It should not be news that firefighting and several types of cancer are related, but truly understanding the impact and what to do about the correlation is news.
Recently, “The Columbus Dispatch” published a five-part series on firefighter cancer. The series focused on the life, cancer diagnosis and cancer treatment of 36-year-old Columbus Firefighter Mark Rine.
Rine has dedicated what remains of his life to cancer prevention efforts within the fire service. He speaks regularly around the state, and now the country, about his losing battle with cancer and gives a face to the epidemic.
The series highlights some of the changing norms and beliefs within the fire service. For instance, with its own survey, the Dispatch found that half of firefighters responding to the survey reported believing that cancer is their greatest occupational risk. A decade ago, only five percent of firefighters believed that same thing.
Differences in views from the leadership compared to line personnel also were highlighted. As an example, 90 percent of fire chiefs believe that firefighters know about the threats of chemical exposures, while only a third of firefighters reported being aware.
Changes in the exposures firefighters face also took center stage in the series with descriptions of the risks associated with flame retardants that were so popular starting in the 1980s. Firefighters are no longer fighting the fires their grandfathers fought. New building materials are making fires faster and more dangerous – including dangers associated with the health risks of exposure.
A call to action for the fire service
The series also poses a call to action for firefighters and the fire service – in particular, work at identifying best practices in the area of prevention and intervention.
While the efforts of fire departments, fire service organizations and the scientific community are focusing on bringing the issue of firefighting and cancer to the forefront as a health and safety issue, this national mainstream call for prevention is relatively new and the message needs reinforcing.
Less than a decade ago, headlines touted findings from the National League of Cities report, "Assessing State Firefighter Cancer Presumption Laws and Current Firefighter Cancer Research," that concluded: "There is concern that conclusive evidence is lacking to demonstrate a causal relationship between firefighting and cancer."
While progress has been made to dispute those claims, there are still firefighters who either don’t believe the risk or who just don’t believe it will happen to them. There are pockets of firefighters and departments where black gear and a black helmet means a successful career rather than a lack of personal responsibility for one’s own health.
The series is pointed directly at them. It puts a face to the “it won’t ever happen to me” mentality from a firefighter who once believed that idea. It lays bare in the rawest form the impact firefighter cancer has not just on the firefighter, but also their biological and fire service families.
A multi-pronged approach to better firefighter health and safety
The series also is a sign of shifting cultural expectations within the fire service. While no singular culture exists in all departments, the typical social norms that once made not wearing SCBAs or gear, not cleaning gear and taking dramatic risks a sign of courage and heroism, are a thing of the past.
The take-home message of Rine’s story is not anything new, but a continuation and reinforcement of the ongoing national conversation.
It highlights the need for prevention efforts both personally and organizationally.
Organizations should be expected to provide the appropriate resources for their firefighters. Not only should every firefighter have the appropriate gear, but resources for cleaning and maintaining that gear.
On the fireground, practices are changing:
- Running into a fire in T-shirt and jeans the way Rine once did is a thing of the past.
- Personal protective equipment is just that – protective – and should be worn at all times.
- Science on carcinogen exposures has confirmed that SCBAs need to be worn throughout the time on the fire ground – even during salvage and overhaul, when some of the exposure risks are the greatest.
- Gross decontamination on the fireground, showering as soon as possible and containing the carcinogens as much as possible all have to be priorities for every firefighter.
For those for whom the message of prevention is too late, Rine’s story is an example. While it is too late to reverse the years of exposures for some, there is still work that can be done educating the newest generation of firefighters and shifting the social norm of what it looks like to be a good firefighter.
Stemming the trend toward more cancers is not a single-pronged approach. While slogans and campaigns go a long way to shape the conversation, for many, it has to be personal. Seeing a face, and seeing yourself in the same shoes, will be the only way some will come around to a healthier and safer way of working. Firefighter Rine’s efforts to use his story to save others is a step in the right direction.