and minimize off-gassing. We made two inch by five inch strips of bunker gear, sewn together with cotton thread, with metal snap buttons to attach. We made sixty straps, distributed them to the different Fire Chiefs who in turn distributed it to their firefighters. These straps were attached to the air canisters of firefighters and exposed to the fire that they were involved in. We were successful in making the straps and distribution was done efficiently by the Fire Chiefs.
Experiment four entailed the exposure of the straps made in Experiment Three to the element in a structure fire. Our hypothesis was that if contaminants are collected on straps, and are identified as toxic elements, then firefighters could be made aware of these dangers and could be alerted to the need for lessening their risk. The straps were collected after a fire, and placed in Ziploc bags then taken to Fire Station 4 to be washed. The wash water after each wash was collected, and then we took it to Texas Tech University, Department of Geosciences and Chemistry to be tested via X-ray Fluorescence (XRF) and Inductively Coupled Plasma Mass Spectrometer (ICP-MS). We identified the contaminants that were on the straps, and found that some elements were indeed carcinogens, such as Arsenic, Lead, Mercury, Chromium, Uranium.
The final experiment was to evaluate the contaminants found during the washing process. Our hypothesis was that if contaminants are found in water coming off the bunker gear after: a) gross decontamination, b) one wash, c) two washes, and then d) three washes, then the amount of contaminants will decrease at each stage. We will then be able to determine cleaning procedures needed to decrease the risk of exposure to contaminants. We identified the concentrations of the contaminants and graphed them. We found that there was a general decrease in total and individual concentrations, with the biggest decrease after two washes. For example, the first wash of the shell was not very effective, as it only removed 0.072 parts per million (PPM) of toxic material, whereas the second wash of the same suits removed 0.655 PPM of toxic material. These numbers may not seem like the washes are doing much, but keep in mind that these chemicals are toxic at parts per billion, not even parts per million.
The summary of all the experiments is that there are carcinogens that are present in the bunker gear, and that at least two washes are recommended in order to decrease the level of contamination significantly. As there are carcinogens on the bunker gear, it would be best to have a designated washing machine, and the use of a specialized detergent that is designed to remove the most carcinogens should be used. Although in the past, it has been a badge of honor for firefighters to have well-used gear, it is now found that there are a lot of contaminants in the dirt, and that continued wear of dirty contaminated gear may be the reason for the increased cancer rate and deaths of firefighters.
As part of our education of firefighters, we made a poster with the increased risk outlined and how they can clean their gear effectively and timely. We also made a brochure which was distributed electronically to firefighters who participated in our survey. We sent out a survey to study the behavior of firefighters when it comes to knowing their risk of cancer, and how often and timely they clean their gear. The results were eye-opening as some still were not aware that they were at increased risk, and did not know that their dirty gear was contributing to the increase. We hope that this project will be able to spread that knowledge and help our heroes be safer in their chosen profession.
The conclusion that we came to based on the data we gathered during our experiments was that there would be a significant reduction of contaminants if we were to wash and rinse the bunker gear at least twice in a designated washing machine with special detergent. This is supported by the significant decrease in the concentration of elements we tested from unwashed straps to straps that were cleaned at least once, then more decreased after the second rinse. The reduction in the concentrations of the elements would support that if less contaminants are on the gear, then the firefighters who wear the gear would not be exposed to as many contaminants, which in turn would reduce their risk of cancer since these contaminants are found to be carcinogenic. The elements that we tested for include Arsenic, Uranium, Lead, Mercury, Antimony, Vanadium, Chromium, Aluminum and many others.
The data we collected did not always show a significant decrease after the first rinse, but there was a significant decrease after the second rinse. Our data shows that the total concentration and individual element concentrations decreased as the number of washes increased. However, the biggest decrease in concentration was between the first and second wash, therefore leading us to the conclusion that we should rinse the bunker gear at least twice.
We also collected one hundred firefighters’ opinions that it typically takes more than one wash or shower to clean off the smell from their clothing and body. The qualitative response from the firefighters supports our hypothesis that cleaning the gear more than once provides a more thorough cleaning.
Our overall hypothesis is the following: If bunker gear is cleaned with water during gross decontamination and goes through a wash and rinse cycle two or more times in a commercially-designed machine, there will be far fewer contaminants present with each cycle. The risk of cancer will be reduced when bunker gear is cleaned in this way.
We broke our experiment up into five different stages or experiments, each of which built on the knowledge we gained from the original experiment plus the kinds of experiments done by researchers before us.
