HYDROGEN CYANIDE IN FIRE OPERATIONS This training program

HYDROGEN CYANIDE IN FIRE OPERATIONS This training program includes the following: • • Review of toxic and hazardous substances found in smoke Review of the health effects of Hydrogen Cyanide Gas on firefighters Review of the New Hydrogen Cyanide and CO Monitoring S. O. P. Review of the operations and maintenance of the Draeger Pac 7000 Single Gas Hydrogen Cyanide Detector

HYDROGEN CYANIDE IN FIRE OPERATIONS PRESENTATION CONTENT A. Toxic Gases Generated by Fire B. Hydrogen Cyanide in Smoke C. Health Effects of HCN D. North County HCN and CO Monitoring SOP E. Gas Detection and Monitoring F. Draeger Safety Gas Pac 7000 Operation

HYDROGEN CYANIDE IN FIRE OPERATIONS TOXIC GASES GENERATED BY FIRE Partial List of Toxic Fire Produced Gases and Vapors • • Carbon Monoxide Carbon Dioxide Hydrogen Cyanide Hydrogen Chloride Nitrous Gases Phosgene Hydrogen Sulfide Sulfur Dioxide • • Acrolein Ammonia Formaldehyde Glutaraldehyde Acetaldehyde Benzene Various PNAs (polynuclear aromatic hydrocarbons)

HYDROGEN CYANIDE IN FIRE OPERATIONS TOXIC GASES GENERATED BY FIRE What chemicals are in that smoke? Acetyls – Aerosol containers, combs, lighters, ink pens Acrylics – apparel, household and commercial furnishings, mattresses, bedding Nylons –apparel, household and commercial furnishings, mattresses, bedding Polyesters – clothes and home furnishings like bedspreads, sheets, pillows, furniture, carpets and even curtains Polypropylene -- packaging, textiles, ropes, thermal underwear, carpets, stationery, plastic parts and reusable containers of various types, laboratory equipment, loudspeakers, automotive components, yogurt, margarine, deli food containers, medicine bottles and caps and other household items Polyethelyne used to produce grocery bags and garbage bags, squeezable bottles, shrink wrap, stretch films, coating for milk cartons, toys, container lids, and product packaging. --

HYDROGEN CYANIDE IN FIRE OPERATIONS TOXIC GASES GENERATED BY FIRE What chemicals are in that smoke? Polyurethanes – used in mattresses, sleeping bags, military clothing Polyvinyl chlorides – Electrical wiring and cable insulation, plumbing piping window and door frames, clothing, upholstery, inflatable products Nitrogen dioxide – inadequately vented gas ranges, gas pilot lights, gas or kerosene heaters, welding activities, and tobacco smoke Polynuclear aromatic hydrocarbons—incomplete burning of carboncontaining materials like oil, wood, garbage or coal. Many useful products such as mothballs, blacktop, and creosote wood preservatives also contain PAHs Formaldehyde -- building materials, tobacco smoke, household products, use of unvented fuel-burning appliances, like gas stoves or kerosene space heaters, used to add permanent-press qualities to clothing and draperies, a component of glues and adhesives found in engineered trusses (TJI), and as a preservative in some paints and coating products.

HYDROGEN CYANIDE IN FIRE OPERATIONS TOXIC GASES GENERATED BY FIRE What chemicals are in that smoke? Acid Gasses – Aerosol containers, combs, lighters, ink pens Phosgene – formed by thermal degradation of chlorinated solvents and polymers. dry cleaning operations, parts cleaning engine cleaning and degreasing agents, adhesives, solvents, aerosol propellants, foam plastic blowing agents, paint removers Benzine – used in the production of other chemicals such as dyes, drugs, pesticides, and products such as rubber, nylon, and glues, found in tobacco smoke, crude oil and gasoline Dioxyns – wood burning, forest fires, and backyard burning of household trash, tobacco smoke, drum and barrel reclamation processes, motor vehicles, residential oil furnaces, scrap electric wire recovery, and rubber tire burning. And the Terrible Two: Hydrogen Cyanide and Carbon Monoxide

HYDROGEN CYANIDE IN FIRE OPERATIONS Major Changes in the Fires we now fight Lightweight construction materials Synthetic and Petro Chemical based materials v Ignite 2 to 3 times faster than conventional materials v Burn 2 to 3 times hotter than conventional materials v When heated, they off gas chemicals, smoke and toxic gasses that also ignite and burn 2 to 3 times faster and hotter that conventional materials.

