Follow-up on cancer risk among wildland firefighters

(Revised @ 2:50 MT, April 26, 2010)

More information has come to light regarding the article we wrote last week about “Cancer risk and smoke exposure among wildland firefighters“. In response to an email, we heard from Brian Sharkey of the USFS’ Missoula Technology and Development Center, an exercise physiologist who was instrumental in the design of the Step Test and Work Capacity Test for wildland firefighters. We asked Mr. Sharkey if he was aware of any studies that considered a possible increased cancer risk for wildland firefighters. He said no, and:

However, our 1997 risk assessment (Booze in Health Hazards of Smoke, 1997) showed an increased risk only when we used “worst case scenario” – which estimated career exposure at exposure levels 95% of highest values measured. No one works for 25 years anywhere near those values. Also, some carcinogens are not as high on fires as they are in winter (from burning wood in stoves) (Smith et al.).

Structural FF do not have increased risk of lung cancer. Chinese women who cook over coal fires have more cancer – those who cook over wood fires do not.

We need a study of health effects that looks at all causes of morbidity and mortality – not just cancer (where risk is about 1 in 3 for US population). We also need an injury/illness surveillance system that tells us the impact of fire on respiratory, cardiovascular and – yes – cancer.

We asked Mr. Sharkey what data supported his statement that “structural FF do not have an increased risk of lung cancer”, and he was in a hurry, about to leave for a “smoke meeting”, but referred to a study on Philadelphia firefighters. We found the 24-year old study to which Mr. Sharkey may be referring. Here is an excerpt, the Methods, Results, and Conclusions:

Methods
We conducted a retrospective cohort mortality study among 7,789 Philadelphia firefighters employed between 1925 and 1986. For each cause of death, the standardized mortality ratios (SMRs) and 95% confidence intervals were estimated. We also compared mortality among groups of firefighters defined by the estimated number of career runs and potential for diesel exposure.

Results
In comparison with U.S. white men, the firefighters had similar mortality from all causes of death combined (SMR = 0.96) and all cancers (SMR = 1.10). There were statistically significant deficits of deaths from nervous system diseases (SMR = 0.47), cerebrovascular diseases (SMR = 0.83), respiratory diseases (SMR = 0.67), genitourinary diseases (SMR = 0.54), all accidents (SMR = 0.72), and suicide (SMR = 0.66). Statistically significant excess risks were observed for colon cancer (SMR = 1.51) and ischemic heart disease (SMR = 1.09). The risks of mortality from colon cancer (SMR = 1.68), kidney cancer (SMR = 2.20), non-Hodgkin’s lymphoma (SMR = 1.72), multiple myeloma (SMR = 2.31), and benign neoplasms (SMR = 2.54) were increased among firefighters with at least 20 years of service.

Conclusions
Our study found no significant increase in overall mortality among Philadelphia firefighters. However, we observed increased mortality for cancers of the colon and kidney, non-Hodgkin’s lymphoma and multiple myeloma. There was insufficient follow-up since the introduction of diesel equipment to adequately assess risk. Am. J. Ind. Med. 39:463-476, 2001. Published 2001 Wiley-Liss, Inc.

Wildfire Today has called for a study on the cancer risks associated with wildland fire. Not just lung cancer. The study needs to be conducted by medical doctors and epidemiologists.

We also learned that a proposal was prepared by Joseph Domitrovich in December, 2008, for the US Forest Service Technology and Development Program to study the effects that carbon monoxide may have on the cognitive function of wildland firefighters. Here is an excerpt.

An extensive EPA review on CO effects (2000) concluded that behavioral impairments in healthy adults are not significant below 20% carboxy hemoglobin (COHb). However, some studies have showed mild impairments at 5% COHb or below. Cigarette smokers have COHb levels of 5-10%, sometimes as high as 15%. In view of the reported adverse effects among fire staff, suspect additive or synergistic interactions among pollutants that worsen the neurobehavioral effects that would be predicted from CO exposure alone.

