“We found a mass on your lung during the CT scan” – words every firefighter dreads hearing from a doctor.
It is no secret that firefighters have a dangerous job and that their exposures to carcinogens are more significant than any other occupation. Firefighter rates of cancer are 9% higher than the general public, and a firefighter’s mortality rate is 14% higher. We also know that many firefighters are prone to accept the Prometheus and Super Man complexes as their fate, destined to live – and die – by the laws of fire dynamics.
I won’t argue a person’s drive to conduct themselves in a professionally heroic manner – to be the first one in the door with the hoseline making up the stairs to make the grab or to be on the rope rappelling down a cliff to reach trapped occupants. I will argue that every exposure to “action” is precipitated by combination of training, evaluation and prevention. We train and test to ensure that we’re at the top of our game.
All this training and testing is our operational prevention activity, making sure we’re ready to do the right thing when we need to, hopefully to prevent much worse things from happening down the line. And as critical as training and testing are to firefighters, there is much more we need to do on the prevention front, particularly in the realm of personal prevention.
A survey by the International Association of Fire Chiefs found that 45% of volunteer firefighters and up to 80% of career firefighters receive annual firefighter physicals. Recognizing that behavioral health is also a big part of your personal prevention/CRR efforts, another shocking statistic, this time from the NFPA, finds that 73% of the departments have NO behavioral health programs.
Leading a preventative lifestyle
Our jobs expose us to so many dangers that it only makes sense to pay greater attention to those things outside of work that also expose us to danger – smoking/vaping, alcohol, sun exposure and the chemicals found in just about everything these days. The revelations of PFAS in our protective gear was bad enough, but then to learn that PFAS is also found in many of our household items adds salt to the proverbial wound. We can control our exposures to smoking/vaping and alcohol and to some extent the sun. It will be much more difficult to control your exposures to the miscellaneous carcinogens around us all the time. And while limiting exposure is easier said than done, awareness is your first line of defense.
The next line of preventative-defense involves you and your department’s attention to medical evaluations. Our organizational efforts have been dismal at best. Fortunately, there could be some light on the horizon in the new OSHA standard, which, as proposed, would finally require entry and annual physicals. It is unconscionable, if not criminal, to me that even simple physicals are not yet universally required. There are so many things we could be preventing (or catching early) by instituting routine and required physicals.
Beyond the standard medical physical that typically includes normal vitals, bloodwork, a treadmill test, and hearing and vision tests, there are other widely available opportunities to monitor our health. Wellness apps and ultrasound testing are important components for your personal-CRR toolbox.
Cordico: Designed by first responder psychologists, Cordico’s wellness app provides a tool for fire and EMS personnel to monitor their health. The app provides 24/7 on-demand access to firefighter mental health and resilience tools, peer support, family support resources, cancer support, and therapists certified to treat first responders. According to David Black, president of Lexipol Wellness Solutions, approximately 9 out of 10 agencies using Cordico report that it provides support for their personnel, with the vast majority of agencies reporting that the program decreases stigma, increases awareness of wellness resources, provides tools for dealing with work-related challenges, and increases utilization of peer support and other support resources. Additionally, 72% of agencies using Cordico report that it provides suicide prevention resources or has prevented an actual suicide within their agency in the past year alone.
Life Scan: Ultrasound exams provide body scanning that can pick up anomalies other diagnostics may miss. One of the most widely known and accepted platforms out there for the fire service has been the Life Scan Wellness Centers ultrasound evaluations. Life Scan has been working for 26 years to not only scan firefighters but also raise industry awareness of the dangers around us and to find ways to make ultrasound evaluations more affordable. Every department should be taking advantage of these evaluations, routinely scanning their firefighters for cancer. The evaluations provide a quick and painless opportunity to find anomalies before they become criticalities.
There are myriad opportunities to fund these programs, as they are all eligible for funding under the Fire ACT grant opportunities. While I think everyone will agree that our own health and wellness is a critical component, it is disheartening to recognize that less than 2% of the applications received ask for funding for health and wellness program enhancements. We are missing that boat folks!
Prevention through legislative action
It has been a long hard fight to get presumptive cancer legislation in all 50 states and Washington, D.C. While the legislation is disparate in specificities, its presence is a start no less. Legislatures fear that presumptive legislation will bankrupt already strained budgets. I submit to them that the inevitable lawsuits for failing to act on “what they should have known” will far outweigh the cost of any presumptive testing and/or coverage.
The New Hampshire state Senate recently unanimously approved a pilot program to offer voluntary comprehensive early-detection cancer screening for all active and retired permanent firefighters. The screening includes a blood test, an ultrasound of vital organs, a lung CT scan if indicated and a skin cancer screening. It’s important to recognize that New Hampshire had previously conducted ultrasound screening as part of a baseline-before-presumption for all firefighters statewide. Life Scan Wellness Centers was the contractor selected to conduct that baseline.
Make it personal
We ALL need to take the cancers within us seriously – take it personally. If not for you, for your crewmembers and your loved ones at home. They’re depending on you to show up healthy every day.
Remember those words from the beginning, “we found a mass”? Those are exactly the words my doctor uttered to me in February 2024. Fortunately, not only have I received routine Life Scan exams over the years that provided me some peace of mind, but I have also led a healthy lifestyle, especially in my later years, improving my chances to live a longer life. My “mass” turned out to be pneumonia, and all biopsies came back negative. Those words were still the four of the most sobering words anyone has ever said to me. I hope you take them as personal as I did – the next time it could be you!
[Read more about my health scare: ‘You have a pneumothorax’: When the provider becomes the patient]
