Cancer, Up Close
A host of new initiatives focuses on the problem of firefighter cancer
BY GREGORY B. CADE
WHEN I ENTERED THE FIRE SERVICE IN THE 1960s, our knowledge of the health hazards posed by exposure to potential carcinogens was virtually nothing. Breathing apparatus was optional if it was even available. Protective equipment use was in its infancy, and decontamination was never discussed.
In 2005, a scan detected a mass in the right side of my thyroid, and I underwent surgery to have that part of my thyroid removed. Despite daily medications and regular visits to the endocrinologist, I have developed a mass on the left side of my thyroid that we’re keeping an eye on. I think there’s a better than even chance that my cancer is related to the exposures I experienced during 38 years of active firefighting.
Until recently, few comprehensive studies existed that looked at the impact of carcinogens on firefighter health. Several recent epidemiological studies have shown that firefighters are at a higher risk for numerous site-specific cancers. In 2010, the National Institute of Occupational Safety and Health launched the most comprehensive of these efforts, a multi-year study that followed 30,000 current and former career firefighters in Chicago, Philadelphia, and San Francisco. The study found “an increasing amount of epidemiological evidence linking occupational exposures from firefighting to various forms of cancer, including cancers of the brain, digestive tract, genitourinary tract, and lymphohematopoietic and respiratory systems.”
Government initiatives are underway to address the problem. A white paper by the Inter-Agency Board (IAB), aimed at manufacturers as well as codes and standards developers, contains seven recommendations highlighting numerous NFPA codes and standards. Recommendations include better adherence to NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments. The IAB also suggests that stakeholders explore improved designs for firefighter personal protective equipment (PPE) to reduce exposure to carcinogens, which could impact NFPA 1971, Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting. Stronger focus on educating firefighters, employers, and healthcare providers are also highlighted in the IAB report.
In February, a bipartisan bill, H.R.4625, was introduced in the House of Representatives that would create a voluntary firefighter cancer registry. A similar bill, S.2799, was introduced in the Senate in April. A registry would enable us to begin collecting the baseline data that would better define the problem, and would also provide more and better data that researchers could use for further study. President Obama’s “cancer moonshot” initiative, discussed during his State of the Union address, will further the effort by making government-sponsored research more readily available to the scientific community, thereby speeding the transfer of cancer information.
In June, the president signed a bill into law that will update the Toxic Substance Control Act—a list of toxic chemicals that had not been updated in 40 years. The Environmental Protection Agency will now begin a review of toxic substances with connections to cancer. A potential outcome is a reduction in the use of known carcinogenic chemicals used in household products that firefighters encounter during fires.
All of this is good news. As better data yields more research and new information, NFPA committees can revise and update the standards for PPE, health screening, and training to better protect first responders.