Firefighters, as a result of their work, are exposed to contaminants that cause cancer. Sean Starbuck reports on an international firefighter conference that shows prevention is possible and that, when this fails, compensation is needed
THE ISSUE of occupational cancer drew around 100 firefighters and their union representatives from across the globe to meet in Reykjavik, Iceland in March this year. The conference, hosted by the LSS fire and medical staffs union, saw leading academics, industry experts and firefighter union representatives discuss practical measures for preventing exposure and campaigns for presumptive legislation.
There is now a body of international academic literature on firefighters developing and dying from cancer. In 2007 the International Agency for Research into Cancer (IARC) deemed firefighting as in its Group 2B: “possibly carcinogenic to humans”.
The conference heard about studies from the United States, Scandinavia and Australia that show firefighters face an elevated risk of getting some cancers.
Alex Forrest, from the International Association of Fire Fighters (IAFF) Canada, reported that IARC appears ready to reassess firefighting in the light of new research.
The conference heard about firefighters’ exposure to carcinogens such as benzene from diesel exhaust emissions, polycyclic aromatic hydrocarbons (PAHs) and volatile organic compounds (VOCs) found in smoke.
All studies identify three routes for exposure: inhalation, skin (dermal) and ingestion. Delegates watched a very powerful Miami IAFF film which showed how contaminants find their way onto firefighters’ bodies, even when they are wearing full personal protective equipment (PPE).
Researchers used ink from the retail sector designed to identify theft. It was sprinkled on firefighters’ gear and then tracked on stations. Evidence of contamination was found in mess rooms, offices and all over firefighters’ skin.
To emphasise the impact on firefighters’ families, a small boy played football and ended up with ink on his hands – a warning about putting fire kits in personal vehicles or washing dirty kit at home.
Jefferey Burgess from the University of Arizona explained his research with the Tucson fire department and IAFF Local 479. His study used urine, blood and skin-wipe samples and DNA testing. It has identified epigenetic changes linked to cancer.
Tommy Kjær, president of the Danish firefighters’ union Brandfolkenes Organisation, described findings from a similar study in Denmark that were published last year.
Juha Laitinen, from the Finnish Institute of Occupational Safety and Health, warned of the risks faced by firefighter trainers, who undertake around 120 “smoke dives” every year and are therefore at increased risk from carcinogens.
Magnús Þórarinsson, a Gothenburg firefighter, explained the Skellefteá model developed in Sweden by firefighters to better protect themselves.
It is a whole-cycle approach that proceeds from the fire station, through the journey on the appliance to a fire call; procedures at the incident; decontamination afterwards; followed by the return on the appliance; and further cleaning at the fire station.
After working at an incident there is wash down on scene, using tents for changing. Contaminated gear is boxed up and transported separately on the appliance.
Swedish firefighters use Viking Guardian suits, which have an outer shell that can be detached after attending a fire, leaving the inner liner as a fully wearable suit to be worn during debriefing and return to base, and are provided with clean hoods and gloves.
Contaminated PPE is washed on site. Firefighters shower and have fresh work wear and PPE.
Ken Block, chief fire officer in Edmonton, Canada, explained similar procedures that his service has introduced to prevent exposure to contaminants.
The conference was shown a film made by the Boston, Massachusetts, fire department, showing its “cancer wall”, with cancer sufferers explaining why there cannot be dirty firefighters any more.
Tommy Verminck, chief executive of the Belgium-based Decontex company, discussed the use of liquid carbon dioxide to clean PPE kit.
Tommy Kristoffersen from the Bergen, Norway, fire service trade union described a new reporting app that firefighters can use to record exposures. It is ready to launch shortly.
Alex Forrest, who pioneered presumptive legislation in Canada, the USA and elsewhere, explained that such laws include a list of occupational cancers linked to some kind of compensation.
If a firefighter covered by the presumptive legislation contracts a disease or condition that is specified in the presumptive law, then that disease or condition is presumed to have come from their occupation.
BURDEN OF PROOF
The burden of proof is on the employer to show that the condition was not caused by the firefighter’s work, rather than on the firefighter to prove that it was.
Forrest said the campaign for presumptive legislation had started because of a lack of universal health care (particularly in the US) and expensive cancer treatment bills. It has been extended to cover loss of earnings and pension arrangements.
He pointed out that presumptive legislation in the USA was “all over the place”. Although 40 out of 50 states have some kind of presumptive law, the firefighters covered, the cancers specified and the benefits received, vary from place to place.
It was also clear that the cancer risk thresholds needed for presumption differed from the UK, where a doubling of risk is required.
Peter Marshall, national secretary of the United Firefighters Union of Australia, explained its successful campaign for presumptive legislation.
The union organised a legislative conference and worked with politicians. It got testimony from international experts because no chief officer in Australia was prepared to give evidence.
Jim Quinn, FBU executive council member for Northern Ireland, who also attended the conference, said these findings were “dynamite”.
“Clean is the new tough,” Quinn said after hearing the presentations. The FBU will take everything learned from this conference and put it into the campaign to protect members in the UK.