Attitudes of fire service personnel toward respiratory protection in wildland firefighting.

Wildland and wildland-urban interface (W/WUI) fires are increasing in frequency and intensity, increasing concerns about firefighters' exposure to hazardous smoke and the need for respiratory protection. This qualitative study explored the perspectives of California fire service personnel on the use of respiratory protective devices (RPDs), particularly powered air-purifying respirators, and a potential Cal/OSHA regulation mandating their use in W/WUI firefighting. Participants were experienced in W/WUI firefighting and had some role in their fire department related to respiratory protection or other aspect of firefighter safety. While all participants recognized the health risks associated with smoke exposure, including cancer and acute respiratory symptoms, and that RPDs would reduce their exposures, participants had concerns that RPDs would negatively affect fatigue, comfort, communication, mobility, and situational awareness. Some concerns specifically relate to the design of the RPDs. Most participants supported using RPDs in specific scenarios such as mop-up and prescribed burns, but fewer supported RPD use during high-exertion tasks like cutting line. Participants preferred flexibility or guidance rather than prescriptive regulation and advocated for engagement of firefighters in the development of any potential regulation to ensure practicality and feasibility. Some participants acknowledged resistance to change in the industry as a barrier for RPD adoption, but felt that evidence of RPD effectiveness and usability, including opportunities for training with devices and changes to device design, could assist with adoption. A programmatic regulation, coupled with education and engagement, can facilitate the incorporation of RPDs in W/WUI firefighting.