Fighting Cancer in our Nation’s Volunteer Fire Service

By Nathaniel J. Melby, Fire Chief, Town of Campbell Fire Department

Cancer. Yes, cancer. It’s not a fun topic, and it’s something that we would all just rather not think about. This is a disease that sneaks up on firefighters, and is something that none of us can really say that we fully understand. Even the forefront of medical research does not yet have a clear understanding of all of the causes, risks, and cures, as there are so many variations that exist. At this point, the best that we can offer from our fire service and medical experts is that firefighters are at an increased risk for multiple types of cancer. We know that we encounter bad stuff from time to time, but do we really know what the result of that is?  In 20 or 30 years, do we know that we won’t be impacted from this?

Let’s talk about what we do know… it’s fair for us to say that cancer is the most unrecognized and dangerous threat to the health and safety of firefighters. The increased risks for cancer that have been measured by studies, compared to the general American population include:1

  • Testicular cancer (2.02 times greater risk)
  • Multiple myeloma (1.53 times greater risk)
  • Non-Hodgkin’s lymphoma (1.51 times greater risk)
  • Skin cancer (1.39 times greater risk)
  • Prostate cancer (1.28 times greater risk)
  • Malignant melanoma (1.31 times great risk)
  • Brain cancer (1.31 times greater risk)
  • Colon cancer (1.21 times great risk)
  • Leukemia (1.14 times greater risk)
  • Breast cancer in women (preliminary study results from the San Francisco Fire Department)

Firefighters are consistently exposed to carcinogens, and even though we’re starting to understand that risks exist, we do not have a solid understanding of how large the risks are, or the root causes that will drive changes to our operational and training practices to help protect our ranks.

Let’s think about some of the things we see and do on a routine basis that we know increase our cancer risk:

  1. Dirty turnout gear.
  2. SCBA on backs, but masks not worn.
  3. Breathing diesel exhaust in contaminated fire stations and apparatus bays.
  4. Not washing gear, even when we have facilities available.
  5. Taking contaminated gear into sleeping quarters and placing it in the cabs of apparatus.
  6. Not showering immediately after fires.

Photo courtesy of Lauralee Veitch.

There are some things that we have done for a long time, like hanging our gear in the same apparatus bays where carcinogenic diesel exhaust permeates the air every time our trucks start. I remember the “blue cloud” from our old engine… using even basic ventilation principles and equipment at our fire stations could help us with this, but it’s something we never used to think about. Now we know the potential consequences, and we need to think about it to prevent the consequences.

According to a three-person panel that reports to the President of the United States on cancer risks, approximately 41 percent of Americans will be diagnosed with cancer during their lifetime. There is some good news though, because in the 1970s the five-year survival rate for cancer was only 43 percent, with dreadful treatments. Today, the five-year survival rate has improved to 67 percent, with more precise treatments. But, none of this is something that you want to go through unless you have to. Chemotherapy, radiation, and surgery, the main treatments for cancer, are life-saving measures.

In May of 2016, the National Volunteer Fire Council (NVFC) hosted a roundtable on cancer prevention and awareness in the volunteer fire service. It was an interesting discussion, but unfortunately we aren’t be able to solve all of these problems in one day. This is a big problem for all Americans, and it’s increased in the fire service just by the very nature of the work that we do.

I can almost hear it now: “C’mon Chief… enough talk. What can I DO about this?” Well, get the nasty stuff off of you and your gear before you leave the scene. Gross decontamination is a great start. Hose it off, and wash that gear when you get back. Get soot off of your head, neck, throat, jaw, underarms, and hands immediately after the fire. Take a shower. Don’t put the gear in the cab until it has been cleaned. Keep gear out of your living and sleeping areas.

With this in mind, I’d like to offer kudos to our firefighter brothers and sisters in South Milwaukee, and chief Joe Knitter for their safety leadership. Within the past few months, they have added disposable adult wipes to all of their fire trucks so that crews can do a gross decontamination at the scene. They clean up right there, and throw the wipes away on-scene. This way, the large particles of cancer causing badness can stay at the scene and not come back to contaminate the fire trucks and station. The wipes are stored in coolers, and are a best practice recommended by the Firefighter Cancer Support Network. Something to think about, something that you can DO… and a low cost compared to the risks.

The next few years will yield additional information about the risks that we all face. Right now, it’s just time and research that separates us from this knowledge. In the meantime, let’s do the things that we can, and should, to protect our personnel.

1 Firefighter Cancer Support Network (2013). Taking Action Against Cancer in the Fire Service (Version 2). August 2013.

Dr. Nathaniel J. Melby, a 20-year veteran of the fire service, is the fire chief of the Campbell Fire Department on French Island, WI. He is the president of the La Crosse County Fire Officers’ Association and the 2nd Vice President and Safety Section Chair of the Wisconsin State Fire Chiefs Association. A Wisconsin Technical College System (WTCS) Fire Service Training State Representative and a Fire Instructor for Western Technical College, he has a B.S. from the University of Wisconsin-La Crosse, an M.B.A. from the University of Wisconsin-Whitewater, and a Ph.D. from Nova Southeastern University. He is a recipient of the Chief Fire Officer designation from the Center for Public Safety Excellence and the member grade designation from the Institution of Fire Engineers. In his full-time career, he works in the energy industry as a technology executive.