Over the past few years, cancer has been one of the most often discussed topics in the fire service.   There has also been a tremendous amount of research dedicated to deciphering why we as firefighters are more likely to get cancer.

 

Read more about the research and statistics in THE FIRE SERVICE CANCER TOOLKIT FIRE SERVICE OCCUPATIONAL CANCER ALLIANCE provided by FRCE  (click here for the PDF)

 

FIREFIGHTER CANCER- THE FACTS  

Before I talk about ways to combat it, I think it is very important to understand the facts about the numbers.   There seems to be some very extreme statistics out on social media about the instances of cancer in the fire service.   There have been numerous studies completed and are currently in progress,  each having different outcomes based on the study group.  The one study most people reference is the NIOSH study of 2010 of approximately 30,000 firefighters from Chicago, Philadelphia, and San Francisco.  

The NIOSH study showed the following about firefighters:

• 9% higher risk of being diagnosed with cancer.
• 14% higher risk of dying from cancer than the general population.
• And, according to data from the International Association of Fire Fighters (IAFF), cancer caused 61 percent of deaths for career firefighters in the line of duty from Jan. 1, 2002, to Dec. 31, 2016.
• Cancer caused 70 percent of line-of-duty deaths for career firefighters in 2016, according to IAFF.

The news isn't very positive.  But, as more is being discovered and more research is revealed, we are finding ways to combat and prevent it.  Thus far, based on research, here are the top five ways firefighters can significantly decrease the chances of becoming a cancer statistic.  

 

#1. CLEAN AND WEAR PROPER PPE ON ALL CALLS.  One of the glaring discoveries of the research is that wearing PPE including SCBA from the moment of entry until the completion of overhaul can greatly reduce exposure to carcinogens.  And by wiping your skin upon exit from a fire and thoroughly and regularly cleaning your gear these exposures are decreased even more.  Clean your neck, face, arms, and groin thoroughly after each fire. These are areas with lots of blood vessels where particulates tend to collect. It was once considered a badge of honor for a firefighter to come home with a sooty face, but we know better now. Take care to remove this threat to your health as soon as possible.  Click here for a great training video on firefighter decon after a fire (click here).

#2. GET YOUR MEDICAL AND CANCER SCREENING TESTS EVERY YEAR.   It does not matter if you are a volunteer or a career firefighter, we are all exposed to the same stresses and carcinogens.  Annual physicals are the best way to detect potentially life-threatening medical conditions.  There is no guarantee that every medical issue will be identified.  What the research is telling us is that early detection can save lives!

The best way to diminish the effects of any diseases, illnesses, or injuries is to detect them as early as possible. This is especially true for firefighters who, in many cases, are at greater risk for certain diseases, illnesses, and injuries than the general population. The best way to find these diseases, illnesses, and injuries early is for healthcare providers to have increased awareness and for firefighters to have annual physicals that can catch abnormalities early.  

Here are some great resources to provide to your physician to help them understand the risks and tests firefighters require.  Please print these out and take them to your next physical.

• A Healthcare Provider’s Guide to Firefighter Physicals- click here
• Firefighter Cancer Support Network Physician Guide to Cancer Screenings for Fire Service- click here.

A firefighter’s blood work alone can provide a ton of insight into his risk for heart attack, stroke, and cancer. Research shows that almost all firefighters who suffer fatal cardiac events on duty possess one or more of the risk factors for heart disease – and two of these are identified in a typical blood panel: cholesterol and blood glucose. Markers of inflammation and cancerous growths can also be identified in the blood. And, most importantly, with annual physicals, you will be able to live longer, more fruitful lives with your family and friends.

Cancer Early Detection Crew Drill

Prevention methods improve your chance of staying healthy. Early detection improves your chance of cancer survival.  DetecTogether is a non-profit organization that teaches you how to seize the power of early detection with the 3 Steps Detect program.  This program is FREE and can be taken online with your crew.   Learn the essentials of early cancer detection, click here to register and take the course.  The course is FREE and is only 30 minutes which would make a great afternoon drill for the crew.  And it might just save a life!

#3. EAT A HEALTHY DIET.  Cancer is a systemic disease with various causes, some of which include a poor diet, toxin exposure, nutrient deficiencies, and to some extent genetics. One extremely important way to prevent and/or treat cancer is nutritional, by eating a nutrient-dense diet and avoiding things that are known to increase cancer risk. 

For many people, however,  navigating the modern-day food system often seems overwhelming. Ingredients found in ultra-processed foods are being blamed for everything health-related, from cancer and diabetes to reduced kidney function and bone loss.  Cancer has even been linked to how we cook certain foods.

Unfortunately, until food manufacturers are forced to clean up the ingredients they use in their products, it’s up to us to avoid the worst kinds and choose cancer-fighting foods. Researchers have known about the dangers associated with some unhealthy habits and cancer-causing foods for decades, while others are just now emerging as possible culprits.

Inflammation is the underlying issue that dictates cancerous tumor initiation, progression, and growth. Studies suggest that 30 percent to 40 percent of all kinds of cancer can be prevented with a healthy lifestyle and dietary measures!  And other sources claim that this number is in fact much higher, with around 75 percent of cancer cases being lifestyle-related.

