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Why fire agencies should be tracking exposure to fireground contaminants

Data linking exposures to fire incidents can be critical to helping firefighters get the cancer support they need

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Keeping records of fireground exposure to toxins is important to getting firefighters the support they need should they receive a cancer diagnosis. (image/Getty)

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By Margarita Birnbaum for FireRescue1 BrandFocus

When he implemented a policy mandating cardiac tests to help firefighters prevent heart disease, Bill Gardner knew he had to walk the walk, and talk the talk. He signed up for the test, but the longtime runner was not expecting to hear bad news.

Then Fire Chief in Leander, Texas, Gardner, learned that one of his arteries was significantly blocked, and he was at high risk for a deadly heart attack dubbed the widowmaker because so few people survive it. Not unlike other firefighters facing a serious health diagnosis, Gardner didn’t want to tell his colleagues and superiors because he worried that he would have to cut back on his duties, that he wouldn’t be able to go to a fire scene or worse, that he would have to give up doing the job he loved.

But Gardner knew he had to lead by example and shared his health news.

“I was absolutely terrified,” says Gardner, who has more than three decades of experience in fire and emergency medical services. “But everything went back to normal.”

Today, Gardner, the senior fire products director for ESO, continues to drive home the message that it’s important that firefighters report and that fire departments collect information about exposure to toxic chemicals using software such as ESO.

Gardner also wants to encourage the more than 1.1 million U.S. career and volunteer firefighters and their superiors to share their health and exposure data with their employers to track the potential link between job-related exposures to carcinogens and cancer risk. Gardner says it’s also important for firefighters to share that data with state and national registries to allow scientists to examine the data.

“At the end of the day,” Gardner said, “it’s about having a preventive mindset, preventive policies. We’re not in this business to trade lives, we’re in this to save lives.”

Why agencies should track exposure

By now, the association between firefighting and cancer is fairly well known. But there are still hurdles that prevent firefighters from getting the support they need to adequately mitigate their risk of exposure to fireground byproducts that may cause cancer.

A common hurdle is time. Time is always of the essence, but it’s not worth taking an unnecessary risk for, says Gardner. While firefighters may feel pressured to rush from one fire to the next, agency leaders should provide both the time and materials for fire crews to go through recommended decontamination protocols. He recommends following protocols that include steps like spraying down turnout gear, continuing to use PPE while doffing gear and using wipes on exposed skin.

Ideally, crews would have time between calls to do a gross decon on scene, bag up dirty gear – and store it outside the cab – and have time to shower at the station. “But some days the real world doesn’t let that happen,” said Gardner.

In addition, Gardner says, it is critical that fire departments are aware that their first responders may have prolonged exposures to harmful chemicals in carrying out their routine training and maintenance duties at the station. Contact with toxic substances may not be from obvious sources, such as diesel exhaust from trucks or fumes from small motors, he said.

“You may not fight a fire every time you’re on shift based on your call volume,” Gardner said. “But you’re going to get in that truck and maybe run to the store. So, if the truck’s not cleaned, and your gear’s not cleaned, you’re still getting those exposures.”

Tracking data like what decontamination procedures were followed, what kind of fire it was and what byproducts firefighters were likely exposed to can help tie an illness or diagnosis to an exposure. This becomes important when the firefighter (or his or her family) seeks medical coverage, workers compensation or line of duty death benefits.

It’s also important for fire agency leaders to show they are taking preventative measures to protect the agency from liability and, more importantly, to protect its crews.

For starters, it leads to better protective policies and practices that help keep firefighters safe from unnecessary exposure to known and potential carcinogens when they’re at the scene of a fire and when they’re cleaning their gear and equipment at the station. Beyond helping firefighters stay in good physical health, those policies and practices will help them be in good emotional health. There’s plenty of evidence that shows chronic illnesses such as cancer are a source of great stress for both the people who suffer them and their caregivers.

To firefighters who may be hesitant to share their personal health information and job-related exposures, Gardner has a reminder that served him well when he went through his heart-related health woes.

“You’re doing it not just for you, but for your family.”

The really big picture

Gardner is among fire experts across the country who are hopeful that firefighters participate in the National Firefighter Registry, a database administered by the Centers for Disease Control and Prevention, that scientists hope will allow them to more precisely identify the link between firefighting duties and higher cancer risk among those first responders. The data collected from that registry, among others, will also allow researchers to delve into the association between job-related duties and cancer risk.

Although scientists have been studying the associations between cancer and firefighting duties for at least five decades, many of the existing studies were made between the 1940s and the 1980s, when firefighters’ duties were different from what they are today. In addition to suppressing fires, current firefighter duties include making emergency medical calls, rescues, and hazardous materials incidents. Among other shortcomings of those older studies is that they looked at small samples of firefighters over a short timeframe.

Over the last two decades, the increase in research studies that look at the relationship between cancer risk and firefighting duties was driven largely by the cancer deaths in firefighters who were exposed to toxic substances in the immediate aftermath of the September 11 terrorist attacks. There’s also been more awareness for long-term studies because the latency period of some cancers can be several decades, as is the case with malignant mesothelioma, a rare cancer associated with exposure to asbestos— and that at least one study suggests is twice as prevalent among U.S. firefighters than it is in the American population as a whole.

One of the recent long-term studies that looked at job-related cancer risk in firefighters was done by the National Institute of Occupational Health in partnership with other institutions. For that study, researchers examined more than 50 years of data collected from almost 30,000 firefighters in Chicago, Philadelphia, and San Francisco.

One of the significant findings from that landmark study was that, when compared to the general U.S. population, firefighters appeared to have a 9 percent higher risk of being diagnosed with cancer and a 14 percent higher risk cancer death. In addition, findings suggested that the first responders had higher rates of respiratory, oral, and digestive cancers compared with national rates.

Beyond examining the effect that smoke, foam, and other organic and synthetic toxic substances have on cancer risk, researchers studying firefighter health want to examine the association between cancer risk and the substances used to decontaminate protective gear, tools and even the cabs of the apparatus used to transport equipment to a fire incident. To do that, fire departments will have to step up their efforts in collecting descriptive information about firefighter duties.

Gardner urges fire leaders to collect data to make sure the current generation of firefighters are protected, as well as those who follow. “Someone taught us to be good firefighters,” he said. “For us to carry on the tradition, we need to make sure we’re collecting data that can help protect the firefighters coming in behind us.”

To learn more about why it’s important to collect data around fire byproduct exposure, register for this virtual roundtable happening February 3, 2021 at 11 am CST/12 pm EST/9 am PST, featuring Chief Gardner and Dr. Lori Moore-Merrell, President and CEO of The International Public Safety Data Institute.

Read next: How to create a culture of support around firefighter trauma