Why Cancer Is a Work-Related Illness for Firefighters

Firefighter in uniform spraying water against smoke at night.

Written by the International Association of Firefighters (IAFF)

The firefighting occupation is constantly changing and so are the associated health concerns. Firefighters dying from occupational-related cancers now account for more than half of the line-of-duty deaths each year, where the number of traditional line-of-duty deaths such as structural collapse, asphyxiation, and burns- have decreased drastically. Unlike other industries or occupations, firefighting takes place in a chaotic and constantly changing environment. Many home products are now made of synthetic materials.  Additionally, furniture and its fabrics are synthetic based, instead of natural fibers, and are treated with flame retardants. The shift has changed the ways fires burn and the fire products of combustion. Fires now burn hotter and faster, and the combustion products are highly toxic. This has resulted in cancer becoming the largest health‐related issue facing the firefighting profession.

Firefighters are routinely exposed to a variety of chemical substances. The mixture of hazardous chemicals are different at every fire, but the common combustion products encountered by firefighters include but are not limited to asbestos, arsenic, benzene, polycyclic hydrocarbons (PAHs), formaldehyde, diesel fumes, polychlorinated biphenyls (PCBs) and volatile organic compounds (VOCs). In addition to those, toxic flame retardants have taken center stage, and the International Association of Fire Fighters (IAFF) has spent the past decade pushing to ban the various classes that are known to cause cancer.

The National Institute for Occupational Safety and Health (NIOSH) recently conducted a landmark study of cancer among U.S. firefighters that included data from over 30,000 career firefighters employed between 1950 and 2010. The research found that firefighters compared to the general US population had statistically significant increases in both diagnosis and death from certain cancers. This is because firefighters are exposed to toxic chemicals under firefighting conditions.  Additionally, the continuous exposure to apparatus diesel exhaust can cause health implications.

Firefighters are exposed to carcinogens during fire suppression and post-fire overhaul operations. Besides inhalation hazards, chemicals pose a significant threat to firefighter health through skin absorption, even though they wear full protective ensembles.  After the incident, they are exposed to the toxic soot that covers their turnout gear and equipment. It is the IAFF’s position that these exposures are why our members have a significantly higher incidence rate of certain types of cancer.

As a result of these findings, new decontamination efforts have been emphasized. It is not possible to extinguish a fire and not be covered in toxic soot and smoke, therefore there is a push to clean the skin before leaving the scene and to quickly shower after returning to the station.  Additionally, turnout gear is soap-brushed and rinsed (decontamination) before removing it at the scene to clean as much soot and particles off as possible. In addition to proper decontamination, it is important for firefighters to keep their Self-Containing Breathing Apparatus (SCBA) on during all phases of fire suppression, overhaul, and on-scene gross-decontamination because these toxic chemicals and particulates can remain in the air even after the fire is extinguished. The hope is that these procedures will minimize fire fighter’s exposure to potentially harmful toxins as they off-gas from the turnout gear.

As cancer becomes more recognized as an occupational disease, more states are passing presumptive laws.  This reduces the burden that firefighters must prove that their cancer was contracted on the job—something that can be impossible to track because the carcinogens firefighters are exposed to accumulate over time.

The occupation is the evidence. Unfortunately, presumptive law is not the same as federal laws, and they vary state-by-state. Some states are progressive and have presumptive laws covering multiple forms of cancer, while others are just starting the process to get one type of cancer covered. The IAFF has a database displaying presumptions in each state, and it shows the gaps between what diseases and cancers are covered in each state. Our goal is to have all states and municipalities recognize that cancer is an occupational disease, and covered under presumptive laws so these brave men and women do not have to prove their proud occupation caused their disease.