How leaders dictate firefighter cancer risk

Every firefighter has to take precautions against cancer from day one, but officers lead by rules and examples

Firefighters are more likely to get cancer than the general population of this country, in some cases a lot more likely. According to a report published in August 2013, firefighters are more than twice as likely to suffer from testicular cancer, and have elevated risk for nine other forms of cancer, from lymphoma to leukemia.

In addition, firefighters have a statistically higher risk for multiple cancers than the general public.

What factors contribute to this increased risk of cancer for firefighters? While each case is different, firefighters have regular contact with substances that are known carcinogens.

These risk factors include exposure to products of combustion, diesel exhaust, and chemicals. Many of these exposures can be mitigated through the use of safety equipment and the development of good policies, but the will to change culture in this area must exist from the top down.

Days gone by
When I was a young firefighter 30 years ago, having dirty bunker gear was a badge of honor. If your bunker gear was clean, the conclusion was that you had not been fighting much real fire lately.

Those were the days when firefighters were also transitioning to the idea of wearing full protective gear for the duration of every fire. I can still remember doing mop-up on a large garage fire with several vehicles involved. I was wearing full bunkers and my air pack, but my officer was wearing uniform pants, cowboy boots, an open bunker coat, and was smoking a cigarette.

Thankfully, things have changed since then — and sadly, many of those old school firefighters did not live to enjoy a full retirement.

Now most departments have policies about what kind of protective gear must be worn on all types of calls. In addition, most fire departments provide facilities for washing turnout gear on site, and often provide back-up equipment so firefighters can clean their gear immediately at the end of an incident vs. the next day. And there are paid services that clean and repair bunker gear.

Risk still high
But even with the change in attitudes, the risk for exposure to cancer-causing materials or events is high. Consider volunteer or paid on-call firefighters, who often carry their bunker gear in their personal vehicles and may be forced to take gear home to clean it.

Dirty gear kept in a hot vehicle is more likely to off-gas and endanger not only firefighters, but their families as well.

When I first became a firefighter, there was no such thing as diesel exhaust systems for fire stations. We found the oily residue of diesel everywhere in the fire station — on our clothes in our lockers, on every surface in the living area, even on our food in the refrigerator. When exhaust systems became available and we asked for the department to purchase them, we initially got push back that those systems were too expensive and not necessary.

Again, things have changed for the better — diesel exhaust systems are the rule rather than the exception now. But are they always used properly? Are firefighters meticulous about properly hooking them up not only for station start-ups but also when returning to the station?

Officers' role
Firefighter safety, in all aspects, starts with company officers. According to the Firefighter Cancer Support Network, "the company officer is the single most influential person concerning the team's attitude, operations, and willingness to change."

If company officers do not always wear proper protective gear, it is more likely their crews won't either. If an officer is in a hurry to get back in the station, it is unlikely that priority will be given to proper use of exhaust systems. Officers set the standard as to whether bunker gear is permitted in sleeping areas. Even a company officer who makes a point of wearing sunscreen will have positive influence on coworkers.

By some accounts, firefighters who use all protective gear should be less likely to develop cancer, since statistically they fall into what researchers consider to be the "healthy worker" group — those who come to the job in better health and physical condition than those in the general public. If not for this factor, the cancer rates might be even higher.

In addition, since many cancers are slow growing, firefighters who have had toxic exposures may not be diagnosed until after retirement, and thus are not included in statistics for the profession.

Ask any firefighter — they all know someone who has had cancer. A retired firefighter friend of mine died from pancreatic cancer a couple years ago. Her husband, a firefighter with the same department, had died of brain cancer at age 39. Among their recruit class, nearly half had developed cancer within 15 years on the job.

Coincidence? Maybe. But there is no excuse not to take every precaution against this devastating disease, from the first day on the job. A proactive attitude begins with leadership by example, and this starts with the company officer.

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