Photo courtesy of Kristopher Wilson, U.S. Navy.
By Jim Burneka Jr.
Multiple studies, including the National Institute of Occupational Safety and Health Cancer Study, are showing a link to occupational cancer and firefighters. Many of us wonder what we can do within our own departments to decrease our odds of receiving a cancer diagnosis.
This article will discuss multiple policy, habits, and procedural items that our departments can do to decrease our chance of receiving a cancer diagnosis. Some of these ideas are as simple as educating our members and have little to no cost associated with them. Some ideas carry a large price tag; these ideas should be viewed as an investment. It’s important to note that these ideas are not 100-percent guaranteed to make us cancer-proof. However, these ideas can certainly make us more cancer resistant.
The first thing departments must do is to establish a Cancer Awareness and Prevention Committee. This committee should be a mixture of labor and management individuals that have already accepted that cancer is an epidemic within the fire service and wish to work together to lessen the future diagnoses of members of their department.
I will begin by discussing the ideas that you can start doing today that have no associated cost.
We must first change the mentality that firefighters have regarding cancer. This is no easy task; in fact, it’s probably the single hardest thing to accomplish on this list.
Firefighters generally feel as if they are invincible; they have this attitude of “it won’t happen to me.” Ours is a unique occupation that has its roots deep in tradition. Many times, these traditions get in the way of our and others’ safety. We need to realize that the odds are not in our favor regarding cancer. We must take steps to decrease our risk. Education and time are the two major components to changing the fire service’s outlook on occupational cancer. It starts educating rookies in cancer awareness and prevention, and the leaving of the older, close-minded generation that are full of bad habits.
Designated Area for Fire Gear
We need to keep our fire gear in a designated area. Ideally, our gear is stored at the firehouse in a separate room that has a separate heating, ventilation, and air-conditioning system. If the gear is stored inside the bay, keep it away from any diesel exhaust.
Transporting Fire Gear
Whether you are a career, part-time, or volunteer firefighter, you will transport your fire gear in your personal vehicle occasionally. It’s important to not leave your gear in the same compartment in which you and your family drive any longer than you have to. Your fire gear off-gases toxic fumes that you and your family will inhale. These fumes become worse with heat. Go the extra step and drop off your gear at the firehouse or place it in your garage as soon as possible. I also recommend keeping your gear in an air-tight plastic tote; this should minimize any toxic off-gases.
When we were kids, our parents always taught us to wash our hands after using the restroom. With our occupation, it is important to wash our hands before using the restroom. Toxins that get on our hands at the fire scene or firehouse can easily absorb into the groin area.
Self-Contained Breathing apparatus (SCBA) at Car and Trash Fires
There are numerous harmful chemicals and carcinogens that off-gas in the various stages of a car fire. Wearing SCBA will prevent inhalation of toxic fumes during the incident.
There is no way to tell what could be inside a dumpster that is on fire. Be safe by wearing your full personal protective equipment (PPE) including SCBA to make sure you don’t inhale anything that could be harmful.
Gross Decon on the Fire Scene
Before leaving the incident, spray off your fire gear. If this isn’t an option, brush off the big chunks of debris. Ideally, we would bag our gear and keep it in a separate compartment from the one in which we ride back. When we return to the station, we can switch into a backup set of gear, if possible, and wash the soiled set as soon as possible.
Postfire Decon of Fire Apparatus
We all have a checklist of things to do when we return to the station from a fire. Whether its load hose, fueling a fan, and so on, we should also clean the inside of our cab if we placed our soiled fire gear inside it as well as clean our SCBA. By decontaminating the interior, we will not contaminate ourselves and our fellow members.
Take a shower as soon as possible when you return from a fire. Carcinogens are absorbed into your body, and immediately showering postfire is the only way to get them off your skin.
Changing Clothes Postfire
Not only must you shower after a fire, but you also should put on a new set of clothes. It doesn’t make sense to recontaminate yourself by putting on the same soiled clothes. These clothes are ideally washed in a washer/dryer at the firehouse and not taken home and cross contaminated with your civilian clothes.
