title: Thermal protective uniforms and hoods: impact of design modifications and water content on burn prevention in New York City firefighters: laboratory and field results.
abstract: OBJECTIVE
  To determine (1) the effectiveness of hoods in reducing head burns, (2) the impact of clothes worn under the protective outer uniform (modern = long sleeve shirt and long pants; modified modern = short sleeve T-shirt and short pants) on burns, and (3) whether water content (dry, damp or saturated) affects the level of thermal protection.
  
  
  METHODS
  Fire Department of the City of New York (FDNY).
  
  
  METHODS
  Laboratory tests (fully dressed manikin) evaluated the different uniform and water conditions when exposed to an average 24 cal/cm2 heat flux, approximately 2,250 degrees F air temperature. FDNY field results compared (1) head burns during winters wearing the hood to winters without hood and (2) upper and lower extremity burns during summers wearing traditional, modern, and modified modern uniforms.
  
  
  RESULTS
  Laboratory tests showed that thermal protection was: (1) dramatically improved by the hood with protection increasing as water content increased and (2) not significantly different between modern and modified modern uniforms, regardless of water content. FDNY field results confirmed these tests showing (1) significant decreases in neck burns (by 54%), ear burns (by 60%), and head burn totals (by 46%) wearing the hood and (2) no significant differences in upper or lower extremity burns wearing modern compared with modified modern uniforms.
  
  
  CONCLUSIONS
  Based on combined laboratory and field results, we strongly recommend the use of modern thermal protective hoods and the modified modern uniform.
authors.affiliation: New York City Fire Department, Bureau of Health Services and Albert Einstein College of Medicine, Montefiore Medical Center, USA. prezant@aecom.yu.edu
authors.forename: D J
authors.initials: DJ
authors.lastname: Prezant
authors.forename: K S
authors.initials: KS
authors.lastname: Malley
authors.forename: R L
authors.initials: RL
authors.lastname: Barker
authors.forename: C
authors.initials: C
authors.lastname: Guerth
authors.forename: K J
authors.initials: KJ
authors.lastname: Kelly
mesh_terms: D002056:Burns / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D003257:Consumer Product Safety; D005260:Female; D005390:Fires; D017408:Guidelines as Topic; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D009519:New York City; D016272:Occupational Health; D011322:Primary Prevention / Q000379:methods; D011481:Protective Clothing / Q000592:standards*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015996:Survival Rate