PROPOSED TECHNOLOGY & DEVELOPMENT WORK:
The deliverable outcome of the proposed project is a report detailing the levels of smoke exposure and cognitive effects. This could then be used by IMT, crew bosses along with training (RX-410) to help better understand the potential cognitive effects when exposed to wildland fire smoke.

POTENTIAL BENEFITS:
This project will help us to better understand the effects of wildfire smoke on our cognition, which would increase safety of fire personal.

Wildfire Today recommends that this study be funded.

A “smoke meeting” is being held in Boise this week. It will interesting to see if anything that will benefit the health of firefighters will come out of the meeting. We understand that at least one actual medical doctor is beginning to be involved in smoke studies related to wildland firefighters, which is a step in the right direction.

More information about wildland firefighters and smoke. It begins on page 8 (page 74 of the main publication).

Cancer risk and smoke exposure among wildland firefighters

(Note: after we wrote this article, more information came to light, and we wrote a follow-up piece.)

NIOSH and the U.S. Fire Administration are conducting a study of cancer among firefighters. HERE is a 2.1 Mb Powerpoint presentation describing the project.  I talked with the physician/epidemiologist, Dr. Tom Hales, who is a co-investigator for the study which began in October, 2009 led by Travis Kubale, the study’s primary project officer. He said that over the next four years they will study firefighters from three fire departments: San Francisco, Chicago, and the District of Columbia. They will look at the causes of death of firefighters that have worked for the departments over the last 50 years and compare that with tumor registries in their local communities and the National Death Index for cause of death.

Dr. Hales said that they will ask the firefighters in the study if they have ever worked on wildland fires, but other than that, they will not collect data on firefighters who specialize in wildland fires. He also said that NIOSH has no plans to specifically study cancer rates among wildland firefighters, but emphasized that NIOSH has collected data on smoke exposure on active wildfires and prescribed fires (see below).

What about wildland firefighters?

It is unfortunate that wildland firefighters will not be evaluated in this study, but you have to consider that the probably-flawed TriData study only looked at structural firefighters, and the IAFF and IAFC who helped to push for this new study spend most of their energy and political capital on structural fire.

There needs to be a concerted effort to conduct a similar study on wildland firefighters. It should be led by a physician/epidemiologist and should evaluate the long term health and occurrence of cancer and other diseases among wildland firefighters. There is a lot of grant money out there and it should be possible to get some of it pointed towards this overlooked niche of firefighting.

Wildfire Today is calling out the following organizations to get together and put some pressure on FEMA, NIOSH, and the U.S. Fire Administration to get this done:

  • National Park Service
  • Bureau of Land Management
  • U.S. Fish and Wildlife Service
  • Bureau of Indian Affairs
  • U. S. Forest Service
  • National Wildfire Coordinating Group and their Risk Mgt. Comm.
  • State land management agencies
  • International Association of Wildland Fire
  • International Association of Fire Chiefs
  • International Association of Fire Fighters
  • Federal Wildland Fire Service Association

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Below are links to studies about smoke exposure on wildfires, as well as excerpts from a bibliography on the same subject.

Continue reading “Cancer risk and smoke exposure among wildland firefighters”

Wildfire news, July 8, 2009

After 90 years, Whitefish, MT fire siren is silent

The Whitefish, MT fire siren. Lifo Vizzutti/Flathead Beacon photo

After 90 years of summoning volunteer firefighters to staff the fire engines, the siren in Whitefish, Montana is being shut down because it exceeded the noise levels issued by OSHA and the NFPA. Whitefish fire chief Tom Kennelly said the noise was too loud for the full time staff that now reside in the fire station, just 20 feet from the siren’s many horns.

More information

History of firefighting helicopters

Forest protection supervisor Jack Dillon experiments with a water nozzle in a Bell 47D-1 owned by the Ontario Department of Lands and Forests around the early 1950s. The pilot is Shorty Ferguson. Ontario Ministry of Natural Resources Photo

Verticle On Line, “The Pulse of the Helicopter Industry”, has an interesting article about the history of helicopters used in fighting fire.

