The University of California has awarded nearly $6 million in state funding to advance research aimed at reducing cancer and cancer risk among firefighters. Grants were awarded to eight research teams through the California Firefighter Cancer Prevention and Research Program, established in 2023 by the State legislature.

The program is administered by the University of California, which works closely with the State interagency firefighting advisory program, FIRESCOPE, to ensure funded projects address the highest priority research. California firefighters and fire service organizations will participate in the research, taking an active role in helping scientists unravel why cancer rates are so high among their ranks — and helping to design possible solutions.

Disease risk lingers after the fire is out

Cancer is the leading cause of death among firefighters, and studies have found that firefighters are at higher risk of certain types of cancers than the overall population, according to the National Institute for Occupational Safety and Health. In 2022, given the weight of the evidence, the International Agency for Research on Cancer classified occupational exposure as a firefighter a Group 1 carcinogen, on par with well-established carcinogens such as tobacco and benzene. Firefighters routinely encounter smoke and other carcinogenic compounds on the job. And despite specialized protective gear like respirators, firefighters still breathe these chemicals in, ingest them, and get them in their eyes and on their skin.

“The California Firefighter Cancer Prevention and Research Program was created to help firefighters, agencies, regulators and doctors better understand the complex interplay of cancer-causing chemicals, individual biology and life history, protective equipment and workplace norms and dynamics,” says Theresa Maldonado, vice president of Research and Innovation at the University of California. “Each funded project is co-led by a UC researcher and a California firefighter, ensuring that research is asking the most vital questions to firefighter health and that the results of the research make it back to the firefighter community as soon as possible.”

There is an urgent need to find ways to reduce cancer risks for firefighters, said Brian K. Rice, president of California Professional Firefighters, a union representing 35,000 firefighters, paramedics and EMTs that advocated for research funding at the state legislature. The new grant program reflects California’s commitment to do just that.

“The high rate of cancer cases and deaths among firefighters is tragic and unacceptable. These professionals put themselves into dangerous situations to provide essential, lifesaving services to Californians,” says Rice. “They deserve a fuller understanding of the long-term health risks their duties entail and the steps they can take to protect themselves. I’m pleased to see the funding that we advocated for be directed to these critical projects that will help keep our firefighters safer.”

“Without more research into the biological, chemical and social aspects of carcinogenic agents on the job, California's firefighters will continue to face an elevated incidence of cancer,” says Brian Fennessy, chief of the Orange County Fire Authority and FIRESCOPE chair. “We’re proud to partner with the University of California to support rigorous, community-engaged, solutions-focused research that will help us bring down rates of disease among firefighters.”

Learn more about how these expert research teams will help California firefighters stay healthy.

Understanding occupational exposures to PFAS among Orange County firefighters

Co-principal investigators: Derek Biering, captain at the Orange County Fire Authority, and Veronica Vieira, professor of environmental and occupational health at the UC Irvine Joe C. Wen School of Population & Public Health

Per- and polyfluoroalkyl substances (PFAS) are the so-called “forever chemicals” that accumulate in our environment and in our bodies, and growing evidence points to their links to cancer. Some firefighter gear contains PFAS, and PFAS can also be present in smoke from burning structures. Studies have shown that PFAS levels are higher in firefighters than in the population at large. This research team will study PFAS exposure, accumulation and cancer risk by gathering and analyzing data from a thousand firefighters exposed to active fires and indoor environments, such as from fire stations and fire trucks. The findings will be shared with the firefighters to inform cancer risk mitigation approaches.

Examining longitudinal changes in DNA methylation in firefighters exposed to products of combustion

Co-principal investigators: Thomas Sullivan, firefighter paramedic at Los Angeles County Fire Department, and Janine LaSalle, professor of medical microbiology and immunology at UC Davis

Can certain changes to DNA serve as early warning signs of cancer? To find out, researchers will study blood samples from firefighters collected before and after training exercises, analyzing samples for a type of DNA change called DNA methylation, and seek links to exposure to harmful chemicals. The study will compare the effects of different exposure levels by analyzing samples from new recruits and experienced instructors who face different frequencies of exposure. Investigators aim to develop a blood test to detect biomarkers of cancer caused by repeated workplace chemical exposures. This project aims to create practical solutions that can be quickly adopted to protect firefighters' health.

