Cancer in the fire service and methods to reduce risk
Cancer in the fire service is our current reality, but we are beginning to better understand firefight- ers’ increased risks and cancer’s devastating toll:
1. Cancer can be caused by things we eat, drink,
breathe, and absorb, including numerous carcinogens found in our fireground and station working
2. According to a 2013 National Institute for Occupational Safety and Health (NIOSH) study of
approximately 30,000 firefighters, firefighters have
a nine percent higher risk of being diagnosed with
cancer and a 14 percent higher risk of dying from
cancer than the general public. 1
3. According to data from the International Association of Fire Fighters (IAFF), 61 percent of the
line-of-duty deaths (LODDs) for career firefighters since 2002 have resulted from occupational
cancer. In 2016, 70 percent of the LODDs were
attributed to cancer.
4. Some fire departments are tracking even higher
cancer rates among their members. Cancer caused
67 percent of the Boston (MA) Fire Department’s
LODDs between 2002 and 2014. Between 2008 and
2010, 32 percent—nearly one third—of Miami-Dade (FL) Fire Rescue (MDFR) firefighters were
diagnosed with cancer or receiving cancer treatment.
Of the 140 MDFR members who died between July
2006 and July 2016, 56 ( 40 percent) died from cancer and 10 (seven percent) died from cardiac arrest.
We now know carcinogens make it past our personal
protective equipment (PPE) and onto our skin. In 2015,
Jeffrey Stull reported the dramatic results of a Fluorescent Aerosol Screening Test (FAST) 2 funded by the
IAFF. Photos from the test illustrated how carcinogens
get through our PPE, particularly the hood, as well as the
interfaces between jacket and pants and between pants
and boots. The results of that FAST have prompted a
number of PPE design changes as well as revised cleaning practices, both on the fire scene and afterward.
Let’s talk about some of these methods.
• Kenny Fent’s recent study3 of on-scene gross decontamination (decon) showed that using soap, water,
and a brush was approximately 85 percent effective
in removing the soot and polycyclic aromatic hydrocarbons (PAHs) on PPE after interior firefighting.
• Since 2013, the Firefighter Cancer Support Network (FCSN) has urged departments to implement gross decon on scene to reduce firefighters’
exposures. To allay concerns about the potential
for steam burns following gross decon, Palm
Beach County (FL) Fire Rescue conducted a series
of training burns. After interior firefighting, it
tested gross decon procedures and multiple reen-tries into the firefighting environment. Even after
multiple fires and multiple decons in the same
gear, no members suffered burns. 4
• Dry decon—using a brush to remove soot and
other debris while on air—is an option for crews
operating in colder temperatures where wet decon
may not be advisable.
• A number of fire departments have begun a one-
for-one hood swap after every fire.
• Many departments also provide cleansing wipes
to begin the personal decon process immediately.
Fent’s 2017 research showed cleansing wipes could
reduce PAH contamination on neck skin by a
median of 54 percent. ( 3)
• Fent’s research also showed much higher contamination on the hands than previously thought, and
some departments are considering frequent glove
• The Jacksonville (FL) Fire Department implemented
an innovative program that rotates in fresh crews to
do overhaul. At the same time, it sends its first-in
crews back to the stations for showers. Jacksonville’s
policy specifically states that all PPE, including
self-contained breathing apparatus (SCBA), shall be
Firefighter Cancer Support Network