Prevention of occupational risks associated with exposure to smoke, chemicals and pollutants in firefighters, through safety, environmental control and health programs.

Abstract

This literature review article analyzes the available scientific evidence on occupational risk prevention measures associated with exposure to smoke, chemicals and pollutants in fire department operational personnel. The research question investigates which set of measures most effectively reduces occupational exposure and which indicators can demonstrate such reduction in actual field practice. Through an integrative documentary review of literature published between 2019 and 2025 in specialized databases such as PubMed, Scopus, and Web of Science, the main control strategies based on the hierarchy of occupational controls were identified and critically assessed. In 2022, the International Agency for Research on Cancer reclassified occupational exposure as a firefighter to Group 1 (confirmed human carcinogen), with sufficient evidence for bladder cancer and mesothelioma, positioning primary prevention as a strategic priority for the fire service. Findings reveal that comprehensive programs articulate three levels of intervention: engineering controls at stations (diesel emission extraction systems that reduce elemental carbon in apparatus bays), administrative controls (zoning, atmospheric verification, structured decontamination procedures), and personal barriers (continuous use of self-contained breathing apparatus during all operational phases, including overhaul). Personal protective equipment decontamination with soap and water demonstrates 85% effectiveness in polycyclic aromatic hydrocarbon removal. Dermal absorption constitutes a significant exposure route requiring specific targeted interventions, with studies showing contamination concentrations on firefighters' skin ranging from 2.23 to 62.50 ng/cm² on the neck area. Evidence also shows the presence of per- and polyfluoroalkyl substances in PPE textiles as a secondary exposure source requiring specific management strategies. Biomonitoring through urinary metabolites enables objective evaluation of implemented intervention effectiveness.