HYDROGEN CYANIDE IN FIRE OPERATIONS 2005 FIRE STATISTICS • In 2005, there were 1, 602, 000 fires reported in U. S. – 511, 000 structure fires • 3, 105 civilian deaths • 15, 325 civilian injuries • $9. 2 billion in property damage – 87 firefighter deaths in all types of fires – >4000 firefighters injured by smoke inhalation – It is estimated up to 80% of all fire fatalities are attributable to smoke inhalation

HYDROGEN CYANIDE IN FIRE OPERATIONS ANATOMY OF FIRE SMOKE • Toxic composition of smoke varies from fire to fire – – Nature of the burning materials Temperature Oxygen level Ventilation • Conditions of high temperature and low oxygen enhance degradation of synthetics, quickening the release of toxic chemicals into the smoke.

HYDROGEN CYANIDE IN FIRE OPERATIONS CYANIDE TOXICITY IN SMOKE • Historically, carbon monoxide asphyxiation has been considered the primary cause of deaths of those overcome by smoke – Focus of gas monitoring to determine exposures • There is mounting evidence that hydrogen cyanide is directly responsible for many more deaths than previously assumed – Cumulative effect of Hydrogen Cyanide poisoning with CO is worse than either gas individually

HYDROGEN CYANIDE IN FIRE OPERATIONS “Cyanide toxicity from smoke inhalation in a structural or enclosed space fire is the most likely cause of cyanide toxicity that EMS & Fire professionals will ever encounter” JEMS Communications Summer 2004

HYDROGEN CYANIDE IN FIRE OPERATIONS CYANIDE PRODUCING MATERIALS • Cyanide production in a fire – Hydrogen cyanide is produced by incomplete combustion of nitrogen and carbon containing substances (-C≡N) • • Natural Fibers (wool, silk, cotton, paper) Synthetic polymers (nylon, polyurethane) Synthetic rubber Melamine (resins for molding, laminating, etc. )

HYDROGEN CYANIDE IN FIRE OPERATIONS HCN RELEASING POLYMERS • Synthetic polymers found extensively in structures – – – Insulation Cushioning Carpets Bedding (mattresses and pillows) Building materials • Materials can burn up to 2 -3 times hotter and faster than natural materials –Quicker flashovers increase speed of HCN release ---

HYDROGEN CYANIDE IN FIRE OPERATIONS Other sources of Cyanide • Other small scale uses: - Photography labs - Blue printing - Engraving computer chips - Cleaning or reconditioning of jewelry - Found at clandestine drug labs - manufacturing phencyclidine (PCP)

HYDROGEN CYANIDE IN FIRE OPERATIONS Key Cyanide Studies • Two independent studies performed on CN toxicity - Paris France (1988 -89) - 109 fire victims( 66 survivors and 43 fatalities) 144 controlled individuals(drug intoxication and CO poisoning) - Dallas County Texas - 144 smoke inhalation patients at University of Texas Health Science Center Emergency Department - 43 deceased individuals at Dallas County medical examiners office.

