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Living with a Brain Tumor, New Treatment Methods OfferHope
By Ramin Pak, MD, FAANS
“You have a brain tumor.” That’s a diagnosis that no one wants to receive. However, having a brain tumor now, asserts Ramin Rak, M.D., FAANS, a neurosurgeon at Neurological Surgery, P.C. (NSPC) and Director, Brain & Spine Tumor Center, Mount Sinai South Nassau, is not the same as being diagnosed with one 20, 10, or even five years ago.
Dr. Rak points out that “we are finding tumors sooner, and in many cases, we're able to address them before they cause a problem.” Improved MRI and targeting systems have allowed for more accurate minimally invasive biopsies.
The advent of non-invasive options such as stereotactic radiosurgery (Gamma Knife®) have revolutionized the treatment of tumors once thought to be “inoperable.” Patients with multiple tumors, in particular, can benefit from the accuracy and precision of stereotactic radiosurgery (SRS).
Dr. Rak performs most of his radiosurgery procedures using the Gamma Knife ® at the Long Island Gamma Knife Center at Mount Sinai South Nassau in Oceanside which was the first on Long Island to acquire the Gamma Knife radiosurgery system. This center has hosted thousands of procedures over the last two decades. Dr. Rak’s colleague and partner, Michael H. Brisman, M.D., is the co-medical director of the center.
Now more than ever, participation in clinical trials offers patients advanced treatment options while improving our knowledge of which methods offer the best results. Until recently, for example, medical treatment of brain tumors has been somewhat limited due to something called the “blood brain barrier” which prevents most drugs from affecting tumors within the brain. Advances in drug delivery options, and the drugs themselves, now allow tumors to be treated directly.
What was once described as suffering from a brain tumor has now become living with a brain tumor. Or, in some cases, without one.
Ramin Rak M.D., FAANS, FCNS, is a board-certified neurosurgeon who has extensive experience in treating adults with tumors of the brain and spine. He performs complex, as well as minimally invasive, surgical procedures. Dr. Rak is the Director of the Long Island Brain Tumor Center, NSPC/Mount Sinai South Nassau, Oceanside, NY. For more information, or to schedule an appointment for a consultation with Dr. Rak, please call (516) 4422250 or (631) 864-3900. Or visit, nspc.com.
~ CANCERINTHE FIRE SERVICE ~ What Firefighters Need to Know About the NFR
Any FirefighterCan Join the NFR
The NFR (National Firefighters Registry for cancer) is open to all U.S. firefighters, not just those with a previous diagnosis of cancer. Having many types of firefighters join the NFR is crucial to examining relationships between firefighter activities and cancer. NIOSH encourages all firefighters to participate in the NFR, including: Active, former, and retired firefighters; Career, paid-on-call, and volunteer firefighters; Structural firefighters; Wildland firefighters; Industrial firefighters; Military firefighters; Instructors; Fire investigators; and Other fire service members
Registration is Open
Firefighters can join the NFR through the secure web portal. Participation is voluntary. Registration will take about 30 minutes. The NFR is a long-term project that will include voluntary, but important, follow-up questionnaires. Continued participation in the NFR is key to protecting firefighter health. The more researchers know about cancer in the fire service, the more we can do to prevent it.
How it Works
Learn how the NFR will help researchers investigate the link between firefighting and cancer; https://www.cdc.gov/niosh/firefighters/registry.html.
Personal Information Will Be Kept Confidential
Privacy and data security are top priorities for the NFR. Identifying information (like name and date of birth) are protected by an Assurance of Confidentiality. Data are protected by numerous safeguards that meet strict Federal guidelines. For more information, watch our video. – IAFF & FCSN
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Contamination Control Through Design
By Patrick O. Stone, R.A., LEED AP
Research into first responder cancer risk, carcinogenic crosscontamination prevention, and health and well-being has redefined how emergency response architects design stations. Decades of previously accepted practices, such as storing PPE in the apparatus bays or allowing direct access between living quarters and the bays, have changed.
