Posts Tagged cancer in the fire service

Cancer in the fire service

Excerpts from the

Understanding firefighter beliefs and behaviors related to cleaning and decontaminating bunker gear after a fire is an essential first step in devising an effective health intervention to reduce risks.

Firefighters face substantial risks of exposure to carcinogens and other toxins. These exposure risks result most often from dermal absorption during a fire or inhalation of off-gassing particles (volatile organic compounds and polycyclic aromatic hydrocarbons) from contaminated bunker gear during removal.

A recent study1 examined firefighter attitudes, norms, and perceived barriers to field decontamination processes. Data for the study was collected from a survey of 482 firefighters from four south Florida fire departments.

Study results

  • Firefighter attitudes were overwhelmingly favorable towards cleaning gear. However, actual firefighter decontamination and cleaning behaviors did not follow at the same level. We also see this divergence of attitude and behavior in other areas of health concern, such as public attitudes and behaviors related to organ donation.
  • Firefighters only showered about 64 percent of the time within an hour. Ten percent reported they never or only rarely showered immediately after a fire.
  • Other recommended decontamination steps occurred only “sometimes” or even less frequently.
  • Routine cleaning of bunker gear back at the station should be a standard practice but only 15 percent of firefighters reported doing this regularly.
  • Hood swap and field decontamination practices were still considered a “new” practice, with barriers still blocking wide adoption.
  • Firefighters reported high levels of concern about the time it took to clean gear and the negative impact of having wet gear on job performance.
  • Peer-influence may still also adversely impact individual post-fire cleaning behavior.


Firefighters fully recognize the benefits of post-fire cleaning and decontamination. The challenge, though, lies in getting them to act on this knowledge. A successful behavioral health intervention for firefighter decontamination needs to overcome two major potential challenges.

  1. The perceived norm among a group of peers.
  2. The perceived job or organizational barriers that inhibit the adoption of acknowledged decontamination practices.

1Harrison, T.R., Wendorf Muhamad, J. Yang, F., Morgan, S.E., & Talavera, E., Caban-Martinez, A., & Kobetz, N. (2018). Firefighter attitudes, norms, beliefs, barriers, and behaviors toward post-fire decontamination processes in an era of increased cancer risk. Journal of Occupational and Environmental Hygiene, 15(4), 279-284. DOI: 10.1080/15459624.2017.1416389

Tags: , ,

Cancer in the Fire Service

Excerpts from

Retired Richmond (VA) Fire Marshal David Creasy, who died in October after more than four years battling cancer, was represented in the annual legislative battle to extend workers’ compensation benefits automatically to firefighters and other emergency personnel stricken by certain forms of cancer they say are caused by exposure to toxic chemicals in the line of duty.

Colon cancer is among three forms of the disease that would be presumed eligible for workers’ compensation under Senate Bill 1030. The bill also adds cancer of the brain and testicles to the list of diseases presumed eligible for compensation under the program.

The Joint Legislative Audit and Review Commission (JLARC) agreed last month to study the workers’ compensation program, including the presumption in the law that shifts the burden of proof to the state in determining whether a listed disease is related to work.

The Finance Committee ultimately approved the bill on a 14-2 vote but opponents representing local governments, insurers and major employers urged the committee to wait for the JLARC study.

“Please allow the study to go forward before you enact legislation such as this,” said a lobbyist for the Virginia Self-Insurers Association and Metis Services Inc., a risk-control firm for employers.

But some senators said they’ve waited long enough to address a long-standing concern for firefighters and other public safety employees. The bill survived a motion to kill the bill, which died on a 7-9 vote, and a motion to amend the measure so it would not become law unless the budget includes money to pay for what the state estimates would be indeterminate costs. The proposed amendment failed on an 8-8 tie.

However, the committee killed a similar bill to extend workers’ compensation benefits to police and other public safety employees suffering from post-traumatic stress disorder because of events they witness in the line of duty, including the death or serious injury of a co-worker. Instead, that issue will become part of the pending JLARC study.

Firefighters earn the benefit of workers’ compensation through their repeated exposure to toxins they believe cause cancer, including the kind that killed Creasy.

Tags: , ,

Cancer in the fire service

Excerpts from the

After a long legal battle, a judge ruled in favor of Homer Salinas – a Mission, TX firefighter denied workmen’s compensation after he was diagnosed with kidney cancer.

The city’s insurance carrier claimed that his diagnosis was unrelated to his work and refused to cover treatment costs, but Salinas appealed that decision last November and finally got the answer he’d been waiting for. But the fight could continue.

It remains unknown whether or not there will be an appeal on the court’s ruling. 

