Firefighter Cancer
Fire fighters can be exposed to several known and suspected carcinogens throughout their career. In a report published in 2010, the International Agency for Research on Cancer (IARC), part of the World Health organization (WHO), considered there to be sufficient evidence for several firefighting-related exposures causing different types of cancer.
Firefighters have a 9 percent higher risk of being diagnosed with cancer and a 14 percent higher risk of dying from cancer than the general population according to a 2010 NIOSH study. Some additional cancer risks firefighters face are:
• Testicular Cancer – 2.02 times greater risk
• Mesothelioma – 2.00 times greater risk
• Multiple myeloma – 1.53 times greater risk
• Non-Hodgkin’s lymphoma – 1.51 times greater risk
• Skin cancer – 1.39 times greater risk
• Malignant Melanoma – 1.31 times greater risk
• Brain cancer – 1.31 times greater risk
• Prostate cancer – 1.28 times greater risk
• Colon cancer – 1.21 times greater risk
• Leukemia – 1.14 times greater risk
Prevention
Although firefighters are at a greater risk of cancer there are steps that can be taken to lessen that risk.
• Reduce exposure to diesel exhaust inside the fire station.
• Use full PPE and SCBA during all phases of firefighting including overhaul and salvage.
• Gross decontamination and bagging of your PPE at the scene, prior to returning to the station.
• A thorough cleaning of your PPE immediately upon your return to the station
• A thorough cleaning of all equipment immediately upon your return to the station
• A thorough cleaning of yourself immediately upon your return to the station. Shower as soon as possible. Do not take contaminants home with you to your family.
• Get an annual medical exam.
Medical Tests & Exams
Early detection is key to getting the upper hand in the battle against cancer. Be proactive, ask your doctor to be tested regularly. Some of the tests you may want to ask your doctor about are the following:
ANNUAL EXAM
• Blood pressure, pulse
• Respiratory rate, temperature
• Oxygen saturation
• Weight & body-fat index
• Thorough skin exam
• Hearing testing
• Oral exam
• Eye exam
• Heart & Spirometry (lung testing)
• Abdominal & testicular exam
• Fecal occult blood testing
• Pelvic & Pap for females
• Vascular & neurological exams
• Mental health assessment
• Musculoskeletal exam
ANNUAL LABS & SCREENING TESTS
• Complete blood count (White blood cell count (with differential), Red blood cell count, Platelet count, Liver function tests, Triglycerides, Glucose, Blood urea nitrogen, Creatinine, Sodium, Potassium, Total Protein, Albumin, Calcium, Cholesterol, HCO3)
• Comprehensive metabolic / chemistry panel
• Liver function tests
• Hepatitis profile
• Thyroid panel
• Diabetes Test (Fasting Plasma Glucose test) Hemoglobin A1c (for diabetes monitoring);
• Fasting lipid profile and blood glucose
• Urinalysis and urine biomarkers: PH, Glucose, Ketones, Protein, Blood, Bilirubin, (Microscopic: WBC, RBC, White Blood cell casts, Red cell casts, Crystals)
• EKG – All members should undergo a resting EKG & an aerobic/cardiopulmonary test. Members over 50 years old should get EKG’s and the stress test done annually.
• Pulmonary function test every three years
• Low-dose helical chest CT scanning (begin at age 50)
• Colonoscopy (begin age 40 and every five years)
• Exercise stress echocardiogram test (begin age 40 and every three years)
• Mammograms for females (begin age 35)
• Chest X-Ray (every 3 years): An initial Baseline is useful for healthy individuals for late comparison in the event that a disease develops. All members are recommended to have a chest X-ray every 3 years.
Male members are recommended to be screened for prostate specific antigen (PSA) and have a digital rectal exam. The PSA test covered may vary depending on the benefit carrier. Regular testicular self-exams are also recommended.
Female members are recommended to perform regular breast self-exams, to annually have a doctor palpate the breasts, and to have a mammogram every two years at minimum. PAP tests, to screen for cervical cancer, should also be done at minimum every two years, with no family history.
Breast cancer incidence and mortality rates increase with age. An annual clinical breast examination is required. Self-examination should be encouraged, and educational information should be made available to interested patients.
• Mammography screening shall be performed on all women uniformed personnel beginning at age 40 and continuing every other year until age 50, at which point annual mammography is indicated.
• Annual mammography should be obtained before age 50 if clinically indicated.
• The United States Preventive Services Task Force (USPSTF) recommends screening for cervical cancer in women ages 21 to 65 years, with a pap smear every three years.
• For women ages 30 to 65 years who want to be screened less frequently (every five years), screening should be a combination of a pap smear and human papillomavirus (HPV) testing.
Recommended Immunizations
Tetanus/Diphtheria vaccinations (personnel should get tetanus /diphtheria boosters every 10 years). It is also recommended to get annual flu shots.
Presumptive Legislation
The Government of Manitoba adopted the Firefighters Compensation Act in 2002, which was amended in 2005, 2009, 2011, and 2022. This Act recognizes the researched scientific evidence and the connection between the occupation of firefighting, heart injury/disease and certain cancers. According to the Act, these diseases/injuries must be presumed to be due to the nature of the worker’s employment as a fire fighter, unless the contrary is proven.