In 2020, the National Fire Protection Association (NFPA) formed the “Technical Committee on Emergency Responders Occupational Health” to draft new procedures for firefighters and criteria for designers. The NFPAconsiders these procedures to be so important that they asked the Committee to both integrate and coordinate with other NFPA health standards. In addition to procedures at the fire ground and within the apparatus, the Committee has advocated the best practices in station layout, mechanical systems, infrastructure and design in its recommendations for protecting responder's health. These best practices have culminated in the creation of NFPA1585 - Standard for Exposure and Contamination Control, which has recently completed its public comment period.
So, you just need to separate your station into hot and cold zones, right? Not exactly. First, it’s important to note that the NFPAhas adopted “Red/Yellow/Green Zones” and removed ‘Hot/Cold Zone” as the preferred terminology, so it is not confused with hazmat response. Second, it's important to understand that building design and operational culture within the station need to work in harmony.
Poor choices can circumvent even the best design, such as the "buff lounge" in the back of the apparatus bay. We get it, it's cool, but soft seating and a lounge in the most contaminated part of the station is a significant risk. Just as the fire service has removed the culture of "salty" or potentially contaminated PPE and focused on proper gear washing and DeCon, we should exercise the same caution with furniture and seating in the bays.
Other immediate considerations to address include PPE storage and Transition (Yellow) Zones. PPE should be stored away from the appa-
ratus, preferably in their own room. This allows an air scrubber to remove the potentially carcinogenic airborne particulates and any off-gases, as well as creates an opportunity to provide a pressurized HVAC zone. The gear room typically ends up between the bays and the living side of the station, so it becomes a critical part of a Transition Zone.
Take the time to read through the new standards and engage your membership. Find ways to reduce risk and make sure your building design and culture work cohesively. It may not be easy to measure the impact of these decisions, but even one case of prevented cancer makes it worth the time.
Mr. Stone is the Director of the Public Safety Market at H2M architects + engineers, an award winning, nationally recognized firm now in its 90th year of operation. As Director, Patrick leads a specialized group of architects and engineers dedicated to the design of Public Safety Facilities. Patrick is a graduate of both the New York Institute of Technology (NYIT) and New York University (NYU). He has over 17 years of experience in the design of Public Safety facilities. He is a member of the American Institute of Architects (AIA), US Green Building Council (USGBC), and the Construction Specifications Institute (CSI). He is also a board member of the Landmark Preservations Commission for the Town of Oyster Bay, where he currently lives. Patrick not only dedicates his life to architecture, but firefighting as well. He has served as a volunteer for over 19 years in both the Wantagh and Massapequa Fire Departments. He utilizes his "on the job" experience to enhance the facilities he designs as well as integrates the best ideas of all departments he encounters, both as a design professional and firefighter.
H2M architects + engineers, 538 Broad Hollow Road, 4th Floor East, Melville, NY11747. Tel 631.756.8000 x1325 | direct 631.392.5669 | mobile 516.458.6591; www.h2m.com.
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What Is Cancer?
TREATMENT
Chemotherapy: The use of drugs to kill cancer cells.
Radiation: The use of high-powered energy beams, such as X-rays or protons, to kill cancer cells.
Surgery: Remove the cancer cells completely or as much as possible.
Bone marrow transplant: The soft, spongy tissue found in the center of large bones where blood cells are formed. Abone marrow transplant, also known as a stem cell transplant, can use your own bone marrow stem cells or those from a donor. It may also be used to replace diseased bone marrow.
DOCTORS
Oncologist: Adoctor who specializes in treating people with cancer.
Pathologist: Adoctor who specializes in interpreting laboratory tests and evaluating cells, tissues, and organs to diagnose disease.
WHATIS CANCER?
Cancer is the general term for a group of more than 100 different diseases that can begin almost anywhere in the body; it starts when cells lose the ability to regulate their growth and grow out of control. These cancer cells can invade and spread to other tissues within the body. This makes it hard for your body to work the way it should.
Additional examples of collective cancer incidence rates in firefighters you may see in your fire station include:
Mesothelioma - 2.29
Testis - 2.02
Esophagus - 1.62
Multiple Myeloma - 1.53
Non-Hodgkin's Lymphoma - 1.51
Lung - 1.39
Buccal and Pharynx - 1.39
Brain - 1.32
Rectal - 1.36
Skin Melanoma - 1.34
Prostate - 1.28
Kidney - 1.27
Breast - 1.26
Malignant Melanoma - 1.21
Intestine - 1.21
The findings are also responsible for the International Agency for Research on Cancer (IARC) reclassifying the occupational exposure as a fire fighter from Group 2 - Possibly Carcinogenic to Humans to Group 1 -
Known Carcinogenic to humans.