Charles Barkley donates to fire victims

Ex-NBA star Charles Barkley has donated another large sum of money to the victims of the June, 2007 Angora fire which destroyed over 250 homes. A year ago Mr. Barkley gave $100,000 to South Tahoe’s Commuinity Disaster Resource Center. Last week the center received another check from him, this time for $90,000. Shortly after the 2007 fire, Mr. Barkley hosted a dinner for 100 firefighters.

Study: No increased wildfire risk in spotted owl habitat

From the AP:

A new study challenges a basic justification about the threat of wildfires that the Bush administration used to make room for more logging in old growth forests that are home to the northern spotted owl.

The study, appearing in the journal Conservation Biology, found no increasing threat of severe wildfires destroying old growth forests in the drier areas where the owl lives in Oregon, Washington and Northern California.

“The argument used to justify a massive increase in logging under the (spotted owl) recovery program was not based on sound science,” said Chad T. Hanson, a fire and forest ecologist at the University of California, Davis, who was lead author of the study. “The recovery plan took a leap-before-you-look approach and did it without sound data.”

Li’l Smokey children’s book published

Adam Deem, the CalFire firefighter who found and rescued the injured bear cub on the northern California fire last year has written a children’s book about the bear. The book costs $11.99 and Mr. Deem says a portion of the proceeds will be donated to the nonprofit Lake Tahoe Wildlife Care, where “Li’l Smokey” was nursed back to health.

Snags on the Backbone fire

Six Rivers National Forest photo

The Backbone fire, which is being managed by the Atlanta National Incident Management Organization team, is in an area that burned in the 1999 Megram fire. Snags are one of the hazards faced by the firefighters. The fire has burned 4,584 acres in the Trinity Alps Wilderness in northern California and is 25% contained.

Embers burn more homes than flame impingement on some wildfires

The Missoulian has an article about the study completed by the National Institute of Standards and Technology which Wildfire Today first told you about on June 19.

Here is a brief excerpt:

The report found that “out of the 74 destroyed structures, 38 were on the perimeter and the remaining 36 in the interior of the community.”

“Forty percent of homes on the perimeter were destroyed, compared to 20 percent in the interior. In the interior of the community, structure losses were a result of exposure to embers generated from burning wildland and residential vegetation and structural fuels,” according to the report.

Storing carbon vs. thinning forests

A new study concludes that forests are a great way to store carbon to offset global warming, but scientists say thinning would reduce this beneficial effect.

Thanks Dick and Kelly.

USFA issues statement about TriData presumptive cancer report

The United States Fire Administration has issued a statement regarding the very controversial report that was written by TriData a few weeks ago.  As Wildfire Today covered on April 20, the report, which gathered information from some selected studies, discounts some links between cancer occurance and firefighters. The National League of Cities (NLC) paid TriData to complete the report.  The IAFF and the IAFC think the NLC is trying to eliminate presumptive cancer legislation for firefighters.

The USFA statement is HERE (link no longer works), but below are some excerpts:

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The United States Fire Administration (USFA) has completed its review of a recently released study conducted by the TriData Division of the System Planning Corporation, analyzing firefighter presumptive cancer legislation and attempting to prove or disprove a correlation between firefighting activities and the occurrence of cancer. While this study is considered thoughtful and well-presented, its results are scientifically inconclusive, and indicate that more expansive study is in order.

Acting United States Fire Administrator Glenn A. Gaines noted, “The results of this report clearly indicate that more study and analysis is necessary. It is much too early to abandon presumptive laws and benefits for firefighters who present with cancers. To make such a quantum leap at this point in time may be premature.”

As a long time partner of all of the nation’s firefighters and fire service organizations, USFA has regularly and continually supported research efforts, specific training, and other initiatives focusing on firefighter wellness and safety issues.

