We all know that firefighting is a dangerous profession, but can firefighting cause cancer? It’s a good question and one I’ve heard from several people looking to join the fire service.
So, does firefighting actually cause cancer? No, firefighting itself does not cause cancer, but it certainly exposes you to many situations, chemicals and hazards that can cause cancer. While research into causes and specific carcinogens is ongoing, there are some clear links between chemical exposure at incidents and cancer rates.
This guide will look at some of the primary reasons for this high number of cancer cases in firefighters. We will look at these risks as well as some of the poor practices that made the situation worse.
From there, we will also consider the different types of cancers seen as well as some case stories from across America.
Finally, this guide will end with a section on the resources and aids in place to help those dealing with firefighting-related cancers. This includes some of the laws and new initiatives to help protect firefighters in the future
Unfortunately, cancer rates are extraordinarily high for those working in the firefighting service. Decades of exposure to carcinogens and poor prevention methods have led to frequent cases of many types of cancer.
Most firefighters that develop cancer are assumed to have done so due to their occupation. Active fighters and those long retired are paying the price for their service.
How high are the risks for cancer in firefighters?
The National Institute for Occupational Safety and Health (NIOSH)carried out two major studies on the idea that firefighting can cause cancer.
The results showed that firefighters saw a 9% increase in diagnoses of cancer and a 14% increase in terminal cases compared to the rest of the population.
Furthermore, research from the International Association of Fire Fighters. Two-thirds of firefighters that died in the line of duty since 2002 died because of cancer. This means that cancer is deadlier to firefighters than the fires themselves.
Therefore, families have a whole new concern every time loved ones go out on a call.
What are the long-term implications of the event on the health of their loved one?
Will they survive a big blaze just to develop terminal cancer a few years later?
These questions have led some parents to question whether they would allow their kids to follow their dreams into this profession.
Why is the risk so high?
There are two main reasons for this increased risk of cancer in firefighters.
The first is the direct exposure to carcinogens at the scene of the incident. We will discuss some of those in more detail below. These chemicals combine with the ash and soot of a fire and coat any exposed surface. This means that firefighters tackling the fire and smoke walk into a cloud of these dangerous substances.
In an ideal world, they will be completely protected with head-to-toe protective equipment and respiratory devices.
But, some firefighters put themselves at greater risk.
The threat continues when it comes to cleaning the equipment after the incident. This is the second risk: contaminants in stations and homes following bad practice at the site.
Those that bring soot and dust into their workplaces and homes prolong exposure and put others at risk.
A major concern for those involved in firefighting is the use (or misuse) of respiratory masks.
All firefighters should wear these masks during a fire to help prevent the inhalation of soot and other particles. The masks offer oxygen and a clean air supply and block dangerous chemicals.
However, this is only effective if they are worn the whole time that firefighters attend the incident. Some take them off too soon after the fire is out and while they are still in the building.
Others are forced to remove them and change air supplies on long jobs. Those moments breathing in contaminated air could prove to be highly dangerous.
**And yes, I promise at some point in your career you will run into a firefighter who tells you wearing your mask or other PPE makes you weak, inferior, soft etc. DO NOT LISTEN TO THIS PERSON!**
A soot-covered suit shouldn’t be a badge of honor anymore.
A big problem here when examining the issue of can firefighting cause cancer is the cleanliness of the PPE – both the turn out gear and other protective equipment.
There are too many cases of firefighters wearing soiled PPE for far too long. The equipment should be hosed down on site.
This removes the contaminants from the body and stops them from penetrating a secure, clean environment back at the control room. All the dust and mess must stay at the scene and not be brought back to the station.
This also means rinsing off skin and hair if there is any sign of dust and soot. It is better to be safe than sorry in these situations.
Firefighters should take the time to rinse off thoroughly before heading back to the station and to keep their mask on until it is safe to take them off.
Sadly, there is a long-standing stereotype of the American firefighter that gets in the way of this safe practice.
Dust and soot from a fire were once considered to be a badge of honor. It showed that the crew had worked hard to battle the blaze and come out victorious.
