Firefighters and Cancer: Is This Fair? Dear Friends, Last week, I met with the California firefighters who were involved in our recentstudy on firefighting and cancer-causing chemicals. It was a heart-wrenching experience, because, bottom line, most firefighters today are potentially at risk forcancer. As a result of weak regulations coupled with aggressive marketing by the chemical industry, we all have pounds of toxic, unneeded flame retardants in our couches, carpets, baby strollers, plastic TV casings, computers, and foam building insulation. Ironically, adding halogenated flame retardants to products fails to confer a fire safety benefit, yet it is their presence in our homes and buildings that makes fires today so toxic. When flame-retarded materials burn, large amounts of cancer-causing dioxins and furans are released into the smoke and dust that firefighters cannot avoid inhaling, ingesting, and absorbing through their skin – both while on the job and after, during clean-up and through contact with their clothing. No city or town in the United States can afford to be without firefighters and we need to do better by them. Firefighters today are among the most highly exposed Americans, yet there are only a handful of studies looking at their exposures, their health, their high rates of cancers. Meanwhile, the heavily-financedchemical industry is lobbying to add more toxic flame retardant chemicals to furniture, electronics, and other consumer products that when combusted are killing our best and bravest. Is this fair? None of our firefighters wants to quit, but they all want to know how to protect themselves. Clearly, better personal protective equipment with lighter, more effective respirators is needed. Education of firefighters is needed (how long to wear respirators, how long to wait before starting clean-up). Off-site facilities that clean uniforms after firefighting are a huge improvement versus exposing families and children to contaminated clothing. During check-ups, firefighters can have their blood monitored for vitamin D3, which boosts the immune system. Maintaining adequate blood levels of vitamin D3 should be mandatory for firefighters. Replacement Flame Retardants: Ongoing Toxicity? Last week more than 230 scientists from around the world attended the International BFR Workshop on Flame Retardants and related meetings in San Francisco where our study on firefighting and exposure to cancer-causing chemicals was presented. You can view my talk here. To see abstracts from the BFR meeting click here. A major topic is the widespread use of new and untested flame retardants like Firemaster 550 chemicals and chlorinated Tris, a carcinogen that was banned from children’s pajamas in 1977. Many of these are similar to the banned chemicals they are replacing, and they are being found in wildlife. For example, our research team recently found Firemaster chemicals in tissues of baby harbor seals from the northwest Atlantic. Protecting Firefighter Health Further research is required to fully understand how to protect firefighter health, and the process is now underway. But a much larger effort is required to broaden awareness of the problem and ultimately solve it. The good news is, California is moving to update flammability standards which will affect standards worldwide and ultimately eliminate harmful flame retardants in our furniture without compromising fire safety.  At the federal level, the Safe Chemicals Act is our best hope in decades of reforming long overdue regulation of toxic chemicals, including flame retardants. I will be speaking with firefighters in New York, Maine, Louisiana, and around the country to share insights from the initial study. And the State University of New York at Albany is planning a larger, comprehensive study of toxic exposure and health outcomes in firefighters. Thank you for your interest and support of our work to protect firefighters and all Americans from toxic chemical exposure. Dr. Susan Shaw President & Founder Marine Environmental Research Institute Professor, School of Public Health, Department of Environmental Health Sciences, State University of New York, Albany, NY Want To Make A Difference? Apply for An Internship at the Marine Environmental Research Institute Internships are available on a competitive basis for highly motivated college graduates in Science Communication, Policy, Research, and Development. Stipend and housing provided. To learn more about these positions, please contact Center Manager Martha Bell at mbell@meriresearch.org. Donate Now! Please consider contributing to our work to protect our ocean planet and human health. Click here to give a gift to the Marine Environmental Research Institute. Follow us on Facebook and Twitter, share information, join the conversation and become an active advocate.

 

Exposure to Flame Retardent Chemicals Means Firefighters Face Higher Cancer Risk Than Previously Thought

Bangor Daily News — BDN Maine

ELLSWORTH, Maine — New research by a Blue Hill scientist shows that during a fire, firefighters are exposed to dangerous levels of toxic, cancer-causing chemicals created when commercial flame retardants burn.

That firefighters develop cancer at an alarming rate is not news to industry professionals or scientists. But Dr. Susan Shaw, founder and director of the Marine Environmental Research Institute, said there’s still a lot to learn. Shaw and a team of other scientists recently published the results of a study on firefighters in San Francisco.

“We know that firefighters have a high rate of cancer, we know that outcome,” Shaw said in an interview Friday. “So we’re looking for how to connect the dots. What are the chemicals that might be causing these cancers? Do the firefighters have more in their blood immediately after fighting a fire?”

The study tested the blood of 12 firefighters immediately after they responded to an alarm. The results were striking. Its authors, including Shaw, concluded that firefighters are at an even higher risk of cancer than previously thought.

