Firefighters

At a Glance

Firefighters express concerns about breast cancer risk among women in the fire service. Only a few studies have actually assessed this risk—or risk of any cancer—among female firefighters.

A number of studies indicate an elevated risk of cancer among male firefighters. And the research that does include female firefighters—though sparse—suggests elevated risk of several cancers. Other research raises concerns about the chemical exposures they face in their work.

Firefighters for Prevention

Lt. Heather Buren, a firefighter for the San Francisco Fire Department, which has high rates of breast cancer. She doesn’t want to sit back and wait for a cure– she wants to prevent breast cancer.

Cancer in the fire service

In the past several years, firefighters made significant gains regarding cancer prevention and awareness. In Boston, Seattle, San Francisco, Arizona, and Florida, major departments began to recognize and address high rates of cancer among firefighters.

In 2006, retired SFFD Captain Tony Stefani created a leading organization in this movement, the San Francisco’s Cancer Prevention Foundation (SFFCPF). SFFCPF and the United Fire Service Women (UFSW) brought attention to concerns about breast cancer among female firefighters in the San Francisco Fire Department.

Of San Francisco’s approximately 225 female firefighters–the most of any major city–a number of women have faced breast cancer diagnoses. Most of the women received their diagnosis before menopause, which is rare in the population as a whole.

NBC Nightly News

San Francisco Fire Department sees spike in breast cancer rate.

What we know

Women are not included in most studies of firefighters’ health. In our review of the literature on firefighters and cancer, only three out of 20 studies evaluated women firefighters’ cancer risk.

When they are included, the number of women is often too small to draw reliable conclusions. This is true for racial and ethnic backgrounds among both male and female firefighters as well. Often the numbers of black, Latino or Asian firefighters included in studies are too small to evaluate if they face unique health risks.

Based on what we know from the few studies of women firefighters, overall cancer incidence appears elevated. Of the specific cancers studied, cervical, thyroid, and bladder cancer were elevated at a statistically significant level and breast cancer appears elevated, although this was not statistically significant. No other specific cancers have been studied in women.

Cancers that are elevated in male firefighters, but have not been studied in women, include brain cancer, colon cancer and kidney cancer as well as leukemia, Hodgkin’s lymphoma and non-Hodgkin’s lymphoma.

We don’t know if women have elevated risk of these cancers because studies haven’t looked at rates of these cancers among women. In this case, we can’t use the absence of data to say there is an absence of risk.

 

What we are doing

Since 2013, BCPP has partnered with the Women Firefighters Biomonitoring Collaborative. The Collaborative, comprised of firefighters from SFFCPF and UFSW, researchers from UC-Berkeley, UCSF, and Silent Spring Institute, and advocates from BCPP and Commonweal, collected blood and urine from firefighters in 2014. Since then, researchers have been analyzing these samples to get a sense of the unique exposures faced by firefighters.

The study specifically measures exposures to PAHs (which are products of combustion), PFAS chemicals (which are common in firefighting foams and household and commercial products), and flame retardants. In addition, we use novel Time of Flight technology to assess exposure to other chemicals linked to breast cancer.

Policy

The proposed Firefighter Cancer Registry Act (2017-2018) would collect data on all firefighters, include women, minorities, and volunteer firefighters. This could provide the data we need to be able to know more about the rates of cancer among those who are excluded, or included in small numbers, in other studies.

Presumptive laws are regulations that assume a given disease is linked to work by default. This means that when someone is diagnosed with an illness covered under a presumptive law, they are automatically entitled to disability or workers’ compensation, medical expense coverage, and medical leave. Without presumptive laws, firefighters and other workers may have to prove that work caused their disease to get these benefits—a process that can be lengthy and expensive at a time when resources need to go toward treatment, wellness and sometimes end-of-life decisions.

Only eleven states and one Canadian province proactively include breast cancer in presumptive laws: Arkansas, Idaho, Iowa, Maine, Maryland, Missouri, New Mexico, New York, Oregon, Virginia, Wisconsin, and Ontario.

Some states and provinces list many cancers but don’t include breast cancer in the list of illnesses covered by presumptive laws. Other states do not mention specific kinds of cancer but do require documented exposures to known carcinogens or chemicals linked to cancer.

In some cases, individual departments include breast cancer as a presumptive illness. For instance, presumptive laws only cover California firefighters if they can demonstrate exposure to a known carcinogen as defined by the International Agency for Research on Cancer. However, the City and County of San Francisco presumes that cancer that develops during service in the Fire or Police Department arose due to employment, as long as the individual has served for more than five years.

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