Firefighters try to extinguish occupational cancers

Tyler Pennington, 30, is among a growing number of firefighters diagnosed with occupational cancer — the leading cause of death in the field, according to the International Association of Firefighters union. Cancer has been responsible for three of every four line-of-duty deaths since 2019 among union members alone, who make up only one-third of America’s career firefighters.

Pennington had no clue about the “awesome and emotional surprise” in store for him in the hospital parking lot the day of his procedure. Diagnosed with cancer a few days before Christmas, he had tried to keep his emotions in check for the sake of his family.

He and his wife, Mary–Ellen, have four children, ages 4 to 11, and live in Lake of the Woods. He works for the Fairfax County Fire and Rescue Department.

His emotional barrier went up in smoke at the hospital rally, when he saw past and present co-workers along with firefighters and medics he didn’t even know.

“I broke down,” Pennington said. “It was a really good feeling to see everyone.”

More toxins

Firefighters point to several reasons for higher cancer rates, including the very turnout gear that repels water and oil and protects them from heat and smoke inhalation. A study released in August shows that the protective equipment contains per- and polyfluoroalkyl substances, or PFAS, substances known as “forever chemicals” that have been linked to cancers and other diseases.

Then, there are the toxins emitted when synthetic materials and plastics burn, said Steve Weissman, a Spotsylvania County resident who directs the Virginia chapter of the Firefighter Cancer Support Network.

“Back in the day, buildings (and furniture) were constructed of legacy construction, wood, cotton, wools, and so forth. Now we’re seeing a lot of plastics and synthetics and when they burn, they give off toxins like we’ve never seen before,” he said. “Really, our society’s made of plastics.”

Weissman developed prostate cancer before he retired from the fire service in 2016, was treated successfully and remains cancer-free. Along with Ryan McGill, the local union’s cancer reduction chairman, he’s trying to get the word out to firefighters about ways to extinguish some of the risks they face.

The two also have lobbied the General Assembly to expand Workman’s Compensation Insurance to cover more types of cancer.

“That’s to protect our members and their families,” McGill said, “but we want to stop firefighters from even getting cancer in the first place.”

Higher risks

Compared to the general population, firefighters face a 9% higher risk of developing cancer and a 14% higher risk of dying from it, according to the Centers for Disease Control and National Institute for Occupational Health and Safety. Those risks are spelled out on the Firefighter Cancer Support Network website.

A newer study released last year by the Center for Fire, Rescue & EMS Health Research in New York raised yet another alarm. Researchers studied medical records of more than 100,000 Florida firefighters over 34 years and found they have a 22% higher risk of developing thyroid cancer.

Weissman estimates about 10 firefighters in Virginia who’ve developed thyroid cancer have contacted him in the last year. Three are from the Fredericksburg area, including Pennington and Elsa McCorkle, a 28-year-old firefighter/medic with Spotsylvania County.

While she was caught off guard by the diagnosis, she wasn’t totally shocked.

Cancer is “definitely a possibility, given everything we come in contact with,” she said.

The mentality around the firehouse, from what she’s seen, tends to be not if, but “what kind of cancer are you going to have in your lifetime and are we gonna catch it early enough?” McCorkle said.

Pennington, on the other hand, didn’t anticipate the c-word at all. He’s been in the fire service since he was 16, running with the same company in Delaware as his father. In Virginia, he worked with the Fredericksburg Fire Department, then joined Fairfax County 2½ years ago.

During a routine physical in late 2021, a doctor discovered two growths on his thyroid and said to keep an eye on them. A few months ago, he was eating dinner at the firehouse and felt pressure on his throat when he turned his head.

Then he choked on his food, and fellow firefighters jokingly asked if he needed saving.

Pennington, who’s usually reluctant to visit a doctor, got checked out. One growth had doubled in size and plans were made to remove the entire gland.

He’ll take medicine for the rest of his life to produce the hormones the thyroid normally would, to control his metabolism and body temperature.

McCorkle’s cancer was on only one side of the thyroid, which is shaped like a butterfly. She had that lobe removed in mid-December and hopes pending tests show the remaining portion will provide what her body needs.

Both Pennington and McCorkle said the diagnosis doesn’t change how they feel about being firefighters.

“I love this job, 100%,” he said. “If I’m going do anything in this world, it’s gonna be a fireman.”

He acknowledged he’s going to check more things off his bucket list because this “goes to show you never know.” McCorkle plans to focus on staying healthy.

“Honestly, the big thing I do personally is watch my diet and make sure I’m trying to get enough sleep and exercise because (those) are huge impactors to overall health and cancer recovery,” she said. “Control the things you can.”

More prevention

In recent years, departments have added decontamination units that accompany fire apparatus to the scene, and in these units, firefighters are basically hosed off when they’re done, while still wearing their turnout gear.

That on-scene decontamination with soap and water can remove up to 85% of toxins, Weissman said. Getting the gear cleaned, either by a professional company or in an in-house washing machine called an extractor, can take away up to 99% of possible cancer-causing chemicals, he said.

But as with most things, prevention costs money. Firefighters would need two sets of turnout gear in order to get each set cleaned after exposure. One set costs about $4,000, Weissman said. The extractors are about $9,000 each.

He estimates that less than half of fire departments statewide provide two sets of gear.

“Most metropolitan areas comply with that,” Weissman said. “The issue is a lot of rural volunteer organizations can’t afford it.”

Then, there’s the firehouse culture itself, “rooted in hundreds of years of tradition and the way we’ve always done things,” McGill said. “Now we have to change the culture of an industry that’s been around forever.”

Changes include making sure turnout gear is stored in ventilated areas, not where firefighters live, eat and sleep, because what toxins remain maybe be “off-gassing” or sending out toxins, the firefighters said.

There are educational campaigns about occupational cancer as well as information about help provided to firefighters who’ve been diagnosed with one type of disease. That ranges from what to ask physicians to how they can get their wills, medical directives and general house in order, Weissman said.

There’s also a campaign to have manufacturers develop gear that doesn’t contain carcinogens. While firefighters’ breathing masks protect airways, there are other areas of gear that allow chemicals to get through and “they’re dermally absorbed through our skin and that’s the primary route of exposure,” McGill said.

Some localities offer diagnostic screening for firefighters as Spotsylvania’s union recently did. McCorkle’s cancer already had been diagnosed but she appreciates the potentially lifesaving value of such scans.

“Let’s make sure we’re on top of catching it, as early as possible,” she said. “That’s probably one of the biggest impactors on survival. Catch it early and it doesn’t impact their quality of life and ability to return to work. That is a huge help.”