Firefighters and Cancer

Mario H. Trevino

Fire Chief, (retired)

Experience/Exposures

• Seattle Fire Department: 1973-1996•Las Vegas Fire Department: 1997-2001•San Francisco Fire Department: 2001-2004•Bellevue Fire Department: 2004-2008

National Fallen Firefighters Foundation Firefighter Mortality & Morbidity Statistics

• 100 Line of Duty Firefighter Deaths Per Year

• Thousands of Injuries

• Tracking for causes:– Cardiac Arrest

– Vehicle Accidents

– Building Collapse

– Smoke Inhalation

• We don’t track CANCER

• Why?

The Culture of the 1970’s Seattle Fire Department

• Aggressive “interior attack”

• SCBA’s available, but rarely used

• Our heroes were macho “smoke-eaters”

• Turnouts: one-layer treated canvas, wool liners (full turnouts only used at night)

• One-layer leather gloves from hardware stores

• Fibreglass helmets with nylon-webbing for impact

• “Clean-ups” lasted for hours, no protection

• Widespread Tobacco usage.

My Cancer Diagnosis: August, 2008

•Seattle PI Article; 1/3 of Seattle Firefighters Hired

Before 1977 Have Developed Cancer

975 Seattle Firefighters Hired

Before 1977

•347 Had Cancer, Had Been Treated for Cancer, or Died from Cancer (33.8%).•47 Have Been Diagnosed Since July, 2008 (4.5%).• 38.4% Of Total Affected.•FUTURE DIAGNOSES? 50%, 60%, or even 70% Possible.

Cancer Incidence Among Firefighters

• While 100 Firefighters Die Line-of-Duty Deaths Per Year, HUNDREDS More Die From Cancer that we may not know about.

• Firefighters are 200% More Likely To Get Cancer Than General Population:– 300% Above Normal Rate for Lung Cancer– 200% Above Normal Rate for Throat Cancer– 150% Above Normal Rate for Pancreatic Cancer

Carcinogens in smoke

• Common construction since the 1940’s; still widely used today

• Widely used (75%) to treat lumber, discontinued in 2004

• Product of combustion: drywall products, spray-paint cans, etc.

• Commonly found in diesel exhaust• Many, many more. Smoke is a

‘toxic soup” of carcinogens

Asbestos

Arsenic

Formaldehyde

Benzene

Cyanide, Etc.

“Danced With The Devil” article

•What do you do when you hear about someone who gets cancer?•You call•You visit•You send a card•Maybe flowers, fruit basket, books (depending on closeness)•Then, you wait.•Within six months: did they live or die?

•We have an aversion to hearing too much about cancer•Almost a superstition•I wanted to write about the “in between” details that we normally don’t hear about.•I didn’t hold back on the brutal details: I wanted to have an impact on firefighters.•The mission: provide the warning that we never got in the 70’s

Do We Still Have A Problem?•Robert- California…•Chris- Prince William County…•Chandra- Ohio…•Kyle- Texas…•Aileen- Michigan…•Ted- San Francisco…•Larry- California…•Ryan- Washington…•Brandt, Texas…•AND Brian in New York, Paul in Anchorage, David in Indiana, Chris in Arizona, Frank in Los Angeles, Calvin in Utah, Tella in Virginia, Travis in Colorado, etc. etc. etc…..

Yes. Our problem is still our culture.

Has The Article Helped?

•In Their Own Words…•Rick•Jerry•Ty•Shawn•Mark•Roy•Chad•John•Larry

Cultural Change

• Our culture is already changing all around us:– Smoking

– Alcohol

• Sources of the change in the fire service: – Legal mandates

– Contractual requirements

– “New blood”

– Changing customs and social mores

– Science and knowledge

– LEADERSHIP!

Fire Service Culture: present day•Training is better

•Apparatus is better•PPE’s are better

•We are more informed about the hazards

BUT

•We still don’t wear our seat belts at all times while moving•We STILL don’t wear SCBA’s in all IDLH environments

•While PPE’s (turnouts, gloves, hoods, helmets) are far better, we STILL don’t wear them (full turnouts, gloves, hoods)

•We still don’t eat right, exercise enough, control stress, continue to use tobacco, and we don’t get medical evaluations.

Why Am I Here Today?

I “pulled a Wilson”William Gibson

Could You Go The Distance With “Iron Mike?”

PROTECTING YOURSELF FROM CANCER

• Wear Your PPE’s!

• Eat Healthy Foods

• Reduce Stress

• Exercise

• Don’t Use Tobacco

• Get Tested

• Take Minor Infections Seriously

• Find Peace and Faith

The International Firefighter

• Oregon brain cancer, colon cancer, stomach cancer, testicular cancer, prostate cancer, multiple myeloma, non-Hodgkin's lymphoma, cancer of the throat or mouth, rectal cancer, breast cancer or leukemia Rhode Island disabling occupational cancer which develops as a result of the inhalation of noxious fumes or poisonous gases South Dakota impairment of health caused by cancer Tennessee any impairment of health of such fire fighter caused by disease or cancer resulting in hospitalization, medical treatment or any disability Texas cancer that may be caused by exposure to heat, smoke, radiation, or a known or suspected carcinogen as determined by the IARC Vermont cancer limited to leukemia, lymphoma, or multiple myeloma, and cancers originating in the bladder, brain, colon, gastrointestinal tract, kidney, liver, pancreas, skin, or testicles. Virginia Leukemia or pancreatic, prostate, rectal, throat, ovarian or breast Washington brain cancer, malignant melanoma, leukemia, non-Hodgkin's lymphoma, bladder cancer, ureter cancer, and kidney cancer Wisconsin skin, breasts, central nervous system or lymphatic, digestive, hematological, urinary, skeletal, oral or reproductive systems