Boots? Check. Bunker pants? Check. Hood? Check. Coat? Check. Helmet? Check. Gloves? Check. SCBA? Check. It seems so simple.

Countless times a day, firefighters across the country go through the motions of dressing out to perform the duties of their occupation. But do they stop to really think about their PPE? Do they take the time to learn about what each component or element adds to the creation of a safety envelope that lets them do extraordinary things on a daily basis?

In other words, are firefighters dressed simply for success or for survival?

Firefighter deaths have dropped by nearly one-third over the last 30 years. NFPA statistics reveal sudden cardiac-related deaths have dropped from 2.6 per 100,000 structure fires to 1.3 per 100,000 structure fires. Meanwhile, structure fire-related deaths dropped from 79 in 1977 to 34 in 2006. Sounds like some real progress has been made, doesn't it?

The bad news is that structure fires have dropped by about 50% during that same time period. So, the proportion of fire-related deaths to structural fires has remained virtually the same. The U.S. fire service continues to experience devastating, high-profile losses, and the rate of non-cardiac, non-structural injuries and fatalities continues to rise. The last 10 years are particularly disconcerting, with a steady loss of more than 100 firefighters per year.

What does this have to do with PPE? According to the 2007 National Near-Miss Reporting System, “Wearing PPE is one of the most fundamental acts a firefighter can perform to insure individual safety.” Firefighter safety and survival is intrinsically dependent on the personal protective ensemble.

But it is more than just donning the ensemble. It also is a matter of understanding how PPE protects, respecting its limitations, recognizing attitudes about PPE and critically assessing the health and safety risks associated with firefighters' working environments. The safety envelope created by PPE can be examined from three perspectives: technology, culture and environment.

There also is a synergy between these three perspectives that is analogous to the proverbial three-legged stool. Take away our understanding of one leg and the entire protective envelope can collapse. The challenge over the past 30 years has been to keep up with these three perspectives in a balanced and coordinated approach.

Extraordinary Hazards

Given the possible working environments firefighters might encounter on any given day, the demands on PPE are extraordinary. The Project Heroes report identified 52 unique hazards that could contribute to firefighter injury or death, and the NFPA has developed specific PPE standards for specialized environments. Yet most firefighters have only NFPA 1971-compliant structural firefighting PPE as a safeguard. It is neither fiscally nor logistically realistic to outfit each firefighter in the myriad specialized PPE ensembles.

The NFPA 1971 committee understands this dilemma and goes to great lengths to ensure the standard document addresses protection for the broader spectrum of everyday working environments. As these environments change, so does the NFPA 1971 document. It is important to continually reassess fire service working environments by identifying key components and assessing potential risks to firefighter safety and health.

One of the more interesting areas of study right now is the definition of an “ordinary” fire in terms of thermal radiation. Homes are becoming more encapsulated and household items are being manufactured with increasing amounts of synthetic materials that burn at higher temperatures. These facts have tended to shift the range of “routine” and “ordinary” fires into higher thermal ranges.

Closely associated with this trend is the phenomenon of “stored energy.” A relatively new concept that has evolved over the past 10 years, stored energy refers to the thermal energy that is absorbed by the PPE composite as it protects the body from a high-heat environment.

The air spaces between the composite layers are part of the protective system. As a firefighter moves about in the course of firefighting activity, the air continually is mixed and moving. However, there can be spots where air movement is restricted and the temperature of the air in these pockets continues to rise. If this section of a composite is compressed suddenly, the hot air will take the path of least resistance to escape. This path might be toward the firefighter's skin, creating a burn with little or no degradation to the PPE composite layers.

If the fire service continues to fight structural fires the same way but in hotter environments, then technology and tactics need to keep up with the changing environment to ensure firefighters can function safely.