Based on strong science linking carcinogens on the fire ground leading to increased rates of cancer in fire fighters, researchers determined that "there is a critical and immediate need for additional protective equipment to help fire fighters avoid inhalation and skin exposures to known and suspected occupational carcinogens. In addition, firefighters should meticulously wash their entire body to remove soot and other residues from fires to avoid skin exposure."
CANCER TERMINOLOGY
Screening test: Checking your body for cancer before you have symptoms.
Cancer is the general term for a group of more than 100 different diseases that can begin almost anywhere in the body; it starts when cells lose the ability to regulate their growth and grow out of control. These cancer cells can invade and spread to other tissues within the body. This makes it hard for your body to work the way it should.
Diagnostic test: Atype of test used to help diagnose a disease or condition. Some examples would be mammograms and colonoscopies.
Biopsy: The removal and examination, usually microscopic, of tissue from the living body, often to determine whether a tumor is malignant or benign.
Imaging test: Aprocedure that creates pictures of internal body parts, tissues or organs to make a diagnosis, plan treatment, check whether treatment is working or observe a disease over time.
Tumor: Amass (lump in the body) formed when normal cells begin to change and grow uncontrollably. Atumor can be benign (noncancerous) or malignant (cancerous, meaning it can spread to other parts of the body).
Benign: Refers to a tumor that is not cancerous. The tumor does not usually invade
nearby tissue or spread to other parts of the body.
Malignant: Refers to a tumor that is cancerous. It may invade nearby healthy tissue or spread to other parts of the body.
Precancerous: Refers to cells that have the potential to become cancerous. Also called pre-malignant.
Prognosis: Chance of recovery; a prediction of the outcome of a disease.
Stage: Away of describing cancer, such as where it is located, whether or where it has spread,
Stage 0: Cancer in early form.
Stage I: Cancers are localized to one part of the body. Stage I cancer can be surgically removed if small enough.
Stage II: Cancers are early locally advanced. Stage II cancer can be treated by chemo, radiation or surgery.
Stage III: Cancers are late locally advanced. The specific criteria for Stages II and III differ according to diagnosis. Stage III can also be treated by chemo, radiation or surgery.
Stage IV: Cancers have often metastasized or spread to other organs or throughout the body. Stage IVcancer can be treated by chemo, radiation or surgery. In situ: In place. Refers to cancer that has not spread to nearby tissue (also called non-invasive cancer.
Metastasis: The spread of cancer from the place where the cancer began to another part of the body; cancer cells can break away from the primary tumor and travel through the blood or the lymphatic system to the lymph nodes, brain, lungs, bones, liver or other organs.
Sarcoma: Acancer that develops in the tissues that support and connect the body, such as bone, cartilage, fat, muscle and blood vessels.
Carcinoma: Cancer that starts in skin or tissues that line the inside or cover the outside of internal organs.
Invasive cancer: Cancer that has spread outside the layer of tissue in which it started and has the potential to grow into other tissues or parts of the body (also called infiltrating cancer).
Localized cancer: Cancer that is confined to the area where it started and has not spread to other parts of the body. Another term that is used to describe localized cancer is “in situ.” For more information, check the IAFF/FCSN website. – IAFF& FCSN
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Battling Cancerin the Firehouse: ACritical Look at Decontamination Protocols
Rich
Gross, President, Emergency DECON Services
Tom Riedel, Vice President, Emergency DECON Services
Emergency DECON Services' mission goes beyond the fire ground; it's about safeguarding the long-term health of our brothers and sisters in the fire service. As seasoned firefighters, we're all too familiar with the perils inherent in our duty - not just the immediate dangers of fire, but the insidious threat of cancer linked to occupational exposure.
AStark Reality
Recent studies by reputable institutions like the National Institute for Occupational Safety and Health (NIOSH) reveal disturbing trends: firefighters face a 9% increase in cancer diagnoses and a 14% rise in cancer-related deaths compared to the general population. These statistics are not just numbers - they're a call to action.
