January is firefighter cancer awareness month and to help raise awareness we have put together a Q&A.
How many firefighter line-of-duty deaths are caused by cancers each year?
According to data from the International Association of Fire Fighters (IAFF), cancer caused 66 percent of career firefighter line-of-duty deaths from 2002 to 2019. Additionally, during 2016, cancer caused 70 percent of the line-of-duty deaths for career firefighters, while heart disease accounted for 18 percent of career LODDs for the same period. However, the numbers have now started to decline; in 2023, the percentage of deaths caused by cancer was 63 percent. This trend suggests that early detection and the ongoing efforts to raise awareness are proving effective.
https://firefightercancersupport.org/resources/faq/
https://www.iaff.org/cancer-awareness-month/
What causes firefighter cancers?
Numerous amounts of studies indicate that the increased risk firefighters face of developing cancer is due to the toxic exposure of chemical compounds, such as Polycyclic Aromatic Hydrocarbons (PAHs), they face on the fire scene. This exposure can be respiratory, by inhaling soot or smoke, or dermal, through skin absorption.
What can you as a firefighter do to minimize the risk of getting a cancer diagnose?
The number one most important thing you can do to minimize the risk is to minimize your exposure to carcinogens.
- Always use PPE and SCBA when entering a fire or the aftermath of a fire.
- Always wear gloves and don’t leave any skin exposed during an operation or exercise.
- Always perform preliminary exposure reduction (gross decontamination) after an operation or exercise.
- After gross decontamination, it is crucial to bag the contaminated PPE to prevent further exposure during transport and upon arrival at the station.
- Always wash and decontaminate your PPE equipment after every operation or exercise. Use an extractor for your turnout gear and a decon washer for the SCBA, facepiece, helmet, boots, and gloves.
- Always make sure to use appropriate protective gear to minimize dermal and respiratory exposure while handling contaminated gear.
- Always make sure Not to handle and store clean and contaminated gear in the same space within the station. This is to avoid cros-contamination hence putting yourself and/or fellow firefighters at risk.
- Divide the station into contaminated and clean zones.
- Separate the zones with doors and if possible, adjust the ventilation system accordingly to create over- and under-pressure to prevent airborne particles from traveling to clean zones.
- Try to place the contaminated zone along an outside wall of the station with a separate entrance from the outside.
- Try to minimize areas and surfaces within the station where contaminated gear is being handled to minimize the spreading of toxic chemicals throughout the premises.
- Always shower after each operation or exercise. Use cold water in the beginning to make sure your skin pores are closed. This helps minimize dermal exposure.
- Decon wipes that do not contain aloe can preferably be used on the scene but should not be seen as an alternative to showering.
Is cancer considered an occupational disease for firefighters?
In July of 2022 the International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization (WHO), convened a group of 25 international experts, including 3 Invited Specialists, from 8 countries for a meeting in Lyon, France. The group thoroughly reviewed scientific literature and came to the conclusion that occupational exposure as a firefighter is to be considered as carcinogenic to humans, on the basis of sufficient evidence for cancer in humans.
However, this does not necessarily mean that all countries around the world will have cancer presumptive laws. For further information we urge you to look at you state or country to see what cover they offer.
How many US states have currently passed a cancer presumptive law covering certain, but not all, types of cancer?
Today, all 50 states, the District of Columbia, and Federal Firefighters all have some type of presumptive cancer legislation. However, a deeper dive into the specifics of these laws reveals a stunning difference in the coverage and what presumptive legislation means. For further details we urge you to look at your state’s coverage.
https://www.iaff.org/presumptive-health/#cancer
What US state was first to pass a cancer presumptive law, meaning that firefighters who contracted certain types of cancer would be presumed to have gotten it on the job?
California was the first state in the US to pass a Firefighter Cancer Presumption Law in. The death of two L.A. County firefighters from the same extremely rare form of cancer in 1979 brought home the connection between firefighting and cancer. Prompted by a CPF Convention resolution, AB 3011 was introduced to secure workers’ comp protection for firefighter cancer. AB 3011 was the nation’s first firefighter cancer presumption law.
https://www.cpf.org/advocacy/our-legislation/historic-wins
https://www.cpfnewspaper.org/cancer-presumption-marks-40th-anniversary
What is Gross Decontamination (Preliminary Exposure Reduction)?
Gross decontamination or preliminary exposure reduction (PER) refers to the immediate removal of visible contaminants from the body and PPE and includes actions such as brushing off loose debris, removing contaminated clothing and wiping down exposed skin. This can be done by either dry or wet mitigation techniques. While both techniques are acceptable according to the 2020 edition of NFPA 1851, wet mitigation techniques should be the preferred method when possible. This is due to studies that have been conducted verifying that between 80–85% of contaminants are removed during wet PER.
