Firefighters and cancer

‘Not just fighting fires’: Cancer among firefighters causes alarm, uncertainty and heartbreak

By Karen Ann Cullotta

Photos and videos by Stacey Wescott

Nearly 10 months had passed since Buffalo Grove firefighter Kevin Hauber died from colon cancer, but his 39-year-old widow had yet to remove the hospital bed from the dining room of their family home.

Even the sliding glass doors leading to the backyard patio remained unchanged, adorned with hand-painted messages from the four Hauber daughters, such as, “I have the best mom and dad in the world,” “Rest in peace daddy” and “You will be forever missed!”

“I thought I’d be further down the road, but I’m not,” said Kim Hauber, as she tended to the detritus of her husband’s death — the unpaid medical bills, the pending transfer of the title to Kevin’s SUV, what to do with a pair of his old firefighter boots resting on a step.

“I still haven’t even cleaned out Kevin’s closet yet, which is turning out to be a lot more emotional than I thought it would be,” she said.

The Buffalo Grove Firefighter Pension Board ruled that the 51-year-old’s death from colon cancer was related to exposure to toxins found in fires, which some studies recently have linked to a heightened cancer risk for firefighters. The decision earlier this year called for a death-in-the-line-of-duty benefit that would ensure Kevin Hauber’s family would receive his full annual salary, which roughly totals $100,000 a year.

But as Kim Hauber and her four daughters struggled to mend their broken lives, a weekend trip this past summer to the Wisconsin Dells was interrupted by news from officials in Buffalo Grove.

Citing their “fiduciary responsibilities” to area taxpayers, village officials announced they filed a lawsuit in June challenging the pension board’s decision to award a full death pension, arguing that not enough evidence exists that Hauber’s fatal colon cancer was a result of his work.

The Hauber family’s experience is reflected in debates about the still-unclear link between firefighting and cancer unfolding across Illinois and the rest of the country, including Congress, where the Firefighter Cancer Registry Act (H.R. 931) was signed into law in July.

As firefighter pension boards rule some deaths are related to the job, even though the science to prove those claims is in its early stages, officials in cities and villages increasingly are stuck in the middle, sometimes turning to courts to decide if an employee’s death was related to the job and if line-of-duty benefits are warranted.

Under the new federal law, the U.S. Centers for Disease Control and Prevention will 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. Firefighter advocates, meanwhile, cite existing statistics and say the connection already is indisputable.

In the series “Line of duty: Firefighters and cancer,” Pioneer Press and the Chicago Tribune explore the research into the suspected relationship between firefighting and cancer, the challenge facing area policymakers and the effect the complexities of the situation have on firefighters and their families.

It also examines the differences in prevention efforts between well-funded departments, including those in affluent Chicago suburbs, and financially strapped departments farther downstate and in poor cities such as Gary — a situation that often divides members of fire service into haves and have-nots, and one that first responders and their families say is unfair and dangerous.

Yet, it’s not solely an economic issue. Firefighters in the best-funded departments say they are affected by a historic lack of attention to the issue, leaving them without proper protection, and their families, such as the Haubers, fighting with communities over death benefits.

“I was disappointed and confused because when he first started working for Buffalo Grove, they promised that if a firefighter was injured or died because of the job, their family still would be taken care of,” said Kim Hauber, who recently hired an attorney in her battle to retain her current pension benefits.

‘Difficult to analyze’

Since the nation’s first publicly funded fire departments were established in the 17th century, firefighting has been fraught with hazards inherent to the profession, such as back drafts, collapsing roofs, smoke inhalation, disfiguring burns and savage natural disasters like the massive wildfires that have raged across California in recent weeks.

But an advocacy group, the Firefighter Cancer Support Network, maintains cancer was the cause of 70 percent of career firefighter line-of-duty deaths in 2016, with firefighters having a 14 percent higher risk of dying from the disease than the public.

Those numbers do not include cancer deaths among the roughly 814,000 volunteer firefighters, who represent about 70 percent of the 1.16 million firefighters nationwide, according to the National Fire Protection Association.

The newly signed Firefighter Cancer Registry Act also requires the CDC to create a national cancer registry for firefighters to monitor and study the relationship between the profession and exposure to dangerous fumes and toxins while on the job. The data will be used to track the incidence of cancer in firefighters with the goal of developing a national safety protocol, including the recommended use of protective gear and improved prevention methods.

The new law was supported by a multiyear, large-scale study by the CDC’s National Institute for Occupational Safety and Health (NIOSH) of nearly 30,000 firefighters from the Chicago, Philadelphia and San Francisco fire departments.

The study found higher rates of certain types of cancer among firefighters than the general U.S. population. The findings suggest firefighters may be at higher risk of digestive, oral, respiratory and urinary system cancers than the general population.

Despite the new law and the study’s findings, an absence of national guidelines means funding and cancer prevention protocol vary dramatically among the roughly 28,000 fire departments across the United States.

