NIOSH is studying the health effects of fighting wildfires

firefighters health study
Screenshot from the firefighters health study video below.

This is the second year of a multi-year study that is following six crews and taking health data from them on fires as well as at the beginning and end of the fire seasons.

The video provides a brief overview of this new approach to examine the potential health effects that wildland firefighters may experience working on wildland fires. This effort is a collaboration between the National Institute for Occupation Safety and Health (NIOSH), the U.S. Forest Service, and the National Park Service. As you will see in the video, a NIOSH team actually goes into the field on a wildfire in Idaho to test members of the Sawtooth Interagency Hotshot Crew on potential impacts to their overall health, including effects to their hearts, lungs, kidneys, and hearing. As results of this effort are made available, the Wildland Fire Lessons Learned Center will share them.

Jon Stewart scolds Congress regarding reauthorizing the 9/11 victims compensation fund

Blasts ’empty chair’ lawmakers

Senate Judiciary Committee Jon Stewart
While testifying during a June 11, 2019 hearing before the Senate Judiciary Committee, Jon Stewart (at lower left) turns away for a second from the empty Senators’ chairs to look at the first responders in the audience. Screen grab from CNN video. Click to enlarge.

Since at least 2010 Jon Stewart, formerly of the Daily Show, has been striving to get Congress to provide adequate health care for the firefighters and other first responders that fought the fires and assisted victims after the World Trade Center towers were attacked by terrorists in 2001.

This morning he appeared again before the Senate Judiciary Committee to encourage Senators to approve the bill that will be voted on tomorrow, June 12. Every few years the legislation that funds health care for the 9/11 first responders suffering from cancer and other diseases expires, and the fight to do the right thing must be reintroduced and refought. The bill now pending will make health care for the 9/11 first responders permanent.

You will see in the video how strongly Mr. Stewart feels about this issue.

Here are some quotes from Mr. Stewart’s testimony:

This hearing should be flipped. These men and women should be up on that stage and Congress should be down here answering their questions as to why this is so damn hard and takes so damn long.

Setting aside, no American should face financial ruin because of a health issue.

Certainly 9/11 first responders shouldn’t have to decide whether to live or to have a place to live.

They responded in 5 seconds. They did their job with courage, grace, tenacity, humility — 18 years later, DO YOURS.

 

Below is an excerpt from an article at The Sun, published September 11, 2018:

In the following days [after the attacks on 9/11], people from every state – and almost every single district – of America helped at Ground Zero – rescuing casualties, digging up bodies, cleaning up and rebuilding.

Now they are paying a high price for their selflessness – while most of the world remains oblivious to their suffering.

Over 2,000 first responders – anyone who helped out at Ground Zero, including building workers, electricians, doctors and paramedics – have died from illnesses caused by breathing in the toxic fumes that engulfed the site in the weeks after the terror attack.

As thousands more currently battle 9/11-related diseases such as cancer or severe respiratory disease, shockingly, it’s predicted that by the end of this year the number of first responders who have died since the tragic event will overtake the number who died on the day…

All articles on Wildfire Today that mention Jon Stewart and the 9/11 Victims Compensation Fund.

Researchers find prescribed fire smoke to be less harmful than that from wildfires

Therefore, prescribed fires to protect communities can protect residents in more ways than one

Wolf Trap National park prescribed fire
Prescribed fire at Wolf Trap National Park, April, 2018. NPS photo by Nathan King.

Researchers studying the effects of smoke on children found prescribed fire smoke to be less harmful than smoke from wildfires. The Stanford University study looked at three groups of children:

  • Those who were exposed to smoke from a prescribed fire;
  • Children exposed to smoke from a wildfire in which no structures burned; and,
  • Children that were not exposed to smoke.

Sometimes fire personnel refer to a prescribed fire as “good fire”. Now they may call smoke from a planned burn as “good smoke”. A way to look at this research is that removing hazardous fuels near a community is a way to reduce the threat of a wildfire spreading into the town and burning structures or entrapping and killing people. And, removing the fuels with good fire rather than allowing a wildfire to burn the same area, exposes residents to less harmful smoke. For fire-prone areas, it is not IF it burns, it’s WHEN. Do you want your smoke now under controlled conditions or later, possibly under extreme conditions?

From Stanford University:


…The study was published May 30 in the European Journal of Allergy and Clinical Immunology. It was conducted in Fresno, California, a city with high air pollution levels due to its topography and other sources, including traffic and agriculture.

“This study suggests that exposure to wildfire smoke is detrimental above and beyond poor air quality,” said the lead author, Mary Prunicki, MD, PhD, an instructor of medicine.

The study’s senior author is Kari Nadeau, MD, PhD, professor of medicine and of pediatrics and director of the Sean N. Parker Center for Allergy & Asthma Research at Stanford.

Native Americans traditionally used controlled burns to manage California’s forests, but throughout the early 20thcentury, wildfires were widely suppressed. This began to change in the 1960s and 1970s, when scientists recognized fire as a normal part of forest ecology. Recent wildfires have brought more attention to the possible benefits of prescribed burns as a way to reduce fuel levels and wildfire risk, but not everyone is enthusiastic.

Opposition to controlled burns
“We know that there’s some public opposition to doing prescribed burning,” Prunicki said. “It’s our feeling that prescribed burning, because it’s so controlled, may expose people to fewer health effects than wildfires.” Prescribed burns are of lower intensity and are permitted only when weather conditions allow the fire to be contained.

