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Breathing difficulties: CBRN standards are firming up
By Doug Page
On an otherwise normal Monday morning rush hour, members of a fanatical religious sect hoping to hasten the apocalypse enter each of New York’s nine subway lines at different points, each carrying a furled doorman’s umbrella and two liters of the nerve agent sarin in liquid form in twin plastic bags wrapped in newspaper. No one notices that each umbrella tip has been honed to a sharp point.
At prearranged stops, the assailants are instructed to put on surgical masks, drop one bag on the floor of the train, puncture it twice with the umbrella tip, disembark, drop the other bag on the platform in the crowd, puncture it, then exit the station.
 A hazmat instructor adjusts the respirator mask being worn by one of two EMTs who are preparing to respond to a simulated shemical spill in Baton Rouge, La., in Ocotber. Similar training was given to all first responders cleaning up after Hurricanes Katrina and Rita. |
Scores of New York commuters instantly begin to experience symptoms: runny nose, chest tightness, pupil contraction. Soon, the victims have difficulty breathing and experience nausea and drooling. As victims continue to lose control of body functions, they vomit, then evacuate their bowels and bladder, followed by severe convulsions. Ultimately, victims become comatose and suffocate.
Panic spreads throughout the underground platforms. As first responders begin arriving at street-level subway access points, they find stairways choked with bodies, trampled in the stampede, not only blocking escape for those beneath, but preventing entry for arriving help.
The fiction in this scenario is that it didn’t happen in New York. But in the similar incident in Tokyo in 1995, 12 people died and 6,000 were injured, an event that shifted the paradigm of civilian first response.
Into the streets
Prior to the Tokyo sarin attack, CBRN (chemical, biological, radiological and nuclear) threats were not a major concern for civilian first response agencies, standards-setting organizations or response equipment manufacturers.
“The Tokyo sarin attack brought chemical warfare, until then a military problem, into the civilian sector,” says John Eversole, chair of the International Association of Fire Chiefs’ Hazardous Materials Committee.
Suddenly, the dash was on for civilian first responders to acquire equipment and training to meet a potential CBRN threat. Federal grant money was made available to assist in buying equipment. At the time, however, no industry standards existed, and in the rush to acquire equipment, many agencies found themselves with respiratory protection devices that were inadequate to confront a CBRN threat.
According to Eversole, there had been an historic agreement between the Department of Defense and OSHA that civilian self-contained breathing apparatus would not be tested against chemical warfare agents, since CBRN was not considered to be a factor in the civilian world.
Following the Tokyo attack, the IAFC was one of the first organizations to petition the federal government to establish CBRN standards for respiratory protection equipment.
“We were naive enough to think that the SCBA units we were using would protect us, but we found out that is not the case,” Eversole says. Subsequent testing revealed that existing equipment, standard certified SCBA that met all current National Fire Protection Association and National Institute of Occupational Safety and Health requirements, often failed in seconds when tested against chemical warfare agents.
It takes an acronym
In 1998, the Defense and Justice departments created the InterAgency Board for Equipment Standardization and InterOperability (IAB) <www.IAB.gov> to advise federal, state and local agencies on the selection and use of the best available equipment for first responders. The IAB designated the Office of Law Enforcement Standards at the National Institute of Standards and Technology to coordinate development of standards by NOISH and NFPA for respiratory equipment, suits, gloves and other gear that protect against chemical and biological warfare threats.
Over the next few years, with the pace picking up after 9-11, NOISH and NFPA developed a suite of national standards that establish minimum performance requirements for respirators and other essential equipment designed to protect first responders against CBRN hazards.
The first of these standards appeared in 2002 for SCBA, followed in 2003 by standards for SCBA upgrades, gas masks and escape sets, all intended to help manufacturers, and ultimately local procurement officials, provide emergency personnel with the best available protective gear. The guidelines also provide manufacturers with minimum performance requirements for equipment, and test procedures to confirm that the required performance levels are achieved.
“CBRN certification should be a standard requirement for every mask used by every firefighter in this country,” Eversole says. “When that bell rings, our people are going out to protect the community. We want to make sure they can do that in a safe manner. We have no kamikaze firefighters.”
The standardization process wasn’t a simple as merely adopting military respirator standards. There are a number of inherent differences between NOISH and military standards, including purpose, target user groups, hazards, operations and protection, explains Jon Szalajda, chief of the Policy and Standards Development Branch at NOISH’s National Personal Protective Technology Laboratory. <www.cdc.gov/NOISH/npptl>
“Military masks are designed for limited applications, different from industrial or first responder needs,” he says. “The military usually knows what CBRN hazard it might face, but with civilian first responders the hazards are unknown, uncontrolled and uncharacterized. We had to address that in terms of protection capability.”
Civilian SCBA units can now be purchased or upgraded to meet NOISH CBRN standards, giving responders a better idea of how an SCBA will perform in a CBRN event.
Along with that information also comes a safety warning that even upgraded equipment has a six-hour life span once exposed to CBRN agents. “As a planner, that means that potentially after the first six hours of an incident, response agencies would need to replace all their exposed SCBA to continue operations,” says Steve Clendenin, deputy director of hazmat response for the Massachusetts Department of Fire Services and chair of the WMD Working Group in FEMA’s National Urban Search and Rescue (us&r) Response System.
