Medford Fire-Rescue Chief Brian Fish knows all too well how firefighters unintentionally risk their lives.
He knows of one retired battalion chief who is battling cancer believed to be from chemical exposure, and he's seen multiple colleagues get skin cancer over the years. More recently, Fish himself faced skin cancer in what he described as "a spot not normally associated with sun exposure."
Fish says he's determined to limit the next generation's exposure to carcinogenic chemicals.
"Now that our people are aware, they're acting on it," Fish said. "You think, 'Well, everybody gets cancer,' but how much more do we get it?"
From ventilating the firehouse garage to more stringent decontamination protocols, over the past two years Medford Fire-Rescue has implemented programs, procedures and systems to reduce firefighters' contact with hazardous chemicals linked to cancer.
Former Oregon Gov. Ted Kulongoski in 2011 signed into law coverage for firefighters who get occupational cancer, so it's hardly a new concern, but research is building. Numbers as to how many firefighters have filed OSHA claims weren't immediately available.
National studies point to a cancer rate among firefighters double that of the general population. Local numbers aren't as easy to track though they're believed to be lower, according to Medford Fire Capt. Jon Peterson, who is active with the the nonprofit Firefighter Cancer Support Network as a trainer.
Through his volunteer work, Peterson has trained eight fire agencies in Jackson, Josephine and Klamath counties on ways to limit exposure. A ninth agency, Grants Pass Fire/Rescue, is slated to be trained later this month.
"I would say Southern Oregon is ahead of the curve in cancer prevention," Peterson said.
For starters, breathing protection use is far more common on the West Coast than elsewhere in the country. Although the most recent addition to the Oregon Fallen Firefighters Memorial is former Medford Battalion Chief Mark Burns, who ultimately died from severe breathing complications brought on by Ashland's 2010 Oak Knoll fire, his exposure wasn't caused by a cultural aversion to protection. Rather, news reports noted that Burns needed to radio directions clearly during a blaze that rapidly changed from a grass fire to an inferno engulfing multiple houses.
Most agencies in Southern Oregon have been using breathing protection since the late 1980s and early 1990s, according to Peterson. The "macho" culture that limited usage of self-contained breathing apparatus in Columbus, Ohio, illustrated in the Columbus Dispatch "Unmasked" series published last week in the Mail Tribune, isn't the same uphill battle locally, according to Peterson.
Peterson said he's familiar with the education efforts of cancer-stricken Columbus firefighter Mark Rine, and despite those efforts has met firefighters in Columbus who "still don't do best practices."
"We are way more willing to try new things," Peterson said.
There's also a greater priority placed on keeping equipment such as face masks, helmets and ladders clean between fire calls in Oregon, according to Fish. A sooty helmet, for example, isn't considered a "badge of honor" showcasing a firefighter's experience.
Peterson said he's worried about exposure beyond the respiratory system, saying skin absorption rates are "through the roof" during a fire, owing to the mix perspiration, elevated body temperatures and hazardous chemicals from household fire retardant materials.
A quick decontamination using wipes can reduce exposure by half, according to Peterson, but a shower within an hour of a fire can drop exposure by 95 percent.
Fish said extra crews are called out for fires to limit individuals' exposure, especially during the summer months when the heavy protective equipment also risks heat exhaustion.
The department has also turned its attention to firefighters' "turnouts," the protective coats and pants used in the line of duty. Firefighters are asked to bag them up at the scene to be specially cleaned later. In his 11 years with Medford Fire-Rescue, Peterson said, he's always had a second set of turnouts, a luxury not every agency has.
Fish is also working to bring their cleaning in-house, or more specifically in-station. Two stations are equipped with specially designed washing machines known as "extractors," and plans are in the works to add them to two others. The machines are much larger than a standard washing machine, making it difficult to retrofit older stations, whose crews' turnouts are sent to Weldon's cleaners.
The turnouts' seams are inspected yearly, but more focus is also being placed on the way firefighters' turnouts fit at the neck and pant legs.
"You think, 'I'm covered,' but you're not really covered," Fish said.
An extractor can clean about five turnouts at a time. Cleaning them involves a special PH-balanced detergent designed to remove contaminants without harming the special Gore-Tex material that protect from harmful chemicals and pathogens firefighters may come in contact with.
Turnouts in years past would be cleaned after a fire or about once a month. They're now cleaned more frequently, according to Peterson, out of concern that sweat could mix with a chemical the firefighter contacted.
Peterson's interest began in June of last year, after his engine was the first to respond to a three-alarm warehouse fire filled with agricultural chemicals at 640 Mason Way, in which a hazardous materials team ultimately responded. Crews had been wearing standard protective equipment including a respirator, but as many as 30 chemicals could have been released into the air, water and soil from the fire, according to the Oregon Department of Environmental Quality.
Peterson said all protocols were followed in the fire, but he wondered if there was more firefighters could have done to protect themselves. He joined Firefighter Cancer Support Network, participating in a "train the trainer" event in Portland and a conference in San Diego. He's since trained Medford, Ashland, Rogue River, Jackson County fire districts 3 and 5, Klamath County Fire District 1 and Evans Valley Fire District 6 in his three-part workshop titled "Taking Action Against Cancer in the Fire Service."
The first portion of Peterson's training looks at "skyrocketing" national firefighter cancer rates over the past five years, current behaviors and how they're affecting firefighters and exploring ways to decrease exposures.
Concerns include carcinogenic diesel fumes in fire stations. Medford's newer Fire Station 4 near Railroad Park maintains "positive pressure" so gases are pushed from the building when the doors are open. When crews are on a call and the station needs to be locked up, a ventilation system switches on.
Best practices are still evolving, Peterson said, some based on practices that Sweden and other European countries implemented in the late 1990s and early 2000s.
One idea debated nationally is mandating firefighters to work out; advocates point to studies that say diet and exercise could cut cancer rates by half.
"That's very, very controversial," Peterson said. "There's a lot of different rabbit trails that you can go down."
Research has not yet made clear how many chemical exposures in a lifetime lead to a cancer diagnosis, so Fish said the present focus is to limit those exposures and their intensity.
"If we can cut half of those out, it just prolongs that time and it may protect them," Fish said.
Spreading awareness and frequent check-ups are part of the response, Fish said. One firefighter's wife works at a dermatology clinic, where they hold skin cancer clinics for firefighters.
"Now that our people are aware, they're acting on it," Fish said.
— Reach reporter Nick Morgan at 541-776-4471 or firstname.lastname@example.org. Follow him on Twitter at @MTCrimeBeat.