Three Benefits and Two Challenges of Tracking Firefighter Exposures

In a 2016 document on the perils of hazardous materials exposure, Boston Fire Department District Fire Chief Paul F. Burke notes a turning point in the history of modern fire science: a California law designed to limit the risk of fire via mandatory retardant usage ultimately put the public and fire services professionals at risk of toxic exposure.

The story is worrying enough at ground level. Some experts believe children in California suffered twice as much lifelong toxic exposure as kids in other states due to the law.

But there’s a bigger picture here. Exposure tracking should be a bare minimum safety practice anywhere professionals or volunteers fight fires.

The Benefits of Exposure Tracking

1. Earlier cancer detection

Firefighters are at least 9 percent more likely than the average citizen to receive a cancer diagnosis and 14 percent more likely to die of cancer. This figure, initially reported by the NIOSH and covered by the National Fire Protection Association, is just one of many data points suggesting an undeniable link between firefighting and cancer risk.

Tracking exposure—either using a dedicated exposure tracker or as part of an early intervention system (EIS)—just makes sense.

If personnel can document higher-than-normal exposures, they can be eligible for increased screenings, which can catch cancer earlier and allow for faster, less invasive treatment. Understanding exactly what an individual has been exposed to can also be vital for doctors, who may investigate the presence of rarer cancers that would otherwise go undetected by the standard screenings of annual checkups.

Mesothelioma is one example of a rare cancer with a disproportionate presence in firefighting, with firefighters 129 percent more likely than average to die of the illness.

States such as Washington directly cite the link between firefighting and cancer as a reason for their mandatory reporting laws. However, legislation like this is not common.

Until it is, individual agencies must take it upon themselves to record the hazards their people encounter in the field.

2. Required proof

Even with an established risk of various types of cancers, firefighters and the agencies they work for can still struggle to prove that past service led to a current medical condition in the eyes of the law—or in the eyes of the insurance companies.

Research increasingly indicates firefighting carries not only a higher risk of cancer but also a higher risk of different types of cancer per region. In Chief Burke’s insightful piece, for instance, it’s noted that:

“East Coast fire departments are typically exposed to older buildings with dangerous architectural components such as asbestos and wood finishing materials like cresol, both known carcinogens.”

In contrast, firefighters on the West Coast typically encounter “newer, better-insulated” buildings, which contribute to the buildup of different types of toxic smoke when exposed to flame.

As law changes to define what exposure is and strict definitions are made as to what cancers fall beneath the banner of presumption, an easy way to keep a detailed log of proof will be essential to keeping your people covered. That isn’t just good business—it’s a good-faith sign to current and potential employees that you take care of your people the right way.

3. Savings and efficiency

Beyond the personal impact serious illnesses have on individuals, cancer and other diseases can also be expensive for your organization and create staffing and budget issues that can lead to less-than-optimal service. That’s a top concern in any public safety field and thus one worth investigating.

Take overtime and call-outs, two interlinked topics that routinely set council meetings and other municipal functions ablaze with controversy.

Fewer people calling in sick means less need to pay overtime for those who feel well enough to work. Cancer—whether serious or a secondary medical concern—is a notorious thief of work hours when you consider doctor’s visits, surgeries, sick days, etc.

Likewise, less use of major medical services means less healthcare spending overall in the organization.

The Challenges of Exposure Tracking

1. A lack of solid research and standard definitions

How would you define “exposure,” and what metrics would you use to track it? Finding a cohesive answer to either question has proven challenging.

In some instances, an agency or governing body may define exposure as responding to a fire at all; in others, it may only fit the definition if properly equipped PPE somehow failed or suffered a breach in the line of service.

Likewise, knowing what to do with this data isn’t fully clear. For example, what number of exposures (as defined by your agency) prompts an intervention? Which medical protocols should be invoked?

These questions should be explored with the help of medical and legal professionals, provided the agency doesn’t have baseline guidance from state or local law.  

Then there’s the idea of data portability. If a firefighter moves from one department to another and their definitions and standards don’t align, how do the two agencies normalize the difference?

Here, a platform like FirstForward can be of immense use since the data follows the individual—unlike a large, one-size-fits-all database that only works at one location.

2. Privacy

Another issue surrounding tracking exposure is that any system that touches medical data comes with an immediate need for heightened security and compliance.

  • The information firefighters share must be given on a need-to-know basis. Catch-all data collection practices don’t work where health information is involved.
  • To satisfy HIPAA, responses to exposures must be confidential and—again—treated with the utmost care for security.

Because of this, role-related permissions in an exposure tracking system are critical to limit access to sensitive data.


We expect exposure tracking to become a more standardized area of public safety health in the future. Until then, the responsibility lies with individual agencies.

Fortunately, those agencies don’t have to do it alone.

If you are looking for tools to reduce the administrative burden of exposure tracking, learn more about FirstForward or our EIS solution—or reach out to one of our specialists.

Posted on Jul 6, 2021