CBRNE Incidents - The Role of the Firefighter

Five years have passed since the terrorist attacks of 11 September 2001.  Although there have been no additional attacks in the United States during those years, most experts agree that there will be future attacks and that the question is “not if, but when.” Terrorists have time on their side.  They can plan, wait, and launch their attack when and where they want.

The specific details are classified, but it is known that the ongoing efforts of the FBI and other law-enforcement agencies, within and outside the United States, already have foiled many would-be terrorist attacks. However, this does not guarantee that terrorists will not be successful in the future – which should be reason enough for the nation’s first responders to further improve their operational readiness. 

Among the various first-responder units most likely to show up in the earliest stages of a terrorist event involving the release of a chemical or biological agent, or the actuation of a radiological or nuclear device, or the detonation of explosives – CBRNE attacks, in other words – will be local firefighters, police and other law-enforcement personnel, and EMS (emergency medical services) technicians.  However, in the event of a covert biological attack, local and state health departments, working in close cooperation with the U. S. Centers for Disease Control and Prevention (CDC) and the FBI, usually will be among the highest-priority responders at the scene as well. 

Unless they receive intelligence of an impending attack from local law-enforcement agencies, the FBI, or perhaps a regional JTTF (Joint Terrorist Task Force), firefighters responding to a CBRNE event will not have the initial information they need to alert them that the incident they are responding to may be terrorist-related. Instead, they will have to rely on their own previous CBRNE training, combined with their current on-scene observations, to gather clues as to whether the incident was deliberate. Certain signs and symptoms of casualties may indicate that a chemical agent was used in the attack, for example. In addition, the presence of radiation readings above normal background levels at the scene of an undetermined explosion could be an indicator of a radiological (i.e., “dirty bomb”) release.

Self-Protection – The Most Important Priority

Probably the single most important item of a firefighter’s personal protection equipment against exposure to a dispersed chemical or biological agent, or to radioactive/nuclear materials (CBRN), is what is called the self-contained breathing apparatus (SCBA) – which, among other things, prevents contaminants from entering the wearer’s body through the respiratory tract and/or eyes. 

The National Institute for Occupational Safety and Health (NIOSH) is testing and certifying various SCBA systems and other equipment items used by emergency responders working in CBRN environments.  To determine if a specific SCBA has been tested, and certified, by NIOSH for use by emergency responders in CBRN environments, officials say, inspectors should inspect the system to see if a CBRN agent-approval label is on the respirator. If an SCBA has, in fact, been CBRN-approved by NIOSH, it will always carry such a label.

On the other hand, if a CBRN agent-approval label is not on the SCBA, the garment probably has not been approved by NIOSH for use by emergency responders working in CBRN environments.  (The approval number for an SCBA approved for CBRN environments always includes a CBRN suffix – e.g., TC-1F-XXXXCBRN.)

Properly worn turnout gear (i.e., helmet, hood, coat, gloves, turnout pants, and boots) provides some limited protection against CBRN contaminants entering the body through the skin. However, it does not provide protection against exposure to gamma radiation. 

Although ordinary firefighter protective clothing offers some protection against CBRN components, it is not a suitable substitute for the NFPA (National Fire Protection Association) Standard on Protective Ensembles for First Responders to CBRN Terrorism Incidents, also known as NFPA 1994-compliant protective ensembles. NFPA 1994 establishes the minimum requirements for the design, performance, testing, documentation, and certification of protective ensembles, and ensemble elements, designed to protect emergency first-responder personnel from chemicals, biological agents, and radiological particulate terrorism agents. 

“No Community Is Immune”

Although terrorists have voiced, and demonstrated, their intention to attack large metropolises such as New York City and Washington, D.C., “any town, USA,” might be a viable future target.  No community is immune from a possible terrorist strike.  Moreover, terrorists could unleash several simultaneous attacks. 