Proactive Measures at East Meadow and Mastic Beach Fire Departments
Two fire departments, East Meadow and Mastic Beach, are at the forefront of combating cancer risks through comprehensive decontamination strategies.
East Meadow Fire Department has implemented rigorous onscene gross decontamination and regular laundering of gear. Advanced skin decontamination practices are in place using specialized wipes, and the station is equipped with a safe military-grade decontaminant for thorough cleaning of gear and apparatus. Annual inspections and advanced cleanings of turnout gear and apparatus are conducted by EDS/RedLine Gear Cleaning. Ex Captain Daniel J. Wood emphasizes the critical nature of these practices: "With the alarming rise in cancer cases within the fire service, proactive decontamination and rigorous health monitoring aren't just best practicesthey're our duty to the men and women who stand on the front lines."
Mastic Beach Fire Department also utilizes a safe military grade decontaminant for effective neutralization of biological and chemical agents on the fireground as well as back at the station. Their commitment also includes routine laundering of turnout gear along with emergency cleanings by RedLine Gear Cleaning to continuously ensure gear integrity and safety. 2nd Assistant Chief Jason Sharp states, "Effective decontamination is a cornerstone of firefighter safety. Our rigorous cleaning protocols are crucial for reducing carcinogenic exposure, protecting our team's future as well as their present."
Five Tips forSafety
Abroader approach to safety in fire departments should embrace the following key practices:
Full Personal Protective Equipment (PPE) UtilizationFirefighters must wear full PPE during all phases of exposure, espe-
cially during overhaul operations to protect against carcinogenic particles.
Proactive On-Site Decontamination - Immediate decontamination procedures should be enacted on the fireground, using effective decontaminants to physically remove contaminants from gear.
RegularGearMaintenance and Cleaning- All gear and equipment should undergo thorough cleanings post-exposure to eliminate carcinogens.
Cab and Equipment Decontamination - Regular cleaning of fire apparatus interiors, SCBA's and equipment is essential to prevent cross-contamination.
Lifestyle and Health Monitoring - Promoting healthy lifestyle choices and conducting comprehensive annual health screenings specifically designed for firefighting professionals can significantly mitigate cancer risks.
Call to Action
The battle against cancer in the fire service demands a comprehensive strategy involving advanced decontamination technologies, rigorous health and safety protocols, and a proactive health management culture. Emergency DECON Services is dedicated to leading this effort, ensuring that firefighters have the necessary protections to maintain their health well beyond their service years.
AStark Reality
Recent studies by reputable institutions like the National Institute for Occupational Safety and Health (NIOSH) reveal disturbing trends: firefighters face a 9% increase in cancer diagnoses and a 14% rise in cancer-related deaths compared to the general population. These statistics are not just numbers - they’re a call to action.
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Do You Have Questions About the NYS Volunteer FirefighterEnhanced Disability Act? We Have Answers!
By Julia Keiffert, Commercial Claims Coordinator, Hometown Firefighter and EMS Services
ABrief overview on the NYS VolunteerFirefighter Enhanced CancerDisability Act
It is no doubt that our firefighters are the backbone of citizens’ safety. They put their lives on the line to ensure that we get to keep ours. While we citizens benefit from our firefighters’sacrifices, those sacrifices can have consequences, one of them being an increased exposure to carcinogens in today’s smoke. In recent years, studies have shown that firefighters in particular are more prone to developing cancer than the average person because of those carcinogens. Given this statistic, discussions about cancer benefits for firefighters surfaced amongst NYState legislators, and on January 1, 2019, the New York State Volunteer Firefighter Enhanced Cancer Disability Act came into effect.
What is the NYS Volunteer Firefighter Enhanced CancerDisability Act?
The NYS Volunteer Firefighter Enhanced Cancer Disability Act serves as a means to ensure monetary benefits for eligible firefighters who develop cancer. According to the Act, a fire district, department, or company must provide and maintain an insurance program for each eligible volunteer firefighter. The New York State Department of Homeland Security thru the Office of Fire Prevention monitors compliance. The fire protection entity can either carry the Cancer coverage (a Critical Illness insurance policy), or they must agree in writing to fund any cancer claims of eligible volunteer firefighters and their beneficiaries through existing and future revenues.
the firefighter’s death was caused by cancer.
