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Trending in 2018 and Beyond: Firefighters and Cancer

As firefighters learn more about increased risk for cancer, they should protect themselves in case of a future cancer diagnosis by documenting exposure


It’s on you as the individual firefighter or officer to document your exposures – every single one – that you can document from the past and from here on out in your career.



We know firefighters are developing cancer at higher rates than the general public. But we also know that we’ve only begun paying closer attention to the issue of firefighters and cancer in the past 10 years or so. We’ve just seen the tip of the iceberg.

Ten years is probably being generous. When I retired as a battalion chief in December 2007, cancer in firefighters was barely on the radar screen of firefighter health and safety issues. Gross decon following a structure fire? Cleaning your gear after every structure fire? Getting an annual physical with cancer screenings? These were not hot topics in the mid-2000s.

We’re paying more attention to firefighter cancer

We’re getting informed and educated about the hazards presented when modern buildings, their furnishings and their contents burn. We’re adopting new SOGs and using newer technologies to reduce these risks.

But, like the tsunami that’s been triggered by an undersea earthquake, we have no idea when or where we’re going to begin seeing the number of firefighters developing cancers skyrocket.

Why documenting exposures is important

In an article on using using software to implement and manage your fire department’s health and wellness program, I wrote that a fire department’s wellness and fitness initiative should have three goals:

  1. Improve the quality of life for safety personnel.
  2. Create a working environment conducive to maintaining healthy and physically fit firefighters.
  3. Reduce worker’s compensation costs and lost workdays.

In addition to those three, I believe we should add a fourth goal:

  1. Create an employee or member health and wellness record that can withstand the scrutiny of insurance companies, and state and local governments (particularly when it comes to a cancer diagnosis and the resultant treatment, and making the necessary case that the cancer is job-related).

Why is documentation important? Surely, more scrutiny will come as more firefighters seek to claim coverage for cancer treatments under firefighter cancer presumption laws. Today, 33 states in the U.S. and every Canadian province have some version of firefighter cancer presumption legislation on the books.

More recently, President Donald Trump just signed into federal law the Firefighter Cancer Registry Act of 2018 (H.R. 931). With this decisive action, the federal government has taken the first steps towards establishing a one-of-a-kind national cancer registry specifically for firefighters.

The laws are not enough

As the documented incidences of firefighter cancer grow and are more widely recognized, those entities responsible for reviewing these claims – local governments, Worker’s Compensation boards, and insurance companies – will be doing so with an eye toward denying claims based on lack of enough individual case data.

Don’t think so? In the 1990s in Virginia (where I served as a firefighter for 26 years), when some of the first cases seeking coverage under Virginia’s Heart and Lung Bill (which presumed that heart and lung disease relates to service as a firefighter) came before the state’s Worker’s Compensation Board, many were initially denied. Only after proceeding with litigation did a number of those cases get resolved in favor of the firefighter.

Fast forward to today and here’s a recent post from “City sues cancer-stricken firefighter to avoid paying insurance claims.” I strongly urge you to read this piece as it is chilling in its implications. First, because it gives credence to my Goal No. 4 above, and second, because of its potential to set a disturbing legal precedent if the city prevails in its lawsuit.

What should you be doing to protect yourself from firefighter cancer?

Are you doing these things to protect yourself from firefighter cancer, in addition to wearing your PPE and reducing your risk for exposure:

  1. Get an annual health assessment that includes appropriate cancer screenings. Make sure that you and your physician both know what should be included in that health assessment by sharing this free document, A Healthcare Provider’s Guide to Firefighter Physicals, from FSTAR.
  2. Record all your on-duty exposures. Go back through station records and run reports for past calls where you were present and record that information.
  3. Stay current with the latest information on firefighter cancer, prevention and treatment as it becomes available.

Act now to create or utilize an exposure documentation log

It’s on you as the individual firefighter or officer to document your exposures – every single one – that you can document from the past and from here on out in your career. It can be years before you develop cancer, more than likely after you’ve completed your career in the fire service.

It’s already becoming apparent to me that it’s not going to be “good enough” to just say you’ve been a firefighter, now you have cancer, and that the two are connected. You’re going to have to have detailed documentation.

Does your fire department have a system for documenting your exposures (all exposures, emergency scene and live fire training exercises)? If so, great. But it’s only great if you use it! And when you retire from active duty, get a hard-copy record – and if possible, an electronic copy – for all your exposures.

If your department does not have a system, start your own today. Use a notebook or electronic spreadsheet to document every exposure with:

  • Date and time of incident or training exercise
  • Location of incident or training exercise
  • Length of your time in the hazard area
  • What was burning (e.g., dumpster contents, wood-frame single-family dwelling, overturned over-the-road fuel oil tank truck, etc.)
  • Protective clothing and equipment you were wearing and using in the hazard area
  • Name of the incident commander or person in charge of the training exercise

If possible, go back through station logs and past incident reports to collect this information as far back as possible. Nobody else is going to do this for you! It’s on you.

And remember this. You’re not just doing this for you, you’re doing it for your family, too. Because they may be the ones fighting for your cancer treatment coverage or line-of-duty death benefits.

Additional resources on firefighter cancer

Learn more about firefighter cancer and treatment coverage with these resources:

Battalion Chief Robert Avsec (ret.) served with the Chesterfield (Virginia) Fire & EMS Department for 26 years. He was an instructor for fire, EMS and hazardous materials courses at the local, state and federal levels, which included more than 10 years with the National Fire Academy. Chief Avsec earned his bachelor’s degree from the University of Cincinnati and his master’s degree in executive fire service leadership from Grand Canyon University. He is a 2001 graduate of the National Fire Academy’s EFO Program. Beyond his writing for and, Avsec authors the blog Talking “Shop” 4 Fire & EMS and has published his first book, “Successful Transformational Change in a Fire and EMS Department: How a Focused Team Created a Revenue Recovery Program in Six Months – From Scratch.” Connect with Avsec on LinkedIn or via email.