HYDROGEN CYANIDE IN FIRE OPERATIONS KEY CYANIDE STUDIES • Final Conclusion: - Cyanide and carbon monoxide were both important determinants of smoke inhalation-associated morbidity and mortality. - Cyanide concentrations were directly related to the probability of death. - Cyanide may have dominated over CO as a cause of death in some fire victims. - Cyanide and CO may have potentiated the toxic effects of one another

HYDROGEN CYANIDE IN FIRE OPERATIONS THE STATION NIGHTCLUB FIRE • Most notorious incident of deaths from toxic mix of hydrogen cyanide and carbon monoxide was at the West Warwick Rhode Island Station Nightclub fire Feb 20, 2003 – Pyrotechnics instantly set substandard sound suppressing foam into sheet of flame – HCN and CO levels soar and people are quickly overcome by the smoke • 100 deaths and 200 injuries

HYDROGEN CYANIDE IN FIRE OPERATIONS The Station Night Club Fire • National Institute of Standards and Technology “the high temperatures, low oxygen, high carbon monoxide, and high HCN levels within the test room in the absence of a sprinkler all contributed to a nontenable condition within 90 seconds after ignition. ” • Health care providers at all levels of this tragedy did not consider HCN exposure during course of treatment for the surviving victims. • New England Journal of Medicine published report: “despite the signs and symptoms indicating CN poisoning, the victims were treated with standard modalities for burns and CO toxicity”

HYDROGEN CYANIDE IN FIRE OPERATIONS Cyanide Poisoning Of Providence Rhode Island Firefighters March 2006 Ø Thursday March 23 2006 10: 31 hrs 1197 Broad Street Ø Providence Rhode Island Firefighters responded to a relatively uneventful fast food restaurant fire Engine 3’s crew member experienced symptoms of headache, dizziness, difficulty breathing a cough, and at times talking incoherently. Transported to Rhode Island Hospital Level 1 Trauma Center. Tested for HCN to find high levels of blood cyanide at 57 ug/dl Placed on antidote therapy Ø Upon learning of Engine 3’s firefighter, department contacted all members responding to the call 16 members sought medical attention. 14 members went to Rhode Island Hospital 4 found to have whole blood cyanide levels above 20 ug/dl

HYDROGEN CYANIDE IN FIRE OPERATIONS Cyanide Poisoning of Providence Firefighters March 2006 • March 23, 2006 17: 35 hrs. 125 Knight Street Providence Rhode Island firefighters responded to a fire in a six-unit residential apartment Fire in a different part of the city after shift change. Most of the personnel from fast food restaurant relived No injuries reported • March 24, 2006 02: 07 hrs. 70 Ralph Street Providence Rhode Island firefighters responded to a house fire All firefighter responding to Ralph St. had previously responded to Knight Street fire. At 02: 23 hrs. Firefighter Kenneth Baker collapsed at the scene suffering a heart attack. Immediately resuscitated and transported to Rhode Island Hospital

HYDROGEN CYANIDE IN FIRE OPERATIONS Cyanide Poisoning of Rhode Island Firefighters March 2006 • In light of the cyanide cases from the previous day, testing was conducted on Firefighter Baker. Lab test showed that FF. Baker had whole blood cyanide level of 66 ug/dl • After consulting with doctors at Rhode Island Hospital, all members who responded to any of the three fires were instructed to go to Rhode Island Hospital if they experienced any symptoms to cyanide poisoning. 28 members sought medical care 27 had their cyanide levels tested 8 members tested high (above 20 ug/dl) for cyanide • Fire Chief David Costa appointed a five member committee to investigate the causes of cyanide poisoning, review existing policies and procedures, and make recommendations to prevent this from happening again.

HYDROGEN CYANIDE IN FIRE OPERATIONS HEALTH EFFECTS OF HCN Health Effects of HCN on Firefighters

HYDROGEN CYANIDE IN FIRE OPERATIONS ACUTE CYANIDE POISONING • Hydrogen cyanide is a cellular asphyxiant – Inhaled HCN inhibits enzyme system responsible for cell respiration (oxygen utilization by cell) – Cessation of cell respiration makes normal cell function impossible, leading to cell mortality • There is no quick test that allows on-site confirmation of HCN toxicity • There are some signs that can lead to assumption of HCN exposure and administration of countermeasures – Disorientation and weakness/Drowsiness – Shortness of breath and chest tightness(Tachypnea, Dyspnea Tachycardia) – Headache – Bright red discoloration in skin – Smell of almonds on breath – Soot around mouth and nose/burns – Carbonaceous sputum

