Firefighters asked to participate in U.S. cancer registry

As firefighters increasingly risk countless chemical hazards released by modern buildings, whose contents burn faster than ever, a new voluntary U.S. cancer registry will help doctors understand how they work and how best to keep them safe, officials said Monday.

"The purpose of the ... [National Firefighter Registry for Cancer] is to better understand how firefighters’ occupational factors contribute to their risk of developing cancer," said Nura Sadeghpour, a spokeswoman for the federal Centers for Disease Control and Prevention.

Every firefighter is asked to join the registry, Sadeghpour said, though it will provide no medical benefits. "Nor can it be used to prove the cause of any individual's cancer diagnosis," she added.

Congress first directed the registry to be created in 2018, and since then the dangers have only grown clearer, experts said, pointing to the continuing deaths of Ground Zero first responders.

“What’s really striking is not only is the stuff that burns more dangerous in terms of all of the chemicals, but it burns so much faster,” said Dr. Peter Silver, senior vice president and chief quality officer for Northwell Health, and a volunteer firefighter whose second term as Syosset’s fire chief just ended.

Even with swift response times, the speed of these chemically rich blazes means they may be even more out of control when firefighters arrive.

“There are petroleum products in everyday construction, and other chemicals in furniture, and things burn so much faster and hotter than they did decades ago, and so not only is the fire more advanced but this makes it is so much more dangerous,” said Silver, who has 33 years of experience subduing flames.

Synthetics can allow fires to spread faster and release carcinogens, Sadeghpour said.

"Firefighters encounter more hazardous chemicals today than they did 50 years ago because of the increasing amounts of synthetic materials inside our structures and vehicles," she said.

People may only have a couple of minutes to flee because new homes go up so swiftly, experts say. Tests have shown a room with synthetic furnishings can reach “flashover,” when it is fully engulfed in flames, in around three minutes; a legacy room with natural sofas, chairs, curtains and tables might not reach that point for almost half an hour.

“According to the National Institute of Occupational Safety and Health, firefighters have a 9% higher chance of being diagnosed with cancer and a 14% higher risk of dying from cancer than the general U.S. population,” said Curt Floyd, technical lead-first responder for the National Fire Protection Association, a nonprofit in Quincy, Massachusetts.

A study of 30,000 firefighters in San Francisco, Chicago and Philadelphia who worked from 1950 to 2009, the Centers for Disease Control and Prevention says, found “known carcinogens” they may encounter include formaldehyde, benzene, asbestos and many more.

Some of the very chemicals and protections firefighters rely on have turned out to be highly dangerous themselves, as they can contain “forever” classes of chemicals, such as PFAs, which have been used not only in firefighting gear but in fire-quenching foam.

“It repels flammable liquids from seeping into the gear and allows some of the moisture we build up as firefighters to be released from the gear,” Silver explained. “Are the PFAs in the gear dangerous? I don’t think anybody has the answer — other than you’d be foolish not to wear all your protective gear going into a fire.”

Silver and Floyd described another imperative: ensuring no skin is exposed because that is another way carcinogens may enter the body.

Improved hoods, said Floyd, cover any gaps below a respirator mask.

And firefighters try to cleanse their gear and equipment as much as possible with wipes and hoses before returning to shower at the fire station.

“We’ve kept up with that enhanced training and improved gear,” said Silver.

The culture also has changed. “It used to be, years ago, it was a sign of toughness to take your breathing masks off as soon as you could and breathe in a little bit of smoke,” Silver said.

Now, “We know that is very unhealthy and we really discourage that. And the other thing we do, when your gear is soiled with all those chemicals -- this is something relatively new … rather than bring it back to the firehouse and put it on again, or come into contact with it,” those garments go into the station’s heavy-duty washing machines.

Dr. John Howard, NIOSH director, in a statement urged firefighters to enter their information in the database. The more who do so, “the more researchers can learn about cancer arising from firefighting and how to prevent it," he said.

“The National Firefighter Registry for Cancer … is absolutely what’s needed; it’s fantastic,” Floyd said. “It’s taken a while to get up and running, but I think it’s very important for all firefighters, volunteer, industrial, tribal, wild land — to get on the registry.”

Floyd added: “It’s going to collect data and it’s going to help create a better view of what’s happening, where it’s happening.”