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This is the silent killer affecting firefighters

New studies out of Boston and Illinois show cancer risks in firefighters compared to civilians is alarming.

KILLEEN, Texas — For Killeen Fire Department Capt. Tim Rabroker risking his life on the job is not uncommon and part of the oath he took.

"It used to be a badge of honor when your gear was filthy, dirty, sooted up, it was like, ‘that guys been in some fire, you can tell by looking at his gear,’” Rabroker said.

Firefighters put their lives at risk every day when they go to work. What they are just starting to understand is that even when the coats are back on the racks and the hats back on the stands, their lives are still on the line.

New studies out of Boston and Illinois show cancer risks in firefighters compared to civilians is alarming.

“(What) people don’t realize is that fire departments hire based on physical fitness. They test for mental aptitude also,” said Capt. Robert Webb, a 31-year career firefighter. “But the biggest proponent is a physical agility test and they’re very strenuous. So they’re hiring the most physically fit people they can find between 18 and 35 years old. So that group is usually in the top 10 to 15 percent health-wise in the USA. And so that group, which is the most healthy of the healthy, is (at a) 36 to 67 percent higher risk factor for cancer.”

In 2010, Rabroker learned he was among that 67 percent. 

"I was 33, feeling pretty good, prime of life kind of thing. My wife had just found out we were pregnant, so it was a real gut punch,” Rabroker said.

Cpt. Robert Webb of Fort Worth also has work-related cancer and is part of the firefighter cancer support network. The network raises awareness and provides training and support to those whose cancer was caused by an unseen enemy.

"Every fire that we get to we’re exposed to a lot of carcinogens. Many more than most people would understand because the things that are burning in houses now are plastic, Webb said. “So the smoke gets into your pores, your skin, for every four degrees rise in temperature in a fire, your absorption rate goes up 300 percent.”

Carcinogens release dangerous chemicals that land on firefighters’ skin through their breathable gear. Fire departments are just starting to understand the risks and fire departments in Central Texas, and around the world, are feeling the effect of fire-related cancers and they are trying to implement changes.

“Seventeen years ago when I started, there was no talk of firefighter-related cancer,” said Belton Fire Department Asst. Fire Chief Wesley Gilbreath said. “And in the last couple of years, it really came to the forefront. One of our own actually had firefighter-related cancer. That kind of expedited some of the things we did.”

Departments, at the minimum, are trying to reduce exposure to carcinogens through wipes, thorough gear cleaning, showering, and always keeping their gear separate from living quarters.

Both Rabroker and Webb said a lot more needs to be done to effectively reduce cancer risks, but their biggest hurdle is budget constraints.

"Replacing outdated equipment, to trying to implement safer features and things like that. But like we know it takes time and money,” Rabroker said.

It’s hard on bigger stations, but for volunteer departments around Central Texas the mountain is taller and change is incremental.

"We operate on a smaller budget than most paid fire departments,” said Capt. Matthew Lane, who works with the Troy Volunteer Fire Department. “We are working on getting a procedure set up to help the guys clean their gear better. We just try to tell them to wash their gear off the best they can.”

Volunteer firefighters are at a higher risk of cancer because of their time spent fighting fires, but they too are covered by the presumptive laws in Texas as long as their records are in order.

“If a volunteer department told everybody, ‘Hey your risk factor for getting cancer are X,’ they may see a whole lot of people not wanting to do it for free,” Webb said. “But ironically, chapter 607 does cover volunteers, but there is a lot of bookkeeping that needs to take place for that volunteer firefighter to get the coverage. They have to respond to a percentage of the fires or runs on a consistent basis to be covered for a length of time.”

It’s not just the fire releasing these cancer-causing substances.

“In (our fire trucks) diesel exhaust there are 9 groups, one (is)carcinogens,” Webb said. “So even the person standing out next to the truck or checking out the truck in the truck room, or if it’s running in the truck room at all, it’s putting those carcinogens throughout the fire station. That’s what we are exposed to on a daily basis. And remember when the truck’s pumping water, it’s revved up to speeds we’d do on a freeway. And our gear doesn’t protect us from smoke, it’s flame retardant.”  

