Impact of a modem firefighting protective uniform on the incidence and severity of burn injuries in New York City firefighters

The New York City Fire Department (FDNY) is the largest fire department in the United States, with over 11, 000 firefighters. In 1994, FDNY changed to a modern firefighting protective uniform. The major difference between tra ditional and modern uniforms is that modem, uniforms include both protectiv e over-coat and over-pant, whereas traditional uniforms include only the ov er-coat. Furthermore, modern uniforms are manufactured using improved therm al protective textiles that meet or exceed current National Fire Protection Association standards for structural firefighting. The purpose of this stu dy was to determine the impact of the modern uniform on the incidence and s everity of FDNY burn injuries. We also evaluated the incidence and severity of other non-bum, injuries to determine whether there was serious adverse impact. The number of lower-extremity burns decreased by 85% when 2 years' experience while wearing the modem, uniform was compared with 2 years while wearing the traditional uniform. Upper-extremity bums and head burns decre ased by 65% and 40%, respectively. Severity indicators (days lost to medica l leave, hospital admissions, and shin grafts) for lower- and upper-extremi ty burn injuries were all substantially reduced. This occurred without sign ificant change in the incidence or severity of trunk burns, heat exhaustion , inhalation injuries (actually decreased), or cardiac events. The reductio n in the incidence and severity of burn, injuries, the major occupational i njury affecting this workforce, has been so dramatic and without untoward e ffects that the introduction of the modem uniform must be characterized as a sentinel event in the history of firefighter health and safety.