Author: c0recr3ative

Finding the link between firefighters and cancer is vital in protecting our emergency service personnel.

In June 2023, the Fire Brigades Union (FBU) announced that nearly 300 firefighters would be participating in new national health monitoring research for firefighters. The firefighters will provide blood and urine samples to be analysed for biomarkers of cancers and other diseases, as well as toxic chemicals. The results will be used to detect cancers and other diseases at the early stages. The monitoring will further identify evidence linking occupational cancers with exposure to toxic fire chemicals, thus demonstrating a correlation between firefighters and cancer.

At present, despite the recent published research showing that the rate of cancer among UK firefighters aged 35-39 is up to 323% higher than in the general population in the same age category, firefighters are not provided with any regular health monitoring.

Over the past five years, there have been several studies and developments confirming what those in the profession have known for decades, that firefighters face a significant increase in occupational disease as a result of doing their job. In 2019, the then Chief Fire Officer Chris Davies QFSM² acknowledged the high rate of cancer among members of the profession.

“There is a lot of scientific and medical information out there but all of it, that I’m aware of, states that you can’t prove or disprove a link to cancer.”

“What I do acknowledge is firefighters are contracting certain types of cancer above the population norm, I accept that and that is a concern.”

Firefighters and Cancer – Post 2019 Research

Since Mr Davies’ statement, the International Agency for Research on Cancer (IARC) (the specialised cancer agency for the World Health Organization (WHO) declared there was sufficient evidence for occupational exposure as a firefighter to be classified as a carcinogenic to humans (Group 1) on the basis of sufficient evidence for mesothelioma and bladder cancer.

In addition, the IARC found here was limited evidence for cancer from exposure as a firefighter for the following cancer types: colon cancer, prostate cancer, testicular cancer, melanoma of the skin, and non-Hodgkin lymphoma. There was also strong mechanistic evidence that occupational exposure as a firefighter exhibits five of the ten key characteristics (KCs) of carcinogens: “[it] is genotoxic” (KC2), “induces epigenetic alterations” (KC4), “induces oxidative stress” (KC5), “induces chronic inflammation” (KC6), and “modulates receptor-mediated effects” (KC8).

The latest research, published in the January 2023 edition of the Scientific Reports section of the Nature Journal, concluded that

• Firefighters who had served more than 15 years were 1.7 times more likely to develop cancer than those who had served less time.
• Firefighters were at least twice as likely to be diagnosed with cancer if they noticed soot in their nose/throat (odds ratio (OR) = 2.0, 1.1–3.5), or remained in their PPE for more than four hours after attending a fire incident (OR = 2.3, 1.1–5.2).
• Other factors associated with an increased likelihood of cancer were:
  • eating while wearing PPE (OR = 1.8, 1.2–2.7);
  • failing to store clean/dirty PPE separately (OR = 1.3, 1.0–1.7);
• working in a station that smells of fire (OR = 1.3, 1.0–1.8) or not having designated (separated) clean and dirty areas (OR = 1.4, 1.1–1.7);
• using an on-site washing machine to launder fire hoods (OR = 1.3, 1.0–1.7);
• feeling that cleaning is not taken seriously at work (OR = 1.5, 1.2–2.0).

Those undertaking the study pointed out that up until this point, most research concerning firefighters’ chronic exposure to contaminants has been done on US firefighters. The lack of UK-centric research has resulted in the Industrial Injuries Advisory Council (IIAC) not recommending cancer (with the exception of mesothelioma) as a prescriptive disease in firefighters. This has negatively impacted on firefighters’ access to workplace compensation. Contrast this with North America, where presumptive legislation protects firefighters’ right to compensation for several types of cancers and other chronic illnesses.