Ten years ago, firefighters and other first responders in 120 of the nation’s major metropolitan areas began participating in the Nunn-Lugar-Domeneci Domestic Preparedness Program. A principal goal of that program (which later involved some smaller metropolitan areas as well) was to enhance the preparedness of the nation’s first responders to manage the consequences of potential terrorist WMD (weapons of mass destruction) incidents. The authorizing legislation designated the Department of Defense (DOD) as lead agency. Among the other major agencies participating were the Federal Emergency Management Agency (FEMA), the Federal Bureau of Investigation (FBI), the DHS (Department of Health and Human Services) Public Health Service, the Department of Energy, and the Environmental Protection Agency (EPA).

The U.S. Army Soldier and Biological Chemical Command (SBCCOM) followed up with the development of an innovative “train-the-trainer” program to build on the existing knowledge and capabilities of local first responders – fire, law enforcement, and medical personnel and hazardous materials technicians, primarily – who would deal with a WMD incident during the first hours after an attack had taken place. 

Consequence Management and Other Priorities

That training, which started in 1997, served as a springboard from which other training programs were launched around the country. The ultimate goal was to better prepare emergency responders throughout the country to respond to and safely manage the consequences of the incident.

Depending on the particular CBRNE agent used in a terrorist event, the first arriving specialist unit probably will be a hazardous materials response team, a bomb squad, or a public health response team.  Some local jurisdictions have established and are adequately funding at least some of these specialized response teams, but others have not, and therefore have no option but to rely on state, regional, and/or federal resources. 

In any case, the response times of such units heavily influence how helpful they are likely to be in assisting on-scene firefighters. In general, it is safe to assume that, the longer the response time is, the greater will be the stress and challenges to the firefighters and other on-scene personnel attempting to implement their initial consequence-management measures.

Guidelines for Survival

Below are some guidelines recommended by experts to help firefighters improve and/or refresh their response capabilities and, in general, to promote the safer consequence-management phases of CBRNE events:

1. Approach the CBRNE event as if it were a hazardous-materials incident.  Although most firefighters are not specialists in the management of hazmat incidents, they should know the fundamental principles applicable to the safe management of such incidents.  In essence, a CBRNE event is still a hazardous-materials incident at its core – one, though, that has the potential to injure, sicken, or kill large numbers of people, cause widespread public fear, create a media-response overload, and overwhelm the on-scene resources available.  For these reasons alone, on-scene conditions, combined with the perhaps limited training level of the firefighters involved, may limit their actions to a defensive posture while they await the arrival of specialist units.
2. Develop at least a fundamental understanding of the properties and potential consequences of CBRN exposure. The more knowledge that firefighters have about CBRN agents and materials, the safer and more effective they probably will be during the consequence-management phase of CBRN incidents.
3. Prepare CBRNE information and response guides. The infrequency of CBRNE events, and the daily activities of fire-service operations, easily could lead to an environment in which firefighters simply do not devote enough time to adequately address CBRNE event-related concerns. 

The latter measure is a relatively inexpensive but very important way to help firefighters quickly review key information during training sessions – and even while en route to a possible CBRNE incident. Here it should be emphasized that such guides, which should be prepared beforehand, not after an incident has occurred, are meant to reinforce prior training, not substitute for it.

Practical Suggestions and Common Sense

Following are some practical suggestions that have been recommended for preparing printed guides:

• Use index stock paper (8-1/2” x 11”).
• Identify and include critical CBRNE- and operations-related information and concerns. For ease of review, keep the points brief and to the point.
• Have the document reviewed for technical accuracy and readability by a subject matter expert such as a hazmat technician, bomb technician, health physicist, and/or public health official.
• Laminate the document for durability, and use a three-hole punch to carry the guide in a binder.
• Ensure that copies of the guides are available for, and carried in, all emergency-response vehicles.
• Prepare an information bulletin about the guides and distribute it to all members of all units at all stations.
• Finally, and probably of the greatest importance, ensure that all personnel are properly trained in the operations described in the guide. 