Levels of polybrominated diphenyl ethers, or PBDEs, were three times higher than levels in the general U.S. population, at a rate of 135 parts per billion compared with the national average of 40 parts per billion.

PBDEs are used as flame retardants in household furniture, carpets, plastics, computers and foam insulation. A growing body of evidence suggests the chemicals are toxic to human beings and animals.

Two forms of PBDEs were phased out of production in 2004 because of health concerns. Shaw said both are listed as banned chemicals under the Stockholm Convention, a treaty aimed at eliminating persistent organic pollutants.

The study also showed that some of the firefighters harbored high levels of dioxins and furan, two compounds associated with cancer and other health risks that are produced when the flame retardants burn. The levels in firefighters were “hundreds of times higher than has ever been detected in the general population,” Shaw said.

For John Martell, a Portland firefighter and president of the Professional Firefighters of Maine, it’s not just research that links his profession with long-term health risks. It’s experience.

“There’s a group of firefighters in their 50s and early 60s here who have just retired,” he said. “Out of that group, i can think of at least 14 that have come down with cancer. We’ve lost a couple guys to cancer in the last year and a half. … When you look around, and I’ve asked other people who don’t have the job I have, you don’t see that same rate.”

“We’ve always worried about firefighters being killed in duty, buildings collapsing, things like that,” Shaw said. “But the hidden danger now is what’s in the smoke and dust that they’re breathing, or ingesting, or getting on their skin. And that can’t be helped during a fire.”

Chemical flame retardants have been used for decades. Early versions were banned in the late ’70s after they were shown to pose serious health risks, including non-Hodgkins lymphoma. Shaw said that as more evidence mounts about the danger of modern flame retardants, industry groups are already cooking up replacements that are also “troublesome.”

“The proposed replacements are not very different, chemically, than the chemicals they’re replacing,” she said.

The American Chemistry Council, an industry trade group, last year issued a statement defending chemical flame retardants, saying they are necessary to meet safety standards and doubting studies that show a causal link to cancer.

But a 2012 investigation by the Chicago Tribune into flame retardants found that the chemical industry has manipulated scientific findings to overstate the effectiveness of flame retardants and downplay the health risks.

Shaw said a larger study of firefighters in New York is being planned. Researchers will examine the blood of about 300 firefighters in Albany, she said, in an attempt to find indicators of clinical conditions that could be pre-cancer.

The goal is to tie chemical exposure to clinical outcomes, to further prove the link between PBDEs in firefighters blood and the high occupational rate of cancer and other chronic disease.

Shaw said the ultimate goal is to convince Congress to pass laws regulating chemicals such as PBDEs through legislation such an updated Safe Chemicals Act, which would tighten oversight and regulation of risky chemicals. Maine’s U.S. Sen. Angus King is one of the Act’s sponsors.

But there are also efforts on the ground to minimize firefighter exposure and take care of them if they do get sick.

Chief Richard Tupper of the Ellsworth Fire Department demonstrated a washdown procedure at the city’s fire station on Thursday.

Smoke, soot and dust containing these dangerous chemicals often covers a firefighter’s gear during a response and “the products of combustion that adhere to the turnout gear literally off-gas for days after the fire if it isn’t washed properly,” Tupper said. “You could absorb those byproducts simply by standing here at the station.”

So Ellsworth firefighters often hose down their gear before they even leave the scene of the fire. They have also purchased special washing machines dedicated solely for turnout gear.

Martell, from the firefighters’ union, said there have been other changes made since it became clear in the last two decades that firefighters were getting cancer at an alarming rate.

In the past, he said, crews would bring their gear home with them, often leaving their boots and pants in the bedroom for easy access in case of a late-night alarm. That practice has been largely abandoned today. The use of oxygen and specialized gas masks is also growing, with firefighters often wearing them even when they’re not working directly in the hot zone.

Firefighters also secured legislative support to help those who do come down sick. A 2009 law made it easier for firefighters to get workers compensation to cover treatment for the 10 most forms of cancer most common to firefighters.

The firefighters union has also been active in pursuing tighter regulations on dangerous chemicals, Martell said. Professional Firefighters of Maine supported a bill pushed by former Maine House Speaker Hannah Pingree to ban the flame retardant known as “deca” in 2007.

That chemical was a suspected neurotoxin and was linked to other long-term health problems. Maine was one of only two states to ban deca, but today its manufacturers are voluntarily phasing it out of production.

Shaw said that her focus is on firefighters because they are exposed to many more dangerous chemicals than the general population. Still, she said the presence of flame retardants should concern everyone.

“Americans have 10-40 times higher levels of these things than other countries,” she said. “We’re talking about involuntary exposure. People believe they are protected from toxins by the government. The truth is they’re not. That’s the bottom line.”