According to the Firefighter Cancer Support Network, in the state of Texas alone, more than 500 firefighters were diagnosed with cancer in 2018. Firefighters not talking about their cancer is a big part of the problem.

“When I was first diagnosed with my condition I was very private about it,” Rabroker said. “I didn’t tell anybody about it beyond my direct supervisors, so I could get the time off approved. But that’s probably not what I should have done. I’m a very private person, I understand how he or she feels (after being diagnosed with cancer) about not wanting to be pitied. I don’t want a lot of attention on me. But in the long run, that’s what I shouldn’t have done. Ask for help see what is available to you. Everybody needs help and there’s nothing wrong with asking for it.”

For those diagnosed, the proper treatment can often mean the difference between life and death.

“You have one shot to cure it and if you get the wrong cure it cannot only hurt you, it can kill you,” Rabroker said.

Presumptive laws in Texas are helping firefighters with support when diagnosed with work-related cancer.

Chapter 607 in the Texas state law specifies that firefighters who are diagnosed with cancer-related to their job are entitled to workers compensation. The rate of firefighters being denied workers compensation in Texas is around 90 percent. Not only are the denial rates high, but some firefighters are being sued to recoup funds from firefighters, such as the current case in Mission Texas.

Some Texas governments insurance carriers are denying workers compensation because they have said only three types of cancers, for firefighters, are work-related (testicular, prostate and Non-Hodgkin’s lymphoma).

“Unfortunately, firefighters that have a 100 percent legitimate claim, are almost 100 percent of the time denied,” Webb said. “Chapter 607 doesn’t say it covers only three cancers. It states very clearly that it covers any cancer shown to be caused by products of combustion with links back to the arc monographs, from the International Agency for Research on Cancer. And that’s all it says.”

Compensation for firefighters is handled by third-party insurance companies contracted by the cities. Texas Municipal League services more than 2,800 governments and political subdivisions in Texas and is regularly in the headlines trying to recoup money given through workers compensation because they believe only three cancers mentioned above have been shown to be work-related when it comes to firefighters.

In an op-ed by TML executive director Bennett Sandlin, he said being responsible with the cities money and trying to create new presumptive laws is something they are continually working on.

With a 90 percent denial in workers compensation claims for those with work-related cancer, the physiological effect on firefighters is abhorrent.

“It’s (mental health) very important. “It helps with going out there and taking the risks that we do on an everyday basis,” Rabroker said. “Knowing that no matter what, you’re going to be taken care of, your family’s going to be taken care of, knowing that those benefits would be there to take care of your loved ones and yourself definitely help.”

Firefighters aren’t necessarily looking for monetary help when applying for workers compensation.

“The main thing is to get it classified as a line of duty injury. The reason for that is if you die from that cancer, benefits that companies like TML don’t pay for, and cities don’t pay for, it’s a state benefit that covers your children to go to college. It covers your spouse getting an insurance policy check (line of duty policy check), and it also affects the pension that the widow is paid,” Rabroker said.   

Webb warns that for those firefighters who are not diagnosed during active duty, once retirement comes along, the options are limited for help even though signs of cancer might not show for many years that were a result of their work.

“The way 607 reads, it only covers firefighters that are actively employed or were diagnosed during employment,” Webb said. “So the day they retire literally is the end of their coverage for presumptive cancer. I had a firefighter that retired on Dec. 31, 2018 and on Jan. 1 found out he had stage 3 myeloma. He obviously didn’t get stage 3 multiple myeloma in 12 hours, he was obviously sick during his employment. But from the technicality of the law, that’s something he’s going to have to overcome. We are trying to ask for a 5- to 10-year window for retirees.”  

With so much still to discover and understand about the work-related cancer firefighters are experiencing, Webb and Rabroker said it starts with the department culture.

“Our whole way of life is going to have to change on what we do and how we take care of ourselves.”

If you are a firefighter and would like more information or help please visit the Firefighter Cancer Support Network.

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