National Firefighter Registry hopes to begin testing in coming months

Congress required the creation of the registry almost 4 years ago

Lone firefighter in smoke
Image from the NWCG “Wildland Firefighter Mental health” video.

The National Firefighter Registry (NFR) that is supposed to collect data on a voluntary basis to better understand the link between workplace exposures, cancer, and other chronic diseases among firefighters, hopes to begin testing the enrollment system “in the coming months,” according to an update from the leader of the Registry, Kenny Fent.

That is the gist of the message sent by Mr. Fent today, with no other significant details about the registry itself. But he announced three additions to the NFR Subcommittee, one of which is Tom Harbour, the former Director of Fire and Aviation for the US Forest Service. Three members of the Subcommittee are stepping down, including Chuck Bushey who also has a wildland fire background. Mr. Fent said the purpose of the Subcommittee is to “provide independent advice and guidance.”

Almost four years ago the Firefighter Cancer Registry Act of 2018 which passed July 7, 2018 required that the National Institute for Occupational Safety and Health (NIOSH), an agency within the Centers for Disease Control and Prevention (CDC), establish a Firefighter Cancer Registry. Firefighters on the ground have yet to see any concrete examples of the effort, other than changing the name to just “National Firefighter Registry.”

Last year Congress made another attempt to get the registry started by adding a provision into the Tim Hart Wildland Firefighter Classification and Pay Parity Act, legislation which would also accomplish several things to improve the pay and working conditions of federal wildland firefighters. (We covered that legislation in another article.) But the Tim Hart Act has not made it out of committee since it was introduced in the House October 19.

Our take

The National Firefighter Registry has the potential to develop data that documents the health effects of fighting fire. Personnel considering it as a profession could make a better-informed decision in their career choice. And those tactical athletes who have been breathing smoke while working in one of the most physically demanding professions, could have facts to back up claims for treatment of conditions likely caused by the job. Congress and the Office of Worker’s Compensation Programs (OWCP) could better establish presumptive disease policies so that firefighters would not have to attempt to prove that certain cancers or their damaged lungs, knees, or back, were a result of their employment with the government.

Congress must exercise their oversight responsibility and hold hearings if necessary to strongly encourage Kenny Fent, the leader of the FR, to make every effort possible to establish the registry sooner rather than later.

It’s been almost four years.

Firefighters are biased toward action. They know how to get stuff done. Let’s get the NFR done.

Congress may try again to create a firefighter cancer registry

4:35 a.m. MDT Oct. 20, 2021

Pine Gulch Fire Colorado
Firefighters on Pine Gulch Fire during night shift, August 17, 2020. InciWeb.

A bill soon to be introduced in the House of Representatives, the Tim Hart Wildland Firefighter Classification and Pay Parity Act, would accomplish several things to improve the pay and other working conditions of federal wildland firefighters. We covered that in another article.

One of the provisions in that legislation, the creation of a “Federal Wildland Firefighter Cancer and Cardiovascular Disease Database”, is interesting. About three years ago the Firefighter Cancer Registry Act of 2018 which passed July 7, 2018, required that the National Institute for Occupational Safety and Health (NIOSH), an agency within the Centers for Disease Control and Prevention (CDC), establish a Firefighter Cancer Registry. The goal was to better understand the link between workplace exposures and cancer among firefighters. NIOSH has been piddling around with this for four years, led by Kenny Fent, accomplishing very little.

Kudos to the legislators who will attempt to get it done another way, after apparently giving up on the NIOSH Firefighter Cancer Registry.

Articles on Wildfire Today tagged “cancer registry.”

Legislation announced to raise pay for federal wildland firefighters to at least $20 an hour

Would also pay “portal to portal” on fire assignments and provide housing stipends

3:53 p.m. MDT Oct. 19, 2021

Wildland Firefighter Classification and Pay Parity Act

Today federal legislation was announced that would benefit wildland firefighters in several ways. The Tim Hart Wildland Firefighter Classification and Pay Parity Act. (Update Oct. 26, 2021. The bill now has a number: H.R.5631 – Tim Hart Wildland Firefighter Classification and Pay Parity Act.)

