Firefighters often wear dirty yellow Nomex with pride; it’s frequently considered a tangible, wearable sign of the hard work we do. A “dirty yellow” may signal a firefighter has earned their paycheck or has experience that calls for respect. Some firefighters even tell stories of people making bright “yellows” look well-worn by purposely rubbing soot and ash on them. We glorify crews hiking off the line in a cloud of smoke, faces smudged with black. Dirty Nomex has been a cultural point of pride, but the health effects of those actions warrant taking a pause and asking if it’s worth it.  

Firefighting has been linked to an increased risk of certain types of cancers by the World Health Organization. Evidence from scientific studies led the U.S. Department of Labor to streamline processing worker’s compensation claims of certain occupational disease injuries that may be caused by being a federal firefighter. Things that cause cancer like smoke, chemicals, diesel exhaust and ash are part of the wildland fire environment that are difficult to avoid. However, even small reductions in the frequency, amount or duration of exposure over a career may reduce health impacts to firefighters. 

As part of Firefighter Cancer Awareness Month, and every month, fire managers and firefighters should consider how to take precautions to reduce exposure to carcinogens.

Time to clean up our act

Although few statistics are available specifically for wildland firefighters, the Firefighter Cancer Support Network estimates that 72% of line-of-duty deaths across the fire service in 2023 were from occupational cancers. This grim statistic makes occupational cancer the leading cause of line-of-duty deaths. But many questions remain unanswered about how cancer risk may vary across the fire service, particularly in wildland fire.

Experts recommend changing how firefighters work to minimize exposure to carcinogens. These recommendations include raising awareness about smoke hazards, reducing exposure to smoke by rotating crews out of heavy smoke areas and not sleeping in smoke. Other controls include reducing time spent mopping up by securing the perimeter and patrolling instead of cold trailing or working deep into the black.

In addition, recent research indicates that wildland firefighters are exposed to carcinogens through their skin. Skin becomes 400% more absorptive for every 5-degree increase in core body temperature. Washing or swapping dirty personal protective equipment may reduce carcinogen exposure. Looking at recommendations for structure firefighters, showering or cleaning skin with wipes has been shown to reduce skin exposures. Showers and laundry aren’t always available in wildland firefighting, but using a wet wipe to remove soot, particularly from the face, neck, armpits and groin area, is something anyone can do as part of a daily routine. 

Get screened

As firefighters may be at an increased risk for cancer due to exposures on the job, it is important to consider cancer screenings as a preventative tool. DetecTogether is a nonprofit education organization with resources for first responders to learn about cancer screenings and how to work with doctors. Early detection improves your chance of survival.

Support research

The Forest Service is also working with the Department of the Interior, Centers for Disease Control, National Institute for Occupational Safety & Health, and others on a long-term health study (e.g., medical surveillance) to identify these illnesses better, understand the connection points and implement mitigations to reduce cancer in wildland firefighters. This work will ultimately help reduce cancer among firefighters for generations to come.

Join the registry

We can help researchers by signing up for the National Firefighter Registry for Cancer at the National Institute for Occupational Safety and Health. Scientists at NIOSH learn more about the relationship between firefighting and cancer every day. The registry is open to all U.S. firefighters with or without cancer, no matter the length of service. It takes only five minutes to register. 

Reducing exposure, increasing screenings and early detection, and continuing to support research about wildland firefighter cancer are all things we can do. We also can support our coworkers who are diagnosed with cancer. And we all can raise awareness about the parts of our culture that are probably best left in the past. 

So, the next time you see dirty PPE on an assignment, don’t think cool, think contaminated.

For more information about cancer diagnoses and worker’s compensation for federal firefighters, visit 2023 National Defense Authorization Act and Cancer: What firefighters need to know.