Investigators have found that firefighters may face occupational exposures to multiple chemicals that could increase their risk of developing breast cancer, according to a recent study published by Cardona et al in Toxics.
Background
Prior research has revealed that firefighters have significantly higher rates of cancer compared with the general population as a result of work-related exposures to toxic chemicals. However, because most research on cancer in firefighters has been done in men, less is known about the risks in women.
“With more and more women entering the profession, it’s important to understand the impact of workplace exposures on their health so that we can inform policies to reduce exposures and create a safer work environment,” explained senior study author Ruthann Rudel, MS, Director of Research at the Silent Spring Institute.
Study Methods and Results
In the study, the investigators searched through databases from the International Agency for Research on Cancer (IARC) and the U.S. National Toxicology Program to identify chemicals that may cause mammary tumors in animals. They noted that the same chemicals were likely to increase breast cancer risk. The investigators also searched for chemicals that have been associated with breast cancer in human studies.
They then identified over 100 studies describing the different chemicals firefighters encountered in the workplace and screened these studies to determine which of the workplace exposures elevated the risk of breast cancer.
The analysis revealed 12 chemicals or classes of chemicals—including benzene, polycyclic aromatic hydrocarbons (PAH), acetaldehyde, styrene, dioxins, flame retardants, per- and polyfluoroalkyl substances (PFAS), and polychlorinated biphenyls—that firefighters were highly exposed to that were associated with breast cancer risk.
Further, the firefighters were found to be exposed to potentially hazardous chemicals when extinguishing building fires, vehicle fires, and wildfires. They also encountered harmful substances in their protective gear, fire station air and dust, and diesel exhaust from firefighter trucks.
In previous studies, the investigators discovered that female firefighters had higher blood levels of cancer-causing PFAS compared with women working in downtown offices, as well as higher levels of carcinogenic flame retardants in their bodies.
Manufacturers add PFAS to firefighter turnout gear and firefighting foams.
“[However], we don’t know where the flame retardants are coming from—they could be coming from the gear or another source,” Ms. Rudel emphasized. “If it turns out the chemicals are being added to turnout gear, that would be important to know so that they can be replaced with safer alternatives,” she suggested.
Similarly, diesel exhaust from fire trucks contains PAHs. As a result, switching to electric trucks could help lower exposure.
“It’s important to look at all the equipment and materials that firefighters routinely use,” Ms. Rudel indicated.
Conclusions
Understanding the workplace risks female firefighters face may not only help change policies to improve worker safety but could also help ensure that female workers receive the medical care and other benefits they need should they develop breast cancer.
“This study fills an important research gap by underscoring the unique health risks female firefighters face from occupational exposures to toxic chemicals, specifically chemicals linked with breast cancer,” underscored Dan Whu, MD, MPH, Chief Medical Officer at the International Association of Fire Fighters (IAFF).
According to the IAFF, 20 states currently have presumptive laws that specify breast cancer as an occupational disease—entitling firefighters to workers' compensation, disability, medical leave, and medical expense coverage if they are diagnosed with breast cancer. Another 16 states have laws with less specific language that could allow the inclusion of breast cancer. Nonetheless, at the federal level, the current cancer presumptive legislation does not include breast cancer.
“That means there are a lot of places in the country where female firefighters are not protected,” stressed Ms. Rudel. “Hopefully, the findings from our study will change that,” she concluded.
Disclosure: The research in this study was funded by the California Breast Cancer Research Program and the Silent Spring Institute’s Safer Chemicals Program. For full disclosures of the study authors, visit mdpi.com.