FirefighterEligibility
For a firefighter to be eligible for enhanced cancer disability benefits, they must meet the following criteria:
1)Active firefighting service for five or more years as an interior firefighter.
2)Completion of at least five certified annual fit tests
3)Diagnosis of cancer or a malignant growth or tumor affecting the lymphatic or hematological systems or digestive, urinary, prostate, neurological, breast or reproductive systems or a melanoma (to qualify under the basic cancer policy).
What are the Benefits underthe CancerAct?
Whether a fire protection entity opts to carry an insurance policy or fund the cancer benefits without using insurance, their financial responsibilities shall encompass the following benefits:
1)Alump sum payment of $25,000 for invasive cancer, or a lump sum payment of $6,250 for non-invasive cancer.
2)Amonthly disability benefit of $1,500 payable after 180 days have elapsed since the member was deemed by their physician as totally disabled because of the cancer. This monthly disability benefit is payable for up to 36 consecutive monthly payments.
3)Adeath benefit of $50,000 payable to the firefighter’s beneficiary upon acceptable proof by a board-certified physician that
4) Must have undergone a physical examination upon entrance into the volunteer service that shows no evidence of cancer.
Recently, the Office of Fire Prevention and Control has amended the definition of an eligible firefighter to allow for easier determination of eligibility. In addition to the above captioned qualifications, for firefighters who entered the fire service prior to January 1, 2020, documentation identified by the OFPC in the rules and regulations promulgated pursuant to subdivision seven of the Act, shall include, but not be limited to:
Training or certification records; Health care provider records; Internal fire department records; Alternatively, any combination of official documents capable of evidencing that the firefighter meets the aforementioned requirements.
Amember shall remain eligible for cancer benefits for 60 months after the formal cessation of their active firefighting duties.
While eligibility for the lump sum benefit requires a cancer diagnosis, after the Enhanced Cancer Disability Act came into effect in 2019, a member may be eligible for the monthly disability benefit and the death benefit no matter when they were diagnosed, as long as they meet the member eligibility requirements stated above.
To fully understand how the Enhanced Cancer Disability benefits apply, it is important to review the Cancer Act in its entirety, along with any Critical Illness insurance policies that fund the benefits.
Click the following link to review the NYS Volunteer Firefighter Enhanced Cancer Disability Act: https://www.dhses.ny.gov/system /files/documents/2021/12/9-nycrr-210.pdf or call Hometown with your questions at 631-589-2929. Hometown is located at 5 Orville Drive; Suite 400, in Bohemia.
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The #2 Leading Cause of Cancerin Firefighters is Exposure to Diesel Exhaust
By Debbie Anstett
Aire-Deb Corp has been in business for almost 20 years. We are 100% Women owned and based out of Buffalo. We sell exhaust removal products and Back in Safety Systems. We pride ourselves in having 100-percent customer satisfaction. When you call Aire-Deb you talk to DEB… that's right every call goes right to her cell phone 24/7. We sell MAGNEGRIPGroup Exhaust Products.
Firefighters face many job related risks, but we can eliminate the risk of being exposed to pollutants in the station NOW! There is a lot of research linking firefighter cancer to exposures encountered during down time at the station; from idling apparatus and contaminants post-fire from gear.
Did you know?
The #2 leading cause of CANCER in firefighters is EXPOSURE TO DIESELEXHAUST.
The only way to truly eliminate the dangers of diesel is a source capture exhaust system.
(Continued on page 72)
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Reduce CancerRisk Off the Job
The risk factors most linked to increased cancer rates include numerous modifiable factors. Knowing and making small changes can reduce cancer risks significantly. For example, quitting tobacco before the age of 40 reduces the risk of dying from smoking-related diseases by 90 percent.
ALCOHOL
It is well studied that consuming alcohol can increase the risk of cancer of the mouth, throat, esophagus, larynx, liver, and breast. The International Agency for Research on Cancer (IARC) classifies alcohol as a group 1 carcinogen. The risk is increased by the amount you consume.
Data collected over the last decade demonstrate that the fire service has a high rate of heavy and binge drinking. The amount of alcohol consumed over time is the most important factor in raising cancer risk. Alcohol metabolizes into acetaldehyde, which most researchers say is the leading cause for the increase in risk.?
What Can You Do?
