When a 9-1-1 call comes in, firefighters don’t hesitate to respond. They jump on their rigs, head to the emergency scene and quickly handle the problem. Yet, as the alarm sounds about a truly dire emergency within the firefighter community—workplace exposure to toxins and chemicals that lead to higher rates of cancer—some firefighters are slow to respond.
From rank-and-file firefighters to fire departments and health professionals, we’re behind in addressing the growing plague facing our profession. There can no longer be any doubt about the seriousness of the cancer emergency. After all, more firefighters die from occupational cancer each year than they do in a fire. Numerous studies show that firefighters’ exposure to smoke and other chemical products released from burning materials increases the risk of diseases and mortality, including cancer, heart disease and cardiovascular disease.
Firefighters recognize that the danger of their profession goes beyond the hazards of running into a burning building. But far too many firefighters seem to write off some of the more complex dangers and risks. Perhaps they accept them as just part of the job. Or they assume it will never happen to them.
Firefighters would never take that attitude toward helping a citizen in our community. It is time for us to change our thinking about the risks we face. The entire fire service community must come together to solve our professional emergency. It has a central role to play in addressing the crisis, a part that no one else can play, and every firefighter and fire department must now act.
The birth of the National Firefighter Registry
It is time to become active participants in gathering the data needed to better understand the problem. While the correlation between workplace exposures and the growing number of cancer cases among firefighters is clear, more information about these health risks is needed. Only with additional, more in-depth study will we be able to tackle the crisis.
Fortunately, an essential groundbreaking research tool is now being developed. To better understand the link between on-the-job exposure to toxins and cancer, Congress directed the Centers for Disease Control and Prevention to create the National Firefighter Registry (NFR). The NFR will provide the critical information needed to improve our understanding of cancer so we can better protect the health of firefighters.The goal of the NFR is to become the world’s largest database of health and occupational information for firefighters. This database could be used to track and analyze the incidences of cancer, and to search for common links to help the public safety community, researchers, scientists and medical professionals find better ways to protect firefighters and other first responders as they help keep their communities safe.
“A national cancer registry will go a long way towards answering the many questions still out there regarding exposure and cancer,” says Dr. Kenny Fent, the NFR team leader and an industrial hygienist at the National Institute for Occupational Safety and Health (NIOSH). “We’re just laying the groundwork now, but in the long run, we want to help prevent these cancers.”
For the NFR to work and be of value, firefighters must participate in it, providing individual information about themselves that, when combined with data from thousands of other firefighters, will collectively tell us what we need to know. Firefighters must provide the initial data needed to solve this scourge. Only through the action of a broad cross-section of firefighters will we be able to gain a better understanding of cancer and how to attack the problem.
While participation in the NFR is voluntary, all firefighters—career and volunteer, active and retired, those who have had or currently have cancer and those who have never received the diagnosis—should take part.
Every major organization involved in fire services is partnering with the NFR to educate and motivate firefighters to sign up. These groups understand the severity of the problem facing firefighters and the importance of making the NFR work. And they know that only through widespread participation of firefighters will we have the kind of accurate data needed.
“The bigger the sample for this registry, the better the ability to study specific subtypes of cancer,” said NIOSH lead epidemiologist for the registry, Dr. Miriam Siegel. “We could more accurately say what risk factors, what behaviors, what exposures are most related to increasing the risk of cancer.”
With broad participation, the NFR will be able to:
- Track cancer incidences (including rare types of cancer) among the full range of firefighters throughout the U.S.
- Explore possible different cancer risks among specific groups of firefighters, including women, minorities and sub-specialties of the fire service.
- Investigate whether the cancer risk is improving or worsening among more recent firefighters.
- Evaluate how exposures, including large or unusual incidents, relate to firefighters’ cancer risk.
- Gauge how control interventions relate to firefighters’ cancer risk.
By providing vital information about health and work experiences, firefighters will play a critical role in helping to understand more about the health risks the profession faces and potentially help future generations of firefighters.
Scientists, health researchers and other specialists are now doing the initial work needed to develop the database, building the infrastructure, ensuring that the right information will be collected, and creating a complex system that will provide the data researchers need. The actual enrollment of individual firefighters is expected to begin in the fall of 2020.
Fighting back
In the meantime, there are steps every firefighter can take today to help solve the growing cancer crisis. Firefighters should educate themselves about the cancer risks facing themselves and their co-workers. Every fire department and fire station should discuss what actions they may be able to take now to address cancer within their department.
Firefighters can also start tracking their exposures automatically in the National Fire Operations Reporting System (NFORS). The NFORS Exposure Tracker is available now and downloadable free from app stores. The NFORS Exposure Tracker is a private data gathering tool that creates a career diary for individual firefighters. It provides secure data entry and storage for users and will be leveraged to enroll firefighters into the NFR once that database is up and running.
