Cancer and the Fire Service

Motivating leadership to limit exposure to harmful carcinogens

By Matthew Tobia
Published Monday, December 1, 2014 | From the December 2014 Issue of FireRescue

This is a story about a fire chief who gets "it." With his crew member battling cancer in the hospital, the challenge of keeping his people safe from all hazards stares him squarely in the face. So he issues a directive reminding personnel to wash their PPE to reduce their risk of exposure to trapped products of combustion. The response is underwhelming at best. The chief realizes that perhaps the members did not clearly understand the intent of his memo, so he provides clarifying language-"Wash your damn gear!"

What We Know

There is a tremendous amount we don't know about the relationship between cancer and firefighting. But there is also much that we do know-certainly enough to take action immediately. The biggest challenge in addressing cancer prevention is convincing a fresh-faced department member to be worried about a disease that may not reveal itself for 30 years. This is where the criticality of leadership genuinely exists. In general, firefighters have a tendency to believe three things: (1) they are fearless; (2) they do not believe that the laws of nature apply to them; and 3) they have an unrealistic perception of their own invincibility.

A 2013 NIOSH study demonstrated that firefighters experience cancer at a rate higher than the general population. A Scandinavian study produced similar results. It is further supported by a comprehensive review of other studies completed over the past 20 years.

A Department of Health and Human Services/CDC study also confirmed what should be intuitively known to all firefighters: Firefighting is hot, sweaty work. The primary ways that carcinogens (which cause cancer) enter the body are through inhalation and absorption. When we sweat, our skin cannot protect us. For every five-degree increase in surface temperature on the skin, our capacity to absorb increases 400%.

 

We are exposing firefighters to more carcinogens than at any point in our history. The incidence of cancer has grown several-fold as the contents of structure fires have increasingly become synthetic, producing compounds and chemicals that cannot be accurately monitored-certainly not during a firefight. The toxic products of combustion are packed with carcinogens of which we are completely unaware.

We also know that our own culture is perhaps our biggest obstacle. We are self-determined to define our value and routinely indicate that, as long as we get to decide when to stop being firefighters, we can accept the consequences of our profession. We trade our health in exchange for getting to call ourselves firefighters.

Fighting Back

So what can we do? Even as researchers, epidemiologists, economists and politicians continue to wrangle with the issue of causality, the inextricable relationship between cancer and firefighting is settled law. Therefore, we should be taking action now.

In 2013, the Firefighter Cancer Support Network produced a first-ever white paper outlining prevention steps for firefighters. Among the recommendations are some incredibly simple low or no-cost strategies that can be implemented immediately. Examples include wiping down absorption points with baby wipes while in rehab; taking a shower immediately upon returning to the station or home; wearing SCBA throughout the overhaul process; washing hoods and gloves regularly; and providing personnel who transport their PPE in their personal vehicles with plastic tubs and lids to prevent off-gassing from filling the vehicles with carcinogens.

Scratching the Surface

The chief at the beginning of this article would, given the chance, trade places with his firefighter, however unrealistic that may be. Instead, he is doing everything he can to avoid having even one more member travel the same road. Rather than ignoring the problem, he is addressing it in a frontal assault. Company and chief officers reading this article know a firefighter who has died of cancer. There is much that we do not know about cancer, and all of the complexities of the issue cannot and will not be fully addressed in the pages of a magazine. But you have the capacity to significantly impact the lives of your firefighters right now. Take action.