HYDROGEN CYANIDE IN FIRE OPERATIONS CHRONIC EFFECTS OF HCN • Chronic (extended time)effects of hydrogen cyanide – Breathing problems/Respiratory Depression to Respiratory Arrest – Chest pain / Cardiac arrhythmia/Cardiovascular collapse – Eye irritation/vision dimming – Palpitations – Headaches – Loss of appetite – Weakness in extremities/ Paralysis – Enlargement of thyroid gland

HYDROGEN CYANIDE IN FIRE OPERATIONS Acute Cyanide Poisoning • Significance for advocates of “sucking the carpet” - carpet fibers are a large source of HCN - fumes develop long before carpet catches fire. • Quantitative decomposition - long period of time when gas is emitted without the warning presence of flame. - decomposition stage of the fire is more toxic than those emitted during actual burning. - decomposition stage is the real killer because of its high toxicity and long period of time between attainment of quantitative decomposition temperature and ignition temperature

HYDROGEN CYANIDE IN FIRE OPERATIONS Acute Cyanide Poisoning • Narcotic effects of HCN -blamed for bizarre and irrational behavior - instances where victims, including firefighters fought with rescuers until becoming totally overcome by the smoke. • Southwest Supermarket fire Phoenix Arizona - Brett Tarver - rescue teams were hampered on several occasions - succumbed to the environment and pulled through debris and out of the building.

HYDROGEN CYANIDE IN FIRE OPERATIONS HCN LETHALITY DOSE MAKES THE POISON Concentrations Effect mg/m 3 PPM 300 mg/m 3 270 ppm Immediately Lethal 200 mg/m 3 180 ppm Lethal after 10 minutes 150 mg/m 3 135 ppm Lethal after 30 minutes 120 -150 mg/m 3 108 -135 ppm Highly dangerous (Fatal) after 30 -60 minutes 20 -40 mg/m 3 18 -36 ppm Light symptoms after several hours

HYDROGEN CYANIDE IN FIRE OPERATIONS HCN LETHALITY NOISH Chemical Pocket Guide HCN is 35 times more toxic than CO • TWA HCN 4. 7 ppm CO 35 ppm (Time weighted average) • • IDLH HCN 50 ppm CO 1200 ppm LEL HCN 5. 6% CO 12. 5% UEL HCN 40% CO 74% Fl. Pt. (flash point) 0⁰ F VD (vapor density) 0. 94 air = 1 BP (boiling point) 78⁰ F Sp. Gr. (specific gravity) 0. 69 water = 1

HYDROGEN CYANIDE IN FIRE OPERATIONS ACUTE CYANIDE POISONING • Recently there has been the first FDA approved cyanide treatment, Hydroxocobalamin, that can safely be administered at a fire scene – Detoxifies CN by binding it to form cyanocobalamin (B 12) – Marketed as Cyanokit® – Used in France for 10 years – Previously, only supportive measures were available on site • 100% oxygen application • Sodium bicarbonate to counter metabolic acidosis • Cardiopulmonary support and anticonvulsants – Existing antidote involved nitrates that needed to be monitored under hospital care to avoid lethality when combined with CO Taylor Kit Lilly Kit Pasadena Kit

HYDROGEN CYANIDE IN FIRE OPERATIONS PHOENIX OVERHAUL STUDIES • Removal of respiratory equipment during overhaul can expose firefighters to a wide variety of toxic gases – Overhaul phase of fire lasts an average of 30 minutes – Liberated gases, vapors and particulates may remain in overhaul environment for extended periods of time • Vapors may use airborne respirable particulates as entry vehicle into firefighters’ lungs – Maximum concentrations of selected contaminants can exceed occupational exposure limits • Adverse health effects may occur from exposure to mixture of products even if individual components are below exposure limits – Monitoring CO concentrations alone should not be used to predict presence of other contaminants found in the overhaul environment Bolstad-Johnson, et al

