National Firefighter Registry opens for profession-wide cancer monitoring

The National Firefighter Registry (NFR) officially opens its enrollment portal today after a few months in pre-launch testing and years of preparation by the National Institute for Occupational Safety and Health (NIOSH). Wildland and structural firefighters who register and share their exposure histories at will help support the NFR’s goal of understanding and reducing cancer in firefighters.

The registry seeks comprehensive participation and notes four objectives that firefighters will support by enrolling:

      • “Help protect your brothers and sisters in the fire service from developing cancer
      • “Help lessen the impact of cancer on firefighters’ families and friends
      • “Pave the way for new health and safety measures to keep the next generation of firefighters safe
      • “Improve understanding of cancer risk among minority, female, and volunteer firefighters, as well as groups like wildland firefighters”

To develop comprehensive and ongoing  analyses of risks and illnesses, the NFR  encourages participation by all firefighters, structural and wildland, and all statuses — volunteer, on-call, seasonal, full-time, retired, disabled, with or without a cancer diagnosis.

While the images on the registry often focus on structural firefighters, the associated links include background health and cancer information for wildland firefighters and a web page focused on outdoor workers and smoke.

National Firefighter Registry

Bill Gabbert wrote many articles in Wildfire Today covering the genesis and progress toward the National Firefighter Registry (also referred to as the “cancer registry”). One article shared Kathleen Navarro’s “A Brief Look” at cancer and health risks for wildland firefighters, which notes an estimated 8-43% increased chance of lung cancer and a 16-30% increased risk of heart disease mortality among wildland firefighters. Gabbert died of cancer in January.

For agencies and organizations seeking to support enrollment, a communications portal offers a range of print and social media messages.

One suggestion when registering: gather up your experience records first. I completed the first three registration stages (the “profile” stage) in around 10 minutes and then took a break to collect some notes on seasons of service and types and amount of exposure. A registrant can step aside from the profile stage of the portal and continue later, but once you enter details of your fire experience in the “experience” stage of registration, you aren’t able to edit it.

Recording an accurate representation of work and fire experience is a core component of the registry, which seeks to create a database of fire experience, firefighter’s risk exposure and long-term health effects. This has proven a challenge for researchers examining the higher prevalence of cancer occurrence among firefighters.

This can be particularly challenging with wildland firefighters serving on seasonal assignments (and with seasonal exposure to many varieties and quantities of smoke and other potential fireline-related carcinogens). The registry includes questions that may assist in determining wildland smoke exposure, including a firefighter’s role in fire — such as hand crew, engine crew, aviation, etc.; firefighter or fire manager; and the duration and type of fires (wildfire vs. prescribed) that a firefighter responded to on average, by the specific positions held. The experience questionnaire includes most varieties of fire experience, including wildland-urban interface as compared to wildfires. The experience and personal demographic sections may take from 20-30 minutes to complete, longer if you’d had a variety of positions and fire experience in your career.

National Firefighter Registry - Stage 3 profile completed.
National Firefighter Registry – the Profile stages completed. Take a break and gather your exposure history before tackling the Experience Questionnaire.

The document below shares a step-by-step process. Note that the consent is in-depth, in part to ensure participants that their shared information will be kept confidential. Survey questions include general health and demographic questions, including a history of tobacco or alcohol use and workplace but non-fire exposure to potential carcinogens.

Once a firefighter is registered, an anonymized tracking system in state cancer registries will link a cancer diagnosis (if one occurs) to the last four digits of a social security number, which will then correlate the diagnosis with the NFR data that includes the firefighter’s experience and exposure. In some cases, NIOSH may connect with a registered firefighter to seek voluntary participation in additional research.

[pdf-embedder url=”” title=”How to signup for Firefighter Registry”]

Firefighter health and workplace initiatives featured Jan. 26

Finding time and priority for our health is key for firefighters and fire managers. This week, we offer four activities for you to pick and choose or preferably quadruple-up, starting with two online meetings on Jan. 26 that will highlight initiatives to improve firefighter working conditions.

(1) On Thursday Jan. 26, 1 pm EST, Fire Engineering and Vector Solutions will host a webinar with Chief Todd LeDuc (Ret.), Chief Strategy Officer for Life Scan Wellness Centers, and Frank Leeb, Deputy Assistant Chief with FDNY, on “The Impact of Occupational Cancer: How to Reduce Exposure & the Role of Early Detection.”

The announcement notes that “The International Agency for Research on Cancer (IARC) recently updated its classification of the firefighting occupation to Group 1, ‘carcinogenic to humans,’ after conducting a new international study that found sufficient evidence linking cancer risk to the occupation. The danger is real, but there are strategies and resources that can reduce risk, enhance survival, and support firefighters.”

(2) Later on Thursday (and on Pacific Time), the Grassroots Wildland Firefighters offer their quarterly update starting at 5:30 pm PST. Register here or find out more at their home page at This quarter’s updates will likely discuss recent legislation concerning preemptive cancer coverage in the Federal Firefighters Fairness Act and other Grassroots WFF initiatives, as well as the announcement by outgoing president Kelly Martin of the incoming board, which features Luke Mayfield – President, Riva Duncan – Vice President, Bobbie Scopa – Secretary, and Jami Egland – Treasurer. Kudos to Martin’s work with GRWFF and wishing for continued success to the new board.

(3) In related health news, this past week the U.S. Fire Administration announced the pending opening of the National Firefighter Registry.

As the USFA notes, “By adding your information to the National Firefighter Registry (NFR), you can help researchers better understand how your work affects the risk of getting cancer and how to lower this risk. According to National Institute for Occupational Safety and Health (NIOSH) research, cancer is a leading cause of death among firefighters, and research suggests firefighters are at higher risk for certain types of cancers when compared to the general population.”

A direct link to the NIOSH NFR website is at Initially the Registry was anticipated to open this past fall; it’s now scheduled to open this winter for confidential sharing of cancer diagnoses and work histories. As the NFR notes, “The more firefighters who sign up for the registry through its secure web portal, the more information researchers will have to learn about cancer in the fire service and how to protect firefighters from developing cancer in the line of duty.”

(4) Finally, a reminder –- there’s an opportunity to learn more of cancer and PTSD risks while adding a cancer/health donation. See our article Share a few hours for cancer awareness (and help fund our profession’s response) for more – and if you need an extra incentive, remember that the Vector-Solutions sponsored donation deadline is Jan. 31.

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
  • 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.