In addition to the preceding, there are other common-sense recommendations that should be standard operating guidelines for all personnel. Here are some of the more important of those guidelines:

• Wear turnout gear properly, and use a self-contained breathing apparatus – but know the limitations of each.  Ordinary turnout gear is no substitute for personal protective clothing specially designed for CBR exposure (see the NFPA 1994 standard mentioned earlier).

• Always consider the possibility of a radiological “dirty bomb” and the possible presence of other explosive devices when responding to a reported explosion of unknown origin. Unless the cause of the explosion becomes readily apparent after the initial first responders arrive at the incident scene, use (or obtain) a radiological instrument to check the surrounding area for ionizing radiation.  (Some fire departments carry radiation-alerting devices on their emergency response vehicles; others either install them on vehicles when the DHS National Threat Advisory System reaches a certain alert level, or simply do not have them available for use.)

• Conduct on-scene activities consistent with the local department’s standard operating guidelines (SOGs) and the individual firefighter’s own level of training.  Untrained or improperly trained firefighters, no matter how well intentioned, could easily compromise their own safety and the safety of others.

• Develop local action guidelines consistent with the DHS National Threat Advisory System just mentioned.  Some fire departments already have created their own threat advisory systems to determine, in advance (insofar as possible), what actions they should take for each of the five national threat levels (low, guarded, elevated, high, and severe) spelled out in the DHS advisory system.  A local advisory system should not substitute for the national system, but it can enhance readiness, promote safety, improve efficiency, and reduce confusion in the aftermath of a CBRNE event that affects the local community. 

• Participate fully and regularly in tabletop and full-scale exercises. Such exercises not only help participants identify the strengths and weaknesses of their own terrorism units and agencies – and perhaps discover ambiguities and/or inconsistencies in standard and local operating guidelines – but also allow them to interact with representatives of local, state, and federal agencies as well as members of the private sector.

• Review, exercise, and revise (if needed) current mass-casualty and decontamination guidelines.  The nature and extent of a CBRNE event may require firefighters to triage, treat, decontaminate, and transport large numbers of contaminated casualties. 

Maximum Confusion, and the Well-Prepared Mind

To summarize: A CBRNE event can result in a huge number of casualties. It might be a single event, involving one or more CBRNE materials, or several events – occurring either simultaneously or sequentially.  Hazardous materials response teams, bomb squads, and public health response teams are among the principal specially trained CBRNE resources that may be (or may not be) available to respond. Nonetheless, local firefighters are likely to be on their own for at least a short time before these other important resources arrive on the scene of an incident.  During that period of what might be maximum confusion, firefighters must be not only as resourceful as possible but also totally committed to doing the best they can to prevent the event from claiming more casualties.

The best indicator, perhaps, as to how well a fire department is prepared to respond to a CBRNE event is the level of training and preparedness of all of its operating members.  Today, unfortunately, although many firefighters have received substantial CBRNE-related training, and also have participated in exercises testing their knowledge and operational capabilities, others are still in the process of building their knowledge base. In short, there are still too many firefighters in need of CBRNE training. However, regardless of whether they are fully prepared or not, firefighters will be almost always among the first to respond to a fire, explosion, or similar incident.

A word of advice for mayors, county executives, and other state and city officials: A casual visit to the local fire station to talk with firefighters about their domestic preparedness program for the handling of CBRNE events is an excellent way to get an idea as to how well they are (or are not) prepared. Here the important thing to remember is that the fire department’s own leaders are primarily responsible for ensuring that the firefighters under their command receive the CBRNE training they need.

Good training builds both competence and confidence. Waiting until a CBRNE event occurs before ensuring that firefighters and other first responders are properly trained is not only irresponsible but also can lead to counterproductive decision-making and/or unsafe practices at the scene of an incident.  As Louis Pasteur once commented, “Chance favors the prepared mind.”