Occupational Illnesses / Diseases that are recognized in this Act (including minimum employment years)
Occupational Disease: Minimum Employment Years:
1. Primary Site Leukemia 5 years
2. Primary Site Bladder cancer 15 years
3. Primary Site Brain cancer 10 years
4. Primary Site Colorectal cancer 15 years
5. Primary site Esophageal cancer 25 years
6. Primary Site Kidney cancer 20 years
7. Primary Site Non-smoker’s Lung cancer 15 years
8. Primary Site Testicular cancer 10 years
9. Primary Site Ureter cancer 15 years
10. Primary Site Non-Hodgkin’s lymphoma 20 years
11. Multiple Myeloma cancer 15 years
12. Primary Site Prostate cancer 15 years
13. Primary Site Skin cancer 15 years
14. Primary Site Breast cancer 10 years
15. Primary Site Cervical cancer 10 years
16. Primary Site Ovarian cancer 10 years
17. Primary Site Penile cancer 10 years
18. Primary Site Pancreatic cancer 10 years
19. Primary Site Thyroid cancer 10 years
20. Heart Disease & Heart Injury N/A
21. Operational Stress Injury N/A
Making a WCB Claim
While the filing process is straightforward, there are a number of steps that need to be completed. Manitoba WCB considers Occupational Disease claims (the category Firefighter cancer would fall under) to be a specialized claim as the process differs from an injury claim where a specific event caused the injury. Occupational Disease usually occurs from a prolonged period of exposure to a toxic substance or substances, for example, repeated chemical exposure or toxins in smoke. As there is not a single event that could be considered the cause of the disease, a good work history is essential in linking exposure to certain substances to the onset of the disease or cancer. More on this later but the first step is to notify WCB of your condition to initiate the claim process.
You can contact WCB by phone: 204 954-4321 or Toll free 1-855-954-4321, by email: wcb@wcb.mb.ca or by mail, The Workers Compensation Board of Manitoba, 333 Broadway, Winnipeg, Mb R3C 4W3.
The WCB will require a medical report from your Doctor, and completion of a claim form. The claim is assigned to an Adjudicator who will contact you to work through the claim process. The Adjudicator will work with you to establish your employment history including any exposure that might be related to your medical diagnosis. The Adjudicator will contact your employer(s) both past and present along with your Physician to collect supporting evidence for your claim. Expect this process to take a number of weeks to complete. WCB, through the Adjudicator, will provide you with a rough timeline and update you as the process moves forward.
For more information on filing an Occupation Disease (Cancer) claim please review the WCB Occupational Diseases Brochure – https://www.wcb.mb.ca/occupational-diseases-brochure
To download a WCB claim form go to https://www.wcb.mb.ca/ . At the top of the page click on “Worker”. A page will open. Look for “Hurt at Work? – How to report an Injury”. There will be several links to information explaining how to file a claim including links to claim forms that can be downloaded and printed.
As previously mentioned, a detailed work history is very helpful to getting an occupational disease claim accepted. While this can seem to be overwhelming at first, start with a list of employers including dates of employment for each. For each employer provide as much detail as you can with respect to potential exposure to cancer causing substances. As this is difficult for fire fighters where exposure may be unknown or difficult to determine exact substances, you can list number of annual calls involving exposures such as structure fires, vehicle fires, hazmat incidents etc. Be sure to include exposure from non-firefighting sources as well. Remember presumptive legislation is based on length of fire fighting employment so employment dates along with work duties is a critical part of the information required by WCB.
Reporting Exposures
There are times where a firefighter knows they have been exposed to a harmful substance. If the exposure did not cause an immediate effect or time loss injury the exposure should be documented. Following is a copy of the WCB requires to document an unexpected exposure:
If there is concern that an injury or illness may develop at a later date as a result of an unexpected workplace exposure due to a leak, spill, unanticipated emission, explosion, release of a chemical or substance, or contact with an infectious substance or biological agent, workers and employers can contact the WCB’s General Enquiry Line at 204-954-4321 or 1-855-954-4321 to report a statement of concern.
This will ensure the WCB has a record of the exposure should an illness or injury related to exposure develop sometime in the future.
Information gathered by the WCB will include:
• Worker name, address, telephone number, date of birth, social insurance number, individual reported to at the place of employment
• Employer name, address, telephone number
• Date, time and location of exposure
• Source of exposure
• Type of exposure (chemical, other substances)
• Duration or degree of exposure (how long was the exposure and how long was the worker in the affected area?)
• Was any personal protective equipment worn?
When the WCB receives notification of a statement of concern it will clarify any missing details surrounding the exposure and contact the worker(s) in writing to provide confirmation of receipt of the statement of concern. Click here for the Statement of Concern
Details can also be submitted in writing to the WCB:
BY MAIL:
Workers Compensation Board of Manitoba
333 Broadway
Winnipeg MB
R3C 4W3
Attention: Occupational Disease Unit
BY FAX:
204-954-4330
Attention: Occupational Disease Unit
A statement of concern should only be reported if an unexpected workplace exposure has occurred and there has been no lost time from work and no injury or illness.
Bill C-224
June 26, 2023, Ottawa – Bill C-224, an Act to establish a national framework for the prevention and treatment of cancers linked to fire fighting, received royal assent on June 22 and will become law.
Bill C-224 was introduced by Quebec MP Sherry Romanado in January 2022.
Through Bill C-224, the month of January will be declared “Firefighter Cancer Awareness Month” throughout Canada. This important declaration will raise awareness about cancers linked to fire fighting and best practices to prevent these cancers.
Health Canada plans to develop a national framework that raises awareness of cancers linked to fire fighting, that supports improved access for firefighters to cancer prevention and treatment, and that provides a common direction for stakeholders to address cancer among firefighters.
Specifically, Bill C-224 paves the way for Health Canada to support valuable research on the link between certain types of cancer and fire fighting, make recommendations regarding regular screenings for cancers linked to fire fighting, and promote research and improve data collection on the prevention and treatment of cancers linked to firefighting.
Links
Firefighter Cancer Support Network
Fire Fighter Cancer Foundation
IAFC-Best Practices for Preventing Firefighter Cancer