Part of my job as senior editor of The Synergist is to keep up with media coverage of the industrial hygiene and occupational health and safety industries. The association between firefighting and cancer is one topic that has frequently bubbled to the surface over the last six months—and Synergist readers are tuned in. The fourth most-read article in The Synergist Newswire e-newsletter in 2018 was a New York Times story covering the funeral of Ronald R. Spadafora, the fire department chief who oversaw safety for recovery workers at Ground Zero following the Sept. 11, 2001, terrorist attacks. Chief Spadafora died at age 63 of blood cancer believed to be related to toxic exposures from the World Trade Center site, which then-Assistant Secretary of Labor for OSHA John Henshaw described as “potentially the most dangerous workplace in the United States.”

Other news organizations have been covering further aspects of this topic: Firehouse Magazinepublished an article detailing a study of firefighters’ exposures to carcinogens in fire stations; Popular Science delved into two studies published in JAMA Oncology that examine the future burden of cancer among first responders to the World Trade Center and the rates of multiple myeloma, a blood cancer, among firefighters in that group; and many publications, including The Hill, sounded off about potential benefits of the Firefighter Cancer Registry Act of 2018, new federal legislation that requires CDC to set up a registry of firefighters that will track links between workplace exposures and cancer. The NIOSH website states that it will take the lead in establishing this registry.

Researchers have been working for many years to gather evidence that supports a more definitive link between firefighting and certain types of cancer. NIOSH researchers completed the largest multi-year study of cancer among U.S. firefighters in 2015. Nearly 30,000 career firefighters who were part of the NIOSH study (PDF) were found to have higher rates of certain types of cancer than the general U.S. population—mostly digestive, oral, respiratory, and urinary cancers. In a press release about the study, agency researchers and colleagues said that “the results strengthen the scientific evidence for a relation between firefighting and cancer.”

A separate NIOSH study of firefighters in the statewide California Cancer Registry that was published in 2015 found that firefighters have increased risks for several cancers, including melanoma, acute myeloid leukemia, multiple myeloma, and cancers of the esophagus, prostate, brain, and kidney. Black and Hispanic firefighters were found to have increased risks for non-Hodgkin lymphoma, chronic lymphocytic leukemia, chronic myeloid leukemia, and cancers of the tongue, testis, and bladder. Of the California study, NIOSH Director Dr. John Howard said: “This focused study generates novel findings for firefighters of various race and ethnicities and strengthens the body of evidence to support the association between firefighting and several specific cancers.”

NIOSH research and other previous studies that indicate firefighters are at greater risk of developing cancer are no doubt part of the basis for recent legislative action around the issue. The Firefighter Cancer Registry Act of 2018 at the federal level is only one example. Last week, a bill that would add brain, colon, and testicular cancers to Virginia’s Workers’ Compensation Act passed the state’s senate. Under the proposed legislation, more firefighters would be eligible for workers’ compensation if they develop cancer from their occupation. Another bill recently introduced in Montana seeks to make it easier for firefighters in the state to claim workers’ compensation for occupational diseases. And state representatives in Florida are likely to hear a proposal for a measure to benefit firefighters who are dealing with job-related cancers in this year’s legislative session.

It’s encouraging to see an increase in legislative measures intended to help firefighters and other first responders who develop cancers that are likely related to on-the-job exposures. But it’s clear that further research into the association between firefighting and cancer is needed. A review of the recent literature on cancer in firefighters conducted by IRSST, a nonprofit scientific research organization in Québec, Canada, found that the epidemiological data provide little certainty about the association between firefighting and the development of some forms of cancer.

“Apart from mesothelioma, the data available from the current review was insufficient to fully conclude or to rule out any associations between cancer and occupation,” IRSST’s report reads. “There is some evidence of an association between occupation of firefighter and cancers of bladder, brain, colon/rectum, head and neck, kidney, esophagus, skin, and small intestine together with leukemia and multiple myeloma.”

Even the largest study of U.S. firefighters—the multi-year NIOSH study that followed more than 30,000 of them—had several limitations. For example, few women and minorities were in the study; measurements of actual exposures were not available; and the study was not able to consider information on exposures to cancer-causing agents outside of firefighting. For these and other reasons, NIOSH noted in July 2016 (PDF) that its ability to detect links between firefighting and cancer was still limited.

It’s been quite some time—since October 2013—that The Synergist has published a feature-length article about the hazards of firefighting. The 2013 article, “Firefighting: A Toxic Profession” (AIHA member login required), discussed how modern materials in homes have increased the toxicity of today’s fires. Perhaps it’s nearly time for us to revisit the topic.

At any given time, there are several OHS-related stories being discussed in the broader news media, and we do our best to capture and communicate those trends to readers across our Synergist-brand publications. What current news items would you like to read more about?