Cancer among Seattle firefighters

Wildfire Today has covered cancer among firefighters previously, but more information continues to be available about this risk.  Here is an excerpt from an article in the Seattle PI:

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Cancer takes heavy toll on Seattle firefighters
City defends itself against charge it could do more

By KATHY MULADY AND CASEY MCNERTHNEY
P-I REPORTERS

Dave Jacobs started fighting fires when he was 20. It was the only job he ever
wanted. He battled brush fires in California, house fires in Oregon and fires of every kind in more than two decades with the Seattle Fire Department.
Now 57, Jacobs is fighting cancer.

Seattle firefighters cancer chartA year ago he was diagnosed with esophageal cancer. There are days when he can barely swallow a few spoons of soup. The disease has progressed to his liver and lymph system.

Cancer is a presumptive disease in firefighters — more than a third of Seattle firefighters hired before 1977 have developed some form of the illness. Under Washington law, seven forms of cancer are assumed to be job related when they are diagnosed in a firefighter.

But there are many other cancers that aren’t on the list, forcing men such as Jacobs to prove that their illnesses were job related to get workers’ compensation. Seattle firefighters say the city is not doing enough to help screen them for cancers and other health risks. City officials are sympathetic but question the effectiveness and cost of health screenings.

“My heart goes out to the other firefighters who have yet to be diagnosed,” Jacobs said. “This job is a killer.”

According to the International Association of Firefighters, more union firefighters died of cancer in 2007 than from heart attacks or fire-related injuries combined. Nationally, there were 38 union firefighters who died last year from cancer, 16 from heart attacks and 10 from fire-related causes. That trend is continuing in 2008.

It is assumed that if a Washington firefighter who was on the job for 10 years develops prostate cancer before age 50, or brain cancer, bladder or kidney cancer, malignant melanoma or several others, it was in the line of duty.
In this state, three of five active firefighters who died this year were cancer victims. The other two died fighting California wildfires.

Seattle Battalion Chief James Scragg — a survivor of the deadly Pang warehouse fire — died of lung cancer Jan. 17 at age 54. Seattle firefighter Tim Heelan, 43, also died in January after melanoma spread to his lungs and spine.

Marty Hauer, a Kent firefighter who traveled the nation teaching fitness seminars to other firefighters, stunned colleagues when he revealed that he had thymic carcinoma, a rare thymus gland cancer. He died in June at 41. Dozens of others are fighting the disease.

Of 975 firefighters hired in Seattle before 1977, about 350 have been diagnosed with cancer, and 43 of the men were younger than 60 when diagnosed, according to numbers from the Seattle Firefighters Pension Board.

September 11 and firefighters

Seven years after the September 11 attacks we are still seeing the effects among firefighters and other workers who were exposed to the contaminated air around the collapsed World Trade Center towers.  In addition to the thousands of local responders that worked at “ground zero”, Type 1 incident management teams comprised mostly of wildland firefighters were there as well.  I wonder if anyone is conducting any organized tracking of the health of those team members?

Here is an excerpt from The ReviewJournal article that is centered around a New York City sanitation worker who spent months at ground zero:
According to the World Trade Center Medical Monitoring and Treatment Program at Manhattan’s Mount Sinai Medical Center, the rate of exposure-related illness is 70 percent among the 40,000 ground zero workers it monitors. This includes 12,000 New York Fire Department firefighters and 3,000 emergency medical technicians as well as 25,000 police officers, other firefighters, volunteers, transit workers, communications workers, construction workers, building cleaners and sanitation workers.
“The highest frequency of disease is in the people who were most heavily exposed,” says Dr. Philip Landrigan, director of the program.
Quaranti says that some of the 1,500 sanitation workers on site are already dead of what he believes to be exposure-related illnesses.
“A couple of guys died from cancer, a couple had liver problems,” he says.
Causality is a hotly contested issue, however. When asked how many first responders have died as a result of their exposure, Landrigan replies: “I couldn’t begin to tell you.”
Michael Roberts scans a photo hanging in the office of the house he and his wife own in Henderson. It shows Roberts and six other New York-Presbyterian Hospital EMTs rushing toward the towers as they blazed.
According to Roberts, the rate of illness in those pictured is 100 percent.
“Jack Delaney, the guy in the white helmet and blue jacket, he has asthma and nodules on his lungs now,” the 59-year-old says. “John Bergman, he has asthma. Tony DiTomasso, he’s behind me. He’s got asthma, too.
“The other guys, they’re all on inhalers.”

Cancer risk for firefighters

We are not aware of any specific study that has been completed on the occurrence of cancer among wildland firefighters, but there is enough data out there about structural firefighters that make this a major concern.  Wildfire Today has covered this before, but the Spokane Spokesman-Review has a new disturbing article about a local cancer cluster.  Here is an excerpt.