The researchers also concluded:

“A lack of research concerning UK firefighters’ occupational health also poses challenges for the effective implementation of preventative measures, i.e., measures which would limit chronic exposure to harmful contaminants in the first instance. Without an established baseline, it is difficult to implement or quantify the effectiveness of such preventative measures. Similarly, for UK Fire and Rescue Services (FRSs) required to operate under increasingly strained resources, a lack of current research makes it difficult to prioritise such measures in a resource-efficient manner.”

Can PPE help protect against exposure to fire toxins?

The 2023 research also confirmed that after attending a fire incident, PPE worn by firefighters may be heavily contaminated with elements of fire smoke. It was also found that:

“…firefighters who remain in PPE for more than four hours after attending a fire are over twice as likely to develop cancer than those who remain in PPE for 30 min or less after an incident (OR = 2.3, 1.1–5.2). If not effectively removed, contaminants will remain on PPE where they can continue to accumulate, posing a long-term exposure risk. Removing contaminants from PPE and firefighters’ skin (e.g., through washing after an incident) as soon as possible is therefore vital for reducing both acute and chronic dermal exposure.”

One way of significantly reducing the amount of contaminated fire smoke particles reaching the skin is to wear a protective specifically designed to block carcinogens and control against heat stress². This type of protection also increases the quality of life of firefighters, as it prevents smoke odour permeating off the skin in the days following extensive exposure, a situation that can cause embarrassment at the gym and distress to family members.

Firefighters and Cancer

The new research leaves no doubt as to the connection between certain types of cancers and the firefighting occupation. It is imperative that the UK Government examine the evidence as the conclusions of its last published report are now out of date. In addition, the IIAC needs to revise its policies in light of the new findings and recommend a prescription for cancer for current and retired firefighters.

To discuss any points made in this article, please call the Enduro Protect team on 01235 814112.

 

 

¹ Mr Davies announced his retirement on 7 August 2023 – A fond farewell from Chief Fire Officer Chris Davies QFSM (mawwfire.gov.uk)

² When attending a fire, firefighters’ skin is 400% more absorbent due to heat and sweat.

“UK Firefighters suffer significant excess mortality from cancer and other diseases when compared with the general population.”

Such was the findings of the, now infamous, study by Professor Anna Stec published at the start of this year (January 2023). Looking at the mortality records from the National Records of Scotland, the research showed a significantly higher mortality rate for certain types of cancer for firefighters.

Over the past five years, research and developments has begun to confirm what those in the profession have known for decades: that firefighters face a significant increase in occupational disease as a result of doing their job. Speaking on behalf of the Fire Brigades Union, Riccardo la Torre (national officer) commented that “this classification should be a huge wake-up call for both the government and fire and rescue services”, urging the government to acknowledge and take action.

Despite the recent published research showing that the rate of cancer among UK firefighters aged 35-39 is up to 323% higher than in the general population in the same age category, at present, firefighters are not provided with any regular health monitoring.

Research into the Correlation

Scientific and medical information available in 2019 suggested a link between Firefighting and Cancer. Yet the researchers appeared reluctant to summarise their findings as a significant link between the two.

The then Chief Fire Officer Chris Davies QFSM[1] acknowledged the high rate of cancer among members of the profession.

“There is a lot of scientific and medical information out there but all of it, that I’m aware of, states that you can’t prove or disprove a link to cancer.

“What I do acknowledge is firefighters are contracting certain types of cancer above the population norm, I accept that and that is a concern.”

Since Mr Davies’ statement, the International Agency for Research on Cancer (IARC) in 2022 declared there was sufficient evidence for occupational exposure as a firefighter to be classified as a carcinogenic to humans (Group 1, exhibiting five of the ten key characteristics). They found sufficient evidence for cancer from exposure as a firefighter for both mesothelioma and bladder cancer, and limited evidence for other cancer (including prostate, testicular and melanoma).

