Combating the Cancer Emergency

NIOSH writes about how a new research tool and data will fight cancer.

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Photo by Keith Muratori

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When a 9-1-1 call comes in, firefighters don’t hesitate to respond. They jump on their rigs, head to the emergency scene and quickly handle the problem. Yet, as the alarm sounds about a truly dire emergency within the firefighter community—workplace exposure to toxins and chemicals that lead to higher rates of cancer—some firefighters are slow to respond.

From rank-and-file firefighters to fire departments and health professionals, we’re behind in addressing the growing plague facing our profession. There can no longer be any doubt about the seriousness of the cancer emergency. After all, more firefighters die from occupational cancer each year than they do in a fire. Numerous studies show that firefighters’ exposure to smoke and other chemical products released from burning materials increases the risk of diseases and mortality, including cancer, heart disease and cardiovascular disease.

Firefighters recognize that the danger of their profession goes beyond the hazards of running into a burning building. But far too many firefighters seem to write off some of the more complex dangers and risks. Perhaps they accept them as just part of the job. Or they assume it will never happen to them.

Firefighters would never take that attitude toward helping a citizen in our community. It is time for us to change our thinking about the risks we face. The entire fire service community must come together to solve our professional emergency. It has a central role to play in addressing the crisis, a part that no one else can play, and every firefighter and fire department must now act.

The birth of the National Firefighter Registry

It is time to become active participants in gathering the data needed to better understand the problem. While the correlation between workplace exposures and the growing number of cancer cases among firefighters is clear, more information about these health risks is needed. Only with additional, more in-depth study will we be able to tackle the crisis.

Fortunately, an essential groundbreaking research tool is now being developed. To better understand the link between on-the-job exposure to toxins and cancer, Congress directed the Centers for Disease Control and Prevention to create the National Firefighter Registry (NFR). The NFR will provide the critical information needed to improve our understanding of cancer so we can better protect the health of firefighters.Screen Shot 2019 11 22 At 8 31 56 Am

The goal of the NFR is to become the world’s largest database of health and occupational information for firefighters. This database could be used to track and analyze the incidences of cancer, and to search for common links to help the public safety community, researchers, scientists and medical professionals find better ways to protect firefighters and other first responders as they help keep their communities safe.

“A national cancer registry will go a long way towards answering the many questions still out there regarding exposure and cancer,” says Dr. Kenny Fent, the NFR team leader and an industrial hygienist at the National Institute for Occupational Safety and Health (NIOSH). “We’re just laying the groundwork now, but in the long run, we want to help prevent these cancers.”

For the NFR to work and be of value, firefighters must participate in it, providing individual information about themselves that, when combined with data from thousands of other firefighters, will collectively tell us what we need to know. Firefighters must provide the initial data needed to solve this scourge. Only through the action of a broad cross-section of firefighters will we be able to gain a better understanding of cancer and how to attack the problem.

While participation in the NFR is voluntary, all firefighters—career and volunteer, active and retired, those who have had or currently have cancer and those who have never received the diagnosis—should take part.

Every major organization involved in fire services is partnering with the NFR to educate and motivate firefighters to sign up. These groups understand the severity of the problem facing firefighters and the importance of making the NFR work. And they know that only through widespread participation of firefighters will we have the kind of accurate data needed.

“The bigger the sample for this registry, the better the ability to study specific subtypes of cancer,” said NIOSH lead epidemiologist for the registry, Dr. Miriam Siegel. “We could more accurately say what risk factors, what behaviors, what exposures are most related to increasing the risk of cancer.”

With broad participation, the NFR will be able to:

  • Track cancer incidences (including rare types of cancer) among the full range of firefighters throughout the U.S.
  • Explore possible different cancer risks among specific groups of firefighters, including women, minorities and sub-specialties of the fire service.
  • Investigate whether the cancer risk is improving or worsening among more recent firefighters.
  • Evaluate how exposures, including large or unusual incidents, relate to firefighters’ cancer risk.
  • Gauge how control interventions relate to firefighters’ cancer risk.

By providing vital information about health and work experiences, firefighters will play a critical role in helping to understand more about the health risks the profession faces and potentially help future generations of firefighters.

Scientists, health researchers and other specialists are now doing the initial work needed to develop the database, building the infrastructure, ensuring that the right information will be collected, and creating a complex system that will provide the data researchers need. The actual enrollment of individual firefighters is expected to begin in the fall of 2020.

Fighting back

In the meantime, there are steps every firefighter can take today to help solve the growing cancer crisis. Firefighters should educate themselves about the cancer risks facing themselves and their co-workers. Every fire department and fire station should discuss what actions they may be able to take now to address cancer within their department.

Firefighters can also start tracking their exposures automatically in the National Fire Operations Reporting System (NFORS). The NFORS Exposure Tracker is available now and downloadable free from app stores. The NFORS Exposure Tracker is a private data gathering tool that creates a career diary for individual firefighters. It provides secure data entry and storage for users and will be leveraged to enroll firefighters into the NFR once that database is up and running.

Firefighters can start tracking their exposures automatically in the National Fire Operations Reporting System (NFORS) Exposure Tracker available now and downloadable free from app stores. The NFORS Exposure Tracker is a private data gathering tool that creates a career diary for individual firefighters.Firefighters can start tracking their exposures automatically in the National Fire Operations Reporting System (NFORS) Exposure Tracker available now and downloadable free from app stores. The NFORS Exposure Tracker is a private data gathering tool that creates a career diary for individual firefighters.

Firefighters didn’t cause the problem of higher incidences of cancer in their ranks. And they certainly cannot be blamed for insufficient medical knowledge about the problem that currently exists. But firefighters will need to play a central role in solving the problem. Researchers can’t do it without them. To combat cancer, we will need firefighters to participate in the NFR. And the more who do, and the faster they sign up, the better off retired, current and future firefighters will be.

Every day firefighters don’t think twice about running to the rescue of others. They see a crisis, quickly analyze the problem and work as a team to solve it. Soon they will be able to work as a team in another way to solve a problem facing themselves and their co-workers—a problem stemming from their selfless and heroic service to others.

The NFR will be an essential research tool. And it’s a way for all firefighters and fire departments to work together to take action and save lives.

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