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Tag: firefighter health

Montana legislature rejects firefighter health bill

Author Bill GabbertPosted on Categories UncategorizedTags , 15 Comments on Montana legislature rejects firefighter health bill

One Senator who opposed it said “it is something they’re going into with their eyes wide open”.

Above: A firefighter works in smoke on the Water Tower Fire in South Dakota, March 16, 2016. Photo by Bill Gabbert.

On Wednesday a Montana legislative committee voted down a bill that would have provided benefits for firefighters who developed a lung disease on the job. Republican Mark Noland of Bigfork said firefighters “know what they’re doing”, and:

That is their profession, that is what they chose, and we do not want to, you know, slight them in any way, shape or form, but it is something they’re going into with their eyes wide open.

That is asinine, ridiculous, reprehensible, and irresponsible.

Rep. Mark Noland
Rep. Mark Noland of Bigfork, MT.

He is assuming that when firefighters began their careers they knew there was a good chance they would damage their lungs. If that is common knowledge now, or was 20 years ago when the firefighter signed up, why haven’t the employers already established coverage for presumptive diseases? There is a great deal we do not know about the effects of breathing contaminated air on structure, vehicle, and wildland fires.

Many agencies and government bodies have already established a list of presumptive diseases that will enable health coverage for firefighters. For example the British Columbia government recognizes at least nine “presumptive cancers” among firefighters, including leukemia, testicular cancer, lung cancer, brain cancer, bladder cancer, ureter cancer, colorectal cancer, and non-Hodgkins’s lymphoma.

The Montana legislation would have only covered one of these nine illnesses.

According to the Associated Press, Gov. Steve Bullock noted that 46 other states already have presumptive illness protections for firefighters.

When a person enlists in the military and they come home injured or permanently disabled, should we ignore them, saying they knew what they were getting into? Their “eyes were wide open”? How is treating firefighters injured on the job different? One could argue that they are both defending and protecting our homeland; one of them actually IN our homeland while the other may have been on the other side of the world.

Only one Republican on the House committee voted for the measure. Apparently in Montana treating firefighters injured on the job is a partisan issue.

The bill was previously passed by the Senate on a 33-14 vote. It is still possible that the bill could be brought up again by the House. If you want to follow the legislation, the text is HERE and you can track the progress HERE.

Cancer and the San Diego Fire-Rescue Department

Author Bill GabbertPosted on Categories UncategorizedTags , ,

Above: Screenshot from Jason Curtis’ film about San Diego firefighters and the occurrence of cancer.

The San Diego Fireman’s Relief Association has produced a short 8-minute documentary about the occurrence of cancer within the membership of the San Diego Fire-Rescue Department, interviewing 15 firefighters who talked about their job and the disease. Many of them looked back knowing what they know now, and wished they had done some things differently.

(UPDATE March 2, 2017: the film was available at the website of the company hired to make the film, but it has been removed until the cancer awareness program associated with it has been rolled out. It may be available again on YouTube or another site in two to three months, according to Robert Bunsold, a board member of the Relief Association.)

The San Diego FD primarily deals with structure fires. The mix of by-products of combustion they are exposed to is different from what a wildland firefighter works in, but unfortunately we don’t know what the significance of that difference is, if any. There are carcinogens in wood smoke but much work still needs to be done to determine the short and long-term effects on wildland firefighters.

Structural firefighters generally wear breathing apparatus (BA) when they are making an interior attack on a structure, and often when they are on the exterior. But wildland firefighters never wear BAs on a vegetation fire because it is not practical. They can be working on a fire miles from their truck for up to 16 hours, but the air bottles only last for minutes.

Some wildland firefighters wear a bandana or dust mask over their nose and mouth, thinking, incorrectly, that they provide some level of protection from particulates. And they have no effect on carbon monoxide and other dangerous gasses.

The smallest and most dangerous particulates in vegetation fire smoke are so small that if one was near an 8-foot high ceiling in a room with perfectly still air, it would take 8 hours for it to fall to the floor. These particles can easily go through a bandana or a cheap mask and make their way to the lungs. Much more expensive respirators with certain types of replaceable filters could provide better air, but they are hot to wear and create too much resistance as the air is forced through the apparatus.

wildfire firefighter smoke
A firefighter works in the smoke on the Water Tower Fire in Hot Springs, SD March 1, 2016. Photo by Bill Gabbert.

There is no registry that tracks their exposure or health during and after their careers. Another bill was introduced in Washington this month to create a registry, but the one introduced a year ago died a quick death, and this newest one has far fewer co-sponsors and so far looks unlikely to pass.

Washington Post writes about firefighters and cancer

Author Bill GabbertPosted on Categories UncategorizedTags , , , 20 Comments on Washington Post writes about firefighters and cancer

Above: Members of a hotshot crew work in smoke on the Cold Brook Prescribed Fire, October 23, 2014. Photo by Bill Gabbert.

Very slow progress is being made toward recognizing the long term health risks of firefighters and more importantly, taking action to mitigate the effects.