The bill would increase their take home pay by raising firefighters’ salaries and would provide other benefits:

  • Raise federal wildland firefighter pay to at least $20 an hour, and add “portal-to-portal” compensation;
  • Create a federal wildland firefighter classification series, so wildland firefighters are appropriately classified for the dangerous work they are doing;
  • Provide health care and mental health services to temporary and permanent wildland firefighters, including:
    • creating a national “Federal Wildland Firefighter Cancer and Cardiovascular Disease Database” to track chronic disease caused by on the job environmental exposure throughout the lives of current and past wildland firefighters, and
    • launching a mental health awareness campaign, a mental health education and training program and an extensive peer to peer mental health support network for wildland firefighters and immediate family.
  • Ensure all federal wildland firefighters earn retirement benefits for temporary seasonal employment, retroactively applying to the last 10 years of service (this has been corrected, and applies to service since 1989;
  • Provide 1 week of mental health leave for wildland firefighters;
  • Provide housing stipends for all firefighters on duty more than 50 miles from their primary residence; and
  • Provide tuition assistance for all permanent federal employees in the wildland firefighter classification.

The bill would affect the approximately 15,000 firefighters that work for the National Park Service, Bureau of Land Management, Bureau of Indian Affairs, Fish and Wildlife Service, and Forest Service. Their salaries are far below that found in some county, state, and municipal fire departments which has resulted in an exodus of trained and experienced fire personnel to other organizations, and makes recruitment of their replacements difficult.

Currently, wildland firefighters are primarily classified as “forestry technicians,” paid an hourly wage of $13.45 at the starting GS-3 level, and are often can’t afford the costs of housing while on the job. According to recent studies, firefighters nationwide commit suicide 30 times as often as the general public and have a 30% increased risk for cardiovascular diseases, and 43% increase for lung cancer.

The proposed legislation was announced during a virtual press conference Tuesday. Speakers in support included Rep. Joe Neguse (CO) and co-sponsor Rep. Salud Carbajal (CA). Other co-sponsors include Rep. Katie Porter (CA) and Rep. Liz Cheney (WY). Mr. Neguse is Co-Chair of the Bipartisan Wildfire Caucus.

The bill is named after Tim Hart, a smokejumper who died May 24, 2021 after a hard landing while parachuting into the Eicks Fire in New Mexico. Mr. Hart’s widow, Michelle Hart, was one of the speakers at the virtual press conference, expressing her support of the legislation.

“Tim would be humbled and honored to have this legislation be a part of his legacy,” she said. “These issues were deeply important and personal to him. Wildland firefighters deserve to be recognized and compensated for the grueling conditions in which they work and for putting their lives on the line every day. This legislation is a major step forward in achieving that goal.”

The legislation has not yet been introduced, and after that step it has to make it through several committees before it can be voted on in the full House of Representatives. One of those committees, the National Parks, Forests, and Public Lands subcommittee, is chaired by Mr. Neguse who said he will arrange for a hearing on the bill.

Mr. Neguse said he was reasonably certain that a companion Senate bill will be introduced in the coming weeks.

The bill is endorsed by Grassroots Wildland Firefighters, International Association of Firefighters, U.S. Hotshots Association, National Smokejumper Association, Wildland Firefighter Foundation, Eric Marsh Foundation, National Federation of Federal Employees, and Team Rubicon.

The Grassroots Wildland Firefighters, one of the organizations that provided input as the legislation was being formulated, issued a statement on the legislation:

“We urge all members of congress to support Tim’s Act, if you represent a district impacted by wildfire or any type of natural disaster, please understand how these needed fixes impact the well-being of the men and women responding to those incidents.” said Luke Mayfield, GWF Vice President, adding that, “simultaneously Grassroots Wildland Firefighters will work to keep firefighters and their families briefed on how the bill would impact their lives.”

National Firefighter Registry releases time line toward implementation

UPDATED at 10:45 a.m. MDT Nov. 21, 2019

On November 21 the National Firefighter Registry that is being created by the National Institute for Occupational Safety and Health (NIOSH), a division of the Centers for Disease Control and Prevention, released information about their accomplishments. We are updating this article originally published November 17, 2019 to include the new data.


Milestones from this Quarter
Much of the work this quarter focused on creating the NFR protocol, filling staffing needs, and meeting with firefighters and stakeholders about the NFR. Some of our key milestones for this quarter include:

  • Reviewed Federal Register comments made on the NFR’s Request for Information (RFI). Thank you to those that were able to provide feedback. These comments are very helpful in guiding the development of the NFR.
  • Began development of the protocol, informed consent document, and enrollment questionnaire.
  • Started gathering details on record keeping systems at fire departments to better understand what data are available and potential mechanisms for importing the data.
  • Made progress on developing requirements for the registration web portal.
  • Held discussions with representatives from select state cancer registries and related organizations to better understand cancer surveillance on a national level.
  • Hired a new health scientist, Andrea Wilkinson, formerly of the First Responder Health & Safety Laboratory at Skidmore College.
    Created the NFR webpage https://www.cdc.gov/niosh/firefighters/registry.html
  • Began formation of the NFR Advisory Committee. This committee will include at least 10 members with various backgrounds, expertise, and experience related to firefighter health and research.