Above all, firefighters from across Chicago and the suburbs who were interviewed for this series said a major challenge in preventing cancer within their ranks is transforming a deeply entrenched culture built on the image of the brave, soot-covered hero battling fires and saving lives.

“I think in the firefighting community, we have a lot of guys who think they’re invincible,” said Chicago Fire Department Capt. Tony Martin, who serves as a trustee for the Chicago Firefighters Union Local 2 annuity and benefit fund.

“If they work out and work hard, they don’t think cancer will ever happen to them, until it does, and that changes your entire perspective,” said Martin, 53, who was diagnosed with oral squamous cell cancer in 2004.

A fourth-generation firefighter, whose family history with the Chicago Fire Department dates to 1906, Martin said he began work at a desk job within weeks after his diagnosis, followed by a return to the field after his treatment and recovery.

“It’s an Irish thing. … You walk out the door you walked in,” Martin said, adding, “They caught it really early, and I was very fortunate because I didn’t have any symptoms.”

Spurred on by his own experience and the increase in cancer among his peers, Martin said he began to collect data on local cases, looking at active, disabled and retired Chicago firefighters who were diagnosed with the disease.

Martin said he decided to gather his own statistics on the issue due to the dearth of any centralized, governmental database — the type of information that, officials with the CDC say, will be included in the new voluntary cancer registry.

“Working on the pension board, I have the honor to help them,” Martin said. “I’ve seen some terrible tragedies, but it’s something that’s very difficult to analyze because the exposures are so varied.”

How firefighters die in the line of duty

Two organizations that track how firefighters die in the line of duty have different totals. This is because they gather data differently and categorize how deaths occurred differently. The totals when taken together provide a view of active duty deaths.

‘Awareness can only help’

While it is typically difficult to determine if it is one dangerous call or repeated toxic exposures that cause cancers in firefighters, the death of Evanston Fire Department Capt. Ron Shulga, 55, in May 2017 was linked to his work on a December 1989 fire at the Varsity Theater, said Evanston fire Chief Brian Scott.

Shulga was among the crew that arrived at the fire scene 29 years ago at 1710 Sherman Ave., and was exposed to heavy black smoke emanating from the roof and rear of the building, Scott recalled recently.

After working at the scene for several hours, Shulga was exposed to smoke and chemicals, which he was not able to clean off his gear for more than a week, leading to a prolonged exposure to toxins, Scott said.

The source of the fire was an old transformer near the back of the theater that was later determined to contain polychlorinated biphenyls — PCBs — a chemical that is among the carcinogens considered by the U.S. Environmental Protection Agency to pose a cancer risk to people.

Diagnosed in 2000 with non-Hodgkin’s lymphoma, Shulga, who was a married father and a 29-year veteran of the department, was able to return to full duty in 2001, but the disease resurfaced twice, in 2011 and in 2016.

Despite a stem cell transplant and high-dose chemotherapy treatments, Shulga eventually halted his work with the department and died in May 2017.

He had no family history of the disease, Scott said. At that point, cancer risks “had been on our radar for years,” Scott said.

“But Capt. Shulga’s passing was another motivating factor for us to get more defined and comprehensive procedures in place,” he said.

Like other fire departments, the Evanston department now follows a strict cancer prevention protocol before and after a fire call to try and minimize firefighters’ exposure to carcinogenic toxins, Scott said.

“Firefighting is a vocation, and we do whatever we can to help others, and we don’t have a problem putting our own lives at risk,” Scott said. “But for the things we can control, we need to do as much as possible, and I think more data and awareness can only help.”

‘Increased risk’

For decades, researchers have known that fires generate toxic combustion products, some of which are known or suspected to cause cancer, and that firefighters may be exposed to these toxins while performing their jobs.

But while cancer risk among firefighters has been evaluated in previous studies, the conclusions were limited by relatively small study populations and short follow-up periods, said Robert Daniels, lead author of the 2010 CDC’s NIOSH study.

The retrospective, longitudinal study, which is ongoing, has fewer of the limitations found in previous studies.

For the current study, cancer incidence and deaths were analyzed among a large number of career firefighters over a 60-year period, from 1950 to 2009, Daniels said.

Among the study’s key findings were that firefighters had more cancer deaths and cancer cases than expected, with the higher rate of the disease primarily due to digestive, oral, respiratory and urinary cancers, Daniels said.

The study also found there were about twice as many malignant mesothelioma cases than were expected, with firefighters’ exposure to asbestos in buildings while fighting fires likely being the primary cause of the disease, Daniels said.

In addition, some cancers occurred at a higher-than-expected rate among younger firefighters. For example, firefighters who were younger than 65 years old had more bladder and prostate cancers than expected, Daniels said.

While the NIOSH study supports the scientific evidence that firefighters are at increased risk of some types of cancer, Daniels said, the study cannot determine if a specific individual’s cancer is related to his or her job duties.