This month another bill was introduced that would establish a national cancer registry for firefighters diagnosed with cancer, an occupational hazard that many organizations recognize as a presumptive disease in the profession. The bill is titled Firefighter Cancer Registry Act of 2017. A similar bill with 118 co-sponsors died a quick death in 2016, so there is little hope that this one will fare much better. This newest one has 12 co-sponsors as of today.

On Friday the Washington Post published an in-depth look at the topic in an article titled, Firefighters and cancer: Is a risky job even riskier? The authors interviewed several firefighters who have been diagnosed with cancer and laid out some of the health-related risks of the job.

Here is an excerpt from the article:

In 2015, the Centers for Disease Control and Prevention released the final results of what is currently the largest study of cancer risk among career firefighters ever conducted in the United States. The study of about 30,000 firefighters over a 60-year span showed that compared with the general population, firefighters on average are at higher risk for certain kinds of cancer — mainly oral, digestive, respiratory, genital and urinary cancers.

It is important to provide treatment to firefighters that have been injured on the job, including those suffering from diseases that were likely caused by working in a hazardous environment.

It is also important to take steps to reduce the hazard in the first place. For wildland firefighters who don’t have the luxury of breathing air carried in a bottle on their back, avoiding cancer-causing smoke can be difficult. But in some cases supervisors can minimize the number of firefighters that are forced to work in heavy smoke, or rotate them into areas where there is less. A crew can have a small carbon monoxide detector to identify excessive exposure to the dangerous gas, which on a fire would also be associated with the presence of particulates and carcinogens.

Here is another quote from the Washington Post article:

“Smoke on your gear and smoke on your helmet used to be a sign that you’re an experienced firefighter,” said Lt. Sarah Marchegiani of the Arlington County Fire Department. “But now people just recognize it’s a hazard and not worth it.”

Nevada BLM engine crew
A Nevada BLM engine crew in 2016. Inciweb photo. The faces were blurred by Wildfire Today.

An issue that always creates some controversy on Wildfire Today is the fact that some firefighters feel that refusing to change out of very dirty Nomex even when clean clothes or a laundry service are available proves to their colleagues that they are cool, or experienced, or skilled, or manly. The fact is, the contaminants that accumulate on clothing, personal protective equipment, and line gear are dangerous. Having it in contact with your skin can cause it to be absorbed into the body. If the firefighter’s environment is warm their pores will open which allows chemicals to be absorbed even more quickly. Everybody that is knowledgeable about the issue agrees. Contaminants can even build up to the point where the fire resistance of the fabric is compromised, especially if it includes chainsaw oil or the residue of drip torch fuel.

Firefighter Close Calls reports on injuries and accidents in the fire world and has written about the hazards of contaminated fire gear. Here is an example from earlier this week:

Firefighter Close Calls Tweet

And below is a better photo of the helmet:
Cairns dirty helmet firefighter

The fact that a major manufacturer of personal protective equipment for firefighters uses gear in their advertising that is probably contaminated with carcinogens, is an indicator of the difficulty in solving this health-related problem.

firefighters, cancer,
Screenshot from Jason Curtis’ film about San Diego firefighters and the occurrence of cancer.

Information about the hazards of wood smoke:

Research on firefighters that is not Open Access should be boycotted

Author Bill GabbertPosted on Categories UncategorizedTags , , 5 Comments on Research on firefighters that is not Open Access should be boycotted

For Throwback Thursday, here’s an article we originally published in 2011:

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Open Access logo
Open Access logo

We all hate paying for something and then not receiving what we paid for. That is what is happening now to taxpayers who pay for government-funded research and then have no access to the findings.

We have ranted about this before, and documented another example a few days ago when we discovered that it will cost us $41 to obtain a copy of the findings from research conducted by the University of Georgia. Associate Professor Luke Naeher and others found that  lung function decreases for firefighters who work on prescribed fires for multiple days and are exposed to smoke. Further, it showed that respiratory functions slowly declined over a 10-week season.

This is not the only research that has explored the effects of smoke on wildland firefighters, but it may significantly add to the limited body of knowledge we have on the topic. We won’t know, however, unless we pay a second time in order to see their conclusions.

Researchers at some organizations receive pay raises and promotions based partially on the “publish or perish” meme. A system that requires researchers to publish in journals that are not completely open to the public, is antiquated and has no place in 2011 when a paper can be published in seconds on the internet at little or no cost.

Some of the research that has been conducted on firefighters requires a great deal of cooperation from the firefighters, including for example, ingesting core temperature monitors, carrying a drinking water system that monitors every drink they take, and even lubricating and then inserting a rectal thermistor probe attached to wires.

The Boycott

There is no reason for firefighters to go to extreme lengths to help researchers advance the researcher’s career paths unless the firefighters can receive some benefits from the project. So, we are jumping on the idea proposed by Rileymon in a comment on the University of Georgia article:

Maybe it’s time to suggest that firefighter/research subjects boycott new research studies unless the findings are put into the Public Domain?

Here is what we are proposing:

  1. Firefighters, administrators, and land managers should not cooperate with researchers unless they can be assured that findings from the research will be available to the public at no charge immediately following the publication of the findings, or very shortly thereafter.
  2. Researchers should conform to the principles of Open Access.
  3. Scientists who assist in the peer review process for conferences or journals should pledge to only do so only if the accepted publications are made available to the public at no charge via the internet.

