For firefighters across the country, there is a growing realization that a major danger they face lies not just in the flames they battle, but in the fumes they breathe and the toxic soot they touch.
“I can’t think of a fire department or firefighter who doesn’t know someone who’s gone through battling cancer or been touched by cancer or sadly had a death too close to home,” said Massachusetts State Fire Marshal Peter Ostroskey. “We’re really trying to sound the alarm on this and make sure people are conscious of this.”
In Massachusetts, the issue of cancer rates for firefighters resurfaced earlier this fall, when Arlington Deputy Fire Chief Stephen Porciello and Watertown Fire Chief Mario Orangio died within a month of each other due to cancers likely related to their work.
“Chief Orangio died of occupational cancer which is a big issue with firefighters today,” Robert Quinn, Watertown’s provisional fire chief, told Wicked Local in November. “There’s more and more firefighters developing cancer because of their work because of the different types of synthetics and plastics that are involved in the construction of homes and furniture that absorbs into your skin. We’re working around diesel fumes all day. In our fire stations, we have stuff to try to protect us from the fumes but nothing’s 100 percent.”
According to Needham’s Fire Chief John Condon, over the course of his 32 years on the force he knew at least 30 firefighters who were diagnosed with cancer.
“We’re making progress as we learn more about it,” Condon said. “I think the way to look at it is there is better awareness about it now, which is great for preventing future cases.”
Condon said that the attitude towards having dirtier gear has changed drastically over the years that he has been with the department.
“Traditionally in the fire service, the dirtier your gear was the better the firefighter you were seen as. But that view is changing very rapidly,” Condon said.
NFD currently has washing and drying facilities at station one in downtown Needham to clean their gear, and in July they applied for extra funds from the town to pay for second sets of gear.
An increased cancer risk
According to the International Association of Firefighters, 61 percent of line-of-duty deaths from 2002-16 were cancer related. That equates to 1,053 firefighters who died over that span. The IAFF obtained those figures from reports from local unions, meaning the true total may be higher. There is no definitive registry of occupational cancer cases for firefighters.
In one of the most extensive studies on the topic, the National Institute for Occupational Safety and Health examined nearly 60 years of data for approximately 30,000 career firefighters in Chicago, Philadelphia and New York. The research, which was released in 2015, found firefighters in the study were 9 percent more likely than the general public to develop cancer, and 14 percent more likely to die from cancer.
The risk is significantly elevated for certain types of cancer. Firefighters, for example, are two times more likely to develop testicular cancer or mesothelioma, and 1.5 times more likely to develop multiple myeloma or non-Hodgkins lymphoma, according to the NIOSH study.
Emily Sparer, a research fellow at Dana Farber and the Harvard School of Public Health, said it’s not always straightforward to definitively link specific cancer cases to occupational hazards.
“For some diseases such as cancer, it’s hard to say that because this person worked in this job, they developed cancer,” she said.
But the evidence linking increased cancer rates to occupational conditions for firefighters is strong enough that nearly two-dozen states – including Massachusetts – have laws stating cancer in firefighters is presumed to be related to occupational risks unless proven otherwise. In Massachusetts, that means firefighters who don’t use tobacco products are generally eligible for worker’s compensation benefits to cover cancer diagnoses that are made while employed or within five years of retirement.
Sparer also said it’s hard to definitively say a firefighter is at X percent greater risk for developing cancer, because safety practices, conditions, building materials and exposure levels may vary significantly across different regions of the country.
Exposure to toxins
At the scene of a fire, firefighters are often exposed to fumes and debris containing several known and suspected carcinogens, including benzene, asbestos, arsenic, formaldehyde, polycyclic aromatic hydrocarbons and butadiene. Such chemicals may be found in treated wood, upholstery, interior finishes and plastics.
In addition to inhaling toxins in smoke, firefighters can also absorb them through their skin, according to a study the University of Ottawa released earlier this year.
Sparer is currently researching the effects these exposures can have on conditions in fire stations in Boston. The scope of the research includes studying chronic low-level exposures to diesel fumes from idling fire trucks and contaminants firefighters bring back to the station on their clothes and equipment.
“I worked on a project looking at the air quality in stations and gear washing practices,” she said. “Washing machines in Boston stations is a relatively new thing. For years, firefighters weren’t washing their clothing.”
The State Fire Marshal’s Office has recently worked to train departments on best practices, such as installing industrial washing machines and educating firefighters about the importance of wearing their protective equipment.
“Recently, we’ve been doing things like making sure firefighters get some immediate decontamination underway on the fireground,” Ostroskey said. “They may use Wet-Naps to wipe down exposed parts of the body. They may make sure to have their gear cleaned after fires. We’re promoting showering immediately after a fire so that exposure is limited. Those are some significant changes.”
Additionally, some departments provide firefighters with a second set of protective gear to wear while the first set is being cleaned.
“Every time you put on dirty turnout gear, you’re getting exposed again,” Ostroskey said.
In recent years, chemicals in fire-retardant upholstery and children’s clothing have also come under increased scrutiny. The Massachusetts Coalition for Occupational Safety and Health is working with the Alliance for a Healthy Tomorrow to advocate for legislation to phase out the use of certain flame-retardants in residential furniture and clothing.
Tolle Graham, the labor and environment coordinator for MassCOSH, said there is a concern that flame-retardant chemicals could cause adverse health effects for the general public as well as firefighters. A 2008 Environmental Working Group study found traces of polybrominated diphenyl ethers in children’s blood at higher concentrations than in adults.
“This is a family and community health issue as well,” Graham said.
For firefighters, occupational cancer is a topic that has been increasingly discussed in recent years as more data becomes available, Ostroskey said. Years ago, firefighters may have searched for hot spots in the smoldering ruins of a structure without giving much thought to taking off their protective gear. Now, he said, there’s a strong and growing interest in personal safety precautions.
“There’s been some significant cultural changes,” he said.