How to Secure Contaminated Personal Protective Equipment (PPE)?
After undergoing gross decontamination, it is essential to securely package the contaminated PPE to prevent additional exposure during transportation and upon reaching the station. Utilize sealable, impermeable bags specifically crafted for this purpose. Following NFPA 1851 recommendations, it is advised to use bags with a minimum thickness of 2 mm for containing soiled PPE. The use of properly labeled bags guarantees the careful handling of contaminated gear, reducing the risk to others and curbing the spread of contaminants.
Once the PPE is enclosed in the bag, whenever feasible, transport it to an exterior compartment. Upon arrival back at the station, the PPE should undergo advanced cleaning procedures at the earliest opportunity.
https://www.nfpa.org/codes-and-standards/1/8/5/1851?l=276
How can one lower the risk of cancer during off-duty hours and in personal life?
Even when making concerted efforts to avoid carcinogens in the workplace, what about during leisure time, vacations, and holidays? How can we safeguard against cancer risks in our day-to-day lives?
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Steer clear of alcohol, as studies indicate that its consumption elevates the risk of specific types of cancer. Alcohol is classified by IARC as a group of carcinogens.
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Be mindful of tobacco, including cigars and smokeless tobacco.
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Guard against sunlight exposure, whether from natural sunlight, sunlamps, tanning booths, or other sources of UV radiation that can harm the skin and lead to skin cancer. Employ sunscreen or sunblock, minimize skin exposure to UV radiation, wear protective clothing, and prioritize regular screenings for early detection.
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Combat obesity and overweight, recognizing their overarching association with cancer risk. A poor diet devoid of essential nutrients increases the risk of inflammation in the body, providing a conducive environment for cancer cell growth and spread. Avoiding red and processed meats, sugar-sweetened beverages, highly processed foods, refined grain products, and alcohol is advised.
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Embrace exercise and an active lifestyle to bolster the immune system, minimize inflammation, and maintain the health of blood vessels and organs. Adults should aim for 150-300 minutes of moderate-intensity physical activity weekly, with exceeding 300 minutes considered optimal. Limit sedentary activities and plan exercise routines to ensure consistency. For more information on staying active, visit: https://www.iaff.org/peer-fitness/
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Prioritize sleep, acknowledging that WHO classifies shift work as a probable carcinogen. Many firefighters experience disrupted sleep on and off the job. Consistent sleep schedules, going to bed at the same time daily (including weekends), setting a bedtime for 7-8 hours of sleep, and creating a conducive sleep environment are essential. Avoid screen time and heavy meals close to bedtime, and limit caffeine and alcohol intake before sleep.
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Manage stress, recognizing its potential harm and contribution to cancer. Chronic stress weakens the immune system, increases the risk of heart disease, and leads to sleep difficulties. Identify sources of stress, work on removing them, and develop coping strategies.
How can I provide support to someone facing a cancer diagnosis?
- Discussing it may be challenging, but your presence is crucial to demonstrate solidarity and remind them they're not alone in this journey.
- Respect their wish for privacy and refrain from pushing discussions if they're not comfortable. However, assure them you're available if they want to talk.
- Listen actively, maintain a positive outlook, and foster a winning mindset against cancer.
- Offer assistance, whether it's accompanying them to appointments or providing transportation.
- Always respect their boundaries and understand that a 'no' means no.
- Encourage them to keep important documents and scans for potential further opinions.
- Small gestures of encouragement matter greatly in their pursuit of good health.
Don't let them bear the burden alone; be a supportive presence throughout their journey.
https://www.iaff.org/cancer-awareness-month/#week-4-survivorship-prevention
What does the Firefighter Cancer Support Network do?
It aids firefighters, EMS providers, and their immediate families facing a cancer diagnosis by offering direct support, training, and guidance from one badge to another. The FCSN, established in 2005, was founded to assist firefighters and their families dealing with cancer. Their FCSN Toolbox includes resources to navigate the journey from diagnosis to remission. Providing "Badge to Badge support" through mentorship, the network offers a Survivor Guidebook and educational materials for cancer prevention and awareness. Remember, no one fights alone. If you or someone you know in the fire service is dealing with a cancer diagnosis, reach out to them promptly.
https://firefightercancersupport.org/
What is International Association of fire fighters (IAFF)?
IAFF has been instrumental in driving nearly every advancement in the fire and emergency services during the 21st century.
Headquartered in Washington, D.C., and Ottawa, Ontario, the IAFF serves as the representative body for over 343,000 full-time professional firefighters and paramedics across more than 3,500 affiliates. IAFF members play a crucial role in safeguarding over 85 percent of the population in communities spanning the United States and Canada.
https://www.iaff.org/about-us/
