- Cancer is the leading cause of death among firefighters.
- Roswell Park works with the Buffalo Fire Department for regular screenings.
- Exposure from smoke, toxins can damage lungs, skin.
The greatest risk to firefighters is running into burning buildings to save someone’s life. The second biggest risk? Developing cancer from the exposure they face as part of the requirements of their job.
Cancer is the leading cause of death among firefighters, due to the smoke they inhale from burning buildings and the toxins absorbed through their skin from contaminated materials.
The importance of offering regular lung and skin cancer screenings to firefighters came sharply into focus following a 2008 fire in downtown Buffalo inside a pool supply company that burned for several days.
“There were 250 people from Buffalo Fire that filled out exposure forms. Sadly, there were a number of members that became sick and were disabled from that fire and no longer could work as firefighters,” says Mark Mendola, a retired firefighter and the Western New York ambassador to the National Firefighter Registry for Cancer. “Another set of members actually tragically passed away. Four in particular had glioblastomas. To have one person have that sort of condition is pretty rare from what I’m being told, but four really just kind of drives home the point that unfortunately that was an incident that really made our members sick.”
Ladder Six, the company Mendola worked with during that fire, was using a practically new truck, only six months to a year old. After two days, he says, “all the brass fittings on the truck were green. There was physical damage to the actual engines and the ladders that went there. That right away told us that something was wrong,” even before people started getting sick. That led to the Buffalo Fire Commissioner requiring all firefighters involved in that event to fill out an exposure report to get a sense of how many people could be facing illness.
Protecting the protectors
“The scientific evidence that being a firefighter is related to cancer, it’s not a question. It’s an occupation where people who are professional firefighters, especially who have more exposures, have increased risk of cancer, solid tumors, some lymphoma, myeloma, over the general population,” says Mary Reid, BSN, MSPH, PhD, Chief of Cancer Screening and Survivorship at Roswell Park Comprehensive Cancer Center.
“We don’t have to prove it; it’s proven. The awareness of cancer susceptibility in the Buffalo Fire Department has really encouraged them to get better care earlier for melanoma, which is from skin contamination. We offer screening (for) lung cancer. It’s really to get them mobilized so that they don’t put it off.”
Roswell Park has a longstanding and strong relationship with the Buffalo Fire Department. Regular lung cancer screening is available through our mobile lung cancer screening unit, EDDY, or Early Detection Driven to You, which parks in front of various fire stations every month.
One of Mendola’s scans by EDDY identified three nodules in his lungs, two on one side and one on the other. “Thankfully, I’m getting scanned,” he says. “Nothing has changed, but that even further drove home the point for me to try and get involved, especially now that I’m retired.”
That also drove him to get involved with the National Firefighter Registry, part of an act passed by Congress in 2018 and officially launched in 2023. “It’s a free program, open to any active or retired career or volunteer firefighter. You do not have to have cancer to register for it. In fact, it’s probably beneficial that you register very early in your career,” Mendola explains. “If you do develop (cancer), the main goals are cancer awareness and prevention, and they’re really looking to study the data over time to see any of these trends that go on.”
Fighting for first responders
Data indicates it’s not just skin and lung cancer associated with fires.
“There was a study out of San Francisco that female firefighters are about 44% higher risk of getting breast cancer than the general population. Should they be getting mammograms earlier? Definitely, but we need to put that science to work so we can start changing the guidelines,” says Ashley Snowden, Executive Director of Physician and External Partner Engagement at Roswell Park. She works closely with Buffalo’s firefighters to set up screening and educational programs and has been instrumental in bringing EDDY to fire stations across Western New York.
The challenge is, and remains, getting firefighters to sign up for both lung and skin cancer screening. These are tough men and women who do a dangerous job for a living, after all, and they are less inclined to admit the risk they face. “These men and women are risking their lives every day and running into burning buildings and saving people. To think about going to the doctor wasn’t the top priority. It was a really tough sell to try to get them to think about themselves and their own health when their mindset is really community focused,” she says.
Mendola says when he starting out as a firefighter in the 1990s, it was a badge of honor to have the dirtiest gear or helmet of your crew. “It was perceived you were a better, aggressive firefighter. Now the culture has changed, thankfully. You can still be just as aggressive, just as professional, just as much as a hard charger with clean gear. All that gear that people were wearing all those years, unfortunately, it’s ‘off-gassing’ carcinogens and byproducts of combustion.” As firefighters drove back to the station, those dangerous chemicals were blowing back into their lungs, he adds.
Roswell Park and local officials have provided specialized products used to remove some of those exterior carcinogens and toxins from firefighter gear after they return to the station in the hopes of limiting their additional exposure. There’s also pending legislation to require all firefighter equipment to be free of PFAS, another known carcinogen, which Mendola believes is a step in the right direction.
