Live to and through your retirement
By Jim Burneka Jr.
There are a multitude of occupational cancer exposure risks that firefighters face throughout their career. To give firefighters their best chance of having a healthy career and enjoying their retirement, it is paramount they do everything possible to reduce their exposures to carcinogens while on the job.
Firefighter exposures to carcinogens aren’t just limited to the fireground. There are a considerable number of chemicals and carcinogens that firefighters get exposed to on a routine basis while in the firehouse or through their apparatus.
Following are best practices for reducing the risk of occupational cancer for non-fireground issues. Some of these items may be logistically difficult or expensive to implement, so I recommend that each department create a cancer prevention committee to develop a plan to implement these items.
Storage: According to NFPA 18511, fire gear should be stored in a ventilated room. The gear should be dry, hung, and kept away from UV light and diesel exhaust.
Not all firehouses are equipped with fire gear rooms, but with planning and work, most stations can create a fire gear room. For example, this fire station had all its fire gear hung in the apparatus bay.
Fortunately, there was a supply closet connected to the apparatus bay.
The department was able to move the contents of the supply closet and transfer the fire gear into the closet.
If a firehouse doesn’t have the capability to create a fire gear room, another viable option is to place covers over the gear lockers in the apparatus bay. This will help limit the amount of diesel exhaust on the gear as well as avoid exposure to UV light.
No PPE allowed in living quarters: Fire gear should not be allowed in any of the firehouse’s living quarters or office areas. Fire gear should only be allowed in the fire gear room and the apparatus bay at the station while working. Consider hanging signs on all doors leading into living quarters to serve as a reminder.
PPE washing: Fire gear should be washed as soon as possible after a fire in a gear extractor. The liners and hoods should be washed separately from the outer shells and gloves to reduce cross contamination.
Exhaust systems: There are multiple types of exhaust systems integrated throughout all fire stations. Departments should ensure that their system is maintained and use the manufacturer recommendations to limit exposure to diesel exhaust.
Placement of PPE: Be mindful of where fire gear is stored in relation to the surrounding vehicles’ diesel exhaust discharge.
Apparatus checks: Apparatus should be taken outside for their daily checks to limit diesel exhaust exposure.
Compartments over exhaust: Each time the compartment located over the exhaust is opened while the apparatus is running, there will be exposure to diesel exhaust. For this reason, items that are frequently used (such as EMS equipment) should not be stored in this compartment.
Doors to living quarters: All doors should have adequate weatherproofing to keep any diesel exhaust from entering living quarters. This also includes pole holes. Doors to living quarters shouldn’t be propped open.
Drinking fountains, ice and drink machines inside the apparatus bay: Diesel exhaust will travel throughout the apparatus bay, contaminating drinking fountains, ice machines (see picture below), and soda can lids. Ideally, these machines should be cleaned and relocated inside the stations living quarters. If this isn’t a possibility, then consider adding a nonpotable sign. Firefighters should also clean the tops of their soda cans before consumption.
Hand washing: The University of Cincinnati2 stated in its meta-analysis 2006 study that firefighters were more than twice as likely to develop testicular cancer. It also stated that the scrotum has an absorption rate of 300%. Based on the research findings, it is recommended that all firefighters wash their hands before using the restroom to reduce absorption from exposures. Hanging a hand washing sign in restrooms would serve as a good reminder.
Showering: After a fire, all firefighters should take a shower as soon as possible at the station. No members should go home to use their personal showers if showers are available at the firehouse.
Change/wash uniforms: Any contaminated clothing worn in a fire should be washed in a clothes washer at the station. Firefighters should not take their soiled clothing home to avoid cross contamination with their family’s personal clothes.
Preliminary Exposure Reduction (PER) bucket: A study by the Illinois Fire Service Institute (IFSI)3 showed how certain methods can reduce Polycyclic Aromatic Hydrocarbons (PAHs) and other contaminants from fire gear.
- Water with dish soap – 85%
- Dry brush – 54%
- Air blowers – 1.9%
PER buckets should include dish soap or manufacturer-recommended cleaning agent, brush, garden hose, garden hose nozzle, 2.5” to garden hose adapter, and heavy-duty trash bags. Soiled gear should be placed in the trash bags and taken back to the firehouse to the gear extractor. It is recommended to use trash bags that aren’t black so dirty gear isn’t mistaken for trash and thrown away.
Wipes: According to the IFSI4, generic baby wipes can take off 54% of the PAHs. Wipes should be placed on all apparatus and used on all fire scenes after coming out of the hot zone.
