In 2010, NIOSH set out to conduct a comprehensive multi-year study which included over 30,000 fire fighters from the Chicago, Philadelphia and San Francisco Fire Departments employed between 1950 and 20120. The researchers considered a multitude of factors as they set out to examine if fire fighters have an increased risk of developing cancer as a result of job related exposures. The study found that firefighters did in fact have greater risk of cancer diagnosis and death, especially with cancers relating to the respiratory, digestive and genitourinary systems. View the findings here. A comprehensive review of study documents and timelines can be viewed here.
A Study of Cancer Among United States Firefighters
Firefighters are exposed to a wide variety of toxic chemicals. Previous studies have reported excess risk of some cancers but have been limited by small numbers or little information on employment characteristics. This is a retrospective cohort mortality study among 7,789 Philadelphia firefighters employed between 1925 and 1986. Through review of the data, there was increased mortality for cancers of the colon and kidney, non-Hodgkin lymphoma, and multiple myeloma. (2001)
Risk of Cancer Among Firefighters in California, 1988–2007
This is one of the first studies to include an examination of firefighter risk for subtypes of leukemia, esophageal cancer and lung cancer, and cancer risks among firefighters of other races/ethnicities. The study sample included 3,996 firefighters. Among the 32 examined cancers, three were significantly elevated among all firefighters combined and among firefighters in both race groups. These three cancers were melanoma, prostate cancer, and brain cancer. Three cancers were significantly elevated among all firefighters combined and among white firefighters: adenocarcinoma of the esophagus; non-specific, non-small cell lung cancer; and, acute myeloid leukemia (AML). Three cancers were significantly elevated among all firefighters combined and firefighters of other race/ethnicity: kidney cancer, multiple myeloma, and overall leukemia. There were six cancers that were significantly elevated among firefighters of other race/ethnicity only: tongue cancer, testicular cancer, bladder cancer, non-Hodgkin lymphoma, chronic lymphocytic leukemia (CLL), and chronic myeloid leukemia (CML).
Taking Action Against Cancer in the Fire Service
In 2013, the Firefighter Cancer Support Network assembled a team of experts with the goal of developing a white paper examining the issue of cancer within the fire service. This report addresses prevention, diagnosis, treatment, and the long-term implications for the firefighter, the firefighter’s family, their coworkers, the fire department and community policy. (2013)
Cancer Risk Among Firefighters: A Review and Meta-Analysis of 32 Studies
The objective of this study was to review 32 studies on firefighters and to quantitatively and qualitatively determine the cancer risk using a meta-analysis. The results confirm previous findings of an elevated risk for multiple myeloma among firefighters. In addition, a probable association with non-Hodgkin lymphoma, prostate, and testicular cancer was demonstrated. (2006)
Understanding the Health Hazards of Smoke for Wildland Firefighters
The Fire Sciences Laboratory in Missoula conducted a series of laboratory and field studies to determine the components of vegetative smoke and conducted studies of employee exposure at prescribed and wildland fires. A list of recommendations for risk management was developed, including training and tactics, monitoring, health maintenance, respiratory protection, medical surveillance, and additional research.
The aims of this study were to examine mortality and cancer among firefighters and investigate different subgroups, based on type of employment, duration of firefighting service, era of first employment/service, serving before/including or only after 1985, by the number of incidents attended and whether an individual was identified as having been a trainer. For male career full-time firefighters compared to the Australian population, overall cancer incidence was significantly raised for the group as a whole and for those who had worked for longer than 20 years. (2014)
Cancer Morbidity of Professional Emergency Responders in Korea
Many professional emergency responders (ERs) who belong to the Korean National Emergency Management Agency (NEMA) have been cross-trained and serve multiple roles. As such, firefighters and other ERs in Korea are exposed to similar occupational hazards. This study was conducted to estimate cancer morbidity in male ERs and compare that with Korean men. Korean firefighters showed excess morbidity in several cancer types, including colorectal and urologic cancers, and non-Hodgkin lymphoma, demonstrating similar trends to previous studies for firefighters conducted in other countries. (2012)
This article aims to highlight the importance of the dermal exposure and absorption route in occupational settings, identify some of the factors that influence exposure and absorption, and describe methods currently used for the measurement and assessment of dermal exposure.
