MIXING ALCOHOL & FIREFIGHTING IS A DEADLY COCKTAIL

By: Rick Markley, Science Alliance

WHAT MAKES A DRINK A DRINK?

When scientists talk about an alcoholic drink, they mean 14 grams of absolute alcohol. Here’s what that looks like in real life:

• ONE 12-OUNCE BEER AT 5 PERCENT ALCOHOL

• ONE 7-OUNCE MALT LIQUOR AT 7 PERCENT ALCOHOL

• ONE 5-OUNCE GLASS OF WINE AT 12 PERCENT ALCOHOL

• ONE 1.5-OUNCE SHOT OF DISTILLED SPIRITS AT 40 PERCENT ALCOHOL (80 PROOF)

The Andy Griffith Show’s wholesome hometown of Mayberry had Otis – the town drunk who got laughs by locking himself in jail when he’d had a snootful then letting himself out in the morning after he’d sobered up.

Most of Dean Martin’s stage and television comedy persona was built around him always being drunk and ready for debauchery. While he was rarely seen without a cocktail in hand, his children later claimed Martin’s drunkenness on stage was just an act and that his glass held only apple juice.

The truth about heavy alcohol use is far more sobering than entertaining. Hardcore drinkers are rarely as harmless and loveable as Otis and can, in fact, be a wrecking ball freewheeling through life. Those drink-induced antics are more than a few one-offs – they point to deeper troubles.

Though we’ve known for decades about alcohol’s gripping, addictive powers, understanding the nature of that addiction and how to best break it has been long debated.

Like Dean Martin, part of the firefighter mystique is that we are a bunch of hard drinkers. Unlike Dean Martin, we have actual scientific research showing there is truth to the myth – there’s more than apple juice in our glasses.

Two studies led by Science Alliance founder Dr. Sara Jahnke and her team at NDRI-USA showed that 45 percent of career firefighters reported heavy drinking (considered more than two drinks at one time for men, and more than one for women) and binge drinking (five drinks for men or four drinks for women over a two-hour period) over the previous month.

Volunteers were only slightly better, with 39 percent reporting heavy drinking and 45 percent reporting binge drinking.

Think this is only a guy problem? Think again.

Jahnke was also part of a team of researchers who looked at alcohol consumption among female firefighters. Overall, female drinking numbers closely followed those of male firefighters. Two interesting exceptions were that women were more likely than men to completely abstain from alcohol, but were also more likely to be heavy drinkers – they were less likely than men to be both moderate and binge drinkers.

“When nearly half of those in the fire service are drinking excessively, often to dangerous extremes, we have an institution-wide problem,” Jahnke says. “Our culture of heavy alcohol use is contributing to our own literal demise through acute and chronic illnesses affecting both body and mind.”

Heavy drinking will often lead to problems at work, relationship troubles with family and friends, legal issues and physical injuries. These are all documented and well-understood. It is also well understood that these drink related life challenges only compound the stress that comes from being a firefighter. In short, we know drinking is a bad coping mechanism for stress and usually makes matters worse.

It is equally well known that excessive drinking will cause long-term health issues such as liver disease and will also wear down other vital organs already compromised by firefighting.

Like excess stress, alcohol abuse negatively affects heart health –cardiovascular events are a leading cause of firefighter death and injury. Dr. Robert Kloner, a professor of medicine at the University of Southern California says alcohol in excess “can cause high blood pressure and promote arrhythmias. It can cause cardiomyopathy where the alcohol is actually toxic to the heart muscle cells, and that can lead to heart failure.”

Equally disconcerting are the links researchers are now making between alcohol use and cancer. This news is especially disturbing when combined with results from large studies and analyses of smaller studies that show the firefighting community has as much as a 20 percent greater risk of developing cancer than does the general population.

In 2022 the World Health Organization’s International Agency for Research on Cancer gave the occupation of firefighting its highest classification, Group 1 carcinogenic to humans. That means simply being a firefighter is known, not just suspected, to cause cancer.

And that 20 percent greater risk gets a lot scarier when you dive into the weeds of specific cancers. The IARC singled out four types of cancer and showed the increased risk for firefighters and the even greater risk for firefighters who have more than 3.5 drinks at a time. Have a look at the box above.

Take a moment to swallow the numbers above. Even in the best-case scenario for colon cancer, the risk is nearly 50 percent greater when you stir in heavy drinking. The worst case scenario can more than triple your chances of getting throat cancer.

“Be honest with yourself,” Jahnke says. “If you consider yourself a moderate or social drinker, do you believe 3.5 drinks in one night is heavy drinking? Probably very few of us would. And as the number of drinks go up past 3.5, so too do the chances of developing different cancers. We have to completely recalibrate the way we look at our relationship to alcohol if we want to cut our risk of cancer.”

There's more bad news for firefighters reporting that they smoke, even if only when they drink. Research has found there is a strong interaction between smoking, alcohol and cancer development. This mix particularly increases the risks of mouth and throat (oral cavity and esophageal) cancers.

Jahnke was part of a team of researchers who looked at the relationship between smoking and drinking among firefighters in 2015. They found that the firefighters in their study who smoked were seven times more likely to drink heavily and five times more likely to binge drink.

While much of the research tying firefighter alcohol use to firefighter cancer is fairly recent, scientists have suspected there was a connection for decades. A 1989 study led by researchers at Johns Hopkins University found that daily alcohol consumption was associated with cancer-causing markers in firefighter blood tests. While that study focused on the cancer risks of smoking and eating char-broiled food, it noted that daily alcohol use may interfere with detoxifying enzymes that degrade carcinogens from products of combustion.

Even back then, it seemed alcohol was a compounding factor in the cancer risk firefighters faced.

“The causes of cancer in the fire service are multi-pronged,” Jahnke says. “We have to take control of as many variables as we can to put the odds of good health in our favor. Controlling alcohol consumption is as much a cancer-prevention measure as is wearing SCBA and cleaning turnout gear after a fire.”

Alcohol overuse may still be entertaining in some quarters, but aside from maybe comic Tig Notaro, nobody thinks having cancer is funny.

ORAL, BUCCAL AND PHARYNX CANCER:

40 PERCENT GREATER RISK FROM FIREFIGHTING AND 83 PERCENT GREATER RISK WITH DRINKING.

ESOPHAGEAL CANCER:

39 PERCENT TO 59 PERCENT GREATER RISK FROM FIREFIGHTING AND 123 PERCENT GREATER RISK WITH DRINKING.

LIVER CANCER:

30 PERCENT GREATER RISK FROM FIREFIGHTING AND 54 PERCENT GREATER RISK WITH DRINKING.

COLON CANCER:

14 PERCENT TO 21 PERCENT GREATER RISK FROM FIREFIGHTING AND 25 PERCENT GREATER RISK WITH DRINKING.