Firefighters face unique occupational health risks in the line of duty that puts you at elevated risk for diseases less common among other professions. Chronic exposures to heat, smoke, and toxic flame retardants through inhalation, ingestion, and skin absorption put firefighters at risk for many cancers, cardiac-related death and coronary artery disease.
Roswell Park Comprehensive Cancer Center located in Buffalo, New York, and the only National Cancer Institute-designated comprehensive cancer center in Upstate New York, supports cancer screening and early detection strategies for firefighters due to their increased risk for cancer and cancer-related disease.
Did You Know?
Many studies support the evidence that firefighters develop excess rates of cancers across many sites including bladder, brain, colon, leukemia, lymphoma, lung, kidney, NHL, melanoma, multiple myeloma, prostate, and testis. These cancers are typical of sites related to breaking down carcinogens and/or smoking or direct exposure through the skin.
- After 20 years of service, firefighters have an increased risk of kidney cancer.
- After 30 years of service, the risk of colon cancer, brain cancer, and leukemia is increased. After 40 years, there is an increased risk of all precious cancers and bladder cancer.
- Exposure to smoke on top of the occupational exposures increases the risk of lung and smoking-related cancers.
The accumulation of this evidence has led to federal approval of the National Cancer Registry for Firefighters and additional laws in New York State supporting cancer treatment for both professional and volunteer firefighters.
Know Your Risk
The primary recommendation is for firefighters to have a yearly physical by your primary care physician. It is important this is done at your doctor’s office or health care facility. Primary care physicians routinely collect data on personal health behaviors, family history of cancer, and perform comprehensive general exams that can identify serious health risks. Your primary care physician can and should perform routine testing to help detect irregularities that might identify early cancers. The following list describes the comprehensive testing that should be performed each year during this physical examination. Identify your profession and years of service to your primary care physician so that this can be the basis of the comprehensive examination and document this information in the medical record.
Roswell Park Comprehensive Cancer Center fully supports cancer screening and early detection for firefighters with the belief that this will lead to better outcomes, more cost-effective treatment options and improved quality of life for all firefighters.
The National Institute for Occupational Safety and Health (NIOSH) performed a multi-year study of nearly 30,000 firefighters to better understand the potential link between firefighting and cancer. Exposure to aerosolized chemicals like benzene, asbestos, polycyclic aromatic hydrocarbons (PAH), formaldehyde, diesel exhaust, and new building materials with undefined chemicals create special risks. The firefighters studied showed higher rates of certain types of cancer than the general U.S. population.
In a study conducted here at Roswell Park in coordination with 100 firefighter participants from 2 firehouses, we collected 24 air samples from various calls. Our research found that even in fires with low smoke intensity, firefighters were just as exposed to appreciable levels of toxic materials. Exposure included carbon monoxide, benzene, aldehydes, and hydrogen cyanide. Exposure to these chemicals and/or any number of carcinogenic substances put firefighters at elevated risk for diseases less common among other professions.
Additional long term studies also support the need for early cancer detection strategies for firefighters including:
- A San Francisco Firefighter Breast Milk study assessed the breast milk of female firefighters versus non-firefighter controls. Researchers measured levels of fire suppressants, combustion products, PAHs, and mixtures of chemicals to evaluate increases in the risk of breast cancer. In San Francisco women makeup approximately 16% of the firefighters' force and 15% of those women between ages 40 and 50 have been diagnosed with breast cancer. This is a 6-fold increase of over the national average.
- Similarly, a study of Philadelphia Firefighters with 20 years of service or more, roughly 7,789 people, found higher rates of colon and kidney cancers, non-Hodgkin’s lymphoma (NHL), and multiple myeloma.
- A 24-state study between 1984-1993 found elevated rates of lip, colon, NHL, kidney and lung cancer.
- A Missouri study of lung cancer in 15,000 people found a 60% increase of lung cancer among firefighters.
- Environmental exposure of firefighters who were among the first responders exposed to the World Trade Center disaster revealed a higher risk of monoclonal gammopathy of undetermined significance, a precursor disorder of multiple myeloma.
The extent of the evidence over years of research detailing the excess of cancer risk among firefighters, Roswell Park Comprehensive Cancer Center is committed to providing expert advice and support for implementing policies and protocols defining cancer screening strategies that can lead to the early detection and more effective treatment of cancers in this occupational group.