In addition to firefighters’ exposures to toxins, an array of other factors may influence whether a particular cancer develops, Daniels said. Those factors include family history and lifestyle habits, such as diet, exercise, smoking and alcohol consumption.

“There is no way to tell if a cancerous tumor is occupation-related by just looking at the tumor,” Daniels said. “Because of that, there’s always an amount of uncertainty, and it can be hard to get at the truth.”

Still, Daniels said: “There is unequivocal evidence that firefighters are exposed to carcinogens, and it’s not too far of a stretch to say that with increased exposure comes increased risk.”

But Daniels said the NIOSH study does not yet yield scientific evidence to support the general consensus among firefighters that cancer deaths in their ranks are surging.

“There is absolutely more awareness of firefighter cancer deaths than in the past, and more attention is given to prevention, but I can’t say if there are more or less cases,” he said.

Balancing acts

As researchers like Daniels continue to study whether firefighters have a higher risk of cancer due to exposure to toxins while on the job, officials at departments across the Chicago suburbs are becoming increasingly vigilant about combating what many describe as the most daunting challenge now facing firefighters.

The death of Waukegan firefighter Kevin Oldham, 33, from pancreatic cancer in 2011, followed by the diagnoses of two members of the department who currently are battling cancer, has made preventing cancer a top priority for the department, Waukegan fire Chief George Bridges Jr. said.

“Firefighters these days are not just fighting fires. They are dealing with structures that are categorized as (hazardous materials) incidents because of all of the chemical toxins in the buildings,” Bridges said. “As a fire chief, firefighters are my superheroes, and the byproducts of today’s fires are their kryptonite.”

He added: “It really touched home after Kevin’s death. … He was very young, and had a wife and kids.

“We are a family here, and when someone dies or is ill, and to think there’s something we can do to help prevent this, it hurts us even more,” Bridges said.

As fire chiefs like Bridges cope with the loss of a firefighter and struggle to find ways to help those who are still battling cancer, government officials in the area face formidable challenges posed by cancer cases.

In Buffalo Grove, village officials said the decision to file a lawsuit contesting the firefighter pension board’s ruling to grant Kevin Hauber’s family a full pension was made after much deliberation.

Paying the Hauber family the full pension benefit would cost taxpayers an additional $1.7 million over the course of the pension, officials have said.

In addition, officials said the pension board’s decision represented a “precedent-setting case,” which, if not challenged, would have a long-term, negative financial effect on municipalities.

“It’s very difficult to balance the human interests of Kevin’s widow and her children with the financial and fiduciary responsibilities we have to our residents,” Buffalo Grove Village Manager Dane Bragg said. “It is definitely challenging, and we have been sensitive of that from day one. But sometimes, you have to make a decision that is not the most popular position to be in.”

When a municipality designs a pension system, officials should ensure that the contractual agreements in cases of employee disability and death are stated clearly, and they also “need to honor them,” said Jeffrey Brown, dean of the Gies College of Business for the University of Illinois at Urbana-Champaign.

While fatalities from catastrophic injuries suffered during a service call have none of the ambiguity inherent to cancer deaths, Brown said pension policy contracts should be airtight and eliminate any lingering questions for family members about their benefits.

“I’m sympathetic to these families because public pensions have become a hot-button political and financial issue,” Brown said. “But a pension policy should be writ large with a promise that the city is obligated to either pay the pension benefit or not.”

After the cancer death of Lincolnshire-Riverwoods Fire Protection District Lt. James Carney, 43, village officials did not fight the Fire Department pension board’s decision to grant his widow and their two young children a full pension benefit, said Steve Shetsky, a fellow firefighter and member of the International Association of Fire Fighters Local 4224.

Carney, who was raised on his family’s farm in Wadsworth, was diagnosed with cancer in 2013 after medical examinations determined the disease was the result of repeated exposure to carcinogens while he was out fighting fires, Shetsky said.

According to court records, Carney, who had sought medical attention after he was having trouble sleeping and was coughing at night, was diagnosed with pericarditis, which is the swelling of the tissue around the heart.

After a surgery was performed, doctors found a tumor between Carney’s heart and the membrane enclosing the heart. His firefighting career ended after diagnosis and treatment for pericardial mesothelioma, court records show.

While Carney was granted line-of-duty disability pension benefits and his death was ruled as duty-based, officials denied a request that his family be covered by a health insurance benefit under the Public Safety Employee Benefits Act, prompting a February 2016 lawsuit against the fire protection district.

A June decision by the Illinois Appellate Court upheld a ruling by the Circuit Court of Lake County that the Carney family is indeed entitled to the line-of-duty disability pension benefit.

“Every aspect of this entire process has been extremely difficult for everyone involved,” Shetsky said. “This seems to have become the new norm … municipalities contesting line-of-duty benefits. They risked their lives for their communities in the short time they lived, and now, their loved ones face a battle.”

Twitter @kcullotta