What makes some foods carcinogens (cancer-causing) and others cancer-fighters? Foods that potentially contribute to cancer can include any number of chemicals, pesticides, preservatives, and additives.  Although making healthy selections at the grocery store and mealtime can't guarantee cancer prevention, it might help reduce your risk.  First responders should try to follow these guidelines:

• Eat plenty of fruits and vegetables. Base your diet on fruits, vegetables, and other foods from plant sources — such as whole grains and beans.
• Monitor your weight and avoid obesity (see below). Be as mindful as possible when you eat and understand portion control.  And, eat slowly!  This can dramatically help to reduce your caloric intake.   Your brain needs about 20 minutes to get the "signal" that you are not hungry anymore and that you can stop eating, give it time to let you know are full by slowing down.   Click here for a great resource on portion control for the firehouse (or any house).
• Limit processed meats. A report from the International Agency for Research on Cancer, the cancer agency of the World Health Organization, concluded that eating large amounts of processed meat can slightly increase the risk of certain types of cancer.
• Eat a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts.   The Mediterranean diet focuses mostly on plant-based foods, such as fruits and vegetables, whole grains, legumes, and nuts. People who follow the Mediterranean diet choose healthy fats, like olive oil, over butter and fish, eggs, and lean poultry instead of red meat.
• Hydrate- Drinking plenty of water and other liquids may reduce the risk of cancer by diluting the concentration of cancer-causing agents and help them flush through the body faster.   Drink at least 8 cups of liquid a day, suggests the American Cancer Society.

Here is a great article confirming this:  Proper Nutrition: Harvard University’s Dr. Stefanos Kales’ “Feeding America’s Bravest” and the Mediterranean Diet 

 

#4. MAINTAIN A HEALTHY WEIGHT AND EXERCISE REGULARLY.  If you want to prevent disease, you must exercise! Cancer is just one of a very long list of health problems that can arise as a result of chronic inactivity. Adults who participate in any amount of physical activity gain some health benefits. But for substantial health benefits, strive to get at least 150 minutes a week of moderate aerobic activity or 75 minutes a week of vigorous aerobic physical activity.  Also, avoid sitting as much as possible. If you can, limit your sitting to three hours a day or less, as the mere act of standing triggers beneficial changes in your biology.

Due to the physical demands of firefighting, I recommend that you do a combination of moderate and vigorous exercise.  A study in JAMA Internal Medicine found that people who did 1.25 hours of vigorous or 2.5 hours of moderate activity a week had a 31 percent lower risk of dying of cancer than those who didn’t work out.   Physical activity also improves circulation, driving more oxygen into your tissues, and circulating immune cells in your blood. By improving blood flow to your liver, it also helps your body detoxify potentially harmful substances.  

Regular exercise also helps you stay at a healthy weight, which helps regulate hormones and helps the immune system. In fact, being overweight or obese is a factor in an estimated 14% to 20% of cancer deaths in the US. Losing even a small amount of weight has health benefits and is a good place to start.

Thousands of firefighters, EMTs, and medics use this program to stay strong, lean, and fit for duty.  Click here for more information on this workout program (includes eating guidelines, recipes, and more).

 

#5. DON'T USE TOBACCO. Using any type of tobacco puts you on a collision course with cancer. Smoking has been linked to various types of cancer — including cancer of the lung, mouth, throat, larynx, pancreas, bladder, cervix, and kidney. Chewing tobacco has been linked to cancer of the oral cavity and pancreas. Even if you don't use tobacco, exposure to secondhand smoke might increase your risk of lung cancer.  Avoiding tobacco — or deciding to stop using it — is one of the most important health decisions you can make!  

I know that there is a lot of tobacco use in firehouses.  My suggestion, try to organize a contest to quit.  Firefighters love money and a challenge, so pool together some money and challenge members of your crew to stop smoking or tobacco use.  If you need help quitting tobacco, ask your doctor about stop-smoking products and other strategies for quitting.   Here are some great resources to help you quit.

Smoking Cessation - IAFF- Resources from the International Association of Fire Fighters.

Put It Out: Smoking Cessation Resources for Fire/EMS from the National Volunteer Fire Council (NVFC).

 

Cancer can strike anyone, even the healthiest of us, but as science advances toward a cure, it also offers compelling evidence of how much control we actually have in cancer prevention.  We as a fire service must take care of each other and promote proper PPE and gear cleaning.  Challenge each other to reduce tobacco use, and make sure we get our annual check-ups.  And, most importantly we must remember that our own cancer prevention starts in the gym and the kitchen and extends to our working environment (fireground, etc.).

Stay safe and let me know how I can help you and your crew get "fit for duty."

Aaron Zamzow (ZAM)

Additional Resources

The First Responder Center for Excellence has numerous resources on cancer research and prevention.   You can access these resources here: https://www.firstrespondercenter.org/resources/cancer

Originally launched in 2017, the goal of LION's NOT IN OUR HOUSE initiative is to spread awareness of the cancer threat facing the fire service. NOT IN OUR HOUSE is also committed to educating firefighters on the actions they can take to reduce their exposure to cancer-causing agents. Click here for more information: https://www.lionprotects.com/not-in-our-house

 

In partnership with the Firefighter Cancer Support Network (FCSN), the IAFF has created some great resources for firefighters and departments to create awareness and help prevent cancer.  Access these resources here: https://www.iaff.org/cancer/

 

Resources and research from article

https://www.cancer.gov/news-events/press-releases/2015/peak-longevity-physical-activity

http://www.who.int/cancer/prevention/en/

https://www.menshealth.com/health/obesity-and-cancer

http://time.com/4330041/reduce-cancer-risk-exercise/

https://www.healthline.com/health-news/cancer-is-number-one-killer-of-firefighters#8

https://www.ncbi.nlm.nih.gov/pubmed/17172193

https://www.ncbi.nlm.nih.gov/pubmed/20843485