Follow Mario Moretto on Twitter at @riocarmine.

San Francisco Firefighters Cancer Prevention Foundation Memorial Video

Click here.

Read the study here.

By Ashley Godfrey

NIEHS grantee Shuk-mei Ho, Ph.D.,  professor and chair of environmental health at the University of Cincinnati (UC) and colleagues have found an epigenetic change, a modification of a gene that is independent of any change in the gene sequence itself, which can distinguish firefighters from non-firefighters.

Their NIEHS-funded study  suggests there is a link between exposures to smoke, which contains a mixture of pollutants including polycyclic aromatic hydrocarbons (PAHs), and an epigenetic mark of promoter methylation, the addition of a methyl group to the area that controls gene expression. PAHs are one of the many chemicals found in smoke and products of incomplete combustion, and firefighters are often exposed to this complex mixture of toxicants when fighting fire.

“This work was inspired by the fact that exposure science can now look at the physiological changes caused by a complex mixture of chemicals, and it serves as a proof-of-concept study that this approach can work,” stated Ho.

Understanding the link between exposure and future health risks

According to Ho, one of the motivations for this study came from results published by one of her colleagues at UC, NIEHS grantee Grace LeMasters, Ph.D.  LeMasters had completed a large study combining data from 32 different published reports and found that firefighters are at a higher risk for developing a number of different cancers. Ho wanted to investigate why firefighters are at increased risk by looking for a link between their risk of exposure and epigenetic changes in their genome, which emerging evidence suggests are relevant to disease development.

Ho and her large multidisciplinary team considered four different genes that had been reported to be associated with environmental exposures to traffic-related PAHs in an asthma study of children living in traffic-dense areas in an NIEHS-funded collaborative study with Frederica Perara, Ph.D.,  (see story). The promoter methylation status of one of the genes (ACSL3) was validated to be associated with PAH-induced asthma but the other candidates have not been fully investigated.

In the current firefighter study, her research team showed one of these previously not studied candidates, DUSP22, could distinguish between firefighters and non-firefighters.

The study also showed that this mark was associated with years in service because the extent of methylation correlated with the duration of firefighting service and not with age.

“This mark is almost like a memory of how long they have been in service,” said Ho.

She further explained that because epigenetic changes are passed to the next generation of cells over time, the changes could become a signature and a way of measuring both the duration and extent of exposure.

Implications for the field of environmental research

One of the possibilities raised by this study is that environmental exposure can induce epigenetic changes that will last for a long time and could serve as a biomarker for exposure. Combined with other biomarkers, these signatures can help public health professionals better understand the impact of a complex environmental exposure. Ho is hopeful that in the future, measuring this type of exposure related epigenetic marks could help to predict or associate an individual’s risk of developing cancer, or other diseases, in later life.

There are also a number of interesting questions that Ho would like to answer in some of her future studies. One is how long the methylation mark persists after the firefighters stop working and are no longer at risk of being exposed to the toxicants on a regular basis.

Another important public health question is whether an intervention strategy would be able to reverse the changes. Ho believes the answers could lay groundwork for future surveillance and intervention strategies. Ho also suggests the broader implications for this research are important, especially in light of this summer’s wildfire outbreaks.

“Conceptually it might be possible to find epigenetic changes in residents living in wildfire areas and see who has been exposed and for how long,” explained Ho.

She is also interested in expanding this type of research to other types of exposures related to the intense or incomplete combustion of fossil fuels, such as exposures experienced by individuals living in traffic laden cities or oil rig workers and oil spill clean up crews.

Citations: Ouyang B, Baxter CS, Lam HM, Yeramaneni S, Levin L, Haynes E, Ho SM.  2012. Hypomethylation of Dual Specificity Phosphatase 22 Promoter Correlates With Duration of Service in Firefighters and Is Inducible by Low-Dose Benzo[a]Pyrene. J Occup Environ Med 54(7):774-80.

Perera F, Tang WY, Herbstman J, Tang D, Levin L, Miller R, Ho SM.  2009. Relation of DNA methylation of 5′-CpG island of ACSL3 to transplacental exposure to airborne polycyclic aromatic hydrocarbons and childhood asthma. PLoS ONE 4(2):e4488. doi:10.1371/journal.pone.0004488. Summary

(Ashley Godfrey, Ph.D. is a postdoctoral fellow in the Molecular and Genetic Epidemiology Group in the NIEHS Laboratory of Molecular Carcinogenesis.)

Toni Stefani Senate Committee Hearing from MERI Center on Vimeo.

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PORTLAND, Maine (NEWS CENTER) – Most firefighters know when they sign up for the job, that it comes with risks; after all, when we run from a fire, they’re running in; but there may be a hidden risk these men and women face.