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UPDATE February 22, 2017: There is a sign that the new Trump administration will be even less transparent than his predecessor. A great deal of data is now unavailable on the White House open data portal. It is possible this is just an unannounced temporary change…. we’ll see.

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More information:

 

Legislation introduced to establish a national firefighter cancer registry

Author Bill GabbertPosted on Categories UncategorizedTags , , , , 3 Comments on Legislation introduced to establish a national firefighter cancer registry

A bipartisan group of 76 Congressional Representatives have signed on as sponsors for legislation that would establish a national cancer registry for firefighters diagnosed with this deadly disease. The bill is titled Firefighter Cancer Registry Act of 2017. (UPDATE March 25, 2019. A version of the legislation was signed into law. The Centers for Disease Control has more information. We expect to write more about this later, in articles tagged “cancer registry“.)

Most firefighters know others in their profession who have suffered from and in some cases died of various forms of cancer.

The British Columbia government recognizes at least nine “presumptive cancers” among firefighters, including leukemia, testicular cancer, lung cancer, brain cancer, bladder cancer, ureter cancer, colorectal cancer, and non-Hodgkins’s lymphoma.

According to Congressmen Bill Pascrell of New Jersey and Chris Collins of New York:

…The creation of this registry would enable researchers to study the relationship between firefighters’ exposure to dangerous fumes and harmful toxins and the increased risk for several major cancers. In the future, this information could also allow for better protective equipment and prevention techniques to be developed.

“Public servants like our firefighters put their lives on the line every day for us,” said Congressman Chris Collins. “Unfortunately, firefighters see a higher rate of cancer than the rest of the public. This legislation will provide the Centers for Disease Control and Prevention (CDC) the tools they need to improve their data collection capabilities on volunteer, paid-on-call, and career firefighters. We hope that by creating a voluntary ‘Firefighter Registry’ that includes the many variables that occur over a firefighter’s career, the CDC will be able to better study this deadly trend. In the future, this information can be used to provide better safeguards and protocols for these brave men and women.”

Safely training the tactical athlete

Author Bill GabbertPosted on Format AudioCategories UncategorizedTags , , , , 2 Comments on Safely training the tactical athlete

EMTAfter reading the Facilitated Learning Analysis (FLA) about the Rhabdomyolysis (Rhabdo) injury that occurred May 2 in South Dakota on the first day of the fire season after running for more than nine miles before doing uphill sprints, I started thinking about, not so much WHAT happened, but how to prevent similar serious injuries.

A couple of weeks before the Rhabdo case, on April 19 a wildland firefighter in the Northwest suffered a heat stroke while running on day 2 of their season. The employee was unconscious for several hours and spent four days in the hospital.

Both of these exercise-induced conditions can be life-threatening; 33 percent percent of patients diagnosed with Rhabdo develop a quick onset of kidney failure, and 8% of all cases are fatal.

Heat stroke can also kill, according to Medscape:

When therapy is delayed, the mortality rate may be as high as 80%; however, with early diagnosis and immediate cooling, the mortality rate can be reduced to 10%.

These two very serious incidents in a two week period that occurred at the beginning of the fire season should be a wakeup call for agencies employing wildland firefighters.

I am not a medical or exercise specialist, but neither were any of the four members of the South Dakota Rhabdo FLA team. It was comprised of a District Fire Management Officer, a Natural Resources Specialist, an Assistant Superintendent on a Hotshot crew, and an Assistant Fire Engine Operator.

A person might expect that for an exercise-induced injury that is fatal in eight percent of the cases, a medical expert and an exercise physiologist would be members of the team. The FLA concentrated on recognizing symptoms of Rhabdo, which is good. Firefighters need to be be informed, again, about what to look for. But the necessity of treating the symptoms could be avoided if the condition was prevented in the first place.

Prevention was not addressed in the document, except to mention availability of water. Dehydration isn’t the leading cause of Rhabdo, which is caused by exertion, but it can be a contributing factor.

With two life-threatening medical conditions on firefighting crews in a two-week period that occurred during mandatory exercise on day one and two of training, medical and exercise professionals perhaps could have evaluated what caused the injuries, and suggested how to design and implement a physical fitness program that would lessen the chances of killing firefighters on their first or second day on the job. But the LEARNING opportunity of the FLA was squandered.

The wildland fire agencies are not alone in hiring people off the streets and throwing them into a very physically demanding job. The military does this every day, as do high school athletic programs. There is probably a large body of research that has determined how to turn a person into an athlete without putting their lives in danger.

While the three firefighters and the natural resources specialist I’m sure meant well and did the best they could to write the FLA within the limits of their training and experience, the firefighting agencies need to get serious about a professional level exercise training program. After all, they are employing TACTICAL ATHLETES.

This issue is serious enough that the NWCG (since there is no National Wildland Firefighting Agency) should hire an exercise physiologist who can design, implement, and monitor a program for turning people off the street into tactical firefighting athletes.