Some firefighters from this old school of thinking would continue to wear the contaminated suits long after the incident, with many doing so in the fire station. **AGAIN – THIS IS DANGEROUS TO BOTH YOU AND YOUR CREW – DO NOT ALLOW THIS TO HAPPEN!
This leads to two major health issues for the crew.
First, the firefighter in question could still breathe in the dust and carcinogens from their gear and put themselves at greater risk.
Second, their actions contaminated the seats and communal areas of the fire station. Anyone that came into that area could then breathe in the chemicals or get it on their skin.
Not only does this mean the other firefighters on call – who perhaps had nothing to do with that fire – but also any family members or civilians that came by.
The National Fire Association is now much more informed on the subject and understands the contamination risk. They appreciate that any remaining dust on equipment, clothes and tools can transfer into other environments.
There are concerns that this could also mean the family homes of the firefighters. Therefore, there is a potential link in firefighting causing cancer in children through contaminants.
Understanding the risk factors and carcinogens involved.
There is still a lot of work to undertake to understand the full extent of the risks posed to firefighters by the soot and dust from buildings. With more research, we could get a clearer picture of the scale of the problem and find a way to help firefighters further.
The “Fire Fighter Cancer Cohort Study” is a long-term study underway at the University of Arizona. It aims to determine the biggest cancer risks to firefighters and look into ways to protect them in the future.
This study will take around 30 years. Until then, we can focus on some of the known carcinogens that are present in fires and explosions and could be major risk factors for firefighters.
Many people that work in construction and housing renovations will be aware of the potential risks of asbestos.
This dangerous substance is no longer recommended for use in construction because it is so easy to breathe in particles. These particles can aggravate the lining of the lungs and the stomach to create respiratory and abdominal distress.
In the worst cases, this can also include cases of mesothelioma.
This cancer is rare because of its trigger. But, it is most commonly seen in those that handled the material in buildings decades ago. Many buildings still contain asbestos because it isn’t a threat when undisturbed.
However, there is a risk when buildings are demolished or damaged in the fire. Therefore, there is the risk that firefighters will breathe in asbestos, among other chemicals, when dealing with fires.
One of the more recent concerns for firefighters contracting cancer is the presence of polycyclic aromatic hydrocarbons in the atmosphere and on their turn out gear.
These compounds are more common now than ever before because of the amount of plastic found within our homes. Not only does this plastic ignite and burn with a toxic smell, but these plastics can also find their way into the lungs of firefighters.
We often take for granted the amount of plastic in our homes.
Think of all the appliances and items in your kitchen. Now think of how much plastic would burn if one appliance started a major electrical fire.
The risk is also present in many commercial and industrial fires.
Another risk factor for cancer in firefighters comes from the petroleum that burns in a vehicle fire.
Firefighters regularly attend car accidents where the fuel tank has leaked and there is the risk of an explosion.
It isn’t just the fire and blast that is a risk here. Breathing in petroleum fumes can also put firefighters at greater risk of developing cancers.
What Are The Most Common Types Of Cancer For Firefighters?
As you might expect, there are many cases of lung cancer in firefighters.
This is due to the fact that service personnel breathe in so much of the smoke, soot and dust when they tackle a fire.
As I mentioned above, the use of respiratory equipment should help to prevent this.
Yet, many firefighters remove their masks before it is safe. They may also have no choice if they are involved in a long incident and they need to replace their oxygen supply.
Particles and carcinogens get trapped in the lungs and lead to all kinds of illnesses. Lung cancer, including cases of mesothelioma, isn’t always far behind.
That being said, lung cancer isn’t the only major cancer threat because firefighters aren’t just breathing in these chemicals.
Any firefighter that gets a layer of soot and building dust on their skin is at risk.
The chemicals can seep into the body through this layer and enter the bloodstream. Blood cancers are common with firefighters dealing with high rates of leukemia and lymphoma.
While blood and lung cancers are typically the most common in firefighters, they are also at risk for other types as well. This is understandable given the nature of the incident and the amount of soot firefighters breathe in.
