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‘What right looks like’: How FDs across the country tackle cancer prevention

FRCE’s Fire Service Occupational Cancer Alliance spotlighted four efforts to minimize occupational cancer risks


Photo/Marc Bashoor

The Centers for Disease Control and Prevention (CDC) recognizes January as Firefighter Cancer Awareness month, while February is recognized as National Cancer Prevention Month by the American Association for Cancer Research (AACR). Firefighters should be maximizing efforts, especially during these two months, to learn more about carcinogen-reduction efforts and the presumption legislation in their area, and to register for the National Firefighter Registry (NFR) for Cancer.

To the latter point, it is critical that every single firefighter, active or retired, paid or volunteer, take time to register in the system. There’s some misinformation out there, so let’s set that record straight: The NFR is for ALL firefighters, whether they have had cancer or not. We must continue to grow strength in our research and training efforts by gathering the data that can only be provided by YOU! Please take the time now to begin the registration process.

This was one of many critical factors discussed at the recent First Responder Center for Excellence (FRCE) Fire Service Occupational Cancer Alliance meeting.

The FRCE grew as an organization out of the NFFF Tampa and Tampa 2 Summits, from which landmark efforts like the 16 Firefighter Life Safety Initiatives emerged. The FRCE mission is to “promote quality educational awareness and research to reduce physical and psychological health and wellness issues for first responders.” This Cancer Alliance is singularly focused on addressing occupational cancer among firefighters.


Participating members at the recent First Responder Center for Excellence (FRCE) Fire Service Occupational Cancer Alliance meeting.

Photo/Marc Bashoor

Setting the tone

Our meeting commenced with the passing of the leadership baton. Ed Klima had served as the FRCE managing director since the center’s inception. After Klima reviewed the FRCE’s progress over that time, Victor Stagnaro introduced FDNY Deputy Assistant Chief Frank Leeb as the incoming managing director. Leeb stewarded the rest of the meeting with a series of presentations, roundtables and Q&A opportunities.

Victor Stagnaro, CEO of the National Fallen Firefighters Foundation, set the tone with a sobering statement: “We can no longer think of cancer in the fire service as an emerging topic.” Cancer is indeed all around us.

Cancer prevention: “What right looks like”

The meeting featured four presentations on “what right looks like” in different areas of the country.

New York: Tim Graves, a fire protection specialist with the New York State Office of Fire Prevention and Control, addressed state legislation as well as the state’s effort to distribute decontamination buckets and materials to fire departments. The effort aims to use supplies commonly available at any hardware store in order to be easily replicable by all departments for all apparatus. The state provided some training and deployed the materials statewide.

This effort is like Florida’s “green bucket” program in which grant funding provided decontamination supplies for every apparatus. This was a voluntary program in that the jurisdiction or department had to request the supplies. There are many other individual programs (public and private) pushing to make decontamination easy and routine.

Missouri: Chief Mike Snider of the Lee’s Summit Fire Department addressed the “Missouri Firefighter Critical Illness Pool,” which is essentially a voluntary insurance fund to support firefighters who have been diagnosed with any of the currently covered cancers. The “pool” is applicable to all firefighters, paid or volunteer, who have a minimum of five years of active service and complete an annual physical. (Recognizing that not all volunteers may have health insurance, the definition of “annual physical” is less potentially strenuous than a typical NFPA 1582 physical.)

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There are benefits for both the employer and the individual built into the plan, with payout limits, improvements in workers’ compensation rates, a 10-day payment-after-diagnosis provision, line-of-duty presumptions, and retiree coverage for 15-years post-retirement or upon attaining the age of 70.

It should be noted that Missouri’s firefighter cancer presumption law is currently recognized by many of us as the best presumption language in the country. Having mirrored and improved upon successful Colorado cancer presumption legislation, Missouri is currently leading the way in firefighter cancer coverages.

Arizona: Captain John Gulotta of the Tucson Fire Department detailed the Fire Fighter Cancer Cohort Study that evaluated the impact of rigorous intervention efforts and decontamination procedures for Arizona firefighters. The study measured baseline chemical levels in the body against pre-intervention (pre-decon) and post-intervention (post-decon) levels. The analysis clearly shows the effectiveness of decontamination interventions – something I think we all believed or knew, at least anecdotally, but had not previously seen proof of the widespread measurement of the affects.

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The results showed significant improvement post-intervention – a state many of us did not even consider for many years. Using this data to educate firefighters, it’s important to recognize that each of the dots represents individual firefighters – a pretty sobering look at how much improvement can be made with effective decontamination efforts.

Additionally, Captain Gulotta works with the University of Arizona on a wide array of issues impacting the fire service, including PFAS exposures and lithium-ion batteries.

Florida: Safety Harbor Fire Chief Josh Stefancic addressed how the department’s “before, during and after” approach to decontamination is provider cleaner environments for their firefighters. For example, following any fire, firefighters must decon on scene, participate in on-scene rehab, use their second set of gear, and shower within the hour.

Stefancic emphasized that SHFD has not fully converted to clean cabs but is striving for cleaner cabs through regimens of regular and deep cleaning and decontamination.

Additionally, the department instituted a non-smoking policy, set requirements for regular health screenings and pre-hire screenings, guaranteed two sets of gear, created an active health and safety committee, initiated directives on regular washer/dryer versus PPE washer/dryer use, and mandated use of the exhaust capture systems. Firefighters are supported by state cancer presumption language.

Research roundtable

Our industry research partners helped meeting participants focus on both the significant progress that’s been made and on the long path still to travel. The researchers:

  • Kenny Fent, Research Industrial Hygienist – NIOSH
  • Dr. Sara Jahnke, Director/Senior Investigator – NDRI USA
  • Jeff Burgess, Director/Professor, University of Arizona
  • Bryon Ormond, Professor, N.C. State University

The team highlighted the National Firefighter Registry, the Fire Fighter Cancer Cohort Study and the success in identifying Group 1 carcinogen in the fire service. They acknowledged the struggle, and continuing need to translate the science into meaningful actions at the department level. They emphasized the need to stay in front of the science and align FRCE work with groups like Science to the Station to ensure that we’re making informed decisions about cancer prevention efforts.

Moving forward

Chief Leeb discussed breathing meaningful life into the Alliance efforts, including the establishment of multiple work groups to tackle various issues, including legislative efforts/presumptions, coordination between new science and code development, videos to highlight prevention efforts, firefighter cancer risk/vulnerability scoring, and outreach efforts to help move the needle on this essential topic.

We closed a full day with the motivation to keep pushing forward, working together to make a difference in firefighter cancers.

Chief Marc S. Bashoor joined the Lexipol team in 2018, serving as the FireRescue1 and Fire Chief executive editor and a member of the Editorial Advisory Board. With 40 years in emergency services, Chief Bashoor previously served as public safety director in Highlands County, Florida; as chief of the Prince George’s County (Maryland) Fire/EMS Department; and as emergency manager in Mineral County, West Virginia. Chief Bashoor assisted the NFPA with fire service missions in Brazil and China, and has presented at many industry conferences and trade shows. He has contributed to several industry publications. He is a National Pro-board certified Fire Officer IV, Fire Instructor III and Fire Instructor. Connect with Chief Bashoor at on Twitter, Facebook or LinkedIn. Do you have a leadership tip or incident you’d like to discuss? Send the chief an email.