Drink in moderation: According to the American Cancer Society Guideline for Diet and Physical Activity for Cancer Prevention, it is best not to drink alcohol. People who choose to drink alcohol should limit their intake to no more than two drinks per day for men and one drink a day for women.
Firefighters have lower rates of cigarette smoking than the general population; however, cigars and smokeless tobacco are used at a
higher rate. Tobacco use can cause several cancers, including cancer of the lung, larynx, mouth, esophagus, throat, bladder, kidney, liver, stomach, pancreas, colon and rectum, cervix, and acute myeloid leukemia. Smokeless tobacco is linked to increased risks of mouth, esophagus, and pancreas.
TOBACCO
What Can You Do?
Quit using tobacco products. There is no safe level of tobacco use. Quitting smoking today will immediately reduce the risk for cancers associated with tobacco use and have substantial gains in life expectancy compared with those who continue to smoke. Also, quitting smoking at the time of a cancer diagnosis reduces the risk of death.
Sun exposure is a risk that we have control over reducing. The sun, sunlamps, and tanning booths are all sources of ultraviolet (UV) radiation that damages the skin. Excessive UVexposure is directly linked to skin cancer. The risk for melanoma, the most serious form of skin cancer, is increased with exposure to UVradiation from all sources.
SUNLIGHT
What Can You Do?
Limit the amount of time spent in the sun and protect your skin by using sunscreen with sun protection factor (SPF). Reduce your time in the sun, especially between mid-morning and late afternoon, and avoid other sources of UVradiation, such as tanning beds. Keep in mind that UVradiation is reflected by sand, water, snow and ice and can go through windshields and windows. - FCSN
The Hazards of Diesel Exhaust
The hazards of diesel exhaust have been known since the 80s when the National Institute for Occupational Safety and Health (NIOSH) published their first study on the known toxicological hazards of exposure. Over 30 years later the World Health Organization (WHO) classified diesel exhaust as a known carcinogen and further studies show the increased hazards of exhaust exposure to "Ultra-fines" diesel particulate.
Ultra-fines are the smaller particulates emitted after the exhaust passes through on-board diesel particulate filters (DPF) that are now required as part of the Clean Air Act. These particulates are in the sub-micron range making them easier to penetrate deeper into the alveoli region of the lungs. Further studies show an increase in some of the hazardous gasses emitted as a result of the filter regeneration process where the filter temperature is increased to burn off captured particulates.
For more information on the hazards of diesel exhaust and the best methodology for protecting your firefighters, contact the Clean Air Company at 800-7380911.
~ CANCERINTHE FIRE SERVICE ~ OcularCancer: Prevention and Screening
By Dr. Michael Politi
Firefighters may be at increased risk of cancer, including eye cancer, due to prolonged exposure to smoke, chemicals, and other carcinogens.
Two forms of cancer in the eye are melanoma and lymphoma, while basal and squamous cell carcinoma affect the eyelids.
People can develop a Nevus (freckle) in the eye. This can be precancerous and requires monitoring. Abenign choroidal nevus (eye freckle) rarely causes symptoms. However, if it leaks fluid or is associated with the growth of abnormal blood vessels, patients can become symptomatic.
Prevention involves minimizing risk factors. UVradiation from sunlight is a known risk factor for certain eye cancers, particularly melanomas. UV-protective sunglasses and wide-brimmed hats can help reduce exposure. Avoidance of tobacco is recommended since smoking
The #2 Leading Cause of Cancer in Firefighters is Exposure to Diesel Exhaust
(Continued from page 69)
• Diesel Exhaust contains more than 40 Toxic air contaminants.
• Firefighters are over 100% more likely to be diagnosed with certain types of cancer over the general population (University of Cincinnati Study).
• The Fire Fighter Cancer Presumption Act of 2011 recognizes every form of cancer found in a firefighter as a work-related illness Therefore, almost all states have mandated that it is the responsibility of the municipality to provide workers compensation insurance.
• Payment of excessive claims has caused insurance companies to cancel policies that cover fire departments.
• IARC (Int'l Agency for Research on Cancer) lists diesel exhaust as a Group 1 Carcinogen to humans on June 2012.
• No matter how many fans and how much air circulation you have there is no way to eliminate health threats posed to personnel (including Cancer, Asthma, Emphysema, Heat and Lung Disease) except through a source capture system
• Using only big fans leads to heat loss from the building; leading to higher heating costs.
