After a growing number of reports of firefighters being diagnosed with cancer, a variety of organizations collaborated to study this newly recognized risk. Recently, one of the largest studies of firefighter cancer risks among United States firefighters, conducted by the National Institute of Occupational Safety and Health with funding by the U.S. Fire Administration and led by the Centers for Disease Control and Prevention, showed that firefighters on average have an increased risk for certain types of cancer when compared to the general population.
Volunteer firefighters may lack some of the resources available to career firefighters, such as a second set of personal protective equipment (PPE), but there are still steps they can take to help prevent firefighter cancer risks.
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A burning structure won’t alter its behavior because the crew that shows up is volunteer, career or combination. Fire follows its own rules. That’s one reason you’ll often hear volunteers say, “we fight the same fire with the same training as our career brothers and sisters.”
And while that’s true, there are some unavoidable differences. Career fire departments generally have more time, people, and other resources, than many volunteer fire departments. Career firefighters typically have greater access to training, a broader range of firefighting equipment, and higher call volumes.
Much the same can be said about cancer. As a growing cause of firefighter deaths, cancer doesn’t care if the firefighter hails from a career or volunteer fire department. But as with fighting fire, there are some undeniable differences between volunteer and career firefighters when it comes to keeping cancer at bay. Due to the increased awareness of the threat of cancer, many different groups have come together in an attempt to establish some best practices to reduce exposures and risks for cancer. Some of the proposed actions, such as having a second set of turnout gear, and on-scene hood/glove exchanges are hard enough for career departments to fund but become even harder for many volunteer departments to afford.
One of the nation’s leading firefighter safety advocates, Chief Billy Goldfeder is an international director for the International Association of Fire Chiefs’ Safety, Health and Survival Section, and a former volunteer firefighter. He’s most known for FireFighterCloseCalls.com and its email newsletter the “Secret List.” He’s also not one to suffer fools or mince words when it comes to firefighter safety. Some firefighters may try to play the volunteer card as an excuse for not being able to take the steps to reduce their cancer risk, he says. “It’s an invalid excuse. It’s not a volunteer issue, it’s a firefighter issue.”
Despite many of these challenges, there are steps that volunteer firefighters can take to reduce their risk and don’t require a bunch of money, or even effort, for that matter. 
While research has taught us that firefighters are at an increased risk of being diagnosed with cancer, and at a younger age than the general public, we don’t yet know the specific cause or source contributing to that risk. As such, early efforts are simply aimed at limiting or reducing exposures to known and suspected carcinogens and, unfortunately, the fire service in general seems to have frequent and unavoidable contact with a wide array of these substances. So, what can you do? Here are six ways experts say you can limit your exposure risk to cancer while still serving your community as a volunteer firefighter.
1. Wear Your Gear
If you are a firefighter, this responsibility begins and ends with you. Wear all your protective gear and self-contained breathing apparatus (SCBA) on any call where toxins could be present, whether you can see them or not. This includes structure fires, vehicle fires or other fires like trash container fires. It is also just as important that you wear all your protective gear and SCBA during overhaul operations. If you are an officer, make sure everyone on scene is wearing their gear and wearing it properly. There is no excuse for not doing this; it is your first and best line of defense. As Chief Goldfeder says, “Gone are the days of excuses — there are too many firefighters tragically rotting away from cancer. All professions wear their gear — pro football, military, etc. — so stop the b.s. and wear it.”
2. Clean Your Gear
Several research studies have shown that the contaminants that get on a firefighter’s PPE at a fire don’t necessarily stay there. These microscopic, cancer-causing materials fall off and cling to other surfaces and become airborne through off-gassing. As scientists wrestle with trying to figure out how effective various cleaning processes are, most experts agree, based on what is currently known, the best practice is a two-step cleaning process.
First, it is important to conduct a Preliminary Exposure Reduction (PER) on scene after the fire. That means getting as much of the big particles off as possible. Two firefighters can easily clean one another — while still on SCBA air — with a simple dry brush followed by a wet, soapy brush and a hose down. Brushes, mild detergent, and a bucket can easily be stored on the first-due truck. And some departments have gone as far as connecting a small garden hose to the pump panel to draw warm water for this on-scene scrub down.
Second, don’t transport exposed gear inside the cab of the apparatus and, when back at the station, separate and wash the PPE immediately. Go for the clean cab approach. This should include hoods, gloves, helmets, SCBA, and any hoses or tools that were used. Gloves and hoods have been found to harbor cancer-causing particles. And while many volunteer departments cannot afford a high-end PPE washer/extractor and drying cabinet, NFPA’s Ken Willette said in a recent webinar on firefighter cancer that regular washing machines, like those used at home, are a workable solution until funds can be raised for proper cleaning equipment.
