IFSJ Exclusive: Preliminary Exposure Reduction

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Tonya Herbert, President at Thin Red Line Decon, looks at building decontamination habits to reduce firefighter health risks

Today’s fires produce a toxic soup of dangerous chemicals, likely because of the changing landscape of building materials and furnishings. While turnout gear effectively protects against thermal exposure and hazardous fluids, it may not protect against absorption of soot. Emerging research suggests that dermal absorption of toxins is a greater route of exposure than inhalation or ingestion.

The NFPA 1851 standard encourages ‘Preliminary Exposure Reduction,’ defined as ‘techniques for reducing soiling and contamination levels … following incident operations.’ A recent study affirmed this need for fireground exposure reduction interventions. 

Changing your behavior to make preliminary exposure reduction a habit can seem daunting; however, making tiny marginal improvements consistently can yield significant results. A habit is a behavior that has been repeated enough to become automatic.

A habit is a behavior that has been repeated enough to become automatic

The first step in a habit loop is the cue. A cue gets your attention and tells you what to do next. It predicts a reward. Cravings are the second step. They are the motivational force behind every habit and without them, we have no reason to act. These first two steps compromise the “Problem Phase.” The third step of a habit loop is the response. This is the actual habit you form, the action you perform (in this case, decontaminating). The final step that closes the loop is the reward. This is the end goal of every habit. These last two steps form the ‘Solution Phase’. 

To build better habits, you need to build a better system, one that sets you up for success. At first, these tiny habit routines may seem insignificant, but they build on each other, compounding, and can lead to remarkable changes.

Make it obvious

The process of changing behavior starts with awareness. Start by analysing your current decontamination protocol. What do you do between coming out of an IDLH environment or ending suppression activities and returning to the station? By becoming aware of your habits, including whether or not you perform the desired habit, the time at which you perform the habit, and where you perform the habit, you raise them from an unconscious level to a conscious level.

When you make a specific plan for performing a new habit, you are more likely to follow through

To make a new habit obvious, create an implementation intention, which is a plan you make beforehand about how, where, and when you intend to act. For instance, your implementation intention may be ‘Before I come off air, I will enter the ‘green zone’ (or decontamination area) and perform preliminary exposure reduction.’ Or ‘As soon as I doff my gear, I will wash my hands and face with soap and water’. When you make a specific plan for performing a new habit, you are more likely to follow through.

A second strategy is to pair the new habit with a current habit. Habit stacking works by finding one you have mastered and concisely tying the new behavior into it. For instance, “After loading hose back on the truck, personnel will use wipes to remove soot from permeable areas of the body.”

To increase your odds of success, try designing your environment to provide multiple cues. Considering that over half of the brain is devoted to processing visual information, a visual cue may be the most important tool for making a new habit obvious. Try placing a sticker that reads “Did You Decon?” in a location where you will see it before climbing back onto the engine.

Make it attractive

Desire is what drives most behavior. The more attractive an opportunity is, the more likely it is to become habit-forming. If you anticipate that a particular habit will be rewarding, you are more motivated to repeat that action.

An improvement in long-term health is delayed gratification. To make post-fire decontamination more desirable, a firefighter must feel satisfied immediately. Therefore, it is important to develop a protocol where a firefighter feels clean. From the brand of wipes to the detergent you use, it is important to include the field personnel in the selection. Buy-in is critical.

Another way to make the new habit more enticing is to pair an action you need to do with the one you want to do. The first thing you want to do is get into rehab, cool down, and get a drink. If you pair your on-scene decontamination with your rehab routine, you will probably perform it more regularly. As you enter rehab and doff your gear, your next step should be immediately wiping down your skin, especially before you ingest any food or drink.

The desire to fit in within the fire service is strong. When unsure how to act, we look to the group we are a part of for clues. If our behavior is rewarded with approval, praise, or respect, it becomes more attractive. Inversely, when behavior is mocked or criticised, it is unattractive. Therefore, it is critical that influencers within the department, particularly the company officers, support and model the decontamination protocol.

While making a new habit attractive is one strategy, making a bad habit unattractive is another approach. The Boston Fire Department has employed this technique in their Memorial Wall, displaying hundreds of black and white photos of the members of their department who have died in the line of duty from cancer. By highlighting the consequences of a negative habit, they have made it much less desirable. It is an incredibly compelling tactic, one that is hard to ignore.

Make it easy

The key to mastering a habit is to start with repetition, not perfection. You may not have all the details of the decontamination protocol figured out; you just need to start practicing it. The more frequently you perform the behavior, the more automatic it will become. For instance, if you decontaminate every time you handle a nozzle, even for a dumpster fire, soon you will be decontaminating without even thinking about it.

The more friction there is to engage in a behavior, the less likely you are to act on it. Therefore, two other critical components in this third step of the habit loop are to make it convenient and to prime the environment. If your department uses a decontamination bucket, at the beginning of every shift, make sure the necessary components are in the bucket – wipes, a hose, a nozzle, cleaning detergent, a scrub brush, and clear bags for dirty gear, etc. Place the bucket where it is likely to be seen and utilised. Upon return to the station after a call, the bucket should be immediately reset after personnel and gear are fully decontaminated.

A habit is much more likely to stick if it takes less than two minutes to accomplish. If on-scene decontamination is too big of leap, start smaller. Place a wipe in the pocket of your bunker jacket or bunker pants. This makes it convenient, and you have primed the environment. If it doesn’t require much effort you are more likely to stick with it.

Make it satisfying

The final step of the habit loop is to make it satisfying – making it satisfying increases the likelihood of repetition. Additionally, and not surprisingly, the highest value is placed on instant gratification, not on future gratification.

The highest value is placed on instant gratification, not on future gratification

This can be accomplished in multiple ways. First, choose methods and products personnel find pleasing and effective. If you feel you are cleaner, smell better, and feel fresher, the positive sensory perception makes it easier to adopt the habit. The pleasure sends a signal to your brain to repeat this behavior.

Using a habit tracker can also provide instant gratification. There are multiple exposure reporting systems available to the fire service, such as NFORS (National Fire Operating Reporting System) Career Diary and Enviage’s Exposure Tracker. By utilising one of these exposure reporting systems on an individual level, not only are you documenting critical information should you ever be diagnosed with an occupational illness, but you can use them to track your preliminary exposure reduction habits.

Having an accountability partner, such as the company officer, can increase the chances of successfully establishing a habit. A company officer who models appropriate behavior or who calls out members who are not decontaminating can have tremendous influence on the process.

By creating a routine that is manageable, easy to do, and requires as little energy as possible, you can make a preliminary exposure reduction habit stick. When this habit sticks, you can reduce your risk of occupational illness giving you a better chance to live a quality life, long into retirement.

This article was originally published in the April edition of IFSJ. To read your FREE digital copy, click here.

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