托德·J·莱德克（Todd J. Leduc）
Of late, the American fire service has been discussing and focusing on职业癌暴露和潜在的缓解策略。这种缓解策略和预防方法包括许多职业变化：排气装置系统，增强的个人防护装备，引擎盖和手套交换计划，更彻底和更具侵略性的净化方法以及早期的检测和医疗检查。一项国家职业安全与健康研究所（NIOSH）研究了30,000多名费城，旧金山和芝加哥消防员的研究发现，某些癌症的率高于一般人口控制。美国消防局肯定可能会受益于审查全球消防癌症的实践，特别是鉴于他们从污染前进的攻击性实践对“井”消防员的攻击性实践。
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瑞典采用了一种燃烧后期的方法 - 非常类似于美国在污染材料环境和曝光的净化方面的普遍做法（请参见下面的视频，“ Skelleftea模型”。在这种操作环境中，炎热，温暖和冷的区域以及严重的净化。我们从持续的研究和基于证据的数据中知道，在燃烧中接触产品会污染我们的个人防护设备，在许多情况下，我们的皮肤被吸收到我们的循环系统中。因此，我们的癌变后暴露方法需要尽职调查和问责制，以确保我们尽早去除尽可能多的致癌产物。
这种重点应放在立即刷牙上，并在可能的情况下擦洗个人防护装备以去除净化。此外，应尽可能在火场上进行严重的净化，包括使用身体湿巾。消防员应集中于已被证明具有高于正常吸收率的人体区域，尤其是在过热时，从而扩大了身体毛孔。大型血管位于表面以下的身体区域 - 颈动脉（颈部），腹部（胸腔）和下肢的股骨区域，它们具有大动脉血液供应的区域，并且可以快速吸收和循环。尽管“小时内淋浴”的意识运动已采取了积极的衰减步骤，但是当应尽快采取可行的积极攻击措施以限制被吸收到血液中的致癌副产品的数量。
More thorough personal protective gear cleaning should be untaken as soon as possible, as well with extractors/gear washers and removal of any embedded carcinogenic products. Some departments have been swapping hood and gloves on scene to control contamination until they can receive appropriate cleaning, ande issuing members clean replacements on-scene. Each department may have particular challenges when it comes to such an approach. The essence of this model is to control and remove as much carcinogenic exposure as soon as possible.
We all understand that firefighting has inherent risks associated with it. We also know that we have occupational exposures to products of combustion that are linked to elevated rates of certain types of cancer when compared to general population controls. As such, it is incumbent on each of us to take proactive actions to decontaminate ourselves and our personal protective equipment. The early we can decontaminate thoroughly, the more we can mitigate our occupational cancer exposure and risks.
随着循证研究的不断发展，我们对进一步缓解策略的理解和反应肯定会继续发展 - 同时，采取行动来保护自己！
托德·J·莱德克（Todd J. Leduc）,MS, CFO, FIFirE, is a 27-year veteran of and an assistant chief with Broward County (FL) Fire Rescue, an internally accredited metro fire department. He is also the secretary of the International Association of Fire Chief’s Association Safety, Health & Survival Board. He has a master’s degree in executive fire service leadership, is a peer reviewer for agency accreditation and professional credentialing. He is a credentialed chief officer, a certified emergency manager, and a fellow in the Institute of Fire Engineers. You can reach LeDuc by email attjlbcems@aol.com.
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