FIRE FIGHTER RESOURCES
Cancer and Other Illnesses
National Fire Fighter Registry: On Monday, July 9th 2018 President Donald Trump signed legislation requiring the CDC to set up a registry of fire fightersExternal that will track links between their workplace exposures and cancer. NIOSH will take the lead in establishing the registry. In FY19, Congress appropriated $1 million to NIOSH towards implementation activities related to the Firefighter Cancer Registry. The language can be found in the Joint Explanatory Statement of the Committee of Conference-Division B-Labor, HHS accompanying H.R. 6157. If you have questions, email FFRegistry@cdc.gov.
CDC/NIOSH has posted a Request for Information (RFI) to seek input on the National Firefighter RegistryExternal. In the RFI, we outline three possible enrollment strategies and pose a list of questions for our stakeholders. Specifically, NIOSH is asking for input on how to maximize participation for the Registry. We encourage anyone with interest in firefighter health and safety to comment on the RFI. The comment period opened on Thursday, March 28th, 2019 and will close on May 28th, 2019.
National Fire Fighter Registry: Questions and Answers
- Why is this registry being created?
Previous studies, including a multi-year study completed by NIOSHCdc-pdf , indicate that firefighters are at a higher risk of cancer. However, these studies are limited by the inclusion of only small numbers of women and minorities, and a lack of data on volunteer firefighters. The registry will help provide more complete and representative information about fire fighters in the U.S. so that we may better understand the link between workplace exposures and cancer.
- Who is NIOSH, and why is NIOSH in charge of collecting data for the registry?
As the CDC agency responsible for occupational safety and health research, NIOSH has decades of experience designing and conducting occupational cancer studies and establishing cohorts of workers that are followed over time to evaluate cancer incidence.
- How will the data be collected?
NIOSH will design an approach that is systematic and scientifically valid, and will include under-studied groups such as women, minorities, and volunteer fire fighters. We will begin by collecting employment records from participating U.S. fire departments. These records will be processed and then linked with data from state cancer registries to obtain diagnosis information.
- How will the registry be used?
The registry will include fire fighters from a variety of different fire departments (e.g., urban, rural, career, on-call, volunteer). Once established, the registry will be matched against national and state databases to determine causes of death and cancer among fire fighters. For example, statistical analyses will be conducted to investigate the risk of cancer among fire fighters compared to what is seen in the general population.
- Will the data in this registry be available to the public?
Yes. Findings that come from registry data will be available without personal or identifiable information via scientific publications and communications to the public. We also plan to make data from the registry available to investigators who request it, with the appropriate approval.
Fire Fighter Cancer Study
In 2010, NIOSH researchers, with funding assistance from the U.S. Fire AdministrationExternal launched a multi-year studyCdc-pdf to examine whether fire fighters have a higher risk of cancer and other causes of death due to job exposures. Our study was designed to address limitations of previous fire fighter cancer research.
- With more than 30,000 career fire fighters who served in Chicago, Philadelphia, and San Francisco Fire Departments between 1950 and 2010, it is the largest study of United States fire fighters ever undertaken. In addition, both non-white and female fire fighters are represented.
- We looked not only at deaths from cancer, but also at the diagnosis of certain kinds of cancer, such as testicular and prostate cancer, which have higher survival rates. We also examined other causes of death to better understand the risk for various cancers and illnesses among fire fighters compared to the general public.
- We examined more exposures than previous studies. We looked at the number and type of fire runs made (for example, EMS and vehicle fire) and the use of personal protective equipment and diesel exhaust controls.
- Creation of a retrospective job-exposure matrix using surrogate measure of exposure for a cohort of US career firefighters from San Francisco, Chicago and Philadelphia (2015)Cdc-pdf
- Exposure-response relationship for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009) (2015)Cdc-pdf
- Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia, 1950–2009 (2013)Cdc-pdf
- NIOSH study of firefighters finds increased rates of cancer, NIOSH Update (2013)
- NIOSH fire fighter cancer study initial result, Frequently Asked Questions (2013)Cdc-pdf
- Cancer incidence among male Massachusetts firefighters, 1987–2003 (2008)
- Mortality in Florida professional firefighters, 1972 to 1999 (2005)
- Cancer incidence and general mortality in a cohort of Florida firefighters (2003)
- Mortality among fire fighters: A 27 state survey (1994)
- Sudden death from a heart event is the most common cause of death among fire fighters (Preventing fire fighter fatalities, 2007).