Our first experiment was to use a spectrophotometer to evaluate contaminants in fire engines as a health risk to firefighters. We took the wash water from the fire engine seats and ran it through a spectrophotometer. Our first hypothesis is if the rinse water from cleaning seats inside the fire engine is found to contain contaminants by the use of a spectrophotometer, then firefighters will be considered at greater risk for exposure when bunker gear is placed inside engine trucks or vehicles after being in a fire. We identified multiple peaks on the results, but were not always able to correlate it to specific elements or contaminants. We recorded our findings, but the uncertainty in the results taught us that we needed to find a university with better instruments to help us measure the elements.
Our second experiment looked into the effect of contaminants on living organisms. In this experiment, we placed Daphnia magna into spring water and counted their heartbeats and rate of death. We compared this to placing the Daphnia into contaminated water, and repeated the experiment. We found that the Daphnia died sooner in the contaminated water, and the lower the wash count was (i.e. first wash), the sooner they died. This supported our hypothesis that if contaminants found in the rinse water are used in a bioassay experiment on the invertebrate Daphnia magna, then the risk of harm to the living organism will increase with the concentration of contaminated water.
The third experiment was the engineering portion of our experiment. We got together with firefighter, Abi Morales, and obtained a decommissioned bunker gear, and got permission to cut it up. The thought was that we could make small straps from the bunker gear, so that they could be attached to firefighters’ gear when they went into fires, and we would obtain a sample of the contaminants they were exposed to. Our problem statement for this engineering project was to have straps made which would attach and detach well to firefighters’ gear, would not interfere in their ability to fight fire and be safe, and minimize off-gassing. We made two inch by five inch strips of bunker gear, sewn together with cotton thread, with metal snap buttons to attach. We made sixty straps, distributed them to the different Fire Chiefs who in turn distributed it to their firefighters. These straps were attached to the air canisters of firefighters and exposed to the fire that they were involved in. We were successful in making the straps and distribution was done efficiently by the Fire Chiefs.
Experiment four entailed the exposure of the straps made in Experiment Three to the element in a structure fire. Our hypothesis was that if contaminants are collected on straps, and are identified as toxic elements, then firefighters could be made aware of these dangers and could be alerted to the need for lessening their risk. The straps were collected after a fire, and placed in Ziploc bags then taken to Fire Station 4 to be washed. The wash water after each wash was collected, and then we took it to Texas Tech University, Department of Geosciences and Chemistry to be tested via X-ray Fluorescence (XRF) and Inductively Coupled Plasma Mass Spectrometer (ICP-MS). We identified the contaminants that were on the straps, and found that some elements were indeed carcinogens, such as Arsenic, Lead, Mercury, Chromium, Uranium.
The final experiment was to evaluate the contaminants found during the washing process. Our hypothesis was that if contaminants are found in water coming off the bunker gear after: a) gross decontamination, b) one wash, c) two washes, and then d) three washes, then the amount of contaminants will decrease at each stage. We will then be able to determine cleaning procedures needed to decrease the risk of exposure to contaminants. We identified the concentrations of the contaminants and graphed them. We found that there was a general decrease in total and individual concentrations, with the biggest decrease after two washes. For example, the first wash of the shell was not very effective, as it only removed 0.072 parts per million (PPM) of toxic material, whereas the second wash of the same suits removed 0.655 PPM of toxic material. These numbers may not seem like the washes are doing much, but keep in mind that these chemicals are toxic at parts per billion, not even parts per million.
The summary of all the experiments is that there are carcinogens that are present in the bunker gear, and that at least two washes are recommended in order to decrease the level of contamination significantly. As there are carcinogens on the bunker gear, it would be best to have a designated washing machine, and the use of a specialized detergent that is designed to remove the most carcinogens should be used. Although in the past, it has been a badge of honor for firefighters to have well-used gear, it is now found that there are a lot of contaminants in the dirt, and that continued wear of dirty contaminated gear may be the reason for the increased cancer rate and deaths of firefighters.
As part of our education of firefighters, we made a poster with the increased risk outlined and how they can clean their gear effectively and timely. We also made a brochure which was distributed electronically to firefighters who participated in our survey. We sent out a survey to study the behavior of firefighters when it comes to knowing their risk of cancer, and how often and timely they clean their gear. The results were eye-opening as some still were not aware that they were at increased risk, and did not know that their dirty gear was contributing to the increase. We hope that this project will be able to spread that knowledge and help our heroes be safer in their chosen profession.