HYDROGEN CYANIDE IN FIRE OPERATIONS PHOENIX OVERHAUL STUDIES Conclusions of Phoenix Studies • Without the use of respiratory protection, firefighters are overexposed to irritants, chemical asphyxiates and carcinogens • Respiratory protection is recommended during fire overhaul – SCBA should be utilized in atmospheres with CO > 150 ppm – APRs may be considered when CO < 150 ppm, but additional studies to confirm effectiveness in overhaul operations are recommended • NIOSH cartridges for APR don’t provide CO protection • 150 ppm equates to avg. 18. 75 ppm exposure based on 60 minute exposure and 8 -hour working day (TLV= 25 ppm) - Post-fire fuels are still off-gassing, SCBA’s should be used.

HYDROGEN CYANIDE IN FIRE OPERATIONS Recommendations for prevention of cyanide exposures • Training - Explanation why cyanide is more significant today than ever before. - Chemistry of cyanide - Identification of cyanide containing fuels - Medical concerns of cyanide - Why firefighters cannot merely on their past experiences to determine whether or not a particular atmosphere is safe. • Equipment - Deploy cyanide detection equipment into the field for use at fires.

HYDROGEN CYANIDE IN FIRE OPERATIONS Recommendations for prevention of cyanide exposures • Compliance - There needs to be enhanced compliance with the existing mandatory mask regulation. - Enhanced compliance will require a cultural change on the part of firefighters. • Company officers must focus on the protection of their members, and ensure that SCBA’s are utilized when necessary and face pieces removed outside the contaminated area when exiting the structure.

HYDROGEN CYANIDE IN FIRE OPERATIONS Recommendation for prevention of cyanide exposures • SCBA Training for difficult operations - All personnel need physical training with SCBA to enhance the comfort level of members when engaged in difficult operations such as: - climbing ladders - operating on roofs - operating in confined spaces - communicating on air • SCBA Air Management SCBA alarms activated during initial extinguishment and during overhaul

HYDROGEN CYANIDE IN FIRE OPERATIONS Recommendations for Prevention of Cyanide Poisoning • Post-Fire Decontamination - Wash turnout gear after each fire - Shower and change their clothes - Issue second set of gear

HYDROGEN CYANIDE IN FIRE OPERATIONS Recommendations for Prevention of Cyanide Poisoning • Discussion Questions: - How much cyanide is generated at fire scenes? - What conditions yield higher verses lower concentrations of CN? - When CN is released in a fire, does it remain localized (in an area around the fuel that is off gassing) or does it spread out throughout the building? - Is CN released only under certain fire conditions or is it released more commonly whenever CN containing products burn?

HYDROGEN CYANIDE IN FIRE OPERATIONS Recommendations for Prevention of Cyanide Poisoning • Public Education - General public, media and legislators need to be educated about the dangers of smoldering and burning plastics and other cyanide containing fuels. • - Public needs to know the dangers associated with CN may be present before the presence of any flames and that they could possibly become incapacitated by the invisible gases during the incipient stage which could prevent them from safely escaping.

HYDROGEN CYANIDE IN FIRE OPERATIONS Hydrogen Cyanide and Carbon Monoxide Monitoring Procedures These North County Districts and Departments have all adopted this Standard Operating Procedure for monitoring the fire ground for Hydrogen Cyanide, Carbon Monoxide, Oxygen percentages, LEL/UEL Ranges, and Hydrogen Sulfide levels during fire ground activities. Black Jack Community Ferguson Berkeley Jennings Kinloch Metro North Mid-County Northeast Pattonville Riverview Robertson Spanish Lake University City West Overland

HYDROGEN CYANIDE IN FIRE OPERATIONS North County HCN and CO Monitoring SOP • SUBJECT Fire ground air quality monitoring and use of SCBA during fire extinguishment and overhaul. • PURPOSE To help prevent occupational exposure to products of incomplete combustion that may pose a safety hazard to human health, monitoring of air quality is to be conducted to determine the presence of potentially hazardous contaminants including but not limited to, Carbon Monoxide (CO) and Hydrogen Cyanide (HCN). • SCOPE All (City/district name) members and members of all mutual aid / automatic aid companies. • OBJECTIVE An important goal of the (department/district) is to prevent the losses of lives and property by providing procedures to be followed that will ensure maximum protection of personnel. Because of the unusual and hazardous working environments to which they might be exposed, employees shall be held responsible for safely performing their duties and their responsibilities. Therefore, the following personnel safety procedures shall be followed.