• Walls turn black; evidence diesel exhaust is still in the air personnel breathe.
• Gear exposed to diesel exhaust absorbs toxins from diesel exhaust;
• Firefighters are constantly exposed to diesel toxins when wearing gear or driving with gear leads to premature decommissioning due to contamination.
MAGNEGRIPPRO Design is by far the best design in the Emergency Service industry for Exhaust Removal. MAGNEGRIP is also the ONLYExhaust system Manufactured in USA.
AireDeb also sells the ILLUMIDOOR Back-In Safety Guidance System. Aire-Deb invented, designed, and patented the ILLUMIDOOR System for eliminating accidents backing apparatus into a station. ILLUMIDOOR also solves the "black hole" issue when backing in by illuminating the back-in floor line.
Debbie Anstett; AIRE-DEB Corp.; 100% Certified WBE, 140 Dersam Road, Alden, NY14004; (716) 812-3429/(800) 719-3429. Northeast Territory Manager for MAGNEGRIP/AIRHAWK/ HAZVENT.
is associated with increased cancer risk, including some that affect the eye. Screening and early detection are essential, especially for firefighters, with environmental exposures to carcinogens. Afamily history of ocular cancer, or symptoms such as blurred vision, floaters or pain requires an eye exam by an ophthalmologist which can help detect abnormalities early. Adults should consider comprehensive dilated eye exams at least every year, particularly those with risk factors. In cases where ocular tumors or eyelid lesions are detected, treatment may include surgery, radiation, or laser therapy. Early intervention is often key to preserving vision and preventing the spread of cancer. Know your risk factors, get routine screenings, and take protective measures to manage your ocular health and reduce your cancer risk.
Dr. Michael Politi is a Board Certified Ophthalmologist and a fellowship-trained retina specialist, with over 10 years of experience in treating a wide range of eye conditions. Dr. Politi is dedicated to helping patients maintain healthy vision, providing the highest quality retinal and comprehensive ophthalmologic care. He can be reached at Politi Eyecare & Aesthetics 516-403-2565.
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The New York State VolunteerFirefighter Enhanced CancerDisability Benefits Program
By Keith Metz
As 2024 starts to wind down, let's take a quick review of The New York State Volunteer Firefighter Enhanced Cancer Disability Benefits Program. Introduced in 2019, This was a significant initiative that provides financial support to volunteer firefighters who have been diagnosed with certain types of cancer. The program acknowledges the risks that firefighters face, particularly the heightened risk of developing cancer due to prolonged exposure to hazardous substances while on duty. Volunteer firefighters, who often serve their communities without compensation, face the same dangers as their paid counterparts, and this program seeks to address the gap in support for those affected by cancer as a result of their service.
The origins of the program lie in increasing awareness of the link between firefighting and cancer. Firefighters are regularly exposed to carcinogens such as asbestos, smoke, chemicals, and other hazardous materials while fighting fires or working in hazardous environments. Over time, this exposure has been linked to higher rates of cancers such as lung cancer, leukemia, and mesothelioma among firefighters. In response, New York State recognized the need to protect volunteer firefighters and passed legislation mandating cancer coverage for eligible volunteers.
The program was originally designed for volunteer firefighters who have served in an interior firefighting capacity. To qualify, firefighters must have five or more years of serv-
ice as an interior firefighter, as certified by their fire department. Additionally, they must have passed a physical examination when they started service, which must show no evidence of cancer. The goal of the program is to ensure that those who have been exposed to cancer-causing materials during the course of their volunteer work are compensated for the health consequences they may face. Amendments since 2019 have allowed the program to expand and offer protection to additional members, who serve their department in other capacities.
The benefits of the program are significant and multi-faceted. They include a lumpsum payment of $6,250 or $25,000 for a diagnosis of certain types of cancer, depending on the severity. There is a maximum limit of $50,000 for any one member to receive for Diagnosis benefits. In the unfortunate event that a firefighter passes away due to a covered cancer, their beneficiaries can receive a death benefit of $50,000. Most policies offer the ability for the insured to offer expanded coverage, which allows for benefits for any cancer diagnosis, rather than the 9 listed in the original legislation.