Contamination of Firefighter Personal Protective Equipment and Skin and the Effectiveness of Decontamination Procedures
Typically, when someone dies in a fire, it’s attributed to the nebulous cause of “smoke inhalation.” In truth, it’s more complicated than that – we just haven’t been looking at it the right way. We haven’t really digested the combustion chemistry to truly understand why the smoke is so nasty. Understanding the basics of combustion chemistry is the first step toward gaining a new respect for an old foe.
A total of 2,399 Florida firefighters completed the Annual Cancer Survey. On average, the respondents were nearly 42 years old and had been on the job for about 15 years. Overall, 109 of the firefighter respondents reported skin cancer: 17 had melanoma, the most dangerous form, which is likely to grow and spread; 84 had non-melanoma, the most common and most easily treated type of skin cancer; and 18 had some unknown skin cancer type. The frequency of melanoma was 0.7% among the firefighters
surveyed and 0.01% among the general Florida population, the researchers found. The average age at diagnosis for melanoma was about 42 among the firefighters, versus 64 for the general US population.
Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures.
Firefighters’ skin may be exposed to chemicals via permeation/penetration of combustion byproducts through or around personal protective equipment (PPE) or from the cross-transfer of contaminants on PPE to the skin. In this study, wipe sampling of the exterior of the turnout gear was conducted pre- and post-fire. Wipe samples were also collected from a subset of the gear after field decontamination. VOCs off-gassing from gear were also measured pre-fire, post-fire, and post-decon. Field decontamination
using dish soap, water, and scrubbing was able to reduce PAH contamination on turnout jackets by a median of 85%.
Resilience, Culture Change, and Cancer Risk Reduction in a Fire Rescue Organization: Clean Gear as the New Badge of Honor
This study uses grounded theory drawing on concepts of organizational culture and resilience to show how one key partner in the community model of resilience (Palm Beach County Fire Rescue) is working to address their own crisis—an epidemic of cancer. Barriers to change include cultural practices, perceived threats to occupational practice, and logistics and resources to enact desired change. A model of risk reduction and resilience is advanced that explores how organizational culture and practice both support
and undermine individual resilience and organizational resilience. Implications for communication and change efforts are explored.
There is the monumental task of better understanding the biological mechanisms that make firefighters ill. Added to that mix are fire service cultural issues that may resist beneficial equipment and behavioral changes. And there are political and legal forces at play in the battle to decide what impact firefighting as on our health and when benefits are awarded to those with job-related health problems… it’s a broad and complex topic, yet one that impacts every firefighter to some degree.
A team of researchers at the University of Ottawa, working with Health Canada, the University of Toronto and the Institut national de santé publique du Québec, examined chemical exposure experienced by Ottawa Fire Service firefighters during on-shift, emergency fire operations between January 2015 and April 2016.
This research project is led by University of Arizona with collaborative support from multiple other research partners, including the University of Miami, National Institute for Occupational Safety and Health; National Fallen Firefighter Foundation, Fire Protection Research Foundation, and others. Initial funding for this project is through a 3-year DHS/FEMA Assistance to Fire Fighter (AFG) Fire Grant.
The goal of the initial 3-year effort of this overall project is to develop and test a framework for establishing a long-term fire fighter multicenter prospective cohort study focused on carcinogenic exposures and effects. This information is essential to guide interventions to reduce the most important carcinogenic exposures and develop treatment options to potentially reverse carcinogenic effects in their early stages.
The study shows that the best way to reduce a firefighter’s exposure to harmful combustion products is to reduce chemical exposure to the skin. Having a better understanding of how firefighters are exposed to harmful chemicals helps us find ways to reduce those exposures and hopefully reduce the onset of disease.