Tags: ,

Cancer in there Fire Service

Excerpts from

Scientists at the University of Notre Dame will begin an independent study of turnout gear worn by firefighters after initial samples tested positive for fluorine.

Graham Peaslee, a professor of experimental nuclear physics at the University of Notre Dame, and his lab tested fabric swatches taken from unused personal protective gear for the presence of perfluorinated alkyl substances (PFASs).

“The results were phenomenal — off the scale in parts per million of fluorine in all but one of the samples,” Peaslee said. “Everything was just loaded with fluorine.” Following the initial tests, Peaslee is leading a study of new and used turnout and personal protective gear issued throughout the 2000s, including jackets, pants and undershirts — all of which are either new or have been in service for more than a decade.  

Various forms of PFASs have been linked to prostate, kidney, and testicular cancers, as well as thyroid disease and low birthweight. The chemicals are commonly associated with stain-resistant products and the manufacture of nonstick cookware. In 2017, Peaslee was one of several researchers who uncovered the presence of PFASs in fast-food wrappers.

The chemicals are also a component of aqueous film-forming foams. These foam fire suppressants have been linked to incidents of contaminated drinking water. In Michigan, where a number of communities have traced water contamination to the use of the foam, some fire officials are working to limit its use or to use alternative, PFAS-free formulas when possible. The United States Air Force began phasing out PFAS-based foam for an environmentally safer alternative in 2016, and finished replacing its stock in 2017.

To test for PFASs, Peaslee’s lab uses particle-induced gamma-ray emission spectroscopy, a novel and specialized method he developed as an efficient and cost-effective way to analyze for total fluorine content. For this study, Peaslee and his students plan to test for content and how much — if any — is coming off the fabric with time and use.

“We’re going to measure each piece of gear and look at the difference in fluorine content over time and extensive use, including after the fabric has been washed, and look at how much of the chemical can transfer off the fabric,” he said. “The obvious thing is, if you take the new gear and wash it — do the measurements match the old gear? I can also then take the water from the wash and test the liquid. We can expose swatches of this fabric to heat and light and see if the fluorine content is affected. Will the chemical bonds break down?”

The breakdown of those chemical bonds in textiles and the transfer of PFASs is what concerns Peaslee the most. PFASs don’t degrade easily, and have an especially long half-life, meaning that those chemicals remain in the environment for many years, whether accumulating in the ground or the body.

Though scientists have not yet learned if PFASs can transfer to the human body simply by coming in contact with the skin, Peaslee co-authored a study in 2017 describing a method to track certain PFASs in mouse models. The results of that study suggest certain PFASs, such as short-chain PFAS compounds, can accumulate in various organs such as the brain and stomach.

“If I can see a measurable decrease from our tests, that means the PFAS has gone into the environment,” Peaslee said. “That environment is in the workplace where these firefighters work, and where these firefighters live. That would be a pretty significant finding. I think it’s a study that needs to be done.”

Peaslee’s research on PFASs in turnout gear has been conducted pro bono.

Tags: , ,

Cancer in the Fire Service

Excerpts from the International Association of Fire Investigators:

The International Association of Arson Investigators (IAAI) has released a white paper that covers best practices related to health and safety, particularly as it concerns cancer prevention. The paper, which can be found here, was put together by the IAAI Health and Safety Committee after it was re-established in 2016 when it was deemed that health and safety practices and protocols for investigators had not been keeping pace with those of firefighters.

The IAAI says the risks are often overlooked because investigators typically arrive to a scene hours or even days after a fire has been extinguished with less safety preparation and an assumption that because the fire is extinguished, the danger is diminished. However, investigators are often on scene when fires remain active or are still hot, and many develop chronic health issues including respiratory conditions.

The white paper provides detailed information on the types of protections to use in various fire scenarios.

Protection is essential at hot scenes and there are two scenarios described:

  • Fire has been extinguished but overhaul has not yet commenced or is in process.
  • Fire has been extinguished but for less than two hours.

Both of these hot scenes are of greatest danger for fire investigators because of the potential for high levels of gases and particulates. A vetted NIOSH respirator is recommended along with a list of turnout gear and structural firefighter gloves.

A warm scene is when a fire has been extinguished at least two hours prior but less than 72 hours. This is the typical time frame when many investigators find themselves on scene and also remains dangerous due to potential exposure to toxic chemicals. Many of the same protections used in hot scenes apply here.

A cold scene is when a fire has been extinguished for at least 72 hours. While research indicates that particulate and gas hazards are greatly reduced after 72 hours, the disturbing of debris can stir up these hazards. For this reason, respiratory protection is recommended.

Other dangers to investigators include skin exposure to chemicals and contaminants. Research shows that firefighters have a greater incidence of skin cancer due to exposure, and investigators have the same exposure rates. Surveying and properly ventilating a site of gases and vapors will promote better health.