Increasing the Risk: Firefighter’s Habits

The latest research, published in the January 2023 edition of the Scientific Reports section of the Nature Journal, found that firefighters who had served more than 15 years were 1.7 times more likely to develop cancer than those who had served less time. The detailed research found increased risk to firefighters who noticed soot in their nose/throat or who remained in their PPE for more than four hours after attending a fire incident. Both categories were twice as likely to be diagnosed with cancer.

Other factors associated with an increased likelihood of cancer were:

• Eating while wearing PPE.
• Failing to store clean/dirty PPE separately.
• Working in a station that smells of fire.
• Not having designated (separated) clean and dirty areas.
• Using an on-site washing machine to launder fire hoods.
• Feeling that cleaning is not taken seriously at work.

The Role of Protective Wear

Whilst the new research leaves no doubt as to the connection between certain types of cancers and the firefighting occupation, there is still little direction to what preventative measures should be enforced.

Those undertaking the study pointed out that most research concerning firefighters’ chronic exposure to contaminants has focused on US firefighters. Researchers commented that the lack of UK-centric research may pose challenges to the implementation of preventative measures (for example, protective baselayers and flash hoods that limits exposure to contaminants and particulates).

The researchers commented:

“For UK Fire and Rescue Services (FRSs) required to operate under increasingly strained resources, a lack of current research makes it difficult to prioritise such [preventative] measures in a resource-efficient manner.”

One way of significantly reducing the amount of contaminated fire smoke particles reaching the skin is to wear a protective baselayer specifically designed to block carcinogens and control against heat stress[2]. Traditionally, protective wear has been uncomfortable and restrictive. Firefighters have reported issues hearing instructions through flash hoods, and the limited breathability of protective wear. Concerningly, some of the protective wear available to firefighters are only guaranteed as effective for a very limited number of washes.

Recently, modern baselayers have been produced which provide 99% efficiency even after 100 wash/dry cycles. Feedback from the fire services have led to improvements in breathability, comfort and even style – improving the likelihood that firemen and women choose to wear it. This protection increases the quality of life of firefighters, as many firefighters complain of smoke odour permeating off the skin in the days following extensive exposure. A situation that can cause embarrassment at the gym and distress to family members.

It is imperative that the UK Government examine the new evidence of the correlation between firefighting and cancer, as the conclusions of its last published report are now out of date. This will ensure that the awareness of the risk and its prevention is at the forefront of new legislation and guidelines for current and retired firefighters.

Enduro Protect is the leading supplier of protective wear for firefighters and emergency service workers. Their firefighter’s baselayer and flash hood has been developed in conjunction with the fire service to provide market-leading protection (99.99% Particulate Blocking) whilst providing unrivalled comfort and breathability.

For more information, please call the Enduro Protect team on 01235 814112, or visit their website www.enduroprotect.co.uk.

[1] Mr Davies announced his retirement on 7 August 2023 – A fond farewell from Chief Fire Officer Chris Davies QFSM (mawwfire.gov.uk)

[2] When attending a fire, firefighters’ skin is 400% more absorbent due to heat and sweat.

It is an unfortunate reality that Firefighters are exposed to enormous health risks on a daily basis from excessive heat, smoke, and harmful toxins. While there is no doubt that modern protective clothing has made the industry much safer in general, firefighters still face the serious problem of cancer-causing substances being absorbed directly into the skin and heat stress. As we will discuss in this article, Enduro Protect is transforming protective workwear for firefighters by removing many of the health risks that have been long overlooked.

What is the problem with traditional firefighting clothing?

Most firefighters tend to wear a t-shirt and trousers close to their skin, which offers no protection from harmful substances. Usually, when a firefighter takes off their protective gear, carcinogenic soot marks are visible on the skin, evidence that harmful contamination penetrates through firefighter clothing. This is important because, as we discussed in a recent article, the prevalence of cancer among UK firefighters aged between 35-39 is up to 323% higher than in the general population.

What is the Enduro Protect base layer?