Stop Using Tobacco Products
This is a no brainer. Quitting tobacco products will decrease your risk of being diagnosed with cancer. This can be through education or policy.
Following are ideas and items that have a very minimal associated cost:
Washing Fire Gear
Wash your fire gear after every fire. Chemicals and carcinogens can stay on your fire gear and be absorbed into your body. Also remember to wash your hood and the outside and neckflap/ear cover of your helmet. These items are often overlooked.
Policy/Signs Prohibiting Fire Gear in Living Quarters
Create a policy that states that no fire gear should be allowed in firehouse living quarters. Signs can also be created and posted near all of the entrances to living quarters as a reminder to not wear fire gear past that point.
Keep Wet Wipes and Sunscreen on All Fire Apparatus
Use wet wipes on the fire scene to clean yourself off before you return to the station and take a good, quality shower. These wipes are inexpensive and should be carried on all fire apparatus or your personal bag.
Also, there are many times throughout the year that each crew is going to be out in the sun for extended periods. Using sunscreen during these times will decrease your risk of receiving a cancer diagnosis. Also consider bringing a hat along with you.
Exposure Form Documentation
This isn’t referring to the exposure forms used commonly for a needle stick or even a hazmat run; this type of exposure reporting would be for the typical car, dumpster, or house fire. All of these fires expose us to harmful carcinogens and toxic fumes. Complete this type of exposure form for every fire; it can ideally can be part of the run report. It is important to have documentation of all of your exposures in case you are diagnosed with cancer down the road.
The following items have a considerable associated cost:
Diesel Exhaust Systems
Diesel exhaust is a known carcinogen and is linked directly to several types of cancers. It is recommended to hook up all of your diesel apparatus to a diesel exhaust removal system. Many of these systems can be purchased with a federal grant. If you already have this system, ensure that members are hooking it up correctly and that you have procedures in place to maintain it once it is installed.
Having a mandatory wellness plan that includes exercise, nutrition, and annual wellness exams will be beneficial to your members. If a cancer diagnosis is caught in its early stages, there is a much better chance of being able to treat it with a successful outcome. Treating cancer in an early stage will decrease insurance costs, give the member a better quality of life, and possibly save his life.
A Second Set of Fire Gear
Having a second set of fire gear is ideal. If your first gear is contaminated from a fire, do not wear that gear until it is washed. Switching into a second set allows you to wash your original set and not wear the gear with toxins in it that we absorb into our body.
Wear SCBAs from Start to Finish
Not wearing your SCBA while conducting overhaul represents the single largest exposure to harmful carcinogens and chemicals that you receive. Carcinogens such as Arsenic, Asbestos, Formaldehyde, and Cresote, to name a few, have all been found in the atmosphere of the modern fire. Flame retardants also linked to cancer and other genetic diseases are abundant within the modern fire atmosphere. You are not going to find any of these chemicals on your four- or five-gas atmospheric monitor. You must realize that just because the fire is knocked down or placed under control does not make the scene safe.
The majority of firefighters across the nation take off their SCBAs as soon as the fire is listed as “under control” to conduct overhaul. Some firefighters think it’s okay to wear a N-95 or cartridge mask during overhaul. The reality is that SCBAs are the only masks that are truly going to prevent you from inhaling these carcinogens.
To wear SCBAs from start to finish, you are going to have to do things differently such as the following:
- Keep more crews on the scene for a longer period of time.
- Increase the available air bottles on scene through increased storage on a current apparatus or bring in an air truck to all working fires.
- Add a rehab unit to all working fires. Create a policy in which after “one bottle” used the individual must go to rehab to check for vitals and rehydrate.
Consider taking the items listed above and discussing what you could implement within your department in the near future. By implementing some of the less expensive items, you can build a good foundation. A good foundation will make it easier to implement some of those more expensive items down the road. Anything is better than nothing. With some cooperation and time, you can help decrease your risk of an occupational cancer diagnosis and become cancer resistant.
Jim Burneka Jr. is a firefighter paramedic with the Dayton (OH) Fire Department. Burneka has also served as the Ohio director, vice president of regions, and interim president with the Firefighter Cancer Support Network.