By Mike Genet
JEFFERSON CITY, Mo. — They used to be points of pride among firefighters – and with some they might still be considered as such.
But now area fire departments, as well as many others around the country, are trying to teach their personnel that dirty coats and soot-blackened helmets represent cancer risks to be avoided.
Studies have shown firefighters developing or at risk of developing cancer at a higher rate than the general population – nearly twice as much with some forms of cancer such as testicular or malignant mesothelioma. Some firefighters call it an epidemic that's been sweeping through the ranks for several years now, in large part due to the toxic exposures from fires.
The International Association of Fire Fighters claims occupational cancer has become the leading cause of death for firefighters nationwide. Since 2002, 60 percent of the names added to its Fallen Fire Fighter Memorial Walls are people who died from occupational cancers.
Presumptive cancer legislation, designed to help firefighters and their survivors claim workers' comp benefits, has not been fully realized in Missouri as it has in more than 30 states, though Gov. Eric Greitens recently announced his support for pre-filed bill for the upcoming General Assembly session. Meanwhile, those currently in the field and their administrators have been implementing steps the past few years designed to mitigate cancer risks over time.
From keeping all gear on while stepping through charred remains, getting sprayed down and using wet wipes on-site to washing gear and showering at the station, men and women in the fire service have been working to develop a new, more intensive routine.
Changing the mindset
Like many veteran firefighters, Kirk Stobart, president of Independence's firefighters union – IAFF Local 781 – can recall when sporting blackened gear was a matter of pride.
"If your gear wasn't dirty, you weren't doing your job," said Stobart, a 26-year firefighter. "They used to make fun of the people that had clean gear."
"The pride of having dirty gear, that mindset's changed."
"Back in the day, it was like a badge of honor to have dirty gear, a dirty helmet," adds Sam Persell, assistant chief of the Central Jackson County Fire Protection District.
Said recently retired Independence Fire Chief John Greene, "The dirty gear, soot on the helmet, black snot – now we know all that is just signing your death certificate early."
In its online checklist for reducing exposure risk to carcinogens, the IAFF starts the group of self-actions with eliminating the attitude of "The dirtier the gear, the tougher and more experienced I am."
For those whose career began about the same time as Stobart, Persell and Greene, it might not be easy to ditch that attitude. Some might have scoffed at the notion of firefighting leading to cancer like it can a heart attack or stroke.
"We were so focused on heart attacks and strokes for awhile, and this cancer thing started going crazy," CJC Deputy Chief Eddie Saffel said.
In the case of Stobart and Greene, it wasn't a hard sell in the Independence department to work on a joint labor/management initiative to address cancer, signed in July 2016. Both sides had heard the news at conferences and seen the data, but when Captain Rick Winship died less than two months after receiving a grave cancer diagnosis in 2015, the problem hit home hard. Winship had throat cancer that had spread to the liver and brain.
Greene remembers Winship as a model of fitness – a "hiking nut" – and before his colleagues could fully realize that he had cancer, he was gone.
"I hate to think he was the reason, but what happened to him got it going," Stobart said. "On both sides, I think. He came down with cancer, and he never smoked a cigarette, someone who shouldn't have gotten cancer."
"Both sides really let up and both found a way to make it work," he said, adding that he's received multiple inquiries from other fire services trying to put together their own agreements. "Usually when you get sides of opposing forces talking about it, it can work.
"Now we've gotten to the point where guys in the field don't have to be told, do gross decon(tamination) right on the scene. It's amazing to see how well-accepted it's been. It makes me pretty proud of what our union and management has done."
Similarly, Persell refers to a former assistant chief in the department who received a cancer diagnosis. Persell helped enact a program of yearly physicals for all firefighters in CJC – starting from the point of hiring – and those check-ups helped catch cancer in a few firefighters, allowing them a chance to get treatment and either return to fire service or retire.
Union and management in CJC don't quite have a full agreement in writing, but Saffel and Persell say the department has made great strides.
"We train them, we teach them right off the bat, to maintain a sense of wellness and health," Persell said. "We'll get to where we want to be. You can't argue the data (about fire service cancer deaths). The data is there, and it's ever-increasing. Guys are saying, 'I don't want my family to go through that.'"
'Like taking cyanide'
Firefighters like Stobart have often battled a far different fire than their predecessors did. The materials used in housing and other buildings contain far more plastics, petroleums and other synthetics that emit poisonous soot and fumes. Through skin absorption or inhalation, firefighters can easily be exposed, and particles can remain on gear not properly cleaned.
"It's like taking cyanide gas," Persell said. "This is an element in the body that isn't supposed to be there, and the body doesn't know what to do with it."
"I started in 1984, and the equipment has gotten better, but cancer has gone up," he said. "I can't imagine going into fires now with that (old) equipment. All we can do is protect our guys and protect ourselves."
"Those old firefighters that taught me,'' Stobart said, "they battled solid wood and natural stuff."
For those who maintained the dirty gear "badge of honor," or transported that gear in their civilian vehicle and even into their homes, it would be potentially hazardous.
"I've known some Kansas City firefighters that have worn the same gear and never washed it," Stobart said.
Extra steps and equipment
Even before the on-site decontamination following, chiefs have implored their firefighters to keep on all their gear while going through smoldering buildings after a fire is out – the "overhaul" process, it's called – instead of shedding the coat and mask as some might do, particularly on warm days.
Many times, wet wipes are available to clean the hands, face and neck after a fire. Gear should be removed, if not bagged as well, to return to the station, then washed in commercial-grade extractor washers designed to fully decontaminate fire clothing. Such machines have different settings for inner and outer layers and wash only one or two sets at a time. Helmets have to be scrubbed by hand, and inside of fire trucks should also be wiped down.
Central Jackson County has such washers at each of its five stations, and each firefighter has two sets of gear. Independence has five washers among its 10 stations – "It's a good goal we'll have to meet one day," Stobart said of having a washer at each station – but that is mitigated in part by also having two sets of gear per person.
In the Sni Valley Fire Protection District, Battalion Chief Jason Barnett said there are enough second sets for each person on a particular shift.
That extra gear allows firefighters to shed a dirty set, shower at the station – another must in department's minds – and be ready to don clean gear and head back out if necessary in less than an hour.
Persell said he even recommends a stationary bike session to work up a sweat for further detox.
"I can remember taking a shower a couple days after a fire and still smelling it on me," he said.
Barnett said the biggest changes his department has made of late is having a decon site and hood exchanges on site. The department got a washer with its new firehouse several years ago.
Fort Osage Fire Chief John Yocum said his department has been doing on-site decon and keeping gear out of living quarters. Annual screenings are something he also stresses.
"You've got to look at long-term exposures," Yocum said. "I can't stress enough the annual screenings, to make sure guys stay on top of everything."
Yes, all those steps can seem tedious. But Greene, for one, wants to believe it will be worth it in the long run.
"We won't know for years if it has any effect, but it can't hurt," he said. "It causes delays, but I don't want to bury one."
Stobart said he fears the cancer issue in the fire service will get even worse before it gets better – many veterans could already be affected, and it will take time for many anti-exposure measures to fully take root – but hopefully the veterans now are setting a positive new standard.
"We all want to leave this place in a better place than when we started," he said. "We make sure the young guys are as prepped and as safe as they can be.
"The last thing we'd want to see is somebody getting killed for something they've should've known."
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