During routine physicals that include x-rays and blood work, a number of firefighters have learned they were suffering from a number of diseases including diabetes, heart disease and Hepatitis C.
"There are things you can do to protect yourself," said Dr. Don Stewart, who heads a private corporation that provides physicals and medical care for public safety workers in Fairfax County, Va. and Montgomery County, Md.
Stewart advocates firefighters wear SCBA not only while fighting the flames, but while conducting overhaul.
"They can be exposed to some very harmful fumes during overhaul."
He also worries about their closeness to diesel exhaust, and urges responders to take precautions. While some stations have systems to handle fumes, the majority don't.
There should always be good ventilation when the vehicle is running.
During an interview earlier this week with Firehouse.com, the former NASA flight medical director said it's imperative that responders have regular, detailed physicals.
Sometimes, he and his staff make house calls.
"Infectious disease exposure is always a concern. We had an outbreak of whooping cough a year or so ago. We had to give boosters to people in two firehouses."
Crews and the medical staff also are aware of MRSA, and danger of it spreading.
"It was a huge problem," he said, adding that firefighters were very concerned about working with colleagues with the bacterial infection that often is difficult to treat.
"We actually have a policy that they can't go back to work until the wounds are dry, and they have to be covered."
Stewart said he admires the attitude of firefighters who strive to get back to work after an injury or illness.
"One thing going for them is that the majority are healthier than the public," he said, adding that it often helps in faster recovery time.
Stewart said his mission is not to keep people out of a job.
"We went to various firehouses last year to give flu shots during the H1N1 scare."
Universal precautions including the use of gloves, goggles and masks should always be worn to protect against diseases.
Just as important, he said, are regular check-ups and follow-up appointments.
Heating a healthy diet, engaging in a regular fitness routine and watching your weight can boost your immune system.