OF MEN AND FLAMES

The very existence of flame-throwers proves that some time, somewhere, someone said to themselves, You know, I want to set those people over there on fire, but I'm just not close enough to get the job done. -- George Carlin

FIREFIGHTERS are just the opposite. They hate fire. They live to put out fires. Every firefighter's wet dream is a world without flames. Other people flirt with fire. Firefighters go to war, sometimes zigging and zagging through inferno to save people.

Sometimes they die. Those who don't have other dangers to confront.

The Institute for Occupational Health and Safety Development (IOHSAD) cites studies that show firefighters at risk for various kinds of cancers, more so than most of the population.

IOHSAD executive director Noel Colina said the November, 2006 issue of the Journal of Occupational and Environmental Medicine discussed a study of 100,000 firefighters by the University of Cincinnati, which found members of the profession face "greater risk of getting cancer - including testicular, prostate, skin, brain, rectum, stomach and colon cancer, non-Hodgkin's lymphoma, multiple myeloma and malignant melanoma."

This was further affirmed in October, 2007 by the International Agency for Research on Cancer (IARC) as it classified occupational exposure as firefighter as Class 2B carcinogen or “possibly carcinogenic to human”. According to the IARC, firefighters are often exposed to toxic combustion products, including benzene and formaldehyde, which are released during fires.

“The study tells us that toxic compounds, aside from being released into the air, can also accumulate on the clothing and equipment of firefighters, which can cause elevated risks of of testicular cancer, prostate cancer and non-Hodgkin lymphoma,” stated Colina.

The Bureau of Fire Protection of the Philippines had 14,995 personnel nationwide in 2005, according to Colina. These do not include the thousands of volunteer firefighters. The Association of Volunteer Fire Chiefs and Firefighters of the Philippines, Inc., founded in 1987, has 35 volunteer fire brigades with around 1,500 firefighters and paramedics and a complement of around 100 firetrucks, water tankers and rescue units.

I'm actually surprised at how small the number of volunteers seems to be, because they're who we see swarming all over a fire scene while residents wait for the arrival of government units. I'm also not too sure if the Association is a unified body of volunteers. There used to be separate volunteer groups -- by the Federation and Amity; listening to elders discuss the political and philosophical differences of both groups was an interesting past time.

There is no question that cancer is a serious problem among firefighters. It is serious enough for the United States Fire Administration (USFA) and the National Institute for Occupational Safety and Health (NIOSH) to launch a study to examine the potential for increased risk of cancer among firefighters.

The announcement, released April 2010, said:

This multi-year USFA supported NIOSH study will include over 18,000 current and retired career firefighters. The project will improve upon previously published firefighter studies by significantly increasing the number of individuals for whom health data will be analyzed. A larger study provides greater statistical reliability. The study will also improve on past studies by analyzing not only deaths from cancer, but also the incidence of certain cancers that have higher survival rates than others, such as testicular and prostate cancer, as well as deaths from causes other than cancer. This will improve researchers' ability to estimate risk for various cancers and to compare risk of cancer with risks for other causes of death.

Cancers aren't just the only health risks that firefighters face. More common is cardiovascular disease. This problem is alarming enough to have prompted the publication, "Preventing Fire Fighter Fatalities Due to Heart Attacks and Other Cardiovascular Events" by the National Institute for Occupational Safety and Health and the Centers for Disease Control and Prevention of the US Department of Health and Human Services.

"Sudden cardiac death represents the most common cause of a fire fighter fatality," according to the publication. It said a study that spanned 1995 to 2004 showed that sudden cardiac death accounted for 44% (440/1006) of on-duty fire fighter fatalities.

In addition to personal factors that may predispose an individual to coronary artery disease or other cardiovascular diseases, occupational exposures can significantly increase a firefighter's risk, notes the free online encyclopaedia, Wiki.

For instance, carbon monoxide, present in nearly all fire environments, and hydrogen cyanide, formed during the combustion of paper, cotton, plastics, and other substances containing carbon and nitrogen, interfere with the transport of oxygen in the body. Hypoxia can then lead to heart injury. In addition, chronic exposure to particulate matter in smoke is associated with atherosclerosis. Noise exposures may contribute to hypertension and possibly ischemic heart disease. Other factors associated with firefighting, such as stress, heat stress, and heavy physical exertion, also increase the risk of cardiovascular events.

Colina says, "the government, through its appropriate agency, should inform and educate firefighters of the risk they face." (There was nothing though about cardiovascular health in the IOHSAD press release.)

IOHSAD backs the recommendations of the International Myeloma Foundation on cancer prevention among firefighters:

1) Firefighters should have their turnouts professionally cleaned routinely, and to avoid wearing or storing their turnouts in fire station living areas

2) Firefighters should shower as soon as they return from each fire to remove the soot and ash

3) Fire departments review and update guidelines for use of personal protective equipment (PPE)

4) It is advisable for departments to equip fire engines with exhaust removal systems; if not available, avoid idling the engines indoors without adequate ventilation

Whether the BFP can hew to these standards, given the sorry state of equipment of its crews, is anybody's guess. It's hard to imagine close attention being given these serious prescriptions when the biggest headache among firefighters these days is finding high enough ladders for multi-story buildings and/or long enough hoses to reach homes in communities where streets are nothing more than alleys.

(For reference: Institute for Occupational Health and Safety Development, 406 Ramagi Building, 1081 Pedro Gil Avenue, Paco 1007, Manila, Philippines, + 63 2 521 1216)