In the study, the researchers compared blood samples from three groups of children, all of whom were 7 or 8 years old. One group of 32 children had been exposed to smoke from a 553-acre prescribed burn that occurred in March 2015; a second group of 36 children had been exposed to smoke from a 415-acre wildfire in September 2015. Both fires were about 70 miles away from Fresno, and blood samples were collected from the children within three months of each fire.

The study also included blood samples from a control group of 18 children who lived in the San Francisco Bay Area and had not been exposed to wildfire or prescribed-burn smoke.

The researchers measured air pollution levels recorded at four monitoring stations in Fresno and estimated pollution levels at the children’s homes during the fires based on how far they lived from the stations.

Pollutant exposures were higher in the wildfire group compared to the prescribed-burn group.  The air pollutants measured included nitrogen dioxide, polycyclic aromatic hydrocarbons, elemental carbon, carbon monoxide and particulate matter.

Wildfire smoke exposure was associated with lower blood levels of type-1 T helper cells, a group of immune cells that are involved in the immune response. Among children exposed to wildfire smoke, the researchers also saw increased methylation of the Foxp3 gene, indicating reduced activity of this gene, which is broadly involved in modulating allergic and other immune responses. The finding of greater Foxp3 methylation is congruent with earlier studies of the effects of air pollution on the immune system, Prunicki noted.

Significance of particulate matter
One important aspect of the study was that the September 2015 wildfire was confined to forested areas and did not burn any structures.

“Particulate matter from wildfires is different from region to region and depends on what is burning,” Prunicki said. “When a wildfire is going through a town, there are a lot of concerns about what happens to the chemicals in people’s homes and cars when they go up in flames.” Smoke from wildfires that burn inhabited areas almost certainly has worse health effects than those found in the current study, she said.

The researchers plan to conduct larger, more detailed studies of the effects of wildfire smoke on health. They will be enrolling healthy people in a trial at Stanford later this summer to collect baseline data from blood samples. When future wildfires affect Bay Area air quality, the participants will be asked to provide follow-up blood samples.

The scientists also plan to research the health effects of using home air purifiers during wildfires, as well as measure the protection offered by N95 masks, with the aim of developing recommendations for when masks should be used by different populations, such as healthy adults, elderly people, children and people with chronic illnesses.

The study’s other Stanford co-authors are biostatistician Justin Lee; life science researcher Xiaoying Zhou, PhD; Francois Haddad, MD, clinical associate professor of medicine; and Joseph Wu, MD, PhD, professor of medicine and of radiology.

Montana becomes 49th state with some form of presumptive care for firefighters

Montana Governor to sign legislation today

With the passage of Senate Bill 160 Montana becomes the 48th state with some form of presumptive care for firefighters.

The Firefighters Protection Act lists 12 presumptive diseases for which it would be easier for a firefighter to file a workers’ compensation claim if they served a certain number of years:

  • Bladder cancer, 12 years
  • Brain cancer, 10 years
  • Breast cancer, 5 years
  • Myocardial infarction, 10 years
  • colorectal cancer, 10 years
  • Esophageal cancer, 10 years
  • Kidney cancer, 15 years
  • Leukemia, 5 years
  • Mesothelioma or asbestosis, 10 years
  • Multiple myeloma, 15 years
  • Non-Hodgkin’s Lymphoma, 15 years
  • Lung cancer, 4 years

The bill applies to volunteers and local fire departments in Montana, but not to federal firefighters. It is unclear if it affects those employed by the state government.

The federal government has not established a presumptive disease program for their 15,000 wildland firefighters.

At a bill signing ceremony Thursday afternoon Governor Bullock will issue a proclamation ordering flags to be displayed at half-staff in honor of all Montana firefighters who have lost their lives from a job-related illness in the line of duty.

Governor Proclamation Montana firefighters


In a related story from April 12, “British Columbia may expand firefighter occupational disease coverage to wildland firefighters”

British Columbia may expand firefighter occupational disease coverage to wildland firefighters

Minister calls firefighting dangerous, says it can have severe impacts to physical and mental health

Massachusetts firefighters British Columbia
Firefighters from Massachusetts board an aircraft on the way to the Elephant Hill Fire near Kamloops, British Columbia. Photo by Mass. Department of Conservation and Recreation.

The United States government does not have a presumptive disease policy for their 15,000 federal wildland firefighters, but British Columbia is seeking to expand their program.

From The Canadian Broadcasting Corporation:


Firefighters who have battled British Columbia wildfires, fire investigators, and fire crews working for Indigenous groups will be eligible for greater access to job-related health compensation under legislation introduced Thursday.

Labour Minister Harry Bains tabled amendments to the Workers Compensation Act that extends occupational disease and mental health benefits to more people who work around fires.

The proposed changes will expand cancer, heart disease and mental health disorder presumptions to include the three other job categories, because Bains says those workers are often involved in the traumatic issues related to fires.

Presumptive illnesses faced by firefighters are recognized under the act as conditions caused by the nature of the work, rather than having firefighters prove their issue is job related to receive supports and benefits.

Bains says the government expanded the presumptive job-related conditions last year to include mental-health disorders for police officers, paramedics, sheriffs, correctional officers and most urban firefighters. He says firefighting is dangerous work that can have serious impacts on an individual’s physical and mental health.

“They will enjoy the same coverage as the other firefighters — the first responders — receive as part of giving them certain cancer protections, heart disease and injuries and mental health,” Bains said during a news conference after the legislation was introduced.

“These steps are very necessary to ensure our workplaces are the safest in the country.”

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.