Firefighters and Cancer Risk

Firefighters are at an increased risk of developing cancer. There are steps to take that can reduce that risk.


All firefighters, regardless whether they are career or volunteer, put their own lives at risk to save others in their communities. In addition to the danger of putting out fires, firefighters are at an increased risk for different types of cancer due to the smoke and hazardous chemicals they are exposed to in the line of duty. There have been multiple studies that show this increased risk for cancer.
 

Share this information to help raise awareness. Order free copies of our Firefighters and Cancer Risk postcard to distribute at your local firehouse.

Why is there a risk for cancer?

Modern homes and buildings contain many synthetic and plastic materials which create more smoke when burning than natural materials. When materials burn, they release a number of carcinogens (cancer-causing agents) including polycyclic aromatic hydrocarbons (PAHs), a group of more than 100 chemicals. Exposure to some PAHs can cause cancer. Firefighters may also encounter other known carcinogens such as asbestos and diesel exhaust. These carcinogens can be inhaled or absorbed through the skin.

Wearing the proper personal protective equipment (PPE), including self-contained breathing apparatuses (SCBA), offers protection and lessens exposure. However, toxic chemicals can still penetrate the turnout gear and expose the skin to toxins.

World Trade Center First Responders. A study published in 2019 shows that firefighters and other first responders to the World Trade Center (WTC) attacks on September 11, 2001 have higher rates of clonal hematopoiesis. Clonal hematopoiesis happens when blood stem cell starts making cells with the same genetic mutation, which can lead to blood cancers and other disease. People involved in the aftermath of the 9/11 attacks who were subsequently diagnosed with a blood cancer may be eligible for help from the WTC Health Program. For more information, click here. 

National Firefighter Registry. In July 2018, Congress directed the Centers for Disease Control and Prevention (CDC) to create the National Firefighter Registry (NFR). The registry of firefighters will be used to track links between workplace exposures and cancer. With the data collected by this registry, researchers will be able to better understand the risk of cancer among firefighters. Enrollment for all U.S. fire service members is expected to open in the Summer/Fall of 2022. Click here for more information.

As a firefighter, what can I do to reduce my risk of cancer?

Protect yourself at work. As a firefighter, you may be used to putting others before yourself, but your own health and safety are important too. Protect yourself at work by taking steps to reduce your exposure to harmful chemicals:

  • Reduce exposure to diesel exhaust from the fire apparatus.
    • Use and maintain diesel exhaust containment or removal systems.
    • Open bay doors before the engine starts.
    • Keep open bay doors upon return until after engine is shut off.
    • Do not allow apparatus to idle inside the station.
    • Keep the doors to the station office and living areas closed.  Assure they are properly sealed.
    • Conduct a daily apparatus check outside, if the apparatus engine needs to be running
  • Clean and care for PPE and SCBA properly.
    • Clean PPE following NFPA 1851 and manufacturer’s recommendations after every fire.
    • Maintain and test SCBA daily to ensure its properly functioning.
    • Use SCBA and remain on air through the end of overhaul and if exposed to smoke on exterior operations.
    • Perform decontamination of gear and SCBA at the fire ground while still on SCBA air. Keep on SCBA air until on-scene decontamination is complete.
    • Do not wash PPE at home or public laundry mat.
    • Damaged or contaminated gear may need to be destroyed or retired according to Chapter 10 of NFPA 1851.
  • Wash yourself as soon as possible after every fire.
    • Wash exposed face, hands, head, and neck at the fire ground with wet wipes or soap and water. Keep wet wipes available for easy cleanup.
    • Shower your entire body as soon as possible after cleaning equipment upon return to the station.
    • After showering, change into clean clothes.
  • Store PPE gear correctly to avoid contaminating other areas in the firehouse or apparatus.
    • At the firehouse, store gear in designated areas only. Keep gear locker room door closed. Do not wear or leave gear in the living and sleeping areas
    • After a fire, exposed gear should be returned to the station for cleaning via the fire apparatus. Store exposed gear in an outside compartment while returning to the station. If gear must be stored inside the apparatus, place it in a tied garbage bag or an airtight container. If stored in a container that will be reused, the container must also be cleaned.
    • Use a PPE gear bag or an airtight container when transporting clean gear in personal vehicles.
  • Always be cautious at the fire ground.
    • Do not rely on gas detectors to determine when to wear PPE. Even when the fire is out, contaminated particles still saturate the environment.
    • Wear full PPE and SCBA during overhaul.
    • Wear full PPE and SCBA at car and trash fires too.
    • Provide as much natural ventilation as feasible to burned structures before starting investigations. Fire investigators should wear appropriate breathing protection.

