Tackling the toxic threat

Lorna King

116 (1436), March, 2021

In the second part of FIRE’s review of the findings of the UCLan report on contaminants, commissioned by the FBU, Health & Fitness Correspondent Lorna King investigates what fire and rescue services are doing to tackle the threat

In March 2018, an international firefighter conference was held in Reykjavik, Iceland, to discuss the issue of occupational cancer. The conference was designed to highlight the fact that firefighters, as a result of their work, are exposed to contaminants that cause cancer and other diseases. Representatives from the UK Fire Brigade Union (FBU) attended the conference and reported afterwards that, ‘prevention is possible and, when this fails, compensation is needed’.

‘Clean is the New Tough’

The conference saw leading academics, industry experts and firefighter union representatives discussing how the issues of preventing exposure and campaigns for presumptive legislation are managed around the world. Jim Quinn, FBU Executive Council member for Northern Ireland, described the findings as “dynamite”. After hearing all of the presentations on offer at the conference, Quinn remarked: “Clean is the new tough,” and, subsequently, the FBU promised to “take everything learned from this conference and put it into the campaign to protect members in the UK.”

Evidently, the idea that the occupation of being a firefighter creates a greater risk of contracting cancer compared to the general population is nothing new. Skip forward from the conference in 2018 to now, and in that time in the UK, the FBU and the University of Central Lancashire (UCLan) have produced their well-publicised toxicity report on the subject.

Anna Stec, lead researcher and Professor in Fire Chemistry and Toxicity at UCLan, recognises the immediate action that is needed as a result: “It is time for change. If this level of toxic exposure was found in the US or Canada, governments would immediately put measures in place to monitor the health of firefighters and address this. Countries across Europe are also tackling this problem, with Norway, Sweden and Finland working toward identifying their own solutions.

“The UK must do more to tackle the growing issue of cancer in firefighters… government needs to protect those working to save the lives of others by providing them with the best preventative medical care, education and support, whilst investing in guidance and research to ensure best practice is adhered to.”

FBU General Secretary Matt Wrack has also voiced his concerns about the urgency of action needed to protect our firefighters following the first stage of the contaminants research. He said in a recent UCLan article about the report: “There are some hard truths for fire and rescue services in this report – and far more needs to be done to protect firefighters from cancer and other illnesses. And among firefighters, there are still some myths to dispel, which is why regular and up-to-date training on the risk to their health is so essential.”

The UCLan research is not the only toxicity report that is being commissioned in the UK. CFO for Mid and West Wales and Chair of the NFCC’s Personal Protective Equipment Committee, Chris Davies, informed FIRE magazine of the firefighters’ health-risk research project being conducted at Brighton University by Dr Alan Richardson. The project involves blood and urine samples of a large number of firefighters being screened for specific cancerous markers. This research was due to conclude in October 2020 but has been delayed because of the Covid-19 pandemic.

CFO Davies also confirmed: “The NFCC’s current position is that an independent literature review has been undertaken by the Centre for Science and Technology who work within the Defence Science and Technology Laboratory. Based on the current literature, the position at the moment is that a ‘causal link to the role of a firefighter and contracting cancer cannot be proved or disproved’.”

CFO Davies continued: “However, the NFCC welcomes any continued research which will ensure the continued safety of our firefighters… The overriding message is: clean is the new tough. Firefighters can improve their own body’s resistance to absorbing toxins by three basic principles:

• Hydration – stay hydrated. The skin when hydrated protects against natural absorption by up to 30 per cent. It stops acting as a sponge!

• Heat management – try to manage the amount of extreme heat exposure that their bodies are subjected to.

• Hygiene – simply: clean is the new tough. It is no longer acceptable to wear dirty fire kit as a badge of honour.”

The NFCC’s official position statement confirms what is essentially at the heart of the matter: ‘The NFCC takes the safety and welfare of firefighters extremely seriously and are committed to supporting evidence-based research, to understand potential risks as well as inform future guidance and recommendations.

‘Significant improvements have already been realised across the sector, particularly around the cultural interpretations associated with contaminated PPE. The NFCC, fire and rescue services, firefighters, representative bodies and scientific advisors have and will continue to work in partnership, reducing risks to an acceptable level.

‘The NFCC will identify further opportunities to improve firefighter safety as new evidence emerges. The NFCC believe further detailed longitudinal research should be completed to fully understand any potential risks. Of course, if this identifies a problem with our PPE or current decontamination procedures, we would want to provide our firefighters with the best protection available’.

The Industrial Injuries Advisory Council (IIAC) is the government body that certifies occupational diseases for compensation in the UK. At the time of writing, they stated on their website that for 2020-2021 their priorities are to ‘ensure the advice we give about the Industrial Injuries Scheme is impartial, evidence-based, effective, credible and timely’. At the top of the list that their work programme will include for this period is “cancer in firefighters”.

In a personal statement issued to FIRE magazine, Senior Scientific Officer Ian Chetland confirmed the following: ‘A comprehensive review of the recent published literature relating to cancer in firefighters, together with a summary of potential carcinogens to which firefighters may potentially be exposed, has been carried out by members of IIAC. A report has been prepared and is going through procedures for publication on the website. Please keep monitoring the IIAC website where the report will appear in due course’.