A NOISH standard for powered air-purifying respirators is in the works, due to be released sometime in June. Some draft language is already available, reflecting escalating performance demands. <www.cdc.gov/NOISH/npptl/standardsdev/CBRN/> When performing heavy rescue or victim extrication types of operations, rescuers often require air flows three or four times above the approximately 100lpm flows currently standard for most PAPRs.
The new standard is expected to list PAPRs in three categories: industrial, WMD and CBRN, with WMD and CBRN versions likely to specify flow rates higher than units rated for industrial use only.
“We now have better data on what’s actually required,” Clendenin says.
NOISH is also developing standards for closed-circuit SCBA, as well as hybrid SCBA/PAPR and SCBA/APR systems.
Show us the money
One concern in the wake of the standards push is that many emergency response agencies that purchased respirators before release of the standards might now need to acquire replacement equipment that meets higher standards.
“Too much money has been wasted on useless equipment,” says Tara O’Toole, m.d., director of the Center for Biosecurity, University of Pittsburgh Medical Center.
Experts expect that the cost of PAPR units meeting the new standards for CBRN/WMD rescue operations will more than triple, from about $600 currently to around $2,000 per unit.
The challenge as budgets tighten and grant funding becomes both scarcer and more competitive will be how to fund and acquire equipment that meets the standards.
“A few years ago we lacked the standards. Now we finally have the standards, but may be very challenged to locate funding,” Clendenin says.
Funding is not the only issue. Another challenge will be to ensure that appropriate standards and test methods keep pace with evolving technologies, and that standards and equipment support the needs of the spectrum of users.
“We need to develop standards for interoperability and interchangeability of key components to provide flexibility to the responders during large-scale events,” says Philip Mattson, program manager, Critical Incident Technologies at nist’s oles. These include standards for closed-circuit SCBA, hybrid/combination systems and supplied-air respirators.
One of the most critical factors in developing performance standards that meet user needs is user participation in the process.
“This ensures that user needs and concerns are understood and are adequately addressed,” Mattson says. “There are a large number of activities occurring simultaneously. Coordination and communication are critical so that resources are not squandered on duplicative or competing initiatives.”
And providing adequate respiratory protection is not always an issue of standards, funding or technology. O’Toole worries that even simple surgical masks could be in short supply during an outbreak of a contagious disease, such as a pandemic flu.
“Medical workers are at highest risk by far, and there won’t be enough surgical masks for them, let alone police and firefighters,” she says. O’Toole says one Ontario hospital with two dozen SARS patients in 2003 went through a total of 19,000 masks every 24 hours.
“Multiply this across 5,000 hospitals in the U.S. with millions of flu patients and you get the picture,” she says. “The supply lines won’t keep up, and most masks, gowns and gloves come from Asia, which is likely to be hit hard if a flu pandemic occurs.” [Ed.: See sidebar, right.]
Compliance climate
In spite of stout efforts by standards organizations to create a compliance climate, some first responders think that respiratory protection equipment is still too specialized.
“Up to this point, CBRN- or WMD-compliant merchandise for first responders has always been couched as a specific, specialized piece of equipment,” says Jeff Jackson, program manager for the Prepositioned Equipment Program, Texas Engineering Extension Service, and a member of Texas us&r Task Force 1. He says this often leaves first responders wondering whether their equipment is relevant, applicable and, above all, protective.
“A standard is a standard is a standard,” Jackson says, “but if you aren’t wearing equipment that meets those standards, you aren’t protected.”
While the current efforts have created exhaustive respiratory protection standards, the user community is anxious for the next generation of response equipment to appear.
“Users are going to be very grateful down the line that they won’t need to be so hyper-selective in what equipment they choose to use,” Jackson says. “That way, when I don an SCBA, I’m not wondering if this is simply for fire and smoke or will it protect me from WMD attack.”
Instead, Jackson expects a universal respirator to emerge that’s capable of meeting every challenge, though we aren’t there yet.
“That will ultimately be the case, but given the new standards, there will first be modifications made to existing inventories and product lines to reach compliance,” he says. That may mean upgrading some of the materials used in face plates or gaskets.
PPE of the future
While first responders don’t currently have personal protective equipment that’s adequate for multiple tasks (such as firefighting as well as chemical and biological protection), two developmental efforts are nearing final testing that will simultaneously provide both Level A bio/chem protection and turnout gear fire protection.
- A Next Generation Fire Fighter Protective Ensemble is being developed by a team led by North Carolina State University.
- Both of these projects are managed by the Technical Support Working Group <www.tswg.gov> in cooperation with DHS.
- In addition, an Improved Level A Chemical Protective Ensemble (ice) has completed testing. ice provides at least the same level of vapor, aerosol and splash protection from chemical and biological agents as an NFPA 1994 Class 2 ensemble.
According to the West Virginia High Technology Consortium, ice will have improved heat-transfer properties and be compatible with existing commercial and military respiratory protection systems.
“Fortunately, all of these efforts have a manufacturer in place to move the ensembles to the user market rapidly, and we should see them available this year,” says Joe Allen, the consortium’s vice president.
He anticipates that the new turnout gear will cost no more than 10% more than current versions, while still providing increased chemical/biological protection.
Douglas Page writes about science and technology from Pine Mountain, Calif.
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