The Enduro Protect base layer is specialist protective workwear for those in the firefighting industry. Our protective flash hood, top and jogging bottoms have been painstakingly developed over 3 years of research in close collaboration with the firefighting industry. At its core is a patented fabric mesh that is breathable but does not allow fine, harmful particulates to enter and be absorbed by the skin. Enduro Protect base layers offer considerable benefits for firefighters, both in terms of long-term health and protection from cancer and comfort while performing their role.

How Enduro Protect Benefits Firefighters at Work and Home

Our Enduro Protect base layer has been used and tested heavily within the field and offers a number of important benefits, including:

Fully blocks carcinogenic substances from touching the skin

Harmful chemicals that reach the skin are much more likely to be absorbed into the body due to the conditions firefighters face. This is because skin is 400% more absorbent in the presence of heat and sweat. Enduro Protect does not only prevent the absorption of carcinogenic smoke, it also meets the:

• ASTM F903 standard for resistance penetration by liquid chemicals, and the
• ASTM F1671 standard for resistance penetration by viral and blood-borne viruses

Enduro Protect is highly effective at blocking the skin absorption of a wide range of harmful cancer-causing chemicals and even warfare agents such as mustard gas.

In the words of Nicholas Brown of the Oxfordshire FRS, who extensively tested the Enduro Protect base layer, “I found no contamination passing through the clothing. Excellent”.

Controls body temperature to reduce heat stress

The Enduro Protect base layer also excels at controlling body temperature and reducing the potential for heat stress. Nicholas Brown of the Oxfordshire FRS explained:

“It [Enduro Protect] was much more efficient: cooling the entire body evenly, rapidly, and stopping once a reasonable temperature was gained. I never felt too cold in this, and I never felt wet. I was really impressed with this.”

Rapid drying to keep firefighters as comfortable as possible

Due to heat exposure and the thickness of firefighter clothing, profuse sweating is an inevitable result. One of the key benefits of our base layer is its ability to wick sweat away from the body and quickly dry. This means that firefighters feel much more comfortable while performing their roles. When asked if our base layer was effective in wicking away sweat, John Hardy of Oxfordshire FRS told us:

“Although it is impossible not to sweat profusely in a fire kit and especially when exposed to heat, the base layer performed brilliantly. Within a few minutes of removing my fire kit, the base layer dried out the sweat it had wicked away and remained comfortable to wear”.

On the wicking ability of Enduro Protect, Nicholas Brown also said:

“Wicking capability – this is absolutely awesome. This is the first time I’ve worn a base layer like this, so I can only compare it to the cheap cotton(ish) t-shirts all firefighters are issued. I did not feel drenched in sweat like I would have normally and was completely dry almost immediately.”

Comfortable and non-restrictive

Firefighter protective clothing is not normally known for being comfortable. Using the Enduro Protect base layer offers increases comfort throughout the working day. On the level of comfort while wearing our base layer, John Hardy commented:

“Once on, I found the base layer extremely comfortable to wear under my fire kit to the point I wasn’t really aware I was wearing it. I was able to perform all my firefighting tasks without any restriction from the base layer”.

No smoke contamination in the home

Firefighters who have worn the Enduro Protect base layer have found additional benefits when they arrive home from work. Because smoke does not reach the skin when wearing Enduro Protect, firefighters report that they do not smell of smoke, and there are no sooty marks and smears which can get on home furnishings. As John Hardy explained:

“When I went for a shower following exposure to heat and smoke in one of the FBT demo boxes and, although my fire kit was exposed to contaminants, my skin did not smell of smoke or show any signs of contaminants. The inside of the base layer was clean and also did not smell of smoke”.

Final words

The simplicity of the Enduro Protect base layer means that it can be used with existing firefighting kits while overcoming the lack of protection it offers. Given the risks faced by firefighters on a daily basis, the more that can be done to protect them from long-term health conditions and make their working life more comfortable, the better.

To discuss any points made in this article, please call the Enduro Protect team on 01235 814112.