Remember the "Marlboro Man"? This stoic, tough-as-nails persona conveyed the timeless image of rugged individualism – all to sell cigarettes, a habit many once considered "cool" that we now realize is a serious health hazard.
Now, go look around the fire station. Look at the photos hanging on the wall and the images we identify with – pictures of soot-covered firefighters, no SCBA, often engaging in risky behavior.
That's our Marlboro Man.
These icons tell the story of who we believe ourselves to be – descendants, blood or not, of great firefighters. We tell their stories around the kitchen table, recalling their feats with reverent rhetoric. Their stories became our stories, and their personals come to embody what aspiring firefighters seek to emulate.
Where pride and cancer cross
As a young firefighter, I wanted to measure up. I wanted my helmet to be black, covered in soot, tar and ash. I wanted it to look like I had pushed close to the edge. I wanted to prove I was battle-tested. I wanted other crew to see that I too was worthy of being called a firefighter and that I could be trusted under pressure. I could, quite literally, take the heat.
We all wanted the same thing – we wanted the pride that comes with serving as a firefighter.
I have yet to meet a firefighter that entered this profession wanting to develop occupational cancer.
But the numbers are not in our favor. According to the CDC, cancer is a leading cause of death among firefighters, and research suggests that firefighters are at a higher risk of certain types of cancers when compared to the general population.
So, we want the pride, but we don't want the cancer. There's only one solution: It's time to reevaluate what it means to be a proud firefighter.
We can change – when we want to
It should come as no surprise that the fire service is changing rapidly. The idea that the fire service should be proud of the adage "200 years of tradition, unimpeded by progress" is not only short-sighted but, as research tells us, deadly.
During the COVID-19 pandemic, the fire service proved that we are not inextricably bound to past practices. In fact, for many fire service organizations, we were able to quickly flex and pivot and adapt to the demands of the pandemic. For many of us, it felt like flying an airplane while building it – but we did it. We proved that we could navigate change … when we wanted to.
So, where do we begin? First, a mindset shift.
A new form of pride
The mindset that dirty fear is a badge of salty professional accomplishment is not just an arrogance-fueled failure of our profession but also a blatant refusal to accept science, and it requires an immediate change in our fire service culture.
Fire service leaders must focus on changing our mindset related to dirty PPE, including helmets and turnouts. When we see a dirty helmet or bunker gear, we should see negligent behavior. Dirty gear should be viewed as unprofessional and lazy, not to mention selfish, as it forces those working around them to face additional exposure to agents known to cause cancer and other diseases.
Here is another question worthy of consideration: How many of our departments allow crews to wear structural firefighting gear into medical calls? Are we OK with exposing our community members to these same potentially dangerous contaminants? Science has painted a clear picture for us. It's time we take what we know and apply it to our actions.
So, what steps can we take? This might not be as hard as we think. After all, how hard was it to get your crews to mask up during the pandemic – for their safety, the crew's safety, and the communities we are given the privilege of serving?
Putting words into practice
It is long past due for the fire service to truly commit to a cancer prevention focus and mandate that the organizational membership be held accountable for safe work practices. We must actively promote lifestyles that reduce the cancer risk to our members.
Effective training and education, with fire officers leading by example, will produce sound work practices that ultimately result in a safety-focused culture. Such practices will reduce exposure to the wide array of disease-causing agents.
From entry-level firefighters to the fire chief, all members must demonstrate the proper use and care of PPE and turnout gear and, whether by rule or requirement, mandate the use of respiratory protection during all phases of firefighting, beyond initial attack to include salvage and overhaul. This should extend to our fire cause investigators and anyone else operating in the hot or warm zones of the incident.
Senior leadership needs to place value in cancer studies and apply new technologies when designing and retrofitting fire stations. It's time to consider technologies like diesel exhaust removal systems and extractor expellers washing machines for turnouts, or using a third party for turnout cleaning. Further, a new and emerging technology that could be of supreme value is the use of cancer screening tools.
Progressive agencies are even mandating a clean cab mindset, where crew compartments and firefighting gear are separated. It is also worth mentioning the new SCBA washers and ultrasonic helmet-cleaning stations. By investing and providing these resources to our personnel, we are demonstrating a commitment to our members' protection and a tacit expectation. Pay now or pay later.
Considering that we all share the same profession and risk, it is worthwhile to have our membership register with the National Firefighter Registry (NFR), a voluntary registry comprised of active and retired firefighters paying focused attention to understanding and reducing cancer in fire service professionals.
At the battalion and company officer level, this comes down to personal and organizational pride. Considering that professional firefighters are occupational athletes, let's make another comparison. When was the last time you saw the members of a professional sports team step onto the field with a grass-stained, dirty uniform? You don't. They are mandated to represent their brand (team) and personal name with crisp and clean gear. In short, this comes down to organizational pride, health and safety – the big things.
Eliminate the illusion
The profession is headed in the right direction; however, it is going to require a mindset shift where dirty is no longer seen as a badge of courage but rather laziness at best and negligence at worst. Single incidents and one-off behaviors don't just affect the firefighter; they affect the entire crew, the profession and the image of the department. Clean gear corresponds to pride, care, health and embracing the new tradition of protecting ourselves and each other from the illusion that somehow a "salty lid" is a source of pride.