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Mitigating firefighter cancer risks through lifestyle

Firefighters are exposed to harmful carcinogens on the job, but they can take steps to limit their exposure in other ways


Limiting exposure to work-related risks is critical to reducing rates of cancer among firefighters. However, limiting exposure is not enough to win the fight against cancer.


With the rising awareness of the risk of cancer among firefighters, there has been a consistent effort from fire service organizations, fire departments and firefighters themselves to reduce exposure to carcinogens on the fire ground and in the firehouse. Limiting exposure to work-related risks is critical to reducing rates of cancer among firefighters. However, limiting exposure is not enough to win the fight against cancer.

A report from Drs. Mingyang Song and Edward Giovannucci in the Journal of the American Medical Association: Oncology found that 20 to 40 percent of cancer cases, and approximately half of cancer deaths, were related to lifestyle behaviors. Given the baseline exposures firefighters face throughout their careers, managing the modifiable risk factors is even more important than it is for the general population, who do not have the added risks.

The dangers of obesity in the fire service

Obesity can more than double the risk of developing cancers such as multiple myeloma, kidney, liver, and esophageal cancers – all of which are diagnosed at high rates among firefighters. Studies show firefighters are prone to being classified as overweight and obese, likely due to a number of work-related factors such as shift work, interrupted sleep, mental strain of repeated exposure to trauma and an environment that promotes unhealthy eating habits.

In a survey conducted by FireRescue1, the most commonly-consumed foods among firefighters are:

  • Sugar-sweetened beverages
  • French fries
  • Salty snacks
  • Starches from highly processed rice and pasta

Firefighters face unpredictable schedules, which often leads to poor food choices, and a lack of time and resources to make healthy meal choices. Given the cultural norms around eating within crews, making individual changes can be challenging.

Firefighters should limit alcohol consumption

Alcohol consumption has been known to increase the risk for developing cancers such as colorectal, liver and esophageal. While moderate intake of alcohol has found to have some health benefits, consuming three to four drinks daily leads to a risk increase by as much as 50 percent. Firefighters are associated with extremely high rates of binge drinking compared to other occupational groups. Again, data suggests these high levels of intake may be related to work factors, such as stress.

Tobacco has no discernible benefits

According to the National Cancer Institute, “There is no safe level of tobacco use.” While substances such as alcohol and caffeine can have some beneficial levels of use, the same is not true for tobacco. Cigarette smoking increases risk for nearly all types of cancer. The fire service as a whole boasts a lower rate of smoking than the general population or other occupational groups. However, rates of smokeless tobacco use are unusually high. While smokeless tobacco increases risk for fewer cancers than smoking, smokeless tobacco has been linked to higher risk for mouth, esophagus and pancreatic cancer.

Good sleep maintenance is important for shift work

Shift work that requires irregular sleep is also linked to an elevated cancer risk. While emergencies will never be confined to an 9-to-5 schedule, the challenges of shift work make proper sleep management even more important.

The good news about the risks related to modifiable risk factors is that, as the name suggests, they are modifiable. With proper management, these risks can be neutralized.

In addition to improving fire round practices and limiting exposure to carcinogens, fighting the battle with cancer has to include improving health behaviors.

What can you do to mitigate cancer risks?

In an effort to develop good nutrition habits, it is important for firefighters to focus on diet quality and avoid or limit highly-processed foods. Limiting sugar intake is also key to reducing inflammation. Staying hydrated, and depending on a diet that includes a healthy amount fruits, vegetables and good fats will go a long way in warding off potential health issues.

While some levels of alcohol use are safe and even beneficial, binge drinking is dangerous and increases risks significantly. Firefighters need to be aware of how much they drink at a time, and consume a maximum of four drinks per day.

Tobacco should be avoided at all costs, in any form, as there are no benefits to the body.

Sleep management is also crucial to managing shift work and the interrupted circadian rhythms that likely increase cancer risk. Appropriate and effective use of caffeine and naps are important means to consider.

Finally, it is necessary to be aware of your risks and receive appropriate medical screening from knowledgeable providers. Five-year survival rates for most cancers are significantly correlated with stage of diagnosis, and you are your own best advocate. If you notice a change in your health, seek treatment and make sure the providers you work with are aware that you are a firefighter.

Sara Jahnke, PhD, is the director and a senior scientist with the Center for Fire, Rescue & EMS Health Research at the National Development & Research Institutes - USA. With over a decade of research experience on firefighter health, Dr. Jahnke has been the principal investigator on 10 national studies as well as dozens of studies as a co-investigator. Her work has focused on a range of health concerns, including the health of female firefighters, behavioral health, risk of injury, cancer, cardiovascular risk factors, and substance use, with funding from the Assistance to Firefighters Grant R&D Program, the National Institutes of Health and other foundations. Jahnke has more than 100 publications in the peer-reviewed medical literature. Awards include the 2019 Endowed Lecture at the annual conference of the American College of Epidemiology; the 2018 President’s Award for Excellence in Fire Service Research as well as the Excellence in Research, Safety, Health & Survival Award, both from the International Association of Fire Chiefs (IAFC); and the 2016 John Granito Award for Excellence in Firefighter Research from the International Journal of Fire Service Leadership and Management. Connect with Jahnke on LinkedIn, Twitter or via email.