Halting firefighter cancer starts with clean PPE

The company officer sets the stage for how firefighters use and clean their PPE to protect themselves from occupational cancers

Unfortunately, too many firefighters and officers are not getting it. And "it" is that firefighters face an increased cancer risk compared with the general public.

In its 2013 whitepaper "Taking Action Against Cancer in the Fire Service," the Firefighter Cancer Support Network reported that in 2006 researchers at the University of Cincinnati published their meta-analysis of 32 studies of cancer among firefighters.

Based on their analysis, there was a significantly increased risk among firefighters for a number of cancers, including multiple myeloma, non-Hodgkin's lymphoma and prostate and testicular cancer.

The inhalation hazard is just one of the major cancer risks: the contaminants that blanket and impregnate a firefighter's turnout gear during structural firefighting and training is the other. Following the lungs, the skin is the body's second largest organ in surface area and it is highly absorptive.

Some areas of skin are more permeable than others, specifically the face, the jaw line, the groin and the neck and throat. Skin's permeability increases with temperature; for every 5-degree increase in skin temperature, absorption increases 400 percent.

Officer's role
In most fire departments, the company officer controls more departmental resources on a daily basis than any other rank of officer and is the single most influential person concerning their team's attitude, operations and willingness to change.

The company officer must lead by example and set clear expectations concerning cancer awareness, prevention, tracking of exposure and the essential operational changes necessary to minimize exposure to carcinogens and other toxins.

The company officer must accept in their own mind that leaving the scene with those contaminants on turnout gear is not good for their long-term health and the long-term health of their firefighters.

But, they don't have to figure it all out on their own.

To develop its whitepaper, the Firefighter Cancer Support Network invited a small group of experts to Indianapolis. The participants came from the legal, medical- and social-research communities, and included volunteer, combination and career chief officers, firefighters, company officers, union leaders, and local and state fire training directors. Two firefighters who are cancer survivors participated, and every workshop participant knew firefighters who currently have cancer or who died from cancer.

Here are 11 recommendations from the report that firefighters can follow to protect themselves against cancer.

1. Use SCBA from initial attack to finish of overhaul. Not wearing SCBA in both active and post-fire environments is the most dangerous voluntary activity in the fire service today.

2. Do gross decontamination of PPE while in the field to remove as much soot and particulates as possible.

3. Use disposable wet towels or baby wipes to remove as much soot as possible from head, neck, jaw, throat, underarms and hands immediately and while still on the scene.

4. Change your clothes and wash them immediately after a fire.

5. Shower thoroughly after a fire.

6. Clean your PPE, gloves, hood and helmet immediately after a fire.

7. Do not take contaminated clothes or PPE home or store it in your vehicle.

8. Decontaminate the fire apparatus' interior after fires.

9. Keep bunker gear out of living and sleeping quarters.

10. Stop using tobacco products.

11. Use sunscreen or sun block.

The importance of annual medical examinations cannot be overstated — early detection and early treatment are essential to increasing survival.

Emerging ideas
While we've begun to understand the cancer risk presented by contaminated turnout gear on scene following the incident, there are presently no standards to guide us on how to do gross decontamination of our gear on scene. It's truly anyone's guess.

"Many years ago, while I was inventing the Compressed Air Foam System, I discovered that the velocity and expansion of the foam with the surfactants would lift dirt and oily soot out of my turnout gear," Mark Cummins wrote on LinkedIn. Cummins invented CAFS and is owner of Cummins Industries Fire Control.

"CAFS was used by the U.S. Navy to decontaminate and neutralize the warfare agents and it can be used to bio-remediate most of the toxic byproducts of combustion," he wrote. "There are way too many of us being killed slowly from exposure to the stuff that is in the smoke, and CAFS can be used to clean the air and our PPE."

John A. Lewis, a chief officer with the Zion (Ill.) Fire and Rescue Department, completed an applied research project on the subject as a requirement for the Executive Fire Officer Program at the National Fire Academy.

The project, "Decreasing the Health Risks Associated with the By-Products of Combustion," provides a great starting point for any fire service organization to become informed on this firefighter health and safety issue. Lewis includes recommended SOGs that assisted his department in minimizing the risk during tactical operations and the proper cleaning and storing of firefighter turnout gear. 

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