The Big “C” is Something No One Wants: Ground-breaking NIOSH Firefighter Cancer Study
August 1, 2017
By Nathaniel J. Melby, Fire Chief, Town of Campbell Fire Department; and Joseph W. Pfaff, Fire Chief, Stoddard-Bergen Fire Department
As chief officers, we all recognize that firefighting is a high-risk occupation. We have a front-row seat into the risks of the profession, and gain impressions about these risks as our careers progress. Through training and education, we teach the next generation of firefighters to lessen their own risk by performing new or modified behaviors. There have been many efforts in our service to reduce line-of-duty deaths (LODDs) and understand near misses. But, we know so much less about the long-term, chronic illnesses that could befall firefighters as a result of their activities over many years. We know that we are exposed to carcinogens, the things that can cause cancers, and that they are bad for us, but our knowledge of the severity of these exposures is very limited.
At the end of January 2015, NIOSH released a new report about a study of firefighter cancer. This report studied over 20,000 firefighters, and included data from over 1,300 cancer-related deaths and 2,600 incidences of cancer. This is the largest study ever conducted for the purpose of firefighter health research.
The text of the report itself is highly technical, using many statistics and research methods to make a solid, rigorous study of this topic. If you’d like to review it, it is located on the NIOSH web page: athttp://www.cdc.gov/niosh/firefighters/pdfs/Daniels-et-al-%282015%29.pdf
Without getting into all of those details, this report serves as a milestone in the fire service’s understanding of firefighter cancer. In addition, it was large enough and structured well enough to provide statistical data and results that are meaningful for us to draw conclusions. Although we all know that the types of substances and atmospheres we can be exposed to as firefighters are terrible and dangerous for us, and that we could probably get cancer from those exposures, this study actually proves that a link does exist… and with statistics to support it.
An interesting thing to note about the approach used by NIOSH is that researchers tapped into department records to identify potentials for exposure based on the roles assigned to firefighters on calls and information about the fire runs themselves. For example, the first-due engine company is exposed to more smoke than the rescue company that may arrive a few minutes later. This effort is the very first study to tie the length of a fire call to cancer risk. Think about it… if we’re exposed to the “bad stuff” longer on a call, it makes sense that we’re more likely to have problems later.
A key finding of this ground-breaking research is a new awareness of the connections between lung cancer and leukemia deaths and firefighting exposures. While this may not sound like a surprise to those of us that have been around our service for some time, having real research to prove this connection will be a foundation for helping prevent these issues in the future. Another observation in the study was that crews of aerial devices, or truck companies, had a higher probability of lung cancer. Considering the photos in fire service publications of ladders surrounded by smoke, or truck companies venting roofs, this makes sense. In addition, the results of the study suggest that medical screenings can help increase survival in the case of other types of cancer, such as colorectal and prostate cancers.
Most of the studies that have previously existed about firefighters and cancer risk involved small groups of firefighters and specialized risk evaluations. For example, one study reviewed nine firefighters to see if any of them contracted melanoma in four years. In the statistical world, this means that it’s hard to make general predictions about our nationwide fire service that are reliable from their efforts. Even though many previous studies were very limited, consistent findings of increased brain, digestive, and a variety of other cancers that are difficult to spell, pronounce, and that none of us would ever want were prevalent enough in the results to be scary.
In this new study, firefighters from 1950 through 2009 were studied from the fire departments in Chicago, Philadelphia, and San Francisco. We can thank our brothers and sisters in these departments for maintaining high-quality historical data for such a long period. By analyzing large departments like these, we can all benefit from the results of their efforts. If you’ve ever questioned the value of your efforts in detailed record keeping in your department, this is a great example of how valuable it can be.
Though it is very exciting to see this groundbreaking research taking place, we still have much to learn about the way that cancer affects our firefighters decades after their service. The statistics are just now starting to prove what we’ve already known for a long time, and what we’re now teaching our firefighters to protect themselves from in training. It is in our control to prevent these kinds of issues from ever occurring. Take care of yourself and your personnel by setting the example. Don’t breathe that nasty stuff, don’t let them breathe it, and keep your gear clean and inspected. These are simple things that we can do to avoid being a statistic in a NIOSH study during the next 40 years. Your children and grandchildren may even thank you for it.
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.
Chief Joseph W. Pfaff is the fire Chief of the Stoddard-Bergen Fire Department in Wisconsin. He is a fire instructor at Western Technical College and has worked for a private ambulance service for 10 years as an NREMT-B and NREMT-I. He has served on several fire service boards and committees, is currently the treasurer for the Wisconsin State Fire Chiefs Association, and is a member of the organization’s safety section. In his full-time career, he is an IT director for Gillette Pepsi-Cola of La Crosse, WI.