Next Steps

  • Finalize protocol and consent form
  • Begin Office of Management and Budget (OMB) clearance process for enrollment questionnaire
  • Hire Health Communications Specialist
  • Continue conversations with stakeholders and obtain their support
  • Continue conversations with select fire departments throughout the country.

(Originally published at 9:54 a.m. MDT Nov. 17, 2019)

The National Firefighter Registry, originally called the Firefighter Cancer Registry in the authorizing legislation, has released very broad time-based goals for implementing a system which hopefully can identify any relationships between cancer and occupational exposure to toxicants.

Earlier this year the National Institute for Occupational Safety and Health (NIOSH), a division of the Centers for Disease Control and Prevention, asked firefighters for input on how to maximize participation in the Registry (perhaps working on the first goal in the timeline chart). That comment period ended May 28, 2019.

From the time line, it appears that NIOSH hopes to begin enrolling firefighters sometime between 2019 and 2022.

firefighters smoke
Firefighters in a smoky environment on the White Tail Fire, March 8, 2019, Black Hills National Forest.

Previous studies, including one completed by NIOSH in 2014, have highlighted firefighters’ increased risk for certain cancers compared to the general population. However few previous studies have collected data about wildland firefighters, volunteer firefighters, or sufficient numbers of female and minority firefighters in order to draw conclusions regarding their risk of cancer.

In one study that collected data from wildland firefighters in the field, a group of researchers concluded that firefighters’ exposure to smoke can increase the risk of mortality from lung cancer, ischemic heart disease, and cardiovascular disease by 22 to 39 percent. The project only looked at the wildland fire environment, and was not a long term study of firefighters’ health.

The ultimate goal of the Registry is to better understand the link between workplace exposures and cancer among firefighters. The Registry will include all U.S. firefighters, not just those with a cancer diagnosis. The Registry also has the potential to provide a better understanding of cancer risk among subgroups such as women, minorities, and volunteers, and among sub-specialties of the fire service like instructors, wildland firefighters, and arson investigators.

From the Registry information, CDC/NIOSH will estimate an overall rate of cancer for firefighters. They might find certain groups of firefighters are at a higher risk of cancer than others based on level of exposure, geography, gender, or other factors. They may also find that certain protective measures are associated with a reduced risk for cancer, which could provide additional evidence and support for specific control interventions.

The Registry will be completely voluntary, and no one can force a person to join.

All active and retired as well as volunteer, paid-on-call, and career firefighters will be encouraged to join the Registry, regardless of their current health status.

CDC/NIOSH promises that they will always maintain participants’ privacy and will never share personal information with an outside organization including fire departments, unions, or other researchers without permission of the individual.

Establishment of firefighter cancer registry is progressing

The next step is to collect input from firefighters and stakeholders on an approach to the Registry including potential enrollment methods

A firefighter works a blaze in Northern California. Photo courtesy CAL FIRE.
A firefighter works a blaze in Northern California during the fires in Wine Country in 2017. Photo courtesy of CAL FIRE.

(UPDATED at 10 a.m. MDT March 28, 2019)

The Request for Information about the new National Firefighter Registry described below was published today. The National Institute for Occupational Safety and Health (NIOSH), an agency within the Centers for Disease Control and Prevention (CDC), is requesting input about three possible enrollment strategies. Specifically, NIOSH is asking for input on how to maximize participation for the Registry. The comment period will close on May 28th, 2019.

The process for leaving a comment is convoluted. They ask you to click on this link and then you have to search for the appropriate issue. I searched for “National Firefighter Registry” which brought up 208 results. When I checked today it was the first one.

When found, you have to click in the search results on “Comment Now”(over on the right)  Maybe THIS will take you directly to the comment form.

Keep in mind that any information (e.g., personal or contact) you provide on the comment form may be publicly disclosed and searchable on the Internet and in a paper docket. But you don’t have to leave your name or email address.