However, you should never wash your gear at home; it can leave contaminants in your home washing machine — and those contaminants can spread to your family’s clothing. Likewise, avoid taking your PPE home or in your personal vehicle. If you must carry your gear, Willette urges you to keep it in a sealed plastic bin. That will prevent much of the contaminants from traveling from your gear to your vehicle.
You can help prevent exposure to yourself or your family to cancer by practicing these simple cleaning steps.
3. Clean Your Body and Your House
Be sure to wash the clothes you wear under your PPE and shower as soon as possible after a fire. “Shower within the hour” is a reminder that dermal absorption can also be a contributor to carcinogenic exposures, so get those chemicals off your body is important. PPE was not designed for keeping contaminants off you as a firefighter, and while your turnout gear does limit contact to many substances, small particles can still get on your skin.
It is also critical to keep the firehouse clean. Diesel exhaust is a known carcinogen; exhaust removal systems are a must for every department.
If you don’t have such a system or it’s an older model, it is recommended to only run your trucks outside. Keep any offices, dayrooms, kitchens and other common gathering spaces sealed off from the apparatus bay. Not only will this help keep the diesel particles out, it will also help keep the contaminants from your PPE from reaching those rooms — yes, that means you cannot wear your turnout gear in those areas.
And don’t forget the truck. When riding back to the station after a call, all of those contaminants embedded in your PPE are now collecting in the inside of the truck. Make sure to give the interior a good scrub down after every fire.
4. See Your Doctor
Even if you’ve never been sick a day in your life, go to the doctor once a year for a full physical examination. Early detection is key to surviving cancer. If you wait until symptoms are bad enough to “warrant an appointment,” it may be too late. “No one likes going to the doctor,” Chief Goldfeder says. “But you’re a firefighter, so show some of that so-called bravery of yours and make the appointment.”
Remember to tell your doctor on each visit that you are a volunteer firefighter and have an elevated risk for cancer. The International Association of Fire Chiefs published a guide to help medical professionals better understand the inherent health risks of fighting fire.
And consider keeping a digital diary of your fires and the exposure incidents; it’s another way you can work with your primary-care doctor to track your risk factors. It will also come in handy if you are diagnosed with cancer and need to prove that it is job-related.
5. Change Your Lifestyle
If you use tobacco products, now is the time to stop. If you can’t quit on your own, find the resources to help. Being a firefighter already increases your risk of cancer; smoking or dipping further compounds that risk. If firefighting is driving down a dark road at night, smoking is cutting off the headlights; your chances of hitting something are much higher.
“A 5-foot, 5-inch firefighter weighing 350 pounds had a heart attack. How could that happen?” Chief Goldfeder asks. “A 5-foot, 5-inch firefighter weighing 350 pounds, that’s how. We are in physically exhausting work like an athlete, but in athletics there are practices, warm up, times out, etc. You do get those. So, how fit do you want the firefighters to be that may have to rescue a family member of yours? There’s your answer.”
Take a hard and honest inventory of other risk factors in your life such as unprotected sunlight exposure, diet, excessive weight and alcohol use. Regular exercise, proper sleep, and a diet low in saturated fats, simple carbohydrates (white flour products) and refined sugar and high in vegetables, fruits, and high-quality fats will make your body more resistant to several diseases, including cancer. It also will help you better fight off cancer in the event you are diagnosed. Most importantly, it will help you to be a better firefighter.
6. Preach it
Remember when you were a kid and your friends convinced you to do something foolish or ill-advised — jump off the roof or throw eggs at your neighbor’s house? Peer pressure worked then and it can work for you now. Encourage your fellow firefighters to accept the challenge when it comes to proactively taking steps to help reduce their risk of cancer.
Make cancer-prevention a priority among your fellow volunteer firefighters. Follow best practices through deed and word. That means taking care of yourself and encouraging and supporting others to do the same. Once cancer prevention practices have reached a critical mass in your department, it becomes part of your culture — those who don’t follow those practices will be the outliers and peer-pressured into getting in line with the group’s ideals.
But as Chief Goldfeder cautions, you’ve got to first walk the talk. “Make sure that if you’re going to preach it, you are setting an example. Otherwise, start at #1 above. Again. Then go to #6.” For help selecting fire PPE, including SCBA to help in your cancer prevention steps, please contact us today to learn more about our products and trainings.