Are You Doing the Basics?
BY KEITH TYSON
CANCER IN THE FIRE SERVICE HAS become an epidemic. As we conduct more research on this
troubling subject, we start to recognize
that to reduce our exposures—and thus the
number of our members becoming sick and
dying from this disease—we must make
changes, even basic ones that can have a
positive impact on our lives.
Over the past several years, the fire
service has had many discussions on the
simple, low-cost changes that it needs for
prevention while other changes are at the
opposite end of the spectrum such as second
sets of personal protective equipment (PPE),
the (dreaded) “clean cab” apparatus concept,
and even fire station design changes. I have
been heavily involved in pushing forward
these changes, so let’s look at the genesis of
why much of this is happening.
In 2008, I had just retired after 34 years
with Miami-Dade (FL) Fire Rescue (MDFR).
Within six months, I was diagnosed with a
“fairly aggressive” form of prostate cancer.
In my desire to find someone within my
own department that had gone through this
disease, I made numerous phone calls and
became increasingly alarmed at the number of members who stated they also had
some form of cancer, yet no one was talking
about it! This came to light even more so
when after I did some research with our
insurance provider, United Health Care
(UHC). UHC stated that 32 percent of the
active men and women on the job at MDFR
between 2008 and 2010 had been either
diagnosed with or treated for at least one
cancer issue. Further research has shown
that 35 percent of all MDFR deaths since
1952 were related to cancer.
We are not alone; many departments
across the country, such as the Boston
(MA) Fire Department (BFD), have reported
even higher numbers. To truly understand
how these numbers have impacted the fire
service, consider the following two points:
1. According to a 2013 National Institute for
Occupational Safety and Health (NIOSH)
study of approximately 30,000 firefighters,
firefighters have a nine percent higher
risk of being diagnosed with cancer and
a 14 percent higher risk of dying
from cancer than the general public.
2. According to data from the International
Association of Fire Fighters (IAFF), 61
percent of the line-of-duty deaths
(LODDs) for career firefighters since 2002
have resulted from occupational cancer.
In 2016, 70 percent of the LODDs were
attributed to cancer.
These numbers are truly staggering
when compared to the general population,
with two important distinctions: (1) Fire,
police, and military are usually classified
as “healthy workers,” meaning that we are
in better shape and have regular physicals
more often than the general public, and ( 2)
we are constantly doing a dangerous job
and being continually exposed to harmful chemicals and carcinogens. So, this
situation is presumably impossible to avoid
in our occupation because of the emergency nature of our business. However, if we
worked in a “nonemergency” occupation
that exposes us to the same conditions, we
all know that the business would be shut
down by federal or state safety standards.
So, the reality of these two statements is
that the “healthy” worker effect assumes
that we should be less likely to develop
many of the issues we do, but the reality of
the job and our exposures proves otherwise.
In 2013, immediately after the Fire
Department Instructors Conference (FDIC)
International, the Firefighter Cancer Support Network (FCSN) sat down with several
distinguished members from not only
the fire service but also the medical and
scientific fields to evaluate the issues of fire
service cancer that were being discussed
across the country. During this three-day
conference, numerous issues were brought
to light. A document entitled “What
Immediate Actions Can I Take to Protect
Myself?” was produced as a result of this
conference. Within this document are 11
low-cost ideas that were examined and
discussed at length by all those attending.
These actions are presented exactly as they
were written in 2013, which follow:
1. Use self-contained breathing apparatus
(SCBA) from initial attack to the end of
overhaul. Not wearing SCBA in active
and postfire environments is the most
dangerous voluntary activity in the fire
2. Conduct gross field decontamination of
PPE to remove as much soot and
particulates as possible.
3. Use decon wipes to remove as much soot
as possible from head, neck, jaw, throat,
underarms, and hands immediately and
while still on the scene.
4. Change your clothes and wash them
immediately after a fire.
5. Shower thoroughly after a fire.
6. Clean your PPE, gloves, hood, and helmet
immediately after a fire.
7. Do not take contaminated clothes or PPE
home or store it in your vehicle.
8. Decon the fire apparatus interior after
9. Keep bunker gear out of living and
10. Stop using tobacco products.
11. Use sunscreen or sun block on scene.
The importance of annual medical examinations cannot be overstated; early cancer
detection and treatment are essential to
increasing our survival. Consider each of
the following aspects of the examinations:
1. Just because the fire is “out” does not
mean that the danger is over. Some
particles such as dust, dirt, soot, or
smoke are large or dark enough to be
seen with the naked eye. Others are so
small they can only be detected using an
electron microscope; unfortunately, this
also allows these particles to get farther
into the lungs. These particles can also
include diesel exhaust exposure, which
is a known human carcinogen.