Sources:
NIOSH (National Institute for Occupation Safety and Health)
KCBD (Caprock Broadcasting Company) News Channel 11
Worksite Medical
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Button, Kimberly. The Everything Guide to a Healthy Home : All You Need to Protect Yourself and Your Family from Hidden Household Dangers. Avon, Ma, Adams Media Corp, 2012, pp. 13–294.
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Causey Volunteer Fire Department. Causey, New Mexico. Wayne Tivis, firefighter. “Risks Cancer to Firefighters and ways to Prevent It.” Messenger Interview by Ethan Djajadi, Josiah Morales, and Alexa Tindall. 12 Feb 2020.
Champion, V L. “Instrument Development for Health Belief Model Constructs.” ANS. Advances in Nursing Science, vol. 6, no.3, 1984, pp. 73–8 www.ncbi.nlm.nih.gov/pubmed/6426380,10.1097/00012272-198404000-00011. Accessed 5 Feb. 2020.
Chua, Jinnie. “Firefighter Health Risks.” Ready Wristbands, 2016, www.readywristbands.com/firefighter-health-risks/. Accessed. 26 Sept. 2019.“Combating Known Risks to Firefighter Health - In Public Safety.” In Public Safety, 6 June 2018. inpublicsafety.com/2018/06/combating-known-risks-to-firefighter-health/. Accessed 16 Dec. 2019.
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“FireDepartment.Net.” FireDepartment.Net, 2014, www.firedepartment.net/directory/texas/lubbock-county/lubbock/woodrow-volunteer-fire-department. Accessed 10 Oct. 2019.
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Gross, Brian. “I Got Cancer from Firefighting.” Personal Interview by Ethan Djajadi, Alexa Tindall, and Josiah Morales. 12 Oct. 2019.
Hardwicke, Fred, M.D. Program Director of the Hematology/Oncology Fellowship Program, Associate Professor. University Medical Center. Personal Interview by Ethan Djajadi, Josiah Morales, and Alexa Tindall, 5 Dec. 2019.
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Kirk, Katherine M, and Michael B Logan. “Structural Fire Fighting Ensembles: Accumulation and Off-Gassing of Combustion Products.” Journal of Occupational and Environmental Hygiene, vol. 12, no. 6, 2015, pp. 376–83, www.ncbi.nlm.nih.gov/pubmed/25626009, 10.1080/15459624.2015.1006638. Accessed 7 Feb. 2020.
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Liou, Tiffany. A New Texas Law Helps Firefighters Pay for Cancer Treatment. But, Not Everyone Is Eligible. WFAA, 2020, www.wfaa.com/article/news/law-helps-firefighters-workers-comp-cancer/287-052a4e15-0bd4-4eba-ae16-7f08f2ec868c. Accessed 5 Feb. 2020.
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Mechref, Yehia, PhD. “Biochemical analysis of toxins and contaminants.” Texas Tech University Director of Biotechnology, Analytical Chemistry. Personal Interview by Alexa Tindall and Ethan Djajadi. Dec 10 2019.
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Peng, Wenjing, PhD. Assistant Research Scientist. Department of Chemistry. Texas Tech University. Personal Interview by Ethan Djajadi and Alexa Tindall. Dec 10 2019.
Ready Wristbands, 2016, www.readywristbands.com/firefighter-health-risks/. Accessed 16 Dec. 2019.
“Safety Is Dangerous | Spike Edwards | TEDxSantaBarbara.” TedTalk/YouTube, 18 Dec. 2017, www.youtube.com/watch?reload=9&v=P2SptCbTFyk. Accessed 26 Sept. 2019.
Scott, Sean M. “Addressing Toxic Smoke Particulates in Fire Restoration | The Red Guide to Recovery.” Theredguidetorecovery.Com, 2018, www.theredguidetorecovery.com/addressing-toxic-smoke-particulates-in-fire-restoration-2/. Accessed 7 Feb. 2020.
Smyer Volunteer Fire Department. “Risks Cancer to Firefighters and ways to Prevent It.” Personal Interview by Ethan Djajadi, Josiah Morales, and Alexa Tindall. 20 Feb 2020.
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Stull, Grace and Jeff. “Can Firefighting Gear Be Decontaminated on Scene?” FireRecruit.com, Careers in the Fire Service, 20 July 2015, www.firerecruit.com/articles/3010282-Can-firefighting-gear-be-decontaminated-on-scene
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Tijani, Lukman, M.D. Associate Program Director, Hematology/Oncology. Texas Tech University Health Sciences Center. Personal Interview by Ethan Djajadi, Josiah Morales, and Alexa Tindall. 18 Dec. 2019.