(Originally published at 2:41 p.m. MDT March 27, 2019)

In April, 2017 a bill was introduced in Congress that would establish a registry to track the occurrence of cancer among firefighters. A version of the bill was finally signed into law on July 7, 2018. Now, eight months later it appears that the creation of the registry is some distance from becoming a reality, but we can report some progress.

The legislation called it a Firefighter Cancer Registry, but it appears that the name has changed to National Firefighter Registry — a vague term which does not provide a clue about the purpose.

Kenny Fent is the Team Lead for what will become the National Firefighter Registry Program. Mr. Fent is a Research Industrial Hygienist with the National Institute for Occupational Safety and Health, a division of the Centers for Disease Control and Prevention. He told us that soon the agency will post a Request for Information (RFI) to the Federal Register regarding the Registry. During a 60-day period they will seek input on an approach to the Registry including potential enrollment methods. All stakeholders, including firefighters, will be encouraged to review the document and respond with comments.

NIOSH-CDC logoOnce the Registry design is finalized, CDC/NIOSH will begin enrollment. Where possible, CDC/NIOSH will collect work history and exposure records to explore the relationship between exposures and cancer. They will also link with state cancer registries to confirm diagnoses. Findings will be shared through scientific publications and communications to stakeholders and the public.

Previous studies, including a study completed by the National Institute for Occupational Safety and Health (NIOSH) in 2014, have highlighted firefighters’ increased risk for certain cancers compared to the general population. However, few previous studies have collected data about wildland firefighters, volunteer firefighters, or sufficient numbers of female and minority firefighters in order to draw conclusions regarding their risk of cancer.

In one study that collected data from wildland firefighters in the field, a group of researchers concluded that firefighters’ exposure to smoke can increase the risk of mortality from lung cancer, ischemic heart disease, and cardiovascular disease by 22 to 39 percent. The project only looked at the wildland fire environment, and was not a long term study of firefighters’ health.

The ultimate goal of the Registry is to better understand the link between workplace exposures and cancer among firefighters. The Registry will include all U.S. firefighters, not just those with a cancer diagnosis. The Registry also has the potential to provide a better understanding of cancer risk among subgroups such as women, minorities, and volunteers, and among sub-specialties of the fire service like instructors, wildland firefighters, and arson investigators.

From the Registry information, CDC/NIOSH will estimate an overall rate of cancer for firefighters. They might find certain groups of firefighters are at a higher risk of cancer than others based on level of exposure, geography, gender, or other factors. They may also find that certain protective measures are associated with a reduced risk for cancer, which could provide additional evidence and support for specific control interventions.

The Registry will be completely voluntary, and no one can force a person to join.

All active and retired as well as volunteer, paid-on-call, and career firefighters will be encouraged to join the Registry, regardless of their current health status.

CDC/NIOSH promises that they will always maintain participants’ privacy and will never share personal information with an outside organization including fire departments, unions, or other researchers without permission of the individual.

Study shows firefighters’ exposure to smoke increases disease risk

Depending on the type of work performed and the number of years of exposure, the increased risk can be 22 to 39 percent.

Above: Smoky conditions on the Legion Lake Fire in Custer State Park in South Dakota, December 12, 2017. Photo by Bill Gabbert.

Originally published at 6:02 p.m. MT, February 6, 2018.

After collecting data from wildland firefighters in the field, a group of researchers concluded that firefighters’ exposure to smoke can increase the risk of mortality from lung cancer, ischemic heart disease, and cardiovascular disease. In this first section we cover what is in vegetation fire smoke, and after that we have details about the additional mortality risk faced by firefighters who can’t help but breathe the toxic substances.

What is in the air that firefighters breathe?

There have been many studies about smoke dating back to the 1988 NIOSH project at the fires in Yellowstone National Park. Most of them confirmed that yes, wildland firefighters ARE exposed to smoke and in most cases they quantified the amount.

In 2004 Timothy E. Reinhardt and Roger D. Ottmar  found a witches’ brew of methyl ethyl bad stuff that firefighters are breathing. All of these are hazardous to your health:

