Association between perceived organizational prioritization of decontamination and firefighters’ exposure-control practices

Firefighters are repeatedly exposed to hazardous combustion byproducts, and exposure-control practices are important for reducing occupational carcinogen exposure. However, the associations of perceived organizational prioritization, soot-related cultural perceptions, and educational experiences with these practices remain unclear. A nationwide cross-sectional online survey was conducted among 926 Korean firefighters engaged in fire suppression. Perceived organizational prioritization was assessed using a five-category self-report item; soot-related cultural perceptions were measured as a five-category team norm and a binary individual perception; and educational experiences were assessed by training frequency. Seven binary practices were summed into an index ranging from 0 to 7. Poisson regression with robust standard errors was used as the primary analysis, with multivariable logistic regression using an index score ≥ 5 as a sensitivity analysis. The mean index score was 2.87 (SD 1.63), and 16.8% of firefighters met the primary high-practice threshold. Perceived organizational prioritization showed the largest and most consistent association with exposure-control practices across both analyses. Compared with firefighters perceiving strong organizational prioritization, those perceiving no prioritization had lower practice scores (IRR = 0.73, 95% CI: 0.64–0.84). Soot-related cultural perceptions and general hazardous-substance education were not independently associated with exposure-control practices. Perceived organizational prioritization was more consistently associated with firefighters’ exposure-control practices than soot-related cultural perceptions or educational experiences. These findings support further evaluation of organizational approaches that integrate decontamination into routine operations through standardized procedures, operational support, and accessible resources.