QUINCY — The names on the back of a navy blue Relay-for-Life T-shirt read like a who's-who of the Quincy Fire Department.
Captains, lieutenants and firefighters make up a growing list of names of fire service members who have been lost to cancer, now the leading cause of death among firefighters.
Now fire departments, including Quincy's, are starting to take steps to better protect firefighters, as evidence mounts about the health effects of deadly chemicals released during a fire.
"We all know someone who retired who has passed away from cancer. It's eye opening," said Tom Bowes, secretary of the Quincy firefighters' union.
To help protect firefighters, the city is installing $1 million worth of new showers and industrial washers and dryers at fire stations to make sure firefighters can wash dangerous residue from themselves and their gear after a fire.
Firefighting has always been a dangerous job, but the nature of job-related deaths and injuries has changed. Advances in equipment and technology have led to fewer accident-related deaths. Researchers say a spike in cancer rates among active and retired firefighters is a result of modern building materials that create toxic fumes when burned.
Buildings today are filled with synthetics, polymers and plastics that burn faster and coat firefighters in a toxic mix of soot and chemicals that they absorb through their eyes, nose, mouths and skin. Echoing the comments of Boston Fire Commissioner Joseph Finn, Quincy firefighters' union President Paul Moody said every fire fought today is a hazmat incident.
Those chemicals stay with firefighters, manifesting years later as wide-ranging forms of cancer.
"For us as firefighters, after it's extinguished, that's not the end of it for us," Moody said.
Cancer chasing firefighters into retirement
Recent National Institute for Occupational Safety and Health studies found that firefighters face a 9 percent increase in cancer diagnoses, and a 14 percent increase in cancer-related deaths, compared to the general population.
"We all knew the risk when we took this job. We just didn't know it was still going to chase us into retirement," Moody said.
The severity of the issue hit home in Quincy in 2002 with the death of Lt. Robert "BooBoo" McCarthy, who was diagnosed with cancer and died within six months of retirement. His friend, Lt. Ralph Blight, described him as someone who worked hard and was always smiling.
That year the local firefighters' union started Relay for Life Team BooBoo to raise money to fight cancer through the American Cancer Society's annual drive. They made T-shirts and they've continued to walk and raise money for Quincy firefighters lost to cancer in the years since.
The 2017 T-shirt, the last year a shirt was made, has 40 names. Forty firefighters lost to cancer, but Blight said that's just the tip of the iceberg. On the Quincy Fire Department, there are 12 active-duty firefighters who have battled or are currently battling cancer and 11 retired Quincy firefighters have been diagnosed with cancer. Since 2016, 14 more firefighters' lives have been lost to cancer, according to department records.
"The names have really piled up," Blight said.
"Cadillacs" of cleanliness
The loss among the ranks in Quincy and at departments across the country has spurred huge changes in the way firefighters clean up after a fire. Being covered in soot and smelling of smoke are no longer considered badges of honor.
"Back when we got on (the department), the dirtier you were, the better firefighter you were," Bowes said. "It was a pride thing."
Deputy Fire Chief Joe Jackson said the department has worked hard to shift the culture and promote proper health and safety protocols that might protect against cancer risk. They've implemented policies requiring firefighters to wash off and take off protective gear before they even leave the scene of the fire.
The new showers and industrial washers and dryers, which Bowes said are known in the industry as the "Cadillacs" of cleanliness, are being installed at all eight fire stations in Quincy. The money is contained in the city's 2017 appropriation for library, school and fire buildings and Jackson said it's a sign the Quincy community recognizes and cares about the risk posed to firefighters.
"We are very fortunate the city council and mayor have been so supportive of us," Jackson said.
Washing off and cleaning bunker gear is key to preventing cancer among firefighters, research shows. A 2017 study published in the Journal of Occupational and Environmental Hygiene underscores the importance of cleaning personal protective equipment after a fire. It found that chemicals blanketing and settling in bunker gear — the coats, helmets, hoods, pants and boots firefighters wear into a fire — can cause higher incidences of cancers including multiple myeloma, non-Hodgkin's lymphoma and prostate and testicular cancer.
The city's investment in showers and washing machines puts Quincy on the cutting edge when it comes to cleaning up after a fire. The danger from exposure to carcinogenic chemicals during fires has become common knowledge only over the past few years, thanks in large part to fire departments like Boston's that have publicized the issue.
Monitoring the problem
The full breadth of the problem facing the fire service is still not known, and it's hard to pin down exact figures on how many firefighters are dying from exposure-related cancers.
A 2017 report from the International Association of Fire Fighters estimated 61 percent of firefighter line-of-duty deaths from 2002 to 2016 were cancer-related, but the data is based on local union reports and is not definitive. Until last year, when President Donald Trump signed the Firefighter Cancer Registry Act of 2018, no registry existed to track firefighter deaths and the number and type of fires each firefighter attended.
In Quincy, Bowes and Moody said there have been clusters of firefighters who fought in a 1995 Home Depot fire who were later diagnosed or died from cancer. The fire, fed by chlorine and other pool chemicals, made headlines at the time for its severity and later for how exposure to such chemicals affects the long-term health of firefighters.
Bowes and Moody said they hope awareness, data and research can prevent a situation like that from happening in the future.
"It's probably too late for all of us. We've probably had a lot of exposure on jobs, but these younger guys here, maybe they'll have a shot now," Bowes said.
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