Archive for category Cancer in the fire service

Cancer in the fire service

Excerpts from the

Three firefighters in the 36-member Scottsboro Fire Department (AL) have been diagnosed with occupational-related cancer in recent years. One of them died last year. The other two were able to return to work after treatment. One had $20,000 in out-of-pocket expenses, including deductibles and co-pays.

Fire officials around the state praised a new Alabama law that will require local governments to provide supplemental insurance coverage for career firefighters diagnosed with cancer. The bill lists about 20 specific types of cancer, including lung, thyroid, brain, Hodgkin’s lymphoma, and non-Hodgkin’s lymphoma.

The insurance is a better, more flexible option than an expanded workmen’s compensation program. House Bill 360 calls for a lump-sum benefit for firefighters diagnosed with cancer. The cap is $50,000 over a lifetime. There is also a monthly benefit of $3,000 for up to 36 months. The legislation also gives volunteer firefighters and retired firefighters the option of paying for the supplemental coverage themselves.

The Alabama League of Municipalities worked on legislation with firefighters. It estimates the requirement will cost government authorities $200 per policy annually. Local funds would pay for the increase in insurance coverage, which was a part that many of the bill’s cosponsors liked about the bill.

A lot of the cancer-causing contaminants are ingested after the firefighter is done dealing with the deadly fire. When the firefighters return to their station and they fail to properly wash and clean their Personal Protective Equipment, then left over contaminants can be absorbed into the firefighter’s skin and their surroundings. Carcinogens are mostly absorbed through the lungs but the skin is the second most concerning access route.

For firefighters, the dangerous part of their job used to be the actual fires they were putting out or the building collapsing beneath them. However, today cancer is the more likely killer of firefighters.

According to the Firefighter Cancer Support Network, cancer caused 70% of the line-of-duty deaths for career firefighters in 2016. A multi-year study by the National Institute for Occupational Safety and Health found that firefighters had a 9% increase in cancer diagnosis and an 14% increase in cancer-related deaths compared to U.S. population rates.

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Cancer in the fire service

Excerpts from

Legislation designating nine types of cancer as on-the-job injuries for firefighters cleared a House committee Tuesday in North Carolina despite opposition from a powerful lobbying group.

Statistically, firefighters are at a higher risk than the general public for esophageal, intestinal, rectal, testicular, brain, and oral cavity cancers, as well as non-Hodgkin’s lymphoma, multiple myeloma, and mesothelioma. House Bill 520 would change North Carolina’s workers compensation law to presume that a firefighter diagnosed with one of those cancers got it on the job.

Currently, firefighters who can’t prove their cancer was caused by their occupation must get their insurance to cover as much of their treatment costs as possible. Many have to keep working through chemotherapy and radiation treatments.

A legislative counsel for the North Carolina League of Municipalities argued against the change, saying adjusting workers comp for a single class of employees has been found unconstitutional by the courts in the past. Counties and cities worry that the proposal, if passed, would increase workers comp costs for local governments that employ firefighters.

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Cancer in the fire service

Excerpts from the

Arkansas legislators passed Crump’s Law on Monday, granting municipal firefighters across the state an extra six months of paid sick leave when they are being treated for cancer contracted on the job. Although the firefighters initially pushed for one full year of paid sick leave for those who are diagnosed with occupational cancer, they are happy with the compromise because it protects both firefighters and the municipalities they work in.

Crump’s Law is named after Nathanial Crump, a Little Rock firefighter who, due to a lack of sick time available, was forced to return to work while still fighting cancer. Crump later died after being transported to the hospital from his fire station.

Before Crump’s Law, firefighters were entitled to up to 2,160 hours of paid sick leave, depending on the length of their employment with a department. Since firefighters typically work 24-hour shifts, that amounts to about three months of leave. For Crump’s Law to affect a firefighter, they must have been with their department for at least five years; the five year quota is because that is about the least amount of time it could take for someone to be exposed to enough carcinogens on the job to develop occupational cancer. 

Not every type of cancer is covered under the bill; if a firefighter develops a type of cancer that has not been scientifically linked to their job, they will not qualify for the extended leave.

Members of El Dorado Professional Firefighters Local 1704 representing 90 percent of the paid firefighters in El Dorado, lobbied at the state Capitol in February for the bill’s passage. In addition to Crump’s Law, House bill 1345 also passed, allowing firefighters to take a disability retirement if they are diagnosed with occupational cancer and have been working for their department for long enough.

When the firefighters lobbied at the Capitol in February, they were also supporting HB1614, known as the firefighters’ bill of rights. That bill was pulled from the current legislative session in order to make changes to it, but it may be revisited at the next legislative session.

The EFD has a washer/extractor at each station so firefighters can wash their gear after wearing it at the scene of a fire. Firefighters have an extra set of gear to wear when their primary suits are in the wash; there are also enough protective hoods for each firefighter to wash theirs at any time and still have one to wear if they’re called to a fire.

Additionally, when fire trucks are parked at the station, their exhaust pipes are connected to hoses that allow the exhaust to exit the station, instead of getting trapped inside.  Firefighters also use Rescue Wipes, which allow them to clean ash and soot off their skin at the scene of a fire.

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Cancer in the fire service

Excerpts from

Routine firefighting can expose firefighters to substantial cancer risk. A study in 2015 estimated that firefighters have a 14 percent increased lifetime cancer risk compared to the general public.