Firefighter indirect smoke exposure

Co-principal investigators: Gerald May, president of San Jose Fire Fighters IAFF Local 230, and Aris Polyzos, research scientist at Lawrence Berkeley National Laboratory

Firefighters’ chemical exposures don’t always end when they leave the scene. These chemicals can follow firefighters back to the station, or even to their homes, if their gear isn’t adequately cleaned. This research team will test items and surfaces where these chemical residues are likeliest to accumulate, like protective gear, trucks and fire stations. They’ll then do lab tests to determine whether the chemicals they find cause cancer, and will propose and test methods for cleaning or handling contaminated gear to guide new workplace norms and regulations.

The California firefighter cancer research study: Harmonizing cohorts to elucidate cancer risks

Co-principal investigators: Jamie Gabriel, fire captain with Los Angeles County Fire Department, and Shehnaz Hussain, professor of public health sciences at UC Davis

Chemicals in smoke and gear may not be the only thing causing high cancer rates in firefighters. They’re also subject to physical, mental, and behavioral hazards linked to cancer, including sleep deficiencies, metabolic imbalances and stress. But little research has been done into how to protect firefighters from these factors. This research team will follow a group of 647 California firefighters for a year. Participants will provide blood samples, body composition analysis, diet assessments, questionnaires, clinical tests, and continuous monitoring of physical activity, heart rate, and sleep. Cancer risk and protective factors will be examined together with key cancer biomarkers that can gauge the importance of each individual and combination of factors on cancer risk. Results could inform firefighters about their perceived susceptibility to disease, empowering and motivating workplace regulation and behavioral changes aimed at reducing risks.

Firefighters’ perceptions and behavioral patterns: a social science approach to cancer prevention

Co-principal investigators Andrew Violante, fire engineer and paramedic with the San Marcos Professional Firefighters Association, and Wei Zhao, professor of sociology at UC Riverside

Firefighters will have a harder time protecting themselves from cancer-causing exposures if they don’t understand how those exposures happen or if workplace culture doesn’t prioritize their health and safety. The project will investigate how firefighters perceive their cancer risks and the main causes of cancer in their work; how personal background, group dynamics, and organizational culture affect how firefighters use, store and clean their gear; and whether organizational initiatives and educational programs for cancer prevention actually work. Through observations, interviews and surveys, researchers will generate important insights on firefighters’ perceptions of cancer risk and behavioral patterns impact their carcinogenic exposures. The team will use these insights to develop workplace interventions to enhance cancer risk awareness and prevention.

Identifying carcinogenic chemical exposures in firefighters to reduce cancer risk

Co-principal investigators: Jeffrey Kimura, fire captain at Los Angeles County Fire Department and Brigitte Gomperts, professor of pediatrics and pulmonary medicine UCLA.

Scientists know that on-the-job chemical exposures can cause cancer in firefighters, but they don’t understand exactly how the cancer develops or which chemicals are the most hazardous.S o researchers plan to purchase new firefighter jackets and recruit firefighters to wear, monitor and track what their gear is exposed to. Researchers will extract and quantify chemicals from the jackets and expose them to human airway cells to look for cancer effects on the cells, aiming to understand how firefighter gear might be involved in increasing the risk of cancer in firefighters.

Characterization of mutagen-driven landscapes and signatures of tumors arising in firefighters

Co-principal investigators: Jeff Meston, executive director of the California Fire Chiefs Association and John McPherson, professor of Biochemistry and Molecular Medicine at UC Davis

Some cancer-causing chemicals firefighters encounter damage their DNA, and that damage can take years to accumulate. The project team will study tissue from firefighters diagnosed with cancer. They’ll analyze DNA from cells within tumors, looking for tell-tale signs that each chemical leaves behind. The goal is to identify which of the many carcinogens firefighters are exposed to over their career are most likely to cause the kind of DNA damage that leads to cancer, which will enable better practices for limiting exposure through training and changes to protocols and gear.

Individualized exposure assessment of firefighters to airborne carcinogens

Co-principal investigators: Ryan Tripp, fire captain, Los Angeles County Fire Department and Cristina Davis, professor of Mechanical Engineering at UC Davis

Firefighters frequently train on practice fires to keep their skills sharp — but these exercises also add to their chemical exposures. Building on an existing collaboration to develop air sampling tools firefighters use on calls, this team will now deploy these tools during training, and collect samples of firefighters’ exhaled breath, urine, and a swab of their skin. That will enable researchers to pinpoint which trainings caused chemical exposure and change these activities to reduce the risk. Then, they will educate other firefighters across California on how to make training safer.

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