It's long been known among firefighters that cancer is one of the risks of the job. But studies conducted over the past decade are beginning to zero in on some specific causes as well as just how great a risk firefighters face for certain types of cancer. Firefighters have begun paying attention to developments as it becomes clearer just how hazardous the job really is.

For years, firefighters have sensed that cancer seems to be more prevalent among their ranks than in other occupations and the general public, and recent studies appear to bear that out. Nationally, virtually every firefighter serving in a metropolitan fire department knows someone among their ranks who has fought cancer or died of cancer, and odds are if they don't, they will, be it in their department, in their firehouse, even on their shift.

“We're seeing studies coming out now that suggest as many as 70 percent of all firefighters will contract one or more types of cancer,” said North Little Rock Fire Chief Gerald Tucker, during a recent interview. “It actually started in 2004 with studies to determine if some of the materials they're building houses out of are causing it. They've gotten hot and heavy the last four years.”

John Pflasterer, the fire marshal for the North Little Rock Fire Department, said he has watched departmental policies slowly evolve over time as fire departments have come to grips with what Rogers Fire Chief Tom Jenkins, a member of the Review Panel, has called an epidemic in the fire service.

“There's a saying in the fire service,” Pflasterer said with a wry grin, “It's a hundred years of tradition unencumbered by progress.” But, he said over time, things have changed.

Fire departments around the country resisted the move to air packs that supply clean air inside a fire scene when they first came out. Part of the reason was that the first apparatuses to see service were low pressure air tanks that were bulky and cumbersome, with large, long hoses that tended to catch on corners, doorknobs, railings, practically anything they could loop over.

But part of the reason was tradition. In the spirit of “smoke eater” tradition, firefighters around the nation took pride in the toughness required to enter a burning building, battle the blaze, then emerge covered in soot and cinders, coughing and choking, then catch a breath and run right back in.

“When I came on, we had old chiefs and captains who were very resistant to change, even then,” said Pflasterer. “We had guys who would make fun of you for using an Air Pack. That doesn't happen now. We understand what the dangers are now.”

Pflasterer said it isn't widely appreciated just how quickly a person can be overcome by smoke inhalation, even though more people die of smoke inhalation than from burns when trapped in a burning building. He said a North Little Rock police officer learned that the hard way trying to enter a unit at Eastgate Terrace that caught fire in September, attempting to rescue a woman who was trapped inside. In spite of efforts of police and firefighters, the woman died in the fire.

“He popped a window open thinking he was going to go inside but when that smoke hit him, he got one whiff and that was it. He was out,” Pflasterer said. “It took him a week to recover enough to go back to work. That's how bad it is.”

He said policies are in place requiring firefighters to wear full turnouts, consisting of pants, coat, glove, boots, hood, helmet, and two inner layers of material to protect against the intense heat, and Air Packs (self contained pressurized air tanks that supply clean air to firefighters for 15 to 30 minutes). A safety officer staffs every fire scene to enforce adherence to equipment policies.

Turnouts are required to be cleaned twice a year by being run through a specialized washer called a washer-extractor, of which the fire department owns one and is preparing to acquire another. Most are cleaned more often, typically whenever they become visibly contaminated. At fire scenes, firefighters perform what is called a gross decontamination, using fire hoses to clear large pieces of contaminated debris from the turnouts and the firefighters, and all fire trucks now carry sanitary wipes for firefighters to use to wipe down their necks, under their arms, and anywhere else the contaminant-laden soot collects.

In a large structure fire, turnouts will often be collected, bagged up, and sent for cleaning to be ready when those firefighters come back on shift. The department does keep a few sets of spare turnouts for such times.

The importance of getting soot cleared from the skin has become evident with studies that indicate for every five degree rise in body temperature, the human body absorbs contaminants through the skin 400 percent more efficiently. Temperatures inside a burning building can easily reach 1200 degrees, and temperatures inside the turnouts typically rise to between 115 and 130 degrees.

Two hazards that have recently come to light have to do with fire investigations, which commence as soon as a fire scene has been cleared of flames and embers, and the turnouts themselves. For hours after a fire, the fire scene and the turnouts themselves will continue sending contaminants into the air, a process called “offgassing.” These airborne contaminants pose a danger to everyone nearby.

“As far back as the 90s, Air Packs have been pretty well mandated,” Tucker said. “But it wasn't known that they needed to be used during the overhaul phase too, not just fighting the fire. And turnouts need to be kept out of the living quarters.”

“We've come a long way,” he added. “We wear full gear during the overhaul phase, we monitor the air quality, and we make sure everyone is wearing their stuff. And when we get back to the station, we leave the turnouts outside of the living quarters.”

Tucker pointed out another source of contamination that the department is working to mitigate. Diesel fumes from the trucks pose a health hazard, especially in firehouses with living quarters built over the garage, such as the fire department's Central Station. To carry those fumes away, large hoses attached to exhaust fans are placed over the engine exhausts, held in place by a powerful magnet.

As the truck pulls out of the station, the hose follows until the truck is out of the bay, then separates and is retracted back into the bay. Nine of the departments 11 stations are equipped, or will soon be equipped, with the systems, which cost $22,000 for each unit. Central Station has three units, one for each of its three truck bays.

“Three more of these are being installed and we hope to have the other two stations equipped soon,” Tucker said.

At present, until and unless Arkansas passes legislation to recognize certain cancer deaths among firefighters as job-related fatalities, then begin helping firefighters who are sick and seeking preventative measures to keep healthy firefighters from getting sick, departments must take it upon themselves to mitigate the environmental hazards to whatever limit their budgets will allow.

Legislation was introduced in 2015 by Rep. Greg Leding, D-Fayetteville, to implement a presumptive cancer law in Arkansas, which would have made it the 34th state to adopt such legislation, was amended to remove presumptive language and implement instead a review panel to hear claims from families of deceased firefighters. The panel can recommend a death benefit to be paid up to a maximum $150,000, whereas Leding had hoped to provide some relief to firefighters in battling service-related cancer by making them eligible for workman's compensation assistance.

Tucker said, based on the experiences of other states in passing presumptive legislation, it will likely be an uphill battle for Arkansas firefighters, and even passage of such a law isn't a guarantee that things will immediately get better.

“When they first started they wanted to know how many fires you'd been on and which one did you think you got the cancer from,” he said. “There's no telling how many fires I've been on and nobody can pinpoint a single fire and say 'that's the one that gave me cancer.'”

Tucker said cancer among firefighters has become so common that virtually any firefighter knows another firefighter who has contracted the disease, or has died from it. He said it's not uncommon for a firefighter to know someone from the same firehouse, or even the same shift.

“I can think of four right now, right off the top of my head. The ones who have passed away from cancer, as soon as they retired, they found out they had cancer,” Tucker said. At that moment, his face took on a wistful look and his eyes appeared to be looking far beyond the confines of his office as he added, “It really makes you look at retirement differently.”