Moreover, the program provides disability benefits for firefighters who can no longer work due to their illness. Amonthly payment of $1,500 for up to 36 months is available for firefighters who are unable to perform their regular duties due to cancer. This financial support helps ensure that firefighters and their families can manage the economic burden that often accompanies cancer treatment
and recovery.
One of the key features of the program is that it is funded by fire districts, departments, and companies. These organizations are responsible for purchasing the necessary insurance to provide coverage for their volunteers. While this can pose a financial challenge for some smaller volunteer fire departments, the law mandates that they must provide coverage, ensuring that all eligible firefighters in New York State have access to these benefits.
The New York State Volunteer Firefighter Cancer Benefit Program represents a critical step toward protecting those who selflessly serve their communities. It not only offers some financial relief in the face of a devastating illness but also demonstrates the state's recognition of the dangers that volunteer firefighters face. As awareness of cancer risks in firefighting continues to grow, this program stands as a model for how states can support their volunteer emergency responder.
Keith Metz, Marketing Coordinator, Hubbinette Cowell Associates, 1003 Park Blvd. Ste. 3, Massapequa Park, N.Y. 11762; www.hubbinettecowell.com; (516)795-1330 Office; (516)795-5101 Fax; (516)639-7273 Cell.
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Research That Supports the Link Between Firefighting and Cancer
Research spanning decades, continents, and more than 80,000 firefighters validates the connection between firefighting and occupational cancer. Here are some key studies.
The 2017 Blais University of Ottawa study examined chemical exposure occurring during emergency, on-shift fire suppression. The researchers found firefighters absorb harmful chemicals, including polycyclic aromatic hydrocarbons (PAHs), through their skin. Firefighters had from three to more than five times the amount of by-products of PAHs in their urine after a fire compared to before the fire.
The 2013 Daniels NIOSH study (phase 1) is the largest study of U.S. firefighters to date. It examined mortality patterns and cancer incidence for 30,000 firefighters. The NIOSH study, which began in 2010, found statistically significant mortality and incidence rates of all cancers and cancers of the esophagus, intestine, lung, kidney, and oral cavity, as well as increased mesothelioma for firefighters compared with the general population. The NIOSH study found excess risk of bladder and prostate cancers at younger ages. The NIOSH study also is significant because it spanned geo-
graphical distance (San Francisco, Chicago, Philadelphia) and decades (1950-2009). It is one of the few studies to date that has included women and non-white firefighters.
The 2015 Daniels NIOSH study (phase 2) examined firefighters’work histories and variables such as fire runs, use of personal protective equipment (PPE), and use of diesel exhaust control systems. It compared the cancer risk for firefighters with higher exposures to carcinogens with those who had lower exposures. In this phase, researchers found that lung cancer and leukemia risk increased with exposure.
The 2014 Pukkala Nordic study of 16,422 firefighters from five Nordic countries found an increased risk for all cancers combined among firefighters, similar to the NIOSH phase 1 study. It found significant increases in melanoma and non-melanoma skin cancer; lung cancer; and prostate cancer from 1961 to 2005.
The 2008 Kang Massachusetts study compared cancer incidence among Massachusetts firefighters with that of Massachusetts police officers and other occupations. When compared with police officers, firefighters were
found to have increased cancer risks. This study found the firefighters had a 90 percent higher risk for brain cancer and an 81 percent higher risk for Hodgkin's lymphoma. Researchers examined data from 1987-2003.
The 2006 LeMasters meta-analysis reviewed data from 32 studies of firefighters for 20 different types of cancer. Risks for 10 types of cancer were “significantly increased” in firefighters. Risks for the other 10 types were increased, though not to the same extent.
The 2006 Fangchao Ma Florida study compared Florida firefighters’cancer incidence rates (rather than mortality) with those of the general Florida population. It was the first such study to include women. Florida researchers examined data for 34,796 male and 2,017 female firefighters and found 1,032 total cases of cancer (970 male & 52 female). The top cancers for male firefighters were prostate (13.7 percent), skin (8.4 percent), colon (7.1 percent), bladder (6.9 percent), and testicular (5.5 percent). The most prominent cancers for female firefighters in Florida were breast (27.8 percent) skin (7.6 percent), thyroid (5.6 percent) and lung (4.6 percent).
- IAFFand FCSN
~