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Wallace, Joseph. “Firefighters at Risk of Cancer.” Last Line of Cancer Defense. Personal Interview by Ethan Djajadi and Josiah Morales. .” 19 Oct. 2019.
Woodrow Volunteer Fire Department. “Risks Cancer to Firefighters and ways to Prevent It.” Personal Interview by Ethan Djajadi, Josiah Morales, and Alexa Tindall. 02 Dec 2019.
KCBD (Caprock Broadcasting Company) News Channel 11
Worksite Medical
“Aldehydes - ChemicalSafetyFacts.Org.” ChemicalSafetyFacts.Org, 13 Feb. 2019, www.chemicalsafetyfacts.org/aldehydes/. Accessed 16 Dec. 2019.
Avsec, Robert. “It’s in the Smoke: Cancer-Causing Compounds and Contaminates.” FireRescue1, 2017, www.firerescue1.com/fire-products/turnoutgear/articles/its-in-the-smoke-cancer-causing-compounds-and-contaminates-oNwVFdIZBpJIUZMr/. Accessed 7 Feb. 2020.
“Benzene - Cancer-Causing Substances.” National Cancer Institute, Cancer.gov, 14 Jan. 2019, www.cancer.gov/about-cancer/causes-prevention/risk/substances/benzene. Accessed 16 Dec. 2019.
Button, Kimberly. The Everything Guide to a Healthy Home : All You Need to Protect Yourself and Your Family from Hidden Household Dangers. Avon, Ma, Adams Media Corp, 2012, pp. 13–294.
“Cancer.” Responderhelp.Com, 2019, www.responderhelp.com/safety-and-health/cancer/.
Causey Volunteer Fire Department. Causey, New Mexico. Wayne Tivis, firefighter. “Risks Cancer to Firefighters and ways to Prevent It.” Messenger Interview by Ethan Djajadi, Josiah Morales, and Alexa Tindall. 12 Feb 2020.
Champion, V L. “Instrument Development for Health Belief Model Constructs.” ANS. Advances in Nursing Science, vol. 6, no.3, 1984, pp. 73–8 www.ncbi.nlm.nih.gov/pubmed/6426380,10.1097/00012272-198404000-00011. Accessed 5 Feb. 2020.
Chua, Jinnie. “Firefighter Health Risks.” Ready Wristbands, 2016, www.readywristbands.com/firefighter-health-risks/. Accessed. 26 Sept. 2019.“Combating Known Risks to Firefighter Health - In Public Safety.” In Public Safety, 6 June 2018. inpublicsafety.com/2018/06/combating-known-risks-to-firefighter-health/. Accessed 16 Dec. 2019.
“Combating Known Risks to Firefighter Health - In Public Safety.” In Public Safety, 27 June 2018, inpublicsafety.com/2018/06/combating-known-risks-to-firefighter-health/. Accessed 26 Sept. 2019.
“Definition of Dichlorodifluoromethane | Dictionary.Com.” Www.Dictionary.Com, 2019, www.dictionary.com/browse/dichlorodifluoromethane. Accessed 16 Dec. 2019.
Fent, Kenneth W., et al. “Airborne Contaminants during Controlled Residential Fires.” Journal of Occupational and Environmental Hygiene, vol. 15, no. 5, Mar. 2018, pp. 399–412, 10.1080/15459624.2018.1445260.
“FireDepartment.Net.” FireDepartment.Net, 2014, www.firedepartment.net/directory/texas/lubbock-county/lubbock/woodrow-volunteer-fire-department. Accessed 10 Oct. 2019.
“Firefighter Cancer Consultants | Awareness, Prevention, and Support.” Firefighter Cancer Consultants, 2018, firefightercancerconsultants.com/. Accessed 5 Feb. 2020.
“Firefighter Cancer Prevention Advocates | Carney Strong Initiative.” Carney Strong Initiative.
“Firefighters and Cancer - NFPA.” Nfpa.Org, 2013, www.nfpa.org/News-and-Research/Resources/Emergency-Responders/Health-and-Wellness/Firefighters-and-cancer. Accessed 22 Oct. 2019.
“Firefighters Battle Exposure to Carcinogens as Well as Flames.” EHS Today, Oct. 2017, www.ehstoday.com/health/article/21919325/firefighters-battle-exposure-to-carcinogens-as-well-as-flames. Accessed 16 Dec. 2019.
Garcia, Earl. “Sulfur Dioxide – Toxicity, Side Effects, Diseases and Environmental Impacts.” Natural Pedia Com, 15 Feb. 2019, naturalpedia.com/sulfur-dioxide-toxicity-side-effects-diseases-and-environmental-impacts.html. Accessed 16 Dec. 2019.