Firefighters didn’t cause the problem of higher incidences of cancer in their ranks. And they certainly cannot be blamed for insufficient medical knowledge about the problem that currently exists. But firefighters will need to play a central role in solving the problem. Researchers can’t do it without them. To combat cancer, we will need firefighters to participate in the NFR. And the more who do, and the faster they sign up, the better off retired, current and future firefighters will be.
Every day firefighters don’t think twice about running to the rescue of others. They see a crisis, quickly analyze the problem and work as a team to solve it. Soon they will be able to work as a team in another way to solve a problem facing themselves and their co-workers—a problem stemming from their selfless and heroic service to others.
The NFR will be an essential research tool. And it’s a way for all firefighters and fire departments to work together to take action and save lives.
Q&A
The National Firefighter Registry
Key questions and answers about a critical new research initiative
1. What is the National Firefighter Registry (NFR)?
The NFR will be a large database of health and occupational information for firefighters that can be used to analyze and track the incidences of cancer and search for common links to help the public safety community, researchers, scientists and medical professionals find better ways to protect those who protect our communities.
With voluntary participation from firefighters, the privacy-protected National Firefighter Registry will include information about demographics, work assignment and exposure, and relevant health and medical details to monitor, track and improve our knowledge about cancer risks for firefighters, especially those linked to workplace exposures.
2. Why was the NFR created?
Studies of cancer in firefighters, including a study published by the National Institute for Occupational Safety and Health, found that firefighters may have a greater risk of some types of cancer. But many of these studies did not include volunteer firefighters or enough female and minority firefighters. NFR will add information on members of these groups, providing a broader cross-section between firefighters, and track more data from a larger sample of the firefighter population to gain greater insights into the connection of the firefighter occupation and cancer.
3. How will the NFR help firefighters?
It will provide critical information needed to protect the health of firefighters. By learning more about the rate of cancer among firefighters, we might find that some groups of firefighters or response activities have a greater risk of cancer than others due to exposure, geography, gender or other factors. We also may learn more about certain protective measures that are associated with reducing the risk of cancer.
4. What is NIOSH?
The National Institute for Occupational Safety and Health is the part of the Centers for Disease Control and Prevention responsible for researching workplace illness and injury.
5. How do I enroll?
Enrollment is not yet open, but there will be an opportunity in the near future for all firefighters to enroll. The target date to begin enrollment is the fall of 2020. NIOSH will keep their webpage updated as the enrollment period approaches.
6. Can a firefighter enroll if they have never had cancer?
Yes. In fact, cancer-free firefighters are just as critical to making the NFR a success as those who have cancer. NIOSH would like all firefighters to be part of the NFR, not just those who have cancer or other illnesses. Anyone who has ever been a firefighter should join the NFR. This means all active and retired firefighters, including volunteer, paid-on-call, part time and career firefighters are strongly encouraged to join the NFR.
7. Do firefighters have to join the NFR?
No. Being part of the NFR is completely voluntary, and no one can make a firefighter join. NIOSH needs your consent for you to be part of the NFR. However, participation is strongly encouraged, because it will help improve the health and safety of the firefighter community today and in the future. The NFR is your opportunity to leave a legacy for those who follow you.
8. How will the data be collected?
We will collect information from firefighters through web-based surveys, well-known exposure tracking applications and fire department records after obtaining consent from each firefighter. Long term, NIOSH will monitor potential cancer diagnoses for firefighters enrolled in the NFR by linking information with state cancer registries.
9. Do firefighters need to contact NIOSH if they have cancer?
No. NIOSH will be able to track information related to cancer by linking individual firefighters’ information with state cancer registries. Firefighters should consult with their doctor if they have any concerns about their health and to ensure that, if you are diagnosed with cancer of any kind, you are entered into your state cancer registry.
10. How will the registry be used?
Data from the NFR will be matched with information from national and state databases to track cancer cases or find out about causes of death among firefighters. Researchers will use these data to compare the risk of cancer among firefighters to that of the rest of the U.S. population.
11. Will NIOSH share information collected for the NFR?
No personal information about any individual firefighter ever will be shared. However, the overall or aggregate findings from the NFR will be shared with the public and researchers using the database.
To repeat, any information that identifies an individual will not be shared with any outside organizations, including fire departments, unions, elected officials or other researchers without permission of the registry participant.
For more information on the NFR visit www.cdc.gov/niosh/firefighters/health.html or contact [email protected].
NIOSH
December 1, 1992 marked a new era in the promotion of Occupational Safety and Health in Malaysia. On this day the National Institute of Occupational Safety and Health (NIOSH) was launched, after careful preparation and commitment from all parties to improve the safety and health of workers at the workplace in Malaysia. In the words of the Minister of Human Resources, Malaysia, NIOSH would be a "critical catalyst" in the promotion of occupational safety and health that would also serve as the "backbone" to create a "self-regulating occupational safety and health culture" in Malaysia.?