  • Aldehydes (volatile organic compounds); can cause immediate irritation of the eyes, nose, and throat, and inhalation can cause inflammation of the lungs. Short-term effects include cough, shortness of breath, and chest pain. The most abundant aldehyde in smoke is formaldehyde. When formaldehyde enters the body, it is converted to formic acid, which also is toxic.
  • Sulfur dioxide (SO²); causes severe irritation of the eyes, skin, upper respiratory tract, and mucous membranes, and also can cause bronchoconstriction. It forms sulfuric acid in the presence of water vapor and has been shown to damage the airways of humans.
  • Carbon monoxide (CO); As CO is inhaled it displaces O2 as it attaches to red blood cells and forms COHb. COHb reduces the ability of the blood to carry oxygen and causes hypoxia (a condition in which the body does not receive sufficient oxygen). Due to their strenuous work, wildland firefighters often have increased respiratory rates, which will increase the amount of CO being inhaled when smoke is present. COHb has a half-life (the time it takes half of the COHb to dissipate from the body) of about 5 hours. Symptoms of CO exposure include headaches, dizziness, nausea, loss of mental acuity, and fatigue. Prolonged, high exposure can cause confusion and loss of consciousness
  • Particulate matter; Respirable particulates are a major concern as they can be inhaled into the deeper recesses of the lungs, the alveolar region. These particles carry absorbed and condensed toxicants into the lungs
  • Acrolein; may increase the possibility of respiratory infections. It can cause irritation of the nose, throat, and lungs. Long-term effects can include chronic respiratory irritation and permanent loss of lung function if exposure occurs over many years.
  • Benzene; can cause headaches, dizziness, nausea, confusion, and respiratory tract irritation. Although the human body can often recover and repair damage caused by irritants, prolonged exposure from extended work shifts and poorly ventilated fire camps can overwhelm the ability to repair damage to genes and deoxyribonucleic acid (DNA).
  • Crystalline silica; can cause silicosis, a noncancerous lung disease that affects lung function. But OSHA classifies it as a carcinogen.
  • Intermediate chemicals; have been shown to cause a variety of health problems including bronchopulmonary carcinogenesis, fibrogenesis, pulmonary injury, respiratory distress, chronic obstructive pulmonary disease (COPD), and inflammation.

One of the more recent research efforts, from 2009 to 2012, was led by George Broyles of the U.S. Forest Service, National Technology and Development Program, in Boise, Idaho. They collected data in 11 fuel models in 17 states on initial attack, prescribed burns, and large project fires. The group measured carbon monoxide (CO) with electronic datalogging dosimeters and particulate matter using air pumps and filters.

carbon monoxide exposure firefighters
Data from the 2009-2012 wildland firefighter study led by George Broyles. “TWA” stands for Time Weighted Average. CO is carbon monoxide. OEL is Occupational Exposure Limits.

Monitoring carbon monoxide (CO) can be important, and is also fairly easy to do and not terribly expensive. Researchers have found that it can be a surrogate for the primary irritants of concern in wildland smoke near the combustion source. If CO is present, it’s almost certain that the smorgasbord of nasty stuff is in the air.

wildfire smoke monitoring firefighters
Jon Richert displays the various devices the National Technology Development Center research crews use to measure the amount of smoke firefighters deal with during wildfire suppression. This equipment was used in 2016 in a different but similar study than the one described in this article.
Diffusion tube
Diffusion tube.

Electronic CO monitors are available for $100 to $300. Another option is the little disposable CO monitors called diffusion tubes. With the holder they are about the size of a dry erase marker. Many are made by Drager, and for eight hours can record the cumulative CO. You can’t get an instantaneous reading, but the total hourly exposure can be monitored. They cost about $13 each. If one or two people on the crew carry them it can provide a heads up if the air quality is really bad.

What are the health effects of smoke exposure on a wildland fire?

Employers in most if not all workplaces are required to minimize hazards and provide a safe working environment. But of course it is impossible to totally eliminate all risks to firefighters. A cynic might assume that leadership in the wildland fire community may be hesitant to ask the question if they don’t want to hear the answer.

In spite of numerous studies confirming that yes, there is smoke where wildland firefighters work, there has been little in the literature that quantifies the effects on a person’s health. A new study published in August, 2017 contains a preliminary analysis addressing that question.

It is titled Wildland Fire Smoke Health Effects on Wildland Firefighters and the Public – Final Report to the Joint Fire Science Program. The authors are Joe Domitrovich, George Broyles, Roger D. Ottmar, Timothy E. Reinhardt, Luke P. Naeher, Michael T. Kleinman, Kathleen M. Navarro, Christopher E. Mackay, and Olorunfemi Adetona.

They used the field data collected in the 2009 to 2012 George Broyles study to extrapolate the physical and health effects on humans. The authors actually came up with numbers that indicate firefighters’ relative mortality risk for lung cancer, ischemic heart disease, and cardiovascular disease.
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