Similar to firefighters, investigators are also urged to properly decontaminate after working at a scene, removing soot-covered clothing and cleaning and wiping down skin that may have been exposed. Clothing or PPE and tools should be placed in sealed containers during transport or cleaned immediately.

Tags: , ,

Cancer in the fire service

Excerpts from the

On Kevin Leago’s July CT scan, his torso looks like it has been riddled with birdshot. Dark splotches speckle his liver, his pancreas, his spine, marking where his neuroendocrine cancer has spread. The pain in his bones has left the 38-year-old Houston Fire Department senior captain unable to work since the end of May. Within 30 days, he will exhaust all his sick and vacation time, leaving him with no income. His doctors say his best shot at survival is a new treatment that is not offered at the hospital covered by Leago’s city health insurance.

Workers compensation benefits would provide Leago a paycheck while he is ill and allow him to transfer to any hospital that accepts him, but the city of Houston denied his claim. The city’s third-party administrator argued Leago’s cancer is unrelated to his 17 years of service in the fire department, despite a Texas law requiring the government to presume that firefighters’ cancers are caused by exposure to carcinogens on the job.

In the past six years, more than nine in 10 Texas firefighters with cancer have had their workers comp claims denied, according to state statistics. Union leaders and state legislators say cities have ignored Texas’ presumptive cancer statute, and face few consequences for denying claims. The result, they say, is that firefighters often see their personal savings evaporate even as they compromise on their care. All seven HFD members with cancer who have filed workers comp claims since 2016 have been denied, according to the firefighter’s union. 

The Texas Legislature in 2005 unanimously passed a change to state law that requires the government to presume, if firefighters are diagnosed with cancer and meet certain criteria, their illness was caused by exposure to carcinogens on the job. The statute shifts the burden from firefighters having to prove their cancer was caused by firefighting to their employers, who must prove it was not. Legislators wrote the law to help doctors, lawyers, insurance providers and union representatives avoid wrangling over individual cases so firefighters can receive benefits quickly.

The state firefighters union and lawmakers say cities have subverted the law by denying workers comp claims from firefighters who qualify. Of 117 workers comp cancer claims filed by firefighters in the state since 2012, 91 percent have been denied, according to the Texas Department of Insurance.

Firefighters are substantially more likely to win benefits on appeal, prevailing in 64 percent of cases over that same period. Yet, less than one-fifth of firefighters disputed their denied claims, daunted by the prospect of spending months or years sparring with insurers in court while simultaneously battling cancer.

A Houston attorney who has represented dozens of firefighters in their appeals, said the workers comp process has become so arduous that firefighters with cancer are unlikely to get a claim approved without an attorney. The lawyer said a 2011 Texas Supreme Court ruling further puts firefighters at a disadvantage. That decision exempted workers comp administrators from bad faith claims. Previously, cities could have been held liable for dismissing a worker’s claim without evidence.

A memo written by the Texas Intergovernmental Risk Pool, which handles workers comp for more than 2,700 Texas municipalities, outlines the strategy firefighters say cities use to dodge the cancer presumptive law. The memo states Texas law presumes only three types of cancer are caused by firefighting: testicular, prostate and non-Hodgkin’s lymphoma. The risk pool cites a 2007 paper that states dozens of studies have linked firefighting to those three illnesses. Dr. Robert Deuell, a physician and former state senator from Greenville who wrote the presumptive cancer statute, said that interpretation of the law is incorrect.

Firefighter unions say cities are ignoring a wealth of research that links their occupation to other forms of cancer. The presumption statute states it applies to “cancers that may be caused by exposure to heat, smoke, radiation, or a known or suspected carcinogen” as determined by the International Agency for Research on Cancer. The IARC’s published research on cancer in the fire service is 559 pages long. It cites scores of academic papers, including a meta-analysis of 32 studies that concluded 12 cancers were possibly or probably caused by firefighting.

Even if firefighters eventually win their workers comp cases on appeal, they risk provoking lawsuits from the cities that employ them. The city of Baytown sued firefighter Patrick Mahoney, who has thyroid cancer, after he won workers compensation benefits on appeal. Mahoney sought workers comp because the city’s insurance plan does not cover cancer treatment.

The city of Houston sued 23-year HFD veteran Margaret Roberts in 2015 after she appealed and won a workers compensation claim for her blood and bone cancer. Roberts died in 2017, but the city’s suit against her estate continues. 