Apparatus seats: Vinyl seats are the ideal choice of apparatus seats because of their ability to be easily decontaminated. Plastic seat covers are also a cheap option to lessen the contamination. Cloth seats should be steam-cleaned on a regular basis.
Transporting PPE: If possible, PPE should be kept in a separate compartment from the cab to limit inhalation and absorption exposures. This is also known as the “Clean Cab Concept.” It is recommended that other equipment such as SCBAs, flashlights, and tools be kept outside of the cab.
Exercise: A new study from researchers at the American Cancer Society and the National Cancer Institute5 links regular exercise with a lower risk of 13 specific cancers. All firefighters should have access to exercise equipment, ideally at their station.
Nutrition: Eating well is an important part of improving your health and reducing your cancer risks. The American Cancer Society6 recommends the following:
- Choose foods and drinks in amounts that help you get to and maintain a healthy weight.
- Limit how much process meat and red meat you eat.
- Eat at least 2½ cups of vegetables and fruits each day.
- Choose whole grains instead of refined grain products.
Tobacco: According to the National Cancer Institute7, tobacco is the leading cause of cancer and death from cancer. Tobacco products should not be allowed at the station. Departments should offer smoking cessation programs to help members quit tobacco.
Station alert system: In 2007, the International Agency for Research on Cancer8 (part of the World Health Organization) classified shift work with circadian disruption as a probable human carcinogen.
According to the International Journal of Cancer9, the likelihood of a firefighter getting cancer goes up exponentially when the individual is sleep deprived.
In the book Why We Sleep10, Dr. Walker validates their claim by stating, “After just one night of only four or five hours of sleep, your natural killer cells, the ones that attack the cancer cells that appear in your body every day, drop by 70%.”
Firefighters need to take every possible measure to enhance their quality of sleep. Sleep improvements that can implemented at the firehouse include the following:
- Install red lights in the bunkrooms for alarm use to support circadian rhythm.
- Ramp up volume tones.
- Hear only tones for your station or ideally your own apparatus.
Departments should ensure a daily rest and recovery time dedicated to unplugging, napping, or conducting sleep recovery practices.
If a person falls off a ladder and breaks an ankle, it’s obvious what caused the injury. Unfortunately, cancer doesn’t work that way. Cancer has a latency period in which it could take 10 to 25 years to show itself. Because of the extended latency period, it’s difficult to pinpoint the cause of the cancer. It is imperative firefighters take every preventive measure possible to help prevent a cancer diagnosis. Working toward implementing the above items are realistic steps to take to reduce receiving a cancer diagnosis and to live the healthiest life possible.
1. NFPA 1851 Standard on Selection, Care, and Maintenance of Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting. Retrieved from https://www.nfpa.org/codes-and-standards/all-codes-and-standards/list-of-codes-and-standards/detail?code=1851.
2. University of Cincinnati 2009 Firefighter Cancer Survey. 5:30. Retrieved from https://podcasts.apple.com/ca/podcast/fire-science/id431607564.
3. Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures. Retrieved from https://www.fsi.illinois.edu/research/cardiochem/files/Fent-2017-Contamination%20of%20firefighter%20persona.pdf.
4. Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures. Retrieved from https://www.fsi.illinois.edu/research/cardiochem/files/Fent-2017-Contamination%20of%20firefighter%20persona.pdf.
5. Exercise linked with lower risk of 13 types of cancer. Retrieved from https://www.cancer.org/latest-news/exercise-linked-with-lower-risk-of-13-types-of-cancer.html.
6. Diet and Physical Activity: What’s the Cancer Connection? Retrieved from https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/diet-and-physical-activity.html.
7. National Cancer Institute. Retrieved from https://www.cancer.gov/about-cancer/causes-prevention/risk/tobacco.
8. International Agency for Research on Cancer. Retrieved from https://www.iarc.fr/wp-content/uploads/2019/07/QA_Monographs_Volume124.pdf.
9. Long-Term Sleep Duration as a Risk Factor for Breast Cancer: Evidence from a Systematic Review and Dose-Response Meta-Analysis. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5654282/.
10. Walker MP (2018). Why we sleep: Unlocking the power of sleep and dreams. New York, NY: Scribner, an imprint of Simon & Schuster.
Jim Burneka Jr. is a 19-year career firefighter/paramedic for the Dayton (OH) Fire Department. He has been involved in firefighter cancer preventive initiatives since 2006. He is the founder of the Firefighter Cancer Consultants (www.FirefighterCancerConsultants.com) and also hosts “The 25 Live” weekly firefighter health and wellness podcast (www.The25Live.com).