“As with all truly professional disciplines, the fire service must be willing to support independent third party research and reviews of our profession as well as its actions and approaches,” said Administrator Gaines. “Just as importantly, and like other professions, we must also focus on prevention and mitigation strategies limiting exposure to toxins and carcinogens by firefighters, be they career or volunteer.”

Future research efforts in the area of firefighter cancer must recognize the myriad dangers faced by firefighters throughout our country, be it asbestos in the older factories of the east, chemical and plating plants in the Midwest, or wildland fires that occur each year throughout the country.

Any future studies must include methodologies to adequately recognize those firefighters who have already experienced legacy exposures, and must include definitive measures of the effectiveness of the improved PPE, decontamination equipment, and diesel exhaust systems placed in service over the past decade.

Firefighter/cancer link update

From FirefighterCloseCalls:

FF CANCER UPDATE: THE IAFC AND IAFF RESPOND TO TriData/NLC Document:
As you are aware, last week, the National League of Cities released an irresponsible, misleading and confusing document produced by a management consulting firm, TriData, incredibly claiming there is no relationship between fire fighting and certain cancers. The NLC has worked against every single piece of presumptive legislation that protects fire fighters and their families….and it appears they will go to any length on their mission to save their paying membership cities money…no matter what.


The IAFF and the IAFC are on this …and will be providing factual information related to the issues of fire fighting cancer. Both the IAFC and IAFF are ardent supporters of cancer presumption laws, and are deeply concerned about the impact this report (paid for by the NLC) may have on the truth and clear facts related to critical fire fighter protections, as well as future health and safety research.

The IAFC, through the IAFC Safety, Health and Survival Section, and the IAFF, have each assembled high-level teams consisting of doctorate-level academicians, medical physicians and fire service safety and health experts to thoroughly evaluate the report and provide a complete assessment and facts.

Please watch for more factual information via email, on the IAFF website, as well as the IAFC and IAFC Safety, Health and Survival Section websites and related media..

www.IAFF.org

www.IAFC.org

www.IAFCSafety.org

www.FireFighterCancerSupport.org

FEMA study shows firefighters at high risk for heart disease

On March 14 Wildfire Today reported on a study by the University of Kansas that found firefighters are more likely to have prematurely narrowed arteries, which increases their risk for strokes and heart attacks. The data shows that 22 percent of a group of 77 firefighters studied by researchers at the University of Kansas averaged 39 years old but had the blood vessels of 52-year-olds because of significant plaque buildup in their carotid arteries.

Now a FEMA-sponsored study on 300 firefighters in Georgia has more information that will be of concern to firefighters.

H. Robert Superko, MD, principal investigator in the landmark FEMA-sponsored study of firefighters aged 40 and over conducted at Saint Joseph’s Hospital in Atlanta, released preliminary findings in the world’s first study of first responders at risk of suffering sudden death or other significant cardiac events. Firefighters are known to have a three hundred percent increased risk for cardiac disease as compared to other segments of the population.

“Preliminary findings show that one third of firefighters had heart disease that is unrelated to traditional risk factors, such as high cholesterol,” says Dr. Superko. “Those results are astounding and point at job duties and environment as the primary determinants for early death in our country’s first responders.”

Dr. Superko, recognized as a leading expert on lipids, cholesterol and advanced metabolic markets and their contribution to heart disease, and his team performed a comprehensive, scientific battery of sophisticated blood and imaging tests on three hundred firefighters in Gwinnett County, Georgia. Gwinnett County first responders were identified for the study following an emotional report by Fire Chief Steve Rolader, following the sudden death of one of his firefighters from cardiac arrest while fighting a house fire.

“This wasn’t the first firefighter in my department to die but I wanted to do something to make it among the last,” says Chief Rolader. “This man was 53 years old, in great physical shape and he had no known symptoms of heart disease. We also had lost several newly-retired firefighters to sudden cardiac death. There had to be a way to stop it.”