CANCER AND FIREFIGHTING
PROTECTION OF PERSONNEL
There is a hidden danger as lethal as all the other firefighting dangers we face, but one that silently attacks its victims. This silent killer is cancer. Exposure to carcinogenic elements and chemicals, the lack of adequate protection from these carcinogens, and the lack of concern or knowledge about the need for protective equipment all contribute to this growing problem.
According to the International Association of Firefighters, cancer is now becoming one of the major occupational hazards firefighters face. This is probably due to the thousands of new toxic substances found in homes, garages, buildings, and vehicles.
Firefighters often enter uncontrolled environments, and in many instances they are unaware of the cancer-causing agents present. The April 1980 fire at a chemical dump site in Elizabeth, New Jersey is one example. About 40,000 drums of chemical waste were in the area. While battling the blaze, firefighters were unaware of the potential carcinogenic substances in those drums. Most of the firefighters were not wearing SCBAs because of limited availability. The National Institute of Occupational Safety and Health (NIOSH) found that a high percentage of firefighters combating that fire experienced nose and throat irritation along with acute respiratory problems. They also experienced widespread skin dermatitis from chemical contact. The full effects on the exposed firefighters are still unknown.
The Institute of Cancer and Blood Research completed a test in 1982 which showed that Los Angeles firefighters had up to three times the normal rate for mouth and throat cancer and more than two times the normal rates for cancer of the brain, lung, rectum, pancreas, and prostate. Other cancers that afflict firefighters at a higher rate than the general population include intestinal, lymphatic, and leukemia cancers. According to statistics compiled by the IAFF, reported deaths and forced retirements due to occupational-related diseases are increasing at a startling rate.
With the ever-increasing number of chemicals introduced into our society, it is impossible to study the carcinogenic properties in every one of them. So firefighters often find themselves in situations where they don’t know what they are up against
According to I)r. Charles Parker of the University of Texas Southwestern Medical School, products of combustion are more lethal and potent than ever before. Scientists are not certain what effect toxins have on the body, but they are sure that some of them can lead to cancer. A California Occupational Safety and Health Administration study on smoke toxicity identified more than 150 poisonous substances in smoke commonly found at a fire; many of these are known or suspected carcinogens.
Carcinogens are given off as byproducts of combustion. When materials burn, changes take place, and depending on the material being burned, it could release carcinogens into the surrounding air. According to the IAFF, most emergency situations that a firefighter encounters have the potential for members’ exposure to carcinogens.
SUSPECTED CARCINOGENS
Among carcinogens, synthetics are a major concern. Fires burn hotter and the smoke is more dense, partly because of the widespread use of such synthetics as plastics and polyvinyl chloride in building materials and interior furnishings. These synthetics pose a greater cancer risk to firefighters than other building materials: There are 43 known or suspected carcinogens in smoke from synthetic plastics alone. Accoring to the Journal of Combustion Toxicology, the variety of products made from synthetics almost assures that they will be present at every fire emergency, making it almost impossible to avoid at least some exposure.
Another concern to firefighters is benzene. Studies show that there is a relationship between benzene exposure and leukemia. And tests show that benzene is present in more than 90 percent of structure fires. Burning synthetics produce benzene; gasoline, solvents, and glue contain benzene. Firefighters battling automobile fires, gasoline station fires, and all types of structure fires are at great risk of inhaling carcinogens when they come in contact with benzene.
Asbestos is a problem as well. While use of asbestos is now being controlled, for the most part firefighters have no idea which structures contain asbestos. It could be in walls, ceilings, floors, air ducts, insulation, tile, decorating materials, fire-proofing materials, and wall board. A fire can destroy the protective materials surrounding asbestos fibers; or, firefighters might uncover it while pulling down ceilings and breaking through walls to check for possible fire extension. Fans used to help ventilate the structure may spread asbestos fibers even more. Fibers can adhere to clothing. Thus firefighters can bring them home and expose their families as well.
Pesticides are another carcinogen that firefighters may be exposed to. Pesticides are not limited to rural areas; they are regularly found in residential homes and in all types of stores. Some pesticides may penetrate firefighters’ protective clothing. They can have immediate or long-range effects on the body.
Wood is a suspected cancer-causing agent. A report by NIOSH states that people who work with wood, such as cabinet makers, have an increased rate of myeloproliferative cancers. It is not known exactly what causes this increased cancer rate; therefore, fighting fires in wooden structures may cause exposure to an unknown carcinogenic agent.
MOCA C4,4-methylen bis (2-chlorooniline) is yet another obstacle that firefighters must face. According to the IAFF, MOCA has been shown to be associated with liver and lung cancer in rats; thus it is a suspected carcinogen in humans. The IAFF also says that fires involving mattresses or any other product made of polyurethane foam produce MOCA as a by-product of combustion. In addition, insulation in firefighter boots and helmets and personal flotation devices sometimes contains MOCA.
Creosote is another material that may be a factor in the high rate of cancer in firefighters. Creosote is a carcinogen that is found in soot, tars, and mineral oils, according to the IAFF. Fires involving wharves and other wood on or near the water as well as utility poles and other woods treated with creosote (to prevent corrosion) present a risk of exposure. The carcinogen benzopyrene is a by-product of the combustion of creosote. Several types of cancers are associated with creosote and benzopyrene, including lung, skin, and throat cancer.
According to the Massachusetts Coalition of Occupational Safety and Health (Mass COSH), diesel exhaust has been shown to cause lung cancer in animals and it is a suspected human carcinogen. Diesel exhaust is a mixture of about 9,000 chemicals. The known carcinogens, formaldehyde and polyaromatic hydrocarbons (PAH), are included in that list of chemicals. Diesel exhaust has a high concentration of fine, dust-like particles that absorb many hazardous vapors and gases. Inhaling diesel exhaust may result in the settlement of those particles in the lung, consequently trapping the carcinogenic agents with them.
Firehouses accumulate exhaust fumes as apparatus drive in and out throughout the day. In most stations, the only step taken to disperse these fumes is opening windows. Furthermore, the firefighter who is operating the pump at a fire must stand by the truck at all times while the engine is running at a heavy throttle, which in turn makes him vulnerable to diesel fumes.
According to the IAFF, “’Hie list of potential carcinogenic agents that firefighters can be exposed to is almost as long as the list of all known or suspected carcinogens.”
The Journal of Combustion Toxicology states that smoking greatly increases the risk of lung cancer associated with cancer-causing chemicals. This suggests that exposures to several different carcinogens have synergistic effects—the combination of two or more carcinogens puts a person at a greater risk than the sum of the individual substance.
OTHER FACTORS
Besides the inhalation, absorption, and ingestion of carcinogenic agents, the lack of adequate protective clothing also contributes to firefighters’ rising cancer rates. Protective clothing does not provide maximum protection from all exposures —it has not been able to keep up with the increase in hazards. Firefighters may encounter hazardous materials so potent that their masks and shoes will melt. While special suits are now being made for toxic chemicals spills, they are exremely expensive and many cities and towns simply cannot afford them.
The lack of concern about the necessity of protective clothing and equipment is also a contributing factor to the increased cancer rates of firefighters. In Essentials of Firefighting (Fire Protection Publications, 1983), the International Fire Service Training Association (IFSTA) says, “It should be a fundamental rule in firefighting that no one be permitted to enter a building that is charged with smoke and gas unless equipped with self-contained breathing apparatus.” That is sound advice, but unfortunately, firefighters do not always heed it. Occasionally in the rush of an emergency a firefighter will enter a smokefilled structure without SCBA or will wear it but neglect to put on the face mask before entering.
While lack of concern is one reason why firefighters may decide not to use protective equipment, lack of knowledge is another. During overhaul firefighters tend to take their SCBAs off, thinking that they are now safe from carcinogens and other toxic substances. However, this is not the case.
The heart rate of firefighters is sometimes 95 percent of maximum for extended periods during a firefight. This demanding physical exertion coupled with high levels of emotional stress are being closely examined as possible reasons for high cancer rates as well. Some studies show that stress may increase susceptibility to cancer.
Firefighters must pass a thorough physical exam and a strength and agility test before they are hired. Becuase of this, they usually start out healthy. This strongly suggests that their cancer problems do not begin prior to fire department employment.
As we all know, smoking increases the risk of cancer. Studies conducted in Boston show that firefighters’ smoking habits are similar to those of the general population. Thus smoking is not a contributing factor to firefighters’ high cancer rate.
COMBATING CANCER
The key to fighting the cancer problem is high-level training that emphasizes the importance of using protective clothing and self-contained breathing apparatus. Several studies currently are being conducted on the cancer problem in firefighters, such as the Consumer Product Safety Commission’s study on toxics produced by synthetics. As more information is gathered, it should be used to educate firefighters. Also, the organizations that are conducting these studies should work closely with the manufacturers of firefighter safety equipment in order to keep up with the ever-increasing need for better protective equipment.
Firefighters must be made aware that physical exercise, a good diet, and emotional well-being may all very well play a part in reducing the chances of cancer. Although we may not be able to eliminate carcinogens from our structures, we can and should take greater care to develop better protective equipment and to instruct firefighters on the need to use that equipment. Only then can we begin to fight the silent killer.
