Respiratory protection programs for firefighters: A survey of practices for the state of Kentucky

Objective. Firefighters play a crucial role as first responders in a variety of situations that can expose them to respiratory hazards. To ensure their safety and health, fire departments should have a respiratory protection program in place for all firefighters. A survey of Kentucky fire departments was conducted to assess their respiratory protection practices, barriers to program implementation, and medical evaluation programs. Method. A 21-question survey assessing respiratory practices during the previous 12 months was mailed to all Kentucky fire departments. Results. A 62% survey response rate was achieved, with 116 of Kentucky's 120 counties returning at least one survey. All respondents indicated they were utilizing some type of respiratory protection, but only 37% indicated they had a written respiratory protection program. Compensation status and department sizes were found to be significant variables (p<0.01) in determining if a fire department had a written respiratory protection program. Lack of funding (48%) and lack of understanding (39%) were cited as the greatest barriers to program implementation. Only 51% indicated they require their firefighters to receive a fit testing of their respirator, and 23% indicated they had a health-care provider who reviewed medical questionnaires or provided medical evaluations. Conclusion. This survey indicates that many Kentucky fire departments are not meeting the legal and voluntary respiratory protection standards and guidelines, and demonstrates the need for improved education and funding to ensure that firefighters are adequately protected from respiratory hazards. This is particularly applicable to small rural volunteer departments, which had the greatest gap in compliance.