However, there are also cases of cancer across the body that have links to the patient’s time in the fire service. Some will develop brain cancer, often at a terminal level.
There are also cases of bladder cancer, throat cancer, oral cancer and other cancers of the head and neck.
A study in firefighter cancer rates by Jalilian H and co-authors published in Int J Cancer in 2019 backs this up. It also highlights the high risk of “significant SMREs of 1.36” for rectal cancer.
Thus, cancer risks are severe and difficult to predict. We can’t simply say that firefighters are at a high risk of just lung cancer or leukemia.
The reality is that any firefighter with prolonged exposure to these carcinogens could develop any number of cancerous tumors throughout their body.
What is the impact of cancer risk on firefighters?
The statistics mentioned above paint a stark picture of the scale of the problem on a national level.
Yet, there is also a local, personal level of devastation. We can see the horrific impact of cancer on communities and specific crews when we focus in on specific areas and incidents.
There are countless cases every day where firefighters put themselves at risk of contact with carcinogens.
However, if we go back 17 or 18 years we can see how one major event can have a catastrophic impact.
In Boston, back in 2002, 200 firefighters responded to an incident in a city power plant. The blaze was dangerous with a great risk of explosions and chemical leaks.
One member of the crew became separated from the others and found himself coated in a substance that was like petroleum jelly. The individual in question contracted cancer and has since died.
But, he was far from being the only one affected by the incident. It is said that of those 200 firefighting responders, around a quarter have since received a diagnosis of cancer or some form of cardiac ailments.
This just goes to show the impact of contaminants on firefighters no matter how safe they try to be on the scene.
Firefighters and first responders on September 11, 2001.
One of the most infamous incidents of recent times was the terrorist attack on the World Trade Centr in New York – an event now simply call 9/11.
Thousands of responders were called into duty in the city to handle the event and the aftermath of the event. This meant dealing with the fires at the towers and also the evacuation process of all those trapped inside.
Both towers collapsed causing rubble and dust to descend over the city and engulf streets.
Many of the most iconic images of the day show firefighters, officers and downtown workers covered in white dust. We all saw the footage of firefighters coughing it up in the streets.
However, we know now the extent of the damage of that dust. Those particles that coated the skin and lungs of all those involved are now causing great damage to their health.
The effects of this contamination are now clear to see as thousands of people at the scene developed serious illnesses in the following years.
The federal World Trade Centre Health Program has released the following data as of 2018.
They claim that 9,795 people, including all the first responders, residents and downtown workers, have developed 9/11-related cancers. 1,700 of those affected by the incident have died and 420 of those deaths were due to cancer.
What has been done to decrease the risk of cancer in firefighters?
The events of 9/11 and subsequent major emergencies have had a significant impact on the health of personnel.
The effects of those traumas are only now coming to light with the deteriorating health and deaths of so many involved. It is almost 20 years since the World Trade Centre fell and firefighters are now beginning to see some change in practices and the understanding of the dangers they face.
Departments are urged to follow new guidelines at the scene of the fire and back at the station to minimize the risks. The following is a list of some of those guidelines.
Improved use of masks:
The first change relates to the use of masks and respiratory equipment.
There are calls for incident commanders to be a little stricter when ordering firefighters to use their mask. They must keep their masks on until they are away from the scene and safe from contamination.
This also means after the dust has been washed away. There is no point removing the mask and then breathing in particles blown away by the hose.
There is also a plan to upgrade SCBA bottle sizes so that the air tanks offer oxygen for 45 minutes rather than 30. This extra 15 minutes could make a big difference.
The gear must be clean at all times!
This means washing off on scene to avoid contaminants in the vehicles or back at the station. Guidelines from the National Firefighters Association talk about the need for evolving cleaning practices for more effective results.
All firefighters should use industrial machines for their gear and change into a new set when they return from a job. It really is better to be safe than sorry in these cases.
It’s not uncommon to see a special gear washer at a lot of departments these days.
There are also new guidelines about the fumes from vehicles.
The risks of carcinogens from vehicle fumes doesn’t just relate to the fuel tanks in vehicle fires. Where possible, stations should work to reduce exposure to any exhaust fumes from the fire engines and other equipment.
This means that the doors to the station office and communal areas must be closed and well-sealed at all times. There are also exhaust systems that can be installed in apparatus bays at most stations.
Finally, all firefighters need to have a good relationship with their doctor.
Personal physicians need to know all about the work history of a firefighter and any exposure that may have occurred. This is also true for those that are retired from the service.
This opens up the opportunities to discuss cancer risks, take preventative measure to improve health and undertake regular screening for cancer symptoms.
What help is available for firefighters with cancer?
One of the positive changes to come into place following all these cases in the creation of the Firefighter Cancer Registry Act.
This Act came into public law on July 7, 2018. This may be later than you might expect given the length of time that firefighters have suffered from cancer diagnoses and terminal cases.
The law means that the Centers for Disease Control and Prevention (CDC) will maintain a registry of firefighters where they can collect occupational and health information and link this to the data in state cancer registries.
This will be a voluntary registry where firefighters can choose to help by providing a greater sense of the scale of the problem nationally. The aim is that this national data will help to highlight greater links between cancers and carcinogens to help protect service personnel further in the future.
Compensation and monetary support.
Another issue within the protection of those that develop cancer as firefighters is compensation and care.
There are calls for all firefighters to have full compensation as part of their workers’ rights. If a cancer diagnosis is deemed to be work-related, in other words, caused by contaminants at the scene or in the fire station, then patients should be able to make a claim.
Many people, especially families of firefighters, would agree that this would be a fair system.
However, the system isn’t that straight forward. Some firefighters struggle to get this compensation and even those involved in 9/11 have struggled to get the care they need.
There are 38 states in the US now have what are called “presumptive laws” about firefighters and cancer.
This basically means that if you are an active-duty firefighter or one that has recently retired, it is presumed that your cancer diagnosis is work-related.
As you have seen with the stats and risks above, the chances are more than likely.
In theory, this should mean that all firefighters with cancer get simple access to workers compensation benefits.
This should provide a stress-free monetary fund to help with treatment and care. However, this isn’t always the case. In Texas alone, 9 in 10 firefighters since 2012 have seen government officials deny them their workers compensation rights.
This leads to a stressful appeal process that no cancer-stricken firefighter should go through. There should be greater federal statutes on the rights to care for these service personnel.
That being said, we shouldn’t be surprised by the lack of support when we consider recent attempts to protect the rights of those affected by 9/11.
As we mentioned above, the death rates and contamination rates from the incident are catastrophic among first responders and civilians.
We might assume that those that suffered as a result of this terrorist attack would receive all the care they need.
Think again, first responders dealing with cancer and other illnesses have found themselves a little overlooked. The world is seen to have moved on from the tragedy and forgotten the ongoing impact.
In the summer of 2019, the comedian Jon Stewart called on Congress to change the law and support those in need.
His support gave added profile to a campaign fought for nearly 20 years. Congress then agreed on a September 11th Victim Compensation Fund for the next 70 years.
This will provide support for all those that worked in the area following the attack. The next move is to put the idea in front of the President.
So, can firefighting really cause cancer?
Unfortunately, the answer to that question is looking like a yes. As these case studies and reports show, cancer rates are worryingly high within the profession.
More firefighters will die from work-related cancers than from dangerous fires.
That rate of contraction and death has increased in recent years as the result of poor practices from decades ago.
Furthermore, there are even more carcinogens in the atmosphere of a fire with the increased use of plastic. Cases of blood and lung cancer are common but there are also diagnoses across the body.
That’s the bad news for firefighters and those looking to join the profession.
The good news is that it may be possible to lower risks in the future. The fire service can learn from past mistakes over the use of equipment and how to properly maintain your PPE. Tighter measures on mask use, hosing down suits and other practices could help protect current personnel from further harm.
Changes on the part of the fire service need to be matched with efforts from government agencies and legal help.
With time, hopefully, the brave men and women that serve will get the compensation and care they need and we will see fewer firefighter cancer cases.