Talk to your doctor. As a firefighter, make sure your doctor knows your work or volunteer history, even if you are retired. Even if you provide this information on forms, it is also a good idea to bring it up to your doctor yourself. If you change providers, make sure your new doctor knows your work and volunteer history.

Discuss your risk of cancer with your doctor. Firefighters may need to start screening at an earlier age and do screenings more frequently than the general population. Ask about ways to reduce your risk of cancer, such as good nutrition, physical activity, and avoiding tobacco and alcohol.

Record your exposure. The International Association of Firefighters (IAFF) recommends that firefighters keep a personal record that tracks exposures and incident responses. Examples are available through the various fire service organizations.


Follow healthy lifestyle behaviors. Good nutrition, physical activity, and avoiding tobacco and alcohol can decrease your risk of cancer and other diseases. For more information about healthy lifestyle recommendations, download or order the free fact sheet Healthy Behaviors.

Help Spread Awareness

Order free copies of our Firefighters and Cancer Risk postcard to share with others and/or distribute at your local firehouse.
 

Resources for Firefighters


 

Reviewed by:

Phil Vasile

Virginia M Weaver MD MPH
Associate Professor of Environmental Health and Engineering and Medicine
Associate Faculty Member, Welch Center for Prevention, Epidemiology and Clinical Research
Johns Hopkins University Bloomberg School of Public Health
Baltimore, MD

Lt  Jim Reidy
Quartermaster
San Antonio Fire Department
San Antonio, TX

Lawrence G. Petrick Jr.
Deputy Director
Dept. of Occupational Health & Safety
International Association of Fire Fighters
Washington, D.C. 

References

Agency for Toxic Substances and Disease Registry (ATSDR). ToxFAQs for Polycyclic Aromatic Hydrocarbons (PAHs). Last Reviewed August 28, 2014. https://wwwn.cdc.gov/TSP/ToxFAQs/ToxFAQsDetails.aspx?faqid=121&toxid=25. Accessed April 6, 2022.

Centers for Disease Control and Prevention. Fire Fighter Resources. Last reviewed August 8, 2018. https://www.cdc.gov/niosh/firefighters/health.html. Accessed April 15, 2022.

International Association of Fire Fighters (IAFF). Cancer Awareness. Online course. https://my.iaff.org/Web/Events/Event_Display.aspx?EventKey=LMS_070&ibcToken=4b6cbe5a-f5e1-e811-810b-000c2979417c. Accessed November 6, 2018.

Jasra, S, Giricz O, Zeig-Owens R, et al. High Burden of Clonal Hematopoiesis in First Responders Exposed to the World Trade Center Disaster. Blood 2019; 134 (Supplement_1): 3720. doi: https://doi.org/10.1182/blood-2019-129276. Accessed April 6, 2022.

Laroche E, L'Espérance S. Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews. International Journal of Environmental Research and Public Health. March 3, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7967542/. Accessed April 4, 2022.

LeMasters GK, Genaidy AM, Succop P, et al. Cancer risk among firefighters: a review and meta-analysis of 32 studies. Journal of Occupational and Environmental Medicine. 2006;48(11):1189-1202. doi:10.1097/01.jom.0000246229.68697.90 Accessed April 15, 2022.

Memorial Sloan Kettering Cancer Center. Clonal Hematopoiesis (CH). https://www.mskcc.org/cancer-care/types/leukemias/risk-factors/clonal-hematopoiesis-ch. Accessed April 12, 2022.

National Institute for Occupational Safety and Health. Findings from a Study of Cancer among U.S. Fire Fighters. July 2016. https://www.cdc.gov/niosh/pgms/worknotify/pdfs/ff-cancer-factsheet-final-508.pdf. Accessed April 18, 20.

NIOSH [2013]. Health hazard evaluation report: evaluation of dermal exposure to polycyclic aromatic hydrocarbons in fire fighters. By Fent KW, Eisenberg J, Evans D, et al. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, NIOSH HETA Report No. 2010-0156-3196. https://www.cdc.gov/niosh/hhe/reports/pdfs/2010-0156-3196.pdf. Accessed April 15, 2022.

Pukkala E, Martinsen JI, Weiderpass E, et al. Cancer incidence among firefighters: 45 years of follow-up in five Nordic countries. Journal of Occupational and Environmental Medicine. 2014 Jun;71(6):398-404. doi: 10.1136/oemed-2013-101803. Epub 2014 Feb 6. PubMed PMID: 24510539. https://www.ncbi.nlm.nih.gov/pubmed/24510539. Accessed April 15, 2022.