HYDROGEN CYANIDE IN FIRE OPERATIONS Captain Rick Rochford Jacksonville Fire Rescue Department Incident Safety Officer Cr

1. HYDROGEN CYANIDE IN FIRE OPERATIONS Captain Rick Rochford Jacksonville Fire Rescue Department Incident Safety Officer Craig Rogers- Draeger Safety

2. PRESENTATION CONTENT • Toxic Gases Generated by Fire • Hydrogen Cyanide in Smoke • Health Effects of HCN • Gas Detection Options • Questions & Answers

3. TOXIC GASES GENERATED BY FIRE Toxic Gases Generated by Fire

4. Clark County Fire Fighter Fatality Crews operating at the scene of a commercial dice factory fire Heavy smoke and fire conditions All crews are instructed to utilize standard PPE SCBA are used by all responders

5. Clark County Fire Fighter Fatality What are some of the hazards present? As a Incident Commander, what types of injuries or conditions may you expect?

6. Clark County Fire Fighter Fatality All crews are ordered out of the structure. As crews leave the factory, they remove their SCBA masks. A Fire Captain removes his mask as he walks out of the smoke. He collapses outside the structure. He is in cardiac arrest.

7. Clark County Fire Fighter Fatality The Captain did not survive his injuries Coroner ruled this fatality due to cyanide toxicity. Clark County Fire Department Captain Frank E. Testa, April 11, 1970

8. 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

9. 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 chemical release

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

11. 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 • There is mounting evidence that hydrogen cyanide is directly responsible for many more deaths than previously assumed • Cumulative effect with CO worse than either individually

12. “ 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 encounter” JEMS Communications Summer 2004

13. HYDROGEN CYANIDE IN SMOKE Hydrogen Cyanide in Smoke

14. 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.)

15. 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 ---

16. 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)

17. 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.

18. 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

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

20. 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 non-tenable 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”

21. Cyanide Poisoning Of Providence Rhode Island FirefightersMarch 2006 • Thursday March 23 2006 10:31 hrs 1197 Broad Street • Providence Rhode Island Firefighters responded to a fast food restaurant relatively uneventful 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 • 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

22. Cyanide Poisoning of Providence FirefightersMarch 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

23. Cyanide Poisoning of Rhode Island FirefightersMarch 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 66ug/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.

24. HEALTH EFFECTS OF HCN Health Effects of HCN

25. CYANIDE DOSES • Small amounts of cyanide are present in the environment and in humans. • Normal levels of whole blood are believed to be between 0 to 20 micrograms per deciliter (ug/dl). • Cyanide levels as low as 50 ug/dl in the blood have proven to be toxic, and blood cyanide levels of 250 – 300 ug/dl fatal. • With a half-life of one hour, cyanide is short lived in the blood stream. Standards in the procedures for collection of whole blood samples such as: -carboxyhemoglobin saturation -methemoglobin content of sampled blood -time between blood sampling and assay storage temperature of blood samples on the measured concentration of cyanide can complicate the interpretation of assay results or introduce sources of errors.

26. 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

27. CHRONIC EFFECTS OF HCN • Chronic 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

28. 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

29. 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.

30. HCN LETHALITY DOSE MAKES THE POISON

31. HCN LEALITY NOISH Chemical Pocket Guide HCN is 35 times more toxic than CO • TWA HCN 4.7 ppm CO 35 ppm • IDLH HCN 50 ppm CO 1200 ppm • LEL HCN 5.6% CO 12.5% • UEL HCN 40% CO 74% • Fl P. 0⁰ F • VD 0.94 air = 1 • BP 78⁰ F • Sp. Gr. 0.69 water = 1

32. ACUTE CYANIDE POISONING • Recently has there been first FDA approved cyanide treatment, Hydroxocobalamin, that can safely be administered at fire scene • Detoxifies CN by binding it to form cyanocobalamin (B12) • 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

33. PHOENIX OVERHAUL STUDIES • Removal of respiratory equipment during overhaul can potentially expose firefighters to a 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

34. 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.

35. 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 rely 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.

36. 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.

37. 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

38. 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

39. Recommendations for Prevention of Cyanide Poisoning • Fire Research - How much cyanide is generated at fire scenes? - What conditions yield higher verses lower concentrations of CN? - Whether CN that is released in a fire remains localized (in a 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?

40. 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 possibly incapacitated by the invisible gases during the incipient stage which could prevent them from escaping.

41. Clark County Fire Fighter Fatality Crews operating at the scene of a commercial dice factory fire Heavy smoke and fire conditions All crews are instructed to utilize standard PPE SCBA are used by all responders

42. Clark County Fire Fighter Fatality What are some of the hazards present? As a Incident Commander, what types of injuries or conditions may you expect?

43. GAS DETECTION OPTIONS Gas Detection Options

44. DETECTION TECHNOLOGY AND HCN DETECTION TECHNOLOGY AND HCN • Colorimetric Chemistry • Short-term Detector Tubes • Long-term Detector Tubes • Chip Measurement System • Electrochemical Sensors • Infrared Sensors • Gas Chromatographic Methods • Flame Ionization (FID) • Thermionic • Ion Mobility Spectrometry (IMS) • Photo Ionization (PID) • NO – High IP 13.9 eV

45. COMMON MONITORING OPTIONS • There are 2 commonly available detection technologies that can measure hydrogen cyanide and other non-organic toxics at TLV • Portable instruments with electrochemical sensors • Colorimetric detector tubes

46. ADVANTAGES OF DETECTOR TUBES • Inexpensive • Simple to use • No calibration • Wide variety of gases & vapors

47. ELECTROCHEMICAL SENSORS • Based on a chemical reaction that produces an electrical response/signal. • The more gas that is present, the larger the signal that is generated by the sensor. • This signal is directly proportional to the gas that is present.

48. SINGLE GAS OPTIONS • Standard Version • Accepts all Draeger EC Sensors (Toxic & O2) • Full Menu • Hygiene Version • Standard + Datalogging

49. SINGLE GAS OPTIONS • 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