Gross, Brian. “I Got Cancer from Firefighting.” Personal Interview by Ethan Djajadi, Alexa Tindall, and Josiah Morales. 12 Oct. 2019.
Hardwicke, Fred, M.D. Program Director of the Hematology/Oncology Fellowship Program, Associate Professor. University Medical Center. Personal Interview by Ethan Djajadi, Josiah Morales, and Alexa Tindall, 5 Dec. 2019.
“Health Risks To Firefighters.” Iaff.Org, International Association of Fire Fighters, 2007, www.iaff.org/smokefree/specialrisks.asp. Accessed 25 Sept. 2019.
“Hydrogen Chloride | Encyclopedia.Com.” Encyclopedia.Com, 2013, www.encyclopedia.com/history/biographies/ancient-history-northern-europe-biographiehhydrogen-chloride. Accessed 16 Dec. 2019.
Khazan, Olga. “Why Firefighters Get More Cancer.” The Atlantic, The Atlantic, 11 Sept. 2015, www.theatlantic.com/health/archive/2015/09/our-toxic-homes/404722/. Accessed 16 Dec. 2019.
Kirk, Katherine M, and Michael B Logan. “Structural Fire Fighting Ensembles: Accumulation and Off-Gassing of Combustion Products.” Journal of Occupational and Environmental Hygiene, vol. 12, no. 6, 2015, pp. 376–83, www.ncbi.nlm.nih.gov/pubmed/25626009, 10.1080/15459624.2015.1006638. Accessed 7 Feb. 2020.
“Last Line of Cancer Defense.” Last Line of Cancer Defense, 2018, llocd.com/. Accessed 13 Dec. 2019.
Liou, Tiffany. A New Texas Law Helps Firefighters Pay for Cancer Treatment. But, Not Everyone Is Eligible. WFAA, 2020, www.wfaa.com/article/news/law-helps-firefighters-workers-comp-cancer/287-052a4e15-0bd4-4eba-ae16-7f08f2ec868c. Accessed 5 Feb. 2020.
“List of NFPA Codes & Standards.” List of NFPA Codes and Standards, National Fire Prevention Association, 12 June 2016, www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards?mode=code&code=1851.
Mechref, Yehia, PhD. “Biochemical analysis of toxins and contaminants.” Texas Tech University Director of Biotechnology, Analytical Chemistry. Personal Interview by Alexa Tindall and Ethan Djajadi. Dec 10 2019.
Monroe, Eric. “WSCFF: Health and Wellness - Prevention and Reduction Risks.” Washington State Council of Fire Fighters, Firefighter Cancer Support Network, 16 Jan. 2020, www.wscff.org/.
Morales, Abi. “Treatment of Bunker Gear Interview by Ethan Djajadi, Alexa Tindall, and Josiah Morales. .” 17 Oct. 2019.
“National Firefighter Cancer Symposium Focuses on Research, Education and Prevention.” VFIS, 2019, www.vfis.com/fire-ems-news-2019/ID/1804/National-Firefighter-Cancer-Symposium-Focuses-on-Research-Education-and-Prevention. Accessed 5 Feb. 2020.
Pacific Air Forces. “Firefighters Complete Live-Burn Training.” Pacific Air Forces, 16 Dec. 2016, www.pacaf.af.mil/News/Article-Display/Article/1032812/firefighters-complete-live-burn-training/. Accessed 22 Oct. 2019.
Peng, Wenjing, PhD. Assistant Research Scientist. Department of Chemistry. Texas Tech University. Personal Interview by Ethan Djajadi and Alexa Tindall. Dec 10 2019.
Ready Wristbands, 2016, www.readywristbands.com/firefighter-health-risks/. Accessed 16 Dec. 2019.
“Safety Is Dangerous | Spike Edwards | TEDxSantaBarbara.” TedTalk/YouTube, 18 Dec. 2017, www.youtube.com/watch?reload=9&v=P2SptCbTFyk. Accessed 26 Sept. 2019.
Scott, Sean M. “Addressing Toxic Smoke Particulates in Fire Restoration | The Red Guide to Recovery.” Theredguidetorecovery.Com, 2018, www.theredguidetorecovery.com/addressing-toxic-smoke-particulates-in-fire-restoration-2/. Accessed 7 Feb. 2020.
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Strong, Carney. www.carneystrong.org/. Accessed 5 Feb. 2020. Best Practices for Reducing FireFighter Risk of Exposures to Carcinogens.
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