‘All Hands’ Needed to Combat Cancer in Volunteer Firefighters: The FASNY-Northwell Health Firefighter Cancer Study

Dr. Jacqueline Moline, FASNY Health and Wellness Committee Chair

FASNY’s stake in the fight against cancer in the volunteer fire service goes deep and is well known to the membership and everyone familiar with our organization. FASNY’s plan of attack is, by design, wide-ranging, aggressive, collaborative and, therefore, effective:

  • Working year after year with legislators to get the best possible presumptive cancer coverage bill passed.
  • Sponsoring workshops and other training for firefighters on the crucial importance of consistent use of PPE and decontamination of gear to reduce exposure to the carcinogens present at every fire.
  • Advocating for firefighters and their families by taking key leadership roles with the Firefighter Cancer Support Network, the National Volunteer Firefighter Council (NVFC) and the National Fallen Firefighters Foundation’s Fire Service Occupational Cancer Alliance.

This is the level of commitment that’s required to keep making progress and developing the best possible cancer awareness, prevention, detection and treatment for our volunteer firefighters. Chief Dennis Compton, Chairman of the Board of Directors of the National Fallen Firefighters Foundation, echoed the imperative for a multi-level attack in “A Call for Collaboration” from a recent summary of the work being done by the Fire Service Occupational Cancer Alliance (1). He wrote, “Action to prevent firefighter occupational cancer and support those that have cancer must be a collaborative effort involving all parts of the fire department and affiliated organizations. The efforts of everyone need to be coordinated for us to be effective in this fight … In volunteer and combination fire departments, chief officers, fire district or fire department leadership, and firefighters and company officers need to be together. Some departments have unions or member organizations that need to be part of the solution as well … Our best chance of beating cancer is to work together.”

Which Cancers and Why?

Studies of career firefighters have provided much-needed information on how firefighting can increase the risk of cancer. Two recent studies from Scandinavia and Australia strengthened the evidence regarding increased risks of prostate cancer (particularly for younger men, before age 50 or 60), mesothelioma and melanoma (2,3).

For the volunteer fire service, effective programs will depend on having data that specifically addresses cancers in volunteers along with factors that could be modified to minimize their risks. In the meantime, volunteer fire service organizations like FASNY and NVFC are taking action and providing guidance based on the evidence for career firefighters, including the findings from recent studies in the U.S., summarized in the following table (4,5).

The FASNY-Northwell Health Firefighter Cancer Study

FASNY’s sponsorship of the first study in the U.S. to focus exclusively on cancer in volunteer firefighters is a unique opportunity that will require “all hands” to make it work.

The current presumptive cancer bill for volunteers in New York has made unprecedented progress this year by unanimous passage in both the State Assembly and Senate. While no bill is ever perfect, it was developed for maximum viability and that is the most important first step.

To develop the most effective cancer detection, prevention and treatment programs, we need irrefutable data. We need to use the gold standard methodology that established cancer presumption for career firefighters to get comparable information for volunteer firefighters.

Northwell Health’s Department of Occupational Medicine, Epidemiology and Prevention is partnering with FASNY to conduct this critical research. The study will be led by myself, an occupational medicine physician who is the Chair of FASNY’s Health and Wellness Committee and one of the founders of the World Trade Center Health Programs, and Dr. Anne Golden, an occupational epidemiologist who was instrumental in obtaining the data for the Fire Department of New York that led to the first cancer presumption bill for career firefighters in New York State. The FASNY-Northwell Health Firefighter Cancer Study team has begun outreach, recruitment and data collection with fire departments. Outlined below are the “whys” and the “hows” of the study, and we hope that the resounding consensus in every fire department will be, “What took so long? Let’s get this done, now!”

Study Purpose

The FASNY-Northwell Health Firefighter Cancer Study will determine how many members of the volunteer fire service in New York State have developed or died from cancer. In addition to supporting cancer legislation to protect volunteer firefighters who develop cancer in the line of duty, this information will be invaluable for developing targeted cancer prevention and detection programs that will benefit every volunteer firefighter.

Recruiting Fire Departments

There is only one way to gather enough information to answer the most important questions: What cancers are volunteers at greatest risk of developing? When are they getting cancer, are they dying from cancer, and do their risks exceed what we expect for everybody else? Are there trends in risk that are driven by firefighting activities that might be changed?

We are reaching out to every volunteer fire department throughout New York State to participate in this study. The information supplied by fire departments is the only way to do this study right, and the greater the number of participating fire departments, the better our results will be. It’s that simple.

We have received invaluable assistance from various associations, fire chiefs and commissioners throughout Long Island and are ready to keep the momentum going as we begin outreach throughout upstate New York.

Study Data

To participate, your fire department needs to send an email address to ffcancerstudy@northwell.edu to receive your department’s unique link to the study’s data collection forms. The information from fire departments will be collected using a state-of-the-art HIPAA compliant online database called REDCap.

Our Promise

We pledge that our study team will use every data security precaution available, including:

  • NOT requesting Social Security numbers;
  • Never contacting individual firefighters or their families for any reason;
  • Using a research data collection and management system with the highest security protocols;
  • Only reporting completely de-identified data (no individual firefighters’ or fire departments’ names will ever appear in any report from the study); and
  • Not using or sharing the data for any other purpose

For More Information about the Cancer Study

To learn more about the study and how to participate, send an email to ffcancerstudy@northwell.edu or visit
www.feinsteininstitute.org/ff-cancer-study

If you have any questions or concerns, please contact any of the following members of the FASNY-Northwell Health Firefighter Cancer Study Team:

Email address: ffcancerstudy@northwell.edu

Project Coordinator: Gina Arena, MA; office (516) 465-1944 or cell (516) 270-7481 for text or calls

Research Assistant: Vincenza Caruso, BS; office (516) 465-3196

Program Director: Anne Golden, Ph.D.; office (516) 465-3171

Principal Investigator: Jacqueline Moline, MD; office (516) 465-2639

References

  1. http://www.nvfc.org/roundtable-cancer-prevention-and-awareness-in-the-volunteer-fire-service/ NVFC Roundtable: Cancer Prevention and Awareness in the Volunteer Fire Service. May 2016.
  2. Pukkala E, Martinsen JI, Weiderpass E, et al. Cancer incidence among firefighters: 45 years of follow-up in five Nordic countries. Occup Environ Med 2014;71:398–404.
  3. Glass DC, Del Monaco A, Pircher S, et al. Mortality and cancer incidence among male volunteer Australian firefighters. Occup Environ Med 2017;0:1-11.
  4. Daniels RD, Kubale TL, Yiin JH, et al. Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009). Occup Environ Med 2014;71:388–97.
  5. LeMasters GK, Genaidy AM, Succop P, et al. Cancer risk among firefighters: a review and meta-analysis of 32 studies. J Occup Environ Med 2006;48:1189-1202.