Kevin Leago feels fortunate doctors caught his cancer in the first place. Unlike the Austin, Dallas, San Antonio, and El Paso fire departments, HFD does not send its firefighters for regular physicals, where illnesses can be detected. Leago discovered he was sick after the ambulance he was driving collided with another vehicle in October 2012. Doctors ordered a CT scan to survey his broken back and wrist, and discovered a tumor in his pancreas. He was 32, and his wife, Breck, was 7 months pregnant.

A surgery in 2013 removed his spleen, 22 lymph nodes, and 70 percent of his pancreas, and the cancer vanished for nearly five years. It returned in the fall of 2017, and he went under the knife again. When Leago fell ill after extinguishing a routine fire in May, a CT scan revealed the cancer had spread throughout his body. The fentanyl patches he wears soothe the aching in his bones, but are so strong he cannot work or drive. 

Leago does not smoke and is physically fit, and believes the most likely explanation for his cancer is exposure to carcinogens — including benzene, formaldehyde, and asbestos — his body regularly absorbed on fire calls. He cannot pinpoint a blaze that was particularly hazardous, and researchers have been unable to conclusively link pancreatic cancer to firefighting.

The Kelsey-Seybold Clinic, where Leago receives chemotherapy, does not offer PRRT. MD Anderson Cancer Center 2,000 yards east on Holcombe Boulevard does perform the treatment.

Leago finds purpose in his fight for benefits. Though his treatments leave him fatigued and nauseous, he still finds time to consult with his attorney and the firefighters union about his worker’s comp appeal strategy. By having his denial overturned in court, he hopes to create a path for other firefighters to follow with their own claims.

“I want people to be able to take my experience, and use that, and do them some good in the future,” he said.

Tags: , , , ,

Cancer in the fire service

Excerpts from the

The International Association of Fire Chiefs’ (IAFC) Volunteer and Combination Officers Section (VCOS) and the National Volunteer Fire Council (NVFC) have partnered to develop and release the Lavender Ribbon Report: Best Practices for Preventing Firefighter Cancer. This report provides 11 actions that can be taken to mitigate the risk of cancer for firefighters.

Unfortunately, the topic of firefighter cancer has had a significantly increasing impact on firefighter health and welfare. Great strides have been made by departments and responders everywhere in combating and preventing cancer, but more still needs to be done. The time is NOW to make changes.

It is imperative that local leaders take this report to heart and spend the time and energy to make changes to improve the safety and health of firefighters. Too often, we hear about firefighters suffering from and dying of cancer. What if things had been differently and personal protective equipment (PPE) was washed thoroughly and stored it in a better way? There are many relatively cost-effective actions that can be taken to reduce the risk.

This report, released at Fire-Rescue International in Dallas, Texas, is dedicated to those that are battling or have lost their battle with cancer. 

For additional cancer resources, go to

Tags: , , , ,

Cancer in the fire service

Excerpts from

According to the Asheville Fire Department, for the second time in North Carolina history, a firefighter death caused by cancer is being determined by the Industrial Commission as a line of duty death. Asheville fire engineer Will Willis passed away after his battle with cancer earlier this year.

The fire department says this decision means his family will receive a survivor’s benefit. It will also give Willis’ children free college education at public North Carolina universities. Additionally, the decision means Willis’ name will be added to the state memorial in Raleigh. That ceremony should happen sometime in May.

Fire Chief Scott Burnette said the decision by the Industrial Commission was practically unheard of until now. He said the decision is important, not only for the Willis family, but also for the department.

This year, the Asheville City Council approved funds for a second set of turnout gear for Asheville firefighters. The department also has started new decontamination processes. They say the Industrial Commissions’ decision is an important part of recognizing what is happening.

Tags: , , ,

Cancer in the Fire Service

Excerpts from the

Flanked by firefighters and their families, Massachusetts Governor Charlie Baker formally signed legislation that will designate cancer as a work-related injury for firefighters across Massachusetts. The new law will cover all medical treatments for firefighters diagnosed with cancer as well as their time missed because of the illness.

Before the legislation, firefighters diagnosed with cancer were forced to use sick days and personal days while taking time off for treatment, general secretary-treasurer of the International Association of Fire Fighters Edward Kelly said.

Tags: , , ,

Cancer in the fire service

Excerpts from

President Donald Trump on Monday signed legislation to set up a national registry for firefighters to help track links between exposure to fumes and cancer. The Firefighter Cancer Registry Act requires the Centers for Disease Control and Prevention to set up a database in order to study possible links between cancer and the fumes and toxins firefighters are exposed to. The idea is use the information to develop better equipment and other techniques to protect firefighters from cancer-causing chemicals.

The lawmakers cited a 2015 study by the National Institute for Occupational Safety and Health that found that a greater incidence of certain cancers among firefighters compared with the general population.

Tags: ,