It seems urgency for action is on everyone’s lips and government interaction is imminent. But what is happening in fire services across the country right now?

Merseyside

Merseyside Fire and Rescue Service (MFRS) held a Scrutiny Committee meeting in January 2021 to discuss the publication of the UCLan report. The presentation given to the committee by GM Craig Whitfield, Health and Safety Manager for MFRS, showed not only that MRFS is a shining example of implementing the recommendations from the report, but that they have already been doing so for quite some time.

In 2016, Bureau Veritas conducted research within the MFRS on the detection and maintenance of hazardous materials, which prompted many of the health and safety procedures within MFRS today. Whitfield said in his presentation: “This is nothing new. This is something that the fire and rescue service, and certainly MFRS through our Health and Safety Welfare Committee, continually have on the radar. We are continually working towards doing everything we can to keep our firefighters as safe as they can be.”

Whitfield explained the measures they already have in place, to include rigorous, professional cleaning of all soiled PPE with “robust checks in place to ensure that our firefighters have got safe kit before they start a shift,” a clean cab policy that now operates more stringently alongside new Covid-19 regulations, wipes and extra water bottles issued to all staff, lanyards provided to store gloves and clip onto the jacket rather than storing inside helmets or boots, compulsory showering after an incident and particulate filters in all their half-face respirators. Whitfield also said: “We are in a really good and positive place in terms of not having any gaps within the recommendations… In relation to the research of this report we will continue to progress and react.”

Scotland

In 2018, the Scottish Fire and Rescue Service (SFRS) recognised the evidence of contamination exposure that was developing around the world and formed a Contaminants Working Group within their Health, Safety and Wellbeing Committee. The group identified the following key lines of enquiry for consideration:

Station design (to include clean/dirty zones and cleaning regime)
Appliance design (to include separate storage compartments for BA and PPE)
Operations (to include personal hygiene and incident decontamination)
PPE (to include laundering provisions and number of sets per person)
Occupational Health (to include annual health screening and post diagnosis support)
Culture (considering the use of positive statements such as “a clean tunic is a badge of honour”)
Training (to include contaminant awareness and controls)
Records (tracking any potential exposure).

In its Strategic Plan 2019-22, the SFRS states: ‘The safety of our people is paramount and we have created a strong proactive health and safety culture to protect them. Being appropriately trained, and having access to the right information and support is essential to our people’s safety and we are fully committed to ensuring we have the resources in place to achieve that’.

Watch Commander Jim Grove from West Midlands Fire Service has published a report called Firefighter Safety – Pre and Post Incident. The detailed information in Grove’s report highlights the dangers of contaminants and contaminated PPE using scientific evidence, and recommends best practice for reducing exposure and cleaning PPE and equipment.

Bristol Uniforms refer to Grove’s report in a previous FIRE magazine article, praising its recommendation for lighter coloured PPE that will show the dirt more easily. In the December 2020/January 2021 issue of FIRE magazine, Bristol Uniforms announced its new range of PPE, ‘specifically designed to protect against new and emerging dangers’. The EOS range, as well as providing heat protection while working to keep the body cool, also protects areas of the skin that are commonly exposed to contaminants.

National Database

Looking ahead, researchers at UCLan have launched a new nationwide database to assess the link between cancers and other diseases and firefighters. The university has provided the following statement: ‘Known as the UK Firefighters’ Cancer and Disease Registry (FCDR), the database will collect information on firefighters’ work routines, exposure to fire effluents, lifestyle and health. This will enable scientists to identify and recognise most common cancers and diseases related to firefighters’ work, and, in the future, offer preventative health screening, education and support that is specifically designed to protect firefighters’ health’. This project will allow the researchers at UCLan to analyse data on a long-term basis.

Professor Stec said: “The UK’s National Cancer Registry and Analysis Service is currently not able to provide any reliable data on cancer incidence or mortality amongst firefighters. Setting up the UK Firefighters Disease and Cancer Registry will enable us to identify and keep track of all firefighters who have been diagnosed with the diseases and cancers, as well as identify any association between firefighters’ occupation and exposure to fire carcinogens.

“We are calling on all firefighters, including those new to the career and those that have moved on, to register with the UK FCDR. Filling in this registry will help us to track the rates of cancer and disease cases over time, as well as helping us to recognise the most common diseases and cancers related to firefighters’ work and exposure to fire toxins.”

Matt Wrack added: “Every current and former firefighter who has suffered a serious or chronic illness needs to add their name to this register so we can further expose the shocking numbers of firefighters suffering from cancer and other diseases. In Canada and parts of the US, the link between firefighting and deadly diseases has been recognised in legislation, allowing firefighters and their families to receive compensation where health has been affected or where firefighters have died as a result. We need to be doing far more to avoid contamination in the first place but also, as the body of evidence continues to grow here, politicians in the UK must be willing to step up and protect their own firefighters.”

The UK FCDR can be accessed via the UCLan website here: www.uclan.ac.uk/FCDR. All data is stored securely and anonymously and firefighters can request that their data is withdrawn at any time. The registry asks questions about cancers and other common illnesses.