Doug Bacon missed the funeral of a fellow Spokane firefighter because the 59-year-old was in treatment for throat cancer – the same illness that had just killed his friend and co-worker.
A third Spokane firefighter who joined the department with Bacon in the 1970s also has been diagnosed with throat cancer.
“It’s to the point we’re trying to figure out which fire we were all on together,” said Bacon, who survived his cancer and returned to the job in mid-2006. “I’ve got attitude. I fought it.”
Firefighters are at least twice as likely to get cancer as the average person because of exposure to toxins emitted in fires, such as benzene, asbestos and cyanide, studies say. More firefighters have been diagnosed with cancer in the past two years than in the previous 10 years, according to the Firefighter Cancer Support Network and recent studies.
When Bacon was diagnosed with cancer in January 2006, he said he just looked at the doctor and said: “You’re kidding me.” He was unaware at the time that firefighters were more susceptible to the disease. Now, he’s constantly warning young firefighters of the dangers and telling them to keep their masks on – even after the fire’s out.
During July, Spokane area firefighters fought blazes nearly every day, including the massive Valley View wildfire, and two three-alarm fires – The Ugly Duck and Joel building.
Despite wearing protective gear, some walked away from those blazes hacking and coughing. Authorities say asbestos – a cancer-causing agent often found in old building materials – was found in the Joel building.
Research is still being done to determine what level of exposure leads to cancer in firefighters, officials say. Meanwhile, the illness has become a primary concern for the profession.
“Finally we are taking our blinders off when it comes to cancer,” said Michael Dubron, founder and president of the Firefighter Cancer Support Network. Dubron is a cancer survivor and Los Angles firefighter. “With our organization, we are trying to be proactive, such as reducing unnecessary exposure. No longer is it cool to run around with soot-covered uniforms and equipment.”
The soot contains many of the same toxins firefighters are exposed to during a blaze, officials say.
Something Wildfire Today wrote on May 28 is worth repeating:
In Canada, the British Columbia government recognizes as an occupational hazard for firefighters the following diseases:
  • testicular cancer
  • lung cancer in non-smokers
  • brain cancer
  • bladder cancer
  • kidney cancer
  • ureter cancer
  • colorectal cancer
  • non-Hodgkin’s lymphoma
  • leukemia
This means that full-time, volunteer, part-time, and paid on-call firefighters suffering from the diseases will qualify for worker’s compensation and benefits, without having to prove individually that the diseases are linked to their jobs.
There is not a lot that wildland firefighters can do to avoid breathing the byproducts of combustion.  There is no such thing as a breathing apparatus containing clean air that can be carried for a 16-hour shift.
The various filter masks that are sometimes bought by wildland firefighters do nothing except filter out some of the larger particles, sticks, and rocks.  The microscopic smoke particulates are so small, that if one were near the ceiling in a room with still air, it would take about eight hours to fall to the floor.  And the masks do nothing to remove the various toxic gasses and other contaminates.
We need to establish a system to track the long term health and cancer occurence within the wildland firefighter community.

Increased risk of bladder cancer for firefighters

It seems like there are more and more chronic diseases that firefighters are predisposed to get. Now you can add bladder cancer to the list.

ScienceDaily (May 15, 2008) — A new study presented at the Annual Scientific Meeting of the American Urological Association (AUA) suggests that firefighters may be at an increased risk of developing transitional cell carcinoma (TCC, or bladder cancer) and should be considered for routine annual screening. Currently, no guidelines exist for regular TCC screening.

Researchers are from the University of California, San Francisco.

It is well known that prolonged exposure to certain environmental pollutants and chemicals puts humans at a major risk for developing bladder cancer. As the body absorbs carcinogenic chemicals, such as cigarette smoke, the chemicals are transferred to the blood, filtered out by the kidneys and expelled from the body through the urine. Greater concentrations of chemicals in the urine can damage the endothelial lining of the bladder and increase a patient’s odds of developing transitional cell carcinoma (TCC). Firefighters, who are regularly exposed to smoke and chemical fumes, may be at a higher risk for developing the disease than other groups.

Researchers explored this possibility in a screening study of 1,286 active and retired San Francisco firefighters. From August 2006 to March 2007, the subjects – mean age 45 (SD+9.7) – participated in voluntary urine dipstick testing and point-of-care NMP-22 testing. 93 Patients tested positive for hematuria and six tested positive for NMP-22. These 99 patients were referred for upper tract imaging, cystoscopy and urine cytology. Of the group, a single firefighter tested positive for both NMP-22 and hematuria, with two patients – both retired firefighters – ultimately diagnosed with TCC.

The age and sex-adjusted incidence for TCC is 36 per 100,000. These findings represent a higher incidence, suggesting that retired firefighters may be a high-risk group.

In Canada, the British Columbia government recognizes as an occupational hazard for firefighters the following diseases:

  • testicular cancer
  • lung cancer in non-smokers
  • brain cancer
  • bladder cancer
  • kidney cancer
  • ureter cancer
  • colorectal cancer
  • non-Hodgkin’s lymphoma
  • leukemia

This means that full-time, volunteer, part-time, and paid on-call firefighters suffering from the diseases will qualify for worker’s compensation and benefits, without having to prove individually that the diseases are linked to their jobs.

Rather sobering, don’t you think?

Cancer cluster among firefighters

The Firegeezer blog, which always has excellent information about the broad topic of firefighting, had a recent post about a cancer cluster in Queensland, Australia. In part:

” […] Firefighters assigned to the station have a 62% higher rate of brain cancer than the rest of the state.”

Coincidentally, two days ago there was a news story containing preliminary research findings that linked brain cancer with polluted air, and specifically diesel exhaust. Firefighters have a hard time avoiding both.
firefighter smoke
Here is an excerpt from the story about the research:

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Dr. Julia Ljubimova found something disturbing when she probed the brains of rats exposed to air pollution: The dirty air appeared to trigger changes indicating the earliest stage of brain tumors.

Ljubimova, an oncologist and researcher at Cedars-Sinai Medical Center in Los Angeles, stressed that she is not ready to say air pollution is a cause of brain cancer.

“I don’t want to scare anyone, because this is preliminary data,” she said. “But we found something very important.”

Her work suggests that fine particles like those found in diesel soot can switch on firefighter smoke structure firethe tumor genes that many people inherit, jump-starting the disease process that results in brain tumors.

Hundreds of studies have linked air pollution to early deaths, heart attacks, reduced lung function, lung cancer and various other health problems. Ljubimova is among a handful of scientists who are focused on finding out what air pollution does to people’s brains.
Photos by Bill Gabbert