After September 11th, researchers started looking deeper into the link between the toxins firefighters can inhale at a fire site, and cancer. Now many researchers believe their risk for cancer is — in some cases — double what the general public faces.

After 34 years with the Portland Fire Department, Tom Valente had seen his share of battles, but just 5 months into his retirement, he found himself battling for his life against sarcoma – a form of cancer.

Valente is in remission now, but doctors have told him his type of cancer has a high rate of coming back.

In 2006, the University of Cincinnati published a study finding a number of links between the toxins firefighters face and certain types of cancer; toxins, Mike Belliveau, with the Environmental Health Strategy Center of Maine, says are released in fires.

Belliveau says, “Todays buildings are full of synthetic chemical plastics, like PVC plastics, and when PVC burns, you get deadly dioxins, so literally, every fire creates almost like a toxic waste factory with the by products of combustion that are toxic.”

As a result of the University’s study, 10 types of cancers have been linked to firefighting.  Those cancers are: multiple myeloma, non hodgkins lymphoma, prostate, testicular, kidney, bladder, breast, leukemia, brain, and colon cancer.

Tom Valente’s sarcoma, falls under non-hodgkins lymphoma.

Dave Jackson with the Portland fire department, and John Martell, with the state’s local union – Professional Firefighters of Maine -have both worked over the years to pass along the message to not only their fellow firefighters about the increased risk, but also to state legislators.

Three years ago, the Maine legislature joined 32 other states and passed what’s called a rebuttable presumption law. It means if you’re a firefighter, and you have one of the 10 listed types of cancer — it’s likely you got it from the job. That shifts the burden of proof onto the municipalities or worker’s compensation.

Valente says he’s learned a lot over the years about wearing more safety gear on the scene of a fire, and keeping your breathing apparatus on even after the blaze is put out.

The outcome was much different for his co-worker and friend, Tim Flaherty, who died last August from a form of multiple-myeloma. The diagnosis came in 2004, and he was forced to retire early a year later.

His daughter, Melissa McNaboe, says

each retiree at the time was granted 18 months of Cobra, but once that ran out, he was left with a preexisting condition that no insurance company would touch without a large premium.

Flaherty ended up on the state’s insurance plan, Dirigo, which at the time cost him $2,000 a month. The presumptive bill, which came too late for Flaherty, is meant to help take care of firefighters and their families while they go through treatments, but some doctors aren’t convinced by the studies, saying, there still isn’t enough information out there to support the case.

Since the law passed in 2009, there have been 11 cases tried in Maine, all, Martell says, are still pending. “Just take a look at the products in this room,” Martell says, “all the plastics, the carpeting, this table, there’s vinyl chlorides, plastics, and when they off-burn, when the gasses go in a structure fire, which we go into, they’re producing chemicals into the air.”

Both Martell and Jackson admit, the biggest step is educating firefighters about the dangers and making sure they’re using their gear and cleaning it when they get back.

As for Tim Flaherty’s family, they know the outcome would have been the same, with or without the law, but it could have saved them time and money in the process.  In the meantime,

Their advice to firefighters and their families: be your own advocate both on the job, and in the doctor’s office.

While the studies are still fairly fresh, they’re already changing practices in some fire stations.  The overall goal, Martell and Jackson say, is to minimize, if not eliminate that increased risk for cancer.

As we mentioned there are some doctors who don’t think there is enough science to back the increased rate in firefighters, even saying it seems to be just a political agenda nationwide for firefighters. None of the doctors we spoke to were able or willing to speak on camera.

In the meantime, Tim Flaherty’s family says every year around Christmas time they will be holding a blood drive in Yarmouth to raise money and awareness about myelofibrosis.

On Saturday, June 30th, there is a 5k race/walk to benefit Wells firefighter, Ramon Nolette, currently battling cancer. Click here to register.

Colorectal cancer is highly treatable if caught early. Gastroenterologist Dr. Jim Allison says a colonoscopy is a good screening test, but it isn’t the only one that works.

“There are at least three tests that are excellent tests for colorectal cancer,” said Allison.

Colonoscopies are expensive, costing up to $5,000 in the Bay Area. The procedure can also be uncomfortable and carry a small medical risk.

”I think if we got off the idea of there being only one good test, our screening rates would increase, especially in the uninsured/underserved population,” said Allison.

The affordability aspect makes the FIT test a good alternative to colonoscopies. The test detects blood in the stool from larger polyps and cancers, which tend to bleed. FIT can be done in the privacy ofyour home and costs around $8. Tests are recommended about once a year. If the FIT test comes back positive, the patient will need a colonoscopy.

San Francisco General Hospital has been using the test in clinics and have seen increased screening rates of around 30 percent in just one year.

Click here for more information on the SF General Program.

Read more about the accuracy of the test in American Journal Of Gastroenterology.

Read full article here.