HYDROGEN CYANIDE IN FIRE OPERATIONS North County HCN and CO Monitoring SOP • PROCEDURE • Firefighters shall continue to wear PPE and use SCBA while performing interior operations in an IDLH atmosphere until all of the following has occurred: A. Ventilation has been established. B. The entire structure has been monitored with a 4 Gas Meter and Single Gas meter for HCN and the following conditions have been met: 1. Oxygen levels are greater than 20. 8 percent. 2. CO levels are 35 ppm or less. 3. LEL/UEL less 10% of the gases. 4. Hydrogen Sulfide is 10 ppm or less. 5. HCN levels are 5 ppm or less. • C. Incident Commander and/or the Safety Officer determine that is safe to stop using SCBA.

HYDROGEN CYANIDE IN FIRE OPERATIONS North County HCN and CO Monitoring SOP • Personnel monitoring, Rehab and Decontamination • Once incident is under control a random selection of personnel known to have been operating in the structure should have their PPE monitored for HCN. If turnout gear has a reading higher than 5 ppm, a hose line is to be used to decontaminate gear. Briefly rinse with a soft fog pattern to prevent saturation. All personnel operating inside the structure should be decontaminated by the above described means if greater than 5 ppm was found on any one member. In addition, personnel should practice good personal hygiene by washing hands prior to drinking and eating in rehab. • Turnout gear, gloves, flash hood, and helmet ear flaps should be washed in extractor per NFPA 1851. SCBA, face pieces, helmets, etc. should be washed in accordance of manufacturer’s recommendations.

HYDROGEN CYANIDE IN FIRE OPERATIONS North County HCN and CO Monitoring SOP Firefighters should always be aware of the signs and symptoms of Hydrogen Cyanide poisoning, which include: Weakness / Dizziness Prostration Flush / Red / Pink Skin Color Tremors Rapid Breathing Irregular or Rapid Heart Beat Anxiety / Excitement Convulsions / Seizures Perspiration Stupor Vertigo Paralysis Headache Coma Drowsiness Difficulty Breathing / Respiratory Arrest Ventricular Fibrillation / Tachycardia Heart Attack

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000 has a simple menu structure Fresh Air, Span Cal STEL, TWA, Peak Value Bump Test COHb option with CO version (set w/PC) Calibration On-board Calibrate w/o a PC No life limiting feature Replaceable sensors Not exchangeable to different gases Dedicated to the original gas purchased

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000 Dräeger Pac 7000 Instrument with unlimited lifetime and sensor exchange, concentration display, adjustable operating timer from 1 day to 2 years, and data logger.

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000 Dräeger Pac 7000 Features • • Unlimited lifetime changeable sensors Four digit concentration display TWA alarm STEL alarm Peak value Password protected menu for calibration Data logger

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000 Large and language-free Display Personal monitoring orientated size and weight Tight wearing using an alligator clip Ease of use Low cost of ownership

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000 The instrument is maintenance-free and manly service-free Two button intuitive operation Latching buttons Rotate-able alligator clip Leather carrying case Connecting Cradle Bump Test Station Individual configuration Configuration / calibration software: E-Cal Module - Pac Vision - CC-Vision - Gas Vision - CC-Vision E-Cal

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000 Polyamide housing resistant to corrosive chemicals RFI shielding per IEC specification Sealed against water and dust ingress IP 65 Covered with rubber

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000

HYDROGEN CYANIDE IN FIRE OPERATIONS SINGLE GAS MONITOR - DRAEGER PAC 7000