The decon challenge

Protective gear — pants, jackets, boots, gloves, facemasks, helmets and hoods — gets contaminated from emergency vehicle diesel exhaust and from toxic smoke arising from fire incidents. Exposure can occur from the off-gassing of toxins while removing gear post-fire or absorption through the skin from contact with dirty gear.

Using cleansing wipes on skin and field decontamination of dirty gear can significantly reduce these toxic exposures, but researchers have found that firefighters often don’t perform systematic decontamination procedures. The reasons for this vary but often relate to group norms, attitudes and perceived barriers.

The researchers’ hypothesis

Firefighters work in what researchers call high-reliability organizations, where the environment is high-risk and the organizational culture places emphasis on peer-support, teamwork and expertise. Group norms exert a very strong influence in that setting.

If firefighters believe that post-fire decontamination is effective, if they perceive their group of peers recognize the value of it, and if they can overcome any time or resource barriers to performing decontamination, then the researchers would expect to see an increase in post-fire decontamination behaviors.

The intervention

The program to increase decontamination behaviors relied on face-to-face presentations delivered by a member of the research team to audiences of 12-18 firefighters at a time. They presented it to 226 firefighters in the Palm Beach County and Boynton Beach Fire Departments (Florida).

The program had these parts:

  • An overview of firefighter cancer risk (PowerPoint presentation, 5-7 minutes).
  • Role of firefighter culture in addressing cancer risk. The messages were designed to show changing norms and culture, for example “clean gear as a badge of honor” (PowerPoint presentation, 7-8 minutes).
  • Overcoming logistical barriers to decontamination. (PowerPoint presentation, 5-7 minutes).
  • Overview of specially designed campaign materials available for use around fire stations. The messages promoted the seven steps to decontamination and the new norm of clean gear. (5 minutes)
  • Videos showing the spread of toxins from bunker gear using invisible dye and highly respected firefighters talking about culture change and the decontamination process.

Intervention takeaways

  • Researchers measured a significant increase in firefighters’ intention to clean their gear following the presentation.
  • Firefighter attitudes, perceived norms, and self-efficacy in overcoming barriers all showed substantial increases towards gear cleaning.
  • A key element of the intervention was featuring highly respected firefighters delivering the principal messages and demonstrating the desired decontamination procedures. Peer influence in high reliability organizations like the fire service cannot be underestimated.
  • The high occupational demands of the firefighters, who often were running 20 to 30 calls each day, made the reduction of barriers to decontamination behavior a key component in the intervention.

Key takeaway

An intervention that succeeds in increasing firefighters’ intention to perform post-fire decontamination procedures should result in decreased exposure to carcinogens and consequently a decrease in cancer risk from those exposures.

For more information on this study

  • YouTube: Clean Gear as the New Badge of Honor. This video (25:25) demonstrates one approach to field decontamination. It gives firefighters many of the tools and knowledge they need to engage in field decontamination, as well as helping shift norms and attitudes toward clean gear.
  • Firefighter Cancer Initiative Education Campaign. This site has the materials mentioned above and additional materials including posters used in the campaign, bumper stickers, standard operating guidelines implemented at fire departments in Florida, manuscripts, and additional videos developed by Palm Beach County Fire Rescue. (This site requires you to create an account but allows for download and non-commercial use of material.)

1Harrison, T.R., Yang, F., Morgan, S.E., Wendorf Muhamad, J., Talavera, E., Eaton, S., Niemczyk, N., Sheppard, V., Kobetz, E. (2018). The invisible danger of transferring toxins with bunker gear: a theory-based intervention to increase postfire decontamination to reduce cancer risk in firefighters. Journal of Health Communication, published online, 1-9. DOI: 10.1080/10810730.2018.1535633



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

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Buffalo Grove Fire Department news (more)

Excerpts from the

Lake County Circuit Court Judge Diane Winter ruled Tuesday that the family of 51-year-old Buffalo Grove Firefighter Kevin Hauber who died of colon cancer last year should receive a full pension benefit, upholding an earlier decision by a local review board that his fatal cancer was caused in the line of duty. Winter said two medical experts already found that Hauber’s death was likely the result of performing acts of duty, or cumulative acts of duty, which involved repeated exposure to toxic smoke and carcinogens while on the job.

Last summer, Buffalo Grove officials announced they were challenging a decision made earlier in 2018 by the Buffalo Grove Fire Department Pension Board that the family of  should receive a full line-of-duty death pension. Hauber, a veteran firefighter and paramedic in Buffalo Grove, died in January 2018, roughly four years after being diagnosed with colon cancer.

In the village’s lawsuit filed June 2018, Buffalo Grove officials said they were appealing the pension board’s decision because of their fiduciary responsibilities to taxpayers, arguing the state’s pension laws require more evidence that Hauber’s fatal cancer was the result of his 23 years of firefighting. Village officials at the time estimated the full, 100-percent pension award of Hauber’s annual $100,000 salary would create an additional liability of $1.7 million compared to a 75-percent award that the Hauber family was qualified to receive.

The ruling also comes as debates about the still-unclear link between firefighting and cancer unfold across Illinois and the rest of the country. An ongoing, multiyear study by the U.S. Centers for Disease Control and Prevention’s National Institute for Occupational Safely and Health of nearly 30,000 firefighters from the Chicago, Philadelphia, and San Francisco fire departments has found higher rates of certain types of cancer among firefighters than the general population.

The study also supported a newly signed federal law, the Firefighter Cancer Registry Act, requiring the CDC to collect data via a voluntary registry as part of its ongoing research into whether firefighters’ work increases the odds of them developing some types of cancer.

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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.

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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. 

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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.

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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.

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