Fireground Liquid Exposure Survey Question Title * 1. During what percentage of responses where you wear turnout clothing are you exposed to liquids that include contaminated water, chemicals, blood/body fluids, non-water extinguishing agents, fuels, oils, greases, or any other potentially hazardous liquids? <5% of the response calls 5 to<10% of the response calls 10 to <25% of the response calls 25 to 50% of the response calls More than half of your responses Question Title * 2. Indicate how often you encounter the following types of liquids from the previous question on the fireground (using the frequencies indicated below). Never <5% of the responses calls 5 to <10% of the response calls 10 to <25% of the response calls 25 to 50% of the response calls More than half of your responses Contaminated water Contaminated water Never Contaminated water <5% of the responses calls Contaminated water 5 to <10% of the response calls Contaminated water 10 to <25% of the response calls Contaminated water 25 to 50% of the response calls Contaminated water More than half of your responses Chemicals Chemicals Never Chemicals <5% of the responses calls Chemicals 5 to <10% of the response calls Chemicals 10 to <25% of the response calls Chemicals 25 to 50% of the response calls Chemicals More than half of your responses Blood/body fluids Blood/body fluids Never Blood/body fluids <5% of the responses calls Blood/body fluids 5 to <10% of the response calls Blood/body fluids 10 to <25% of the response calls Blood/body fluids 25 to 50% of the response calls Blood/body fluids More than half of your responses Non-water extinguishing agents Non-water extinguishing agents Never Non-water extinguishing agents <5% of the responses calls Non-water extinguishing agents 5 to <10% of the response calls Non-water extinguishing agents 10 to <25% of the response calls Non-water extinguishing agents 25 to 50% of the response calls Non-water extinguishing agents More than half of your responses Fuels, oils, greases, lubricants Fuels, oils, greases, lubricants Never Fuels, oils, greases, lubricants <5% of the responses calls Fuels, oils, greases, lubricants 5 to <10% of the response calls Fuels, oils, greases, lubricants 10 to <25% of the response calls Fuels, oils, greases, lubricants 25 to 50% of the response calls Fuels, oils, greases, lubricants More than half of your responses Pesticides, insecticides Pesticides, insecticides Never Pesticides, insecticides <5% of the responses calls Pesticides, insecticides 5 to <10% of the response calls Pesticides, insecticides 10 to <25% of the response calls Pesticides, insecticides 25 to 50% of the response calls Pesticides, insecticides More than half of your responses Other potentially hazardous liquids Other potentially hazardous liquids Never Other potentially hazardous liquids <5% of the responses calls Other potentially hazardous liquids 5 to <10% of the response calls Other potentially hazardous liquids 10 to <25% of the response calls Other potentially hazardous liquids 25 to 50% of the response calls Other potentially hazardous liquids More than half of your responses Question Title * 3. Have you or your gear been exposed to any of the following liquids during an emergency response? Yes No I don't know AFFF Concentrate AFFF Concentrate Yes AFFF Concentrate No AFFF Concentrate I don't know Battery acid Battery acid Yes Battery acid No Battery acid I don't know Hydraulic fluid Hydraulic fluid Yes Hydraulic fluid No Hydraulic fluid I don't know Gasoline Gasoline Yes Gasoline No Gasoline I don't know Swimming pool chlorine additive (liquid or powders) Swimming pool chlorine additive (liquid or powders) Yes Swimming pool chlorine additive (liquid or powders) No Swimming pool chlorine additive (liquid or powders) I don't know Question Title * 4. If your department uses pneumatic tools, do you handle hydraulic fluid? Yes No I don't know Not applicable Question Title * 5. What type of hydraulic fluid does your department use? Mineral oil based Phosphate ester based Other I don't know Question Title * 6. What is the brand and name of hydraulic fluid your department uses? Question Title * 7. Which potentially hazardous liquid would you most likely encounter (be exposed to) during an emergency response? Question Title * 8. Are there any other liquids that you encounter but have not been identified in this survey? Yes No I don't know Question Title * 9. What additional liquids have you previously encountered that are not identified in this survey? Liquid 1 Liquid 2 Liquid 3 Liquid 4 Liquid 5 Question Title * 10. Rank the portions of your turnout clothing that are most likely to be exposed to the liquids covered in this survey (a ranking of 1 represents the item most likely to be exposed; a ranking of 6 the least likely item to be exposed). 1 2 3 4 5 6 Coat 1 2 3 4 5 6 Pants 1 2 3 4 5 6 Gloves 1 2 3 4 5 6 Footwear 1 2 3 4 5 6 Hood 1 2 3 4 5 6 Helmet Question Title * 11. How does your department handle clothing and gear that has been exposed to liquids (check all that apply)? Isolate and remove gear from service Rinse gear at the scene Wash gear in a washing machine Send to outside cleaning service Rinse out liquid and continue to wear Nothing Other (please specify) Question Title * 12. Does your department wash gloves (select best choice)? Yes, gloves are washed with other gear Yes, gloves are separately washed Yes, gloves are sent to an outside cleaner No, each member is responsible for cleaning their gloves No, my department does not have a policy for cleaning gloves Other (please specify) Question Title * 13. Does your department clean footwear (select best choice)? Yes, department offers some means for cleaning No, each member is responsible for cleaning their footwear No, my department does not have a policy for cleaning footwear Other (please specify) Question Title * 14. What type of fire department do you serve in? Career Volunteer Combined career/volunteer Other (please specify) Question Title * 15. How many responses did you have in the past year? More than 100 Between 100 and 25 Less than 25 Question Title * 16. What percentage of call do you estimate are structural fire fighting calls? Question Title * 17. How many years have you been a firefighter? Done