- Most heart disease can be prevented.
- NIOSH Fire Fighter Fatality Investigation Reports: Cardiac events
- Preventing fire fighter fatalities due to heart attack and other sudden cardiac events, NIOSH Alert, No: 2007-13 (2007)
- Fire fighter wellness regime (2011)
- Physiological recovery from firefighting activities in rehabilitation and beyond (2011)
- Cardiovascular risks in firefighters: Implications for occupational health nurse practice (2004)
- Heart problems, mental health, and job stress in the Anaheim Fire DepartmentCdc-pdf, Health Hazard Evaluation Report: No 94-0390-2822 (2000)
- Correlates of fitness for duty in hazardous materials firefighters (1999)
- NIOSH recommends workplace noise levels are below 85 dBA (8-hour time-weighted average of 85 dBA based on a 3-dB exchange rate).
- NIOSH provides standards to help prevent workplace hearing loss, Criteria for a Recommended Standard: Occupational Noise ExposureCdc-pdf
- Routine fire fighting tasks and emergency response activities often result in noise exposure that exceeds NIOSH recommendations.
- Repeated exposure may gradually cause work-related hearing loss.
- To prevent hearing impairment among fire fighters, we recommend using engineering and administrative controls to limit overall exposure to noise.
- When controls are not possible, we recommend hearing protection training and limiting noise exposures.
- Time-weighted averages and fire fighter hearing loss (2004)
- Noise and hearing loss in firefighting (1995)
- Hamilton Fire Department, Hamilton, OH (hearing loss),Cdc-pdf Health Hazard Evaluation Report: No 89-0026-2495 (1995)
- Pittsburgh Bureau of Fire, Pittsburgh, PA (hearing loss),Cdc-pdf Health Hazard Evaluation Report: No 88-0290-2460 (1994)
- International Association of Fire Fighters, Anaheim, CA (hearing loss), Health Hazard Evaluation Report: No 87-352-2097 (1991)
- Memphis Fire Department, Memphis, TN (hearing loss), Health Hazard Evaluation Report: No 86-138-2017 (1990)
- International Association of Fire Fighters, Cincinnati, OH (hearing loss), Health Hazard Evaluation Report: No 84-454-1890 (1988)
- Rhabdomyolysis (often called rhabdo) is the breakdown of muscle tissue and has many causes including heat exposure, high core body temperature, and prolonged, intense exertion
- Early treatment can prevent serious medical problems.
- If not quickly identified and treated, rhabdo can result in:
- Kidney failure requiring lifelong kidney dialysis or a kidney transplant
- Permanent disability
- Routine fire fighter tasks, such as carrying extra weight of equipment and working in hot environments, may increase fire fighters’ risk for rhabdo
Structural Fire Fighters
- What Structural Fire Fighters Need to Know about Rhabdomyolysis Cdc-pdf
- Wallet Card to notify healthcare providers of structural fire fighters’ increased risk for rhabdomyolysis (PDF attachedCdc-pdf)
Wildland Fire Fighters
- What Wildland Fire Fighters Need to Know about RhabdomyolysisCdc-pdf
- Wallet Card to notify healthcare providers of wildland fire fighters’ increased risk for rhabdomyolysis (PDF attached)Cdc-pdf
Other Illness – Publications
- Fatality Investigation Reports
- Tuberculin skin test conversions at a Mississippi fire department, City of Meridian Fire DepartmentCdc-pdf, Health Hazard Evaluation Report: No. 2007-0012-3046 (2007)
- Particle size-dependent radical generation from wildland fire smoke (2007)
- Acute respiratory effects of smoke exposure in wildland firefighters (NORA Symposium 2006)
- Single nucleotide polymorphisms (SNPs) associated with decline in lung function in firefighters (Research Symposium 2006)
- Acute respiratory effects of smoke exposure in wildland firefighters (2005)
- Blood-borne pathogens among firefighters and emergency medical technicians (2005)
- Adverse respiratory effects following overhaul in firefighters (2001)
- Neurodegenerative diseases: occupational occurrence and potential risk factors, 1982 through 1991 (1996)
- International Association of Fire Fighters (IAFF), Sedgwick County, KS (heat stress)Cdc-pdf Health Hazard Evaluation Report: No 90-0395-2121 (1991)