Firefighters are exposed to a plethora of dangerous chemicals in the course of their careers, and as a result are more likely to be diagnosed with cancer than the average public.
“Our chance of developing different types of cancer is significantly higher than the general public. We are 2 times more likely to get testicular cancer than a non-firefighter,” said Marshfield Fire & Rescue Chief Scott Owen. “When there is a fire, smoke that is created contains several different types of cancer causing chemicals (such as formaldehyde, hydrogen cyanide, acrolein, and others).”
Deputy Chief Jody Clements has been with Marshfield Fire & Rescue for almost 25 years and during his career has witnessed an increased awareness for cancer prevention and firefighter safety. As current chair for the department’s Safety Committee, he is actively researching ways to improve the health and safety of MFRD members.
CANCER RATES FLUCTUATE BY DECADE
Early in his career, Clements attended educational conferences that suggested the use of an SCBA (self contained breathing apparatus) could improve firefighter health. Using an SCBA helps prevent a firefighter from inhaling carcinogens.
“When I first started on some calls, there were older firefighters that would make fun of you for using an SCBA,” he said.
After implementing SCBA’s, life expectancy of firefighters improved for a time period before declining again in the 1980’s.
“It took a dip again and people didn’t understand why that was,” said Clements. “They realized that it wasn’t only the inhalation – it was the absorption exposure. Early on, there was no situational awareness to know that the carcinogens in the smoke were being absorbed into the body.”
Though SCBA’s do make a difference, there are more carcinogens in the air than ever before. Formerly, many items in the home were made from organic materials and fibers such as cotton and wood. Today, the majority of household materials are made from synthetics like plastic.
“If you go into your home now and try to point at something that has natural materials, it will be hard to find anything,” said Clements. “Companies started to put fire retardant chemicals on things, which sounds like it would be good because we don’t want things to burn up, but now the chemical that’s in the fire retardant is a carcinogen. When burned, that carcinogen gets absorbed into the skin.”
Not only do synthetic fibers burn quicker and hotter, when they burn they release harmful chemicals into the air that are then inhaled and absorbed by firefighters. As a result, cancer rates have spiked again.
“This is an issue and we need to do something,” said Clements. “Here in Marshfield we are understanding more and more about it, more and more about what we can do.”
TAKING PRECAUTIONS AGAINST CANCER
The first precaution Marshfield Firefighters utilize is fire hoods.
“We made a policy that every single person on the scene of a fire will have their hood washed after a fire,” said Clements. “What happens often with firefighters is the ‘I was just in for a minute’ excuse, and they don’t wash it.”
The next important element is the washing process.
“We’ve invested into an extractor, which is a fancy word for clothes washer. It’s a big industrial one,” said Clements. “Why that’s important is after firefighters get done with a fire, as soon as they can, we have them wash their gear. That involves a special process.”
Along with fire hood decontamination is the improved access to oxygen. In the early days of SCBA’s, oxygen was a precious commodity for firefighters. Now, tanks are more readily available and firefighters are able to utilize as much oxygen as they want – even if they are not inside the fire itself. This further prevents carcinogens from entering the lungs.
“We have a compressor, which means that right now I can tell everyone to breathe all the air they want,” said Clements. “I tell them: when in doubt, wear it. In today’s fire service, that might sound foreign. Today’s firefighters might not understand how 25 years ago, air was not wasted. Now it’s not a big deal.”
In addition to clean, endless oxygen to breathe, each Marshfield Fire and Rescue engine is now equipped with disinfectant wipes. Early studies indicate that necks and wrists are absorption areas, so each firefighter leaving a fire scene is encouraged to wipe these areas to remove any potentially harmful chemicals from the skin.
Not only are the firefighters better equipped for cancer protection, the fire station itself is designed to be safer with the office area and upstairs sleeping quarters completely separate from the apparatus bay.
“Where your gear is stored and where the apparatus is, is where the carcinogens are,” said Clements. “Fire gear used to be stored next to the firefighter’s bed. Now, nothing dirty is allowed in those areas to prevent contamination.”
There is also a de-con area that all firefighters utilize after a fire, and MFRD is looking to improve that process in the future.
“One thing that we have not done that we are looking into is hosing down and having the firefighter do decon before they leave the fire scene,” said Clements. “There are plusses and minuses with that.”
THE COST OF CANCER PREVENTION
Another method MFRD is exploring to potentially improve firefighter health and cancer prevention, is investing in a small two-person sauna at the department that would allow those returning from a fire scene to detox through a multi-step cleansing process.
“One of the ideas out there is that after a fire, you come back and go into the sauna. You shower, then ride a bike for 10 minutes to work up a sweat, which sweats the toxins out of your pores,” said Fire and Rescue Chief Scott Owen. “The theory is that after you shower for the first time, you’re clean, when actually you’re not. Those chemicals are still in you.”
Owen referenced several cases where firefighters have showered, biked, and then taken a white towel to wipe off. After the second shower, their towels are black after wiping due to the chemical residue they’ve been able to sweat from their bodies.
At a cost of $5,000-$10,000 for a two-person sauna, Owen is hoping that more studies continue to prove the efficacy of this cleansing method.
“It’s such a new trend right now. It hasn’t been thoroughly studied,” he said. “It should work in theory, but it’s just a matter of working through it.”
“It just makes sense that if somebody is absorbing things into their system and they can come back, get a sweat going ,and purge those carcinogens, it’s just common sense thing to do and it’s worth it,” added Clements.
Clements added that it is difficult to conduct studies on this method due to the multiple variables and the lack of test subjects.
Furthermore, the department is looking into gear that has an outer shell and an inner shell that can be swapped as needed, but some methods are cost-prohibitive.
For example, particulate hoods are designed to filter more carcinogens from the air, but at $150 per hood – compared to a $25-30 regular hood – MFRD has opted to provide each firefighter a set of two regular hoods and launder them each time.
Other departments in the state are also taking advantage of new technology to protect firefighters from absorbing chemicals while on-scene. South Milwaukee Fire Department recently implemented filtering hoods, which are more than twice the cost of a normal fire hood, but help to filter out toxins before they can be absorbed in a firefighter’s skin.
“We recently purchased these protective hoods for every firefighter,” said Owen. “They are more expensive, but the safety of the firefighters is worth it.”
Currently, Marshfield Fire and Rescue crews have two regular fire hoods. One stays in a ziploc bag at the station, while the other is their day-to-day hood. After a fire, all hoods are collected and washed, at which point the reserve hood is taken out of the bag in case another fire happens before the first one can be cleaned and dried. Once the first hood is dry, the bagged hood returns to the bag.
Though having two hoods is a start, ideally each member of the fire department would have two sets of gear – similar to how a police officer has two guns.
“Unfortunately, everyone has only one set of gear,” said Owen. “Many departments have two. They come back, put the gear in the washer, and use the spare. We don’t have that. Gear is expensive.”
In Marshfield, firefighters come back from a fire scene, spray their gear, and when their shift is completed they begin to wash them, thus returning to clean gear on their next shift. Only two sets of gear can be washed at one time. Gear is then air-dried.
If there were to be another fire during the same shift (before the sprayed-down gear can be washed and dried), firefighters have to respond to that fire scene with wet fire gear – which is heavy and dangerous.
“You’re basically being steamed in that case,” said Owen, comparing the scenario to using a wet oven mitt. “It’s dangerous, but we have no alternative.”
Though limited by budget restraints, Marshfield Fire & Rescue will continue to research and implement life-saving technology for its staff.
CHANGING THE FIREFIGHTING CULTURE
Perhaps the biggest undertaking for fire and rescue departments striving to improve cancer prevention methods is changing the culture of the profession, and MFRD is making strides in that area.
“When I first started, you saw the guy with the dirtiest gear and most smoked up helmet and assumed he has the most experience,” said Clements. “Now the attitude is, if your gear is dirty, you’re the person we should not be emulating. That’s not the way you should look if you want to be a leader. Now, having clean gear is an example of being a good firefighter.”
“In many different cancers, we’re looking at 1.5x to 2x more likely for firefighters to get them. For our brother firefighters, testicular cancer is 2x greater,” said Clements. “It’s something that is on our mind and that we can improve on. We know that the conditions inside of a fire are going to get more dangerous all the time because we don’t expect society to be going back to natural fibers. It’s not going to happen. What we have to do is improve better on what we use and how we use and the attitudes of everyone that does it.”
With studies showing that firefighters are up to two times more likely to be diagnosed with certain cancers, it’s something that Clements and others at the department are aware of and actively seeking to prevent.
“It’s something that is on our mind. My father was a volunteer firefighter and he died of cancer. My mom also died of cancer,” said Clements. “Cancer is something that has affected me personally and something I’m passionate about preventing.”
“We know the conditions inside of a fire are going to get more dangerous all the time, but our procedures are doing our best to limit exposure,” he added. “We are acknowledging that cancer is an issue and we’re trying to prevent it through improved policies and equipment. It’s the absorption that we need to continue to be diligent on and approve upon. We are doing better all the time.”
Every year, each firefighter in Marshfield either has a physical or has their medical records reviewed. Unfortunately, there isn’t a standard screening for many cancers, but firefighters are encouraged to be aware of common symptoms and undergo tests like prostate screenings and mammograms.
THE FUTURE OF FIREFIGHTING
Clements compares the issue of firefighter cancer to concussions in football, a sport which he coaches.
“As coaches, we’ve changed how we’re coaching with the recent studies on concussions. As a father, looking at all the statistics on concussions, if we were playing football the way we did when I played football, I don’t know if I’d let my son play. But, we’ve changed the game. Will you never get a concussion? Maybe not. But the sport is safer than it’s ever been.”
Clements added that knowledge and research has come a long way, and he doesn’t blame anyone for the challenges of the past, but is thankful that they are making strides towards a safer profession.
“If we were doing the same things we did when I first started, I would not even think of my son or daughter getting into the fire service, but we are getting better. We are acknowledging it. We are trying to prevent it. And we are looking into greater causes to try and take care of it. If my son or daughter wanted to be a firefighter, I would 100% support them.”
“Understanding that there is an issue is the first step,” he added. “It’s all of our responsibility, but things come from the top down and the bottom up. Every fire chief’s job, every firefighter’s job is not only to do the things to try to make you go home at the end of your shift but also enjoy a long, long life.”