LeDuc: Kicking Fire Service Cancer Curbside

Nov. 30, 2015
Perhaps the singular additional area of heightened vigilance is diligent maintenance of respiratory protection during all potential exposure to by products of combustion.

I recently had the honor of addressing a room packed full of chief fire officers-some seasoned and some new to their position. I was speaking to them on the topic cancer in the fire service. One of the first things I reminded them is that as chief officers, there is no greater responsibility of leadership than to protect the health and safety of those under your command. With that being said, we have to lead our personnel in their protection against occupational cancer exposure. What does that mean?

Recent work by National Institute of Occupational Health and Safety (NIOSH) has demonstrated cancer prevalence of certain types among a large population of firefighters. Additionally, work done by the Firefighter Cancer Support Network has elevated the discussion on prevention with the fire service. Personal Protective Equipment studies by Dr. Jeffrey Stull have demonstrated that fire service protective ensembles work well for thermal protection however appear to allow products of combustion through onto the skin which absorbs into the body.

Knowing that exposure to smoke contaminates not our gear necessitating cleaning- but mostly important the skin (the body’s largest organ) with significant rates of absorption due to dilated blood vessels and pores due to elevated body temperature. So removing our bunker gear as soon as particle and rapidly cleaning our bodies removing any combustion by products that may be on the skin is imperative to protection and minimizing risk of exposure. In essence, beginning to think of smoke exposure as a hazardous materials response, with gross and fine decontamination may in fact be one of our first lines of defense in the battle against fire service cancer.

Following the decontamination of our skin, exposure gear must be appropriately cleaned as soon as practical. This should include regular advanced cleaning and inspection pursuant to National Fire Protection Administration. Care should also be taken not to cross-contaminate other clothing or materials by a combined cleaning.

Perhaps the singular additional area of heightened vigilance is diligent maintenance of respiratory protection during all potential exposure to by products of combustion. While many departments are now conducting air quality monitoring post extinguishment, it is important to be mindful of the numerous gases produced by combustion. A conservative and wise approach, is perhaps to gain, thinking of establishing hot and warm zones and maintaining appropriate respirator personal protective equipment (PPE).

This blog and suggested approach may be scoffed at as “new age” thinking- however no doubt expanding research will guide us further in how we best may guard against fire service cancer. Our goal should be to provide as much mitigation of carcinogenic exposure as is possible to limit our risk.

Lastly no discussion on fire service cancer would be complete without discussing the importance of annual medical screening. Firefighting as an occupation has certain inherent risk and most likely always will. NFPA 1582 prescribes annual medical examination for firefighters which will no doubt continue to evolve with research and science. Clearly, regular medical examinations also provide a first line of defense in the early detection and treatment of cancers that we have been unable to prevent.

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