THERE IS NOT A DEPARTMENT out there that hasn’t had a member diagnosed with cancer. Many have lost members to this wretched disease. We have all witnessed the number of post-9/11 cancer-related diagnoses continue to rise. The number of subsequent deaths has surpassed the tragic 343 members lost on that horrific and heroic day.
Great strides have been made in gathering statistics and researching this problem. We know that firefighters have a 9% higher probability of developing cancer than the general population and a 14% higher probability of dying from it. We even know that we are at higher risk for certain types of cancer, including rectal, prostate, bladder, testicular, and lung cancer as well as mesothelioma and malignant melanoma, and the list continues to grow. In 2023, 72% of all line-of-duty deaths were attributed to occupational cancer.
Much of this data comes from research conducted from medical records available through career departments. Medical records on members of volunteer departments, for the most part, do not exist in centralized databases that can be accessed and analyzed. With volunteer departments making up approximately 65% of our nation’s fire service, this data is desperately needed as we continue to understand the issue and develop mitigation strategies.
One of the International Association of Fire Fighters’ (IAFF’s) top priorities is eliminating the forever chemicals (PFAS) from our protective clothing. Some say that these chemicals are everywhere already, and we cannot eliminate our exposure to them. They are in our furniture, our clothing, our water, and soil. While this is true, it is also true that firefighters show higher levels of these chemicals in their system than the general population.
We preach all the time to manage what you can, control what is in your four walls. That is precisely what they are doing. Studies are showing these substances at higher levels in the dust of our stations. While this action alone will not stop all cancer, it is one step on a 10,000-mile journey. Engineering out the exposures we can control while weighing the tradeoffs is an important part of the journey. There will be more findings and balancing risk/ benefits along the way. Make no mistake, we will never eliminate all risks, but moving the numbers closer to those of the general population is certainly a noble goal.
There will be no magic bullet to take out this problem. What we can do as individual firefighters is follow the recommendations for reducing exposures and minimizing the effects of the necessary ones: on-scene decon of equipment, personal decon as soon as possible by simply taking a shower, swapping out your PPE while cleaning your contaminated gear, cleaning/deconning the apparatus cab, and keeping yourself in good physical shape. Like most things, it’s the repeated exposures over a long period of time that lead to problems more so than any one incident. None of these actions require any special legislation, only personal responsibility and leadership.
My generation of firefighters was not equipped with the information to know our practices were harmful until late in our careers. The dirtier our gear, the better; wearing our dirty bunker pants all day in the station, to the grocery store, and to bed meant we were prepared and ready. We didn’t have second sets of gear unless we somehow “acquired” them on our own. The examples we set are still more culturally powerful for those we worked with than any study with the latest information highlighting the dangers. We do not have to abandon our mission or go to extreme measures that affect our operational ability to have influence in reducing our exposures. It is OK to go from one fire scene directly to another in your dirty gear. You are already contaminated, and this is not an everyday occurrence for 99.9% of the fire service units. Just decon and clean up after that one!
There are many groups doing research and others helping members and their families deal with cancer both financially and emotionally. There are groups dedicated to educating us on the risks and risk management practices. Being ignorant of the issue is no longer an excuse for personal inaction—it’s a choice. It’s no different than smoking. We’ve known the numerous health risks and cancer risks of smoking for decades, but many still choose to do it. My generation’s parents did not know the risk until late in their life, so it was just something they accepted. (Sound familiar?)
It is an extraordinarily complex issue. What cancers are due to personal behaviors, genetics, environmental day-to-day exposures, work-related exposures, or a combination? We do not really know the answers to these questions, but we do know how to reduce and manage the risks of many of these, and that is not overly complicated. In fact, it is simple: Clean yourself and your gear!
I applaud and support all the efforts of the IAFF, IAFC, NFFF, FRSE, IFSI, FSRI, USFA, University of Miami, University of Arizona, Firefighter Cancer Support Network, Firefighter Cancer Foundation, and countless other groups that contribute to research or just help a single family in need. With all the great work being done to help us, their collective impact will be nothing compared to the potential power each of us has to reduce these numbers. It would be a shame to not, at least, do our part. Don’t wait for a magic solution. As your parents would always say, “Wash your hands; it’s time for dinner” and “Clean your room!” I will say in my fatherly voice, “Wear your mask, wash up, clean your equipment after a job, and get screened often!”
