Alarming Rates of Cancer in the Fire Service

According to data from the International Association of Fire Fighters (IAFF), cancer caused 70% of line-of-duty deaths for career firefighters in 2016. Firefighters have a 9% higher risk of being diagnosed with cancer than the general U.S. population and 14% higher risk of dying from cancer. It has surpassed heart attacks as the #1 death in firefighting.

What’s this have to do with ARFF you may ask?  Most ARFF components have a structural side to them. In addition, all the talk about AFFF and “PFOS” is raising concerns not only for groundwater contamination, but for firefighters who work in and around it. Have you used AFFF, on a call, or drills?   Perfluorooctane sulfonate (PFOS) is a long-chain perfluorinated compound (PFC) either present in legacy stocks of AFFF or a potential breakdown product of PFOS-based AFFF. Research has shown this causes liver, testicular, and pancreatic cancers. At the least it is a skin irritant and firefighters should always decon after any use with it.

Let’s move on to Composites in aircraft design.  These are highly carcinogenic as well. After an aircraft crash and damage caused to the composite materials, the binder and the matrix can be torn open, allowing the fibers to be dispersed at the accident site. These fibers have been known to cause respiratory illness (acute and chronic) and can manifest into lung cancer. Firefighters operating a known composite material aircraft incident must maintain use of SCBA at all times in and around the aircraft. Wind direction and air speed must be taken into consideration so ARFF responders, ARFF trucks, EMS personnel, patient treatment areas, staging, rehab sector, Command, and etc. are not positioned in the fiber dispersion zone. Composite materials are known to cause rapid onset of asthma. High levels of microfibers that make it to our lungs can attack and manifest into a mass or tumor and with long term exposures it can eventually lead to lung cancer.

So, what can we do?

Start by wearing proper PPE from the beginning of the call to the end…that includes overhaul. Being physically fit for duty.  Get your NFPA 1582 annual physical, early detection is key!

Here’s the top 12 best practice-

  1. Wear your PPE from start to finish. Yes, that means through overhaul phase.
  2. Conduct an on-site gross decon to get rid of contaminates.
  3. Use baby wipes (or other type wipe) to remove as much soot from head, jaw, throat, underarms, and hands as much as possible.
  4. Change your clothes and wash them immediately after fire.
  5. Clean your PPE, and exchange your hood or wash it.
  6. Do not store your gear in a closed-up car or in dorm rooms and living areas of the station.
  7. Take a shower immediately after the fire.
  8. Work out and sweat out the toxins after the fire.
  9. Decontaminate your apparatus, and equipment.
  10. Stop tobacco use and use sunscreen.
  11. Extract the Diesel fumes from your apparatus bay and don’t let them enter your living space.
  12. Document each and every possible toxic exposure.

July 9th 2018 President Donald Trump signed legislation requiring the CDC to set up a registry of fire fighters that will track links between their workplace exposures and cancer. NIOSH will take the lead in establishing the registry. This is for all Firefighters – Paid, Volunteer, ARFF, Structural.

Many states have presumptive cancer laws which shift the burden of proof from one party, in this case the firefighters, to those who would oppose in court. Presumption laws for firefighters with heart or lung diseases have been in place for many years, though cancer presumption laws have become more prominent within the last decade or so.

Firefighters face more risk of developing these cancers.

Type:                                                   Risk:

Testicular                                            102%

Multiple Myeloma                              53%

Non-Hodgkin Lymphoma                51%

Skin Cancer                                         39%

Brain Cancer                                       32%

Prostate Cancer                                  22%

Stomach Colon                                    21%

Source: The Journal of Occupational Medicine

With these statistics, I’m sure we all personally know a firefighter who has been diagnosed with or even lost their battle with cancer. I strongly encourage each and every one to take the necessary precautions, so at the end of the shift you can return home safe to your loved ones.   I will leave you with a quote from Chief Alan V. Brunacini who said, “We used to take better care of our fire trucks than we did our people”.

About the author:   Elizabeth Hendel is a Deputy Fire Chief with the City of Phoenix Fire Department with 36 years of service. She has her Master’s Degree in Public Safety and Emergency Management. She is a AAAE Airport Master Firefighter and currently serves on the ARFFWG board as the Section 7 Director.  She also serves on the Executive Board for IFTSA and on the NFPA, ARFF technical committee.