Just a decade ago, cancer in the fire service only described whenever firefighters treated and transported cancer patients to the hospital. While we still provide this important service, the reality is that cancer is now recognized as a major occupational hazard for firefighters.
In recent years, firefighter cancer claims have risen significantly in the U.S. Simultaneously, epidemiologic research suggests that firefighters are at an increased risk of site-specific cancers. These
cancers affect respiratory, digestive and urinary tract organ systems.
The 2006 LeMasters Study suggests elevated rates of multiple myeloma, non-Hodgkins lymphoma, prostate and testicular cancers in firefighters. This was further validated by the 2010 IARC study which found elevated rates of the same cancers in firefighters. Most recently, these findings were supported by the 2019 Jalliam Meta-analysis, which found elevated rates of these cancers in firefighters.
While there are limitations to the studies, it’s clear that we as firefighters need to protect ourselves. This means we need to wear personal protective equipment, follow standard operating guidelines and pre-event plans, and decon after the event by cleaning affected equipment – including ourselves.
The June 2019 State of the Science National Firefighter Cancer Symposium* reviewed the latest research and real world experience to create a roadmap for the control and prevention of cancer in the U.S. fire service. The International Association of Firefighters (IAFF) presentation noted 65% of their members’ occupational related deaths from 2002 to 2018 were from cancer; and that 47 states have now implemented some type of presumptive laws and/or benefits of eligibility for firefighters with cancer.
IAFF discussed risk countermeasures including strong policies and procedures from a departmental level. From a personal level, IAFF recommended actively managing weight with nutrition and exercise; scheduling annual medical exams and participating in early intervention. However, IAFF stressed leadership as the key to facilitate the change needed.
To help understand and manage this issue, firefighters must be educated in the scenario of initial exposure pathway. This involves the source of the carcinogen, how it comes into contact with the firefighter (by air or surface) and the path into the body – inhalation, ingestion, absorption or injection. Secondary exposure also occurs when the firefighter fails to manage the contaminants which can travel with the firefighter on their protective clothing and apparatus to the station, to their personal vehicle and ultimately into their home.
While future studies will continue to search for better intervention techniques, fire departments can’t wait idly by. Behavioral and cultural changes must occur now at all levels of department operations to achieve a reduction in firefighter cancer.
Concerns about firefighter cancer are increasing. Cultural changes are imminent. Agencies are expanding recommended actions with a continued focus on firefighter health and safety. Fire departments must update and expand standard operational guidelines and best practices to minimize the risk of firefighter cancer.
Credit: State of the Science, National Firefighter Cancer Symposium, University of Miami, Miami, FL, June 10-11, 2019
Chief Bill Jenaway, Ph.D., is Executive Vice President of Education, Training, and Consulting at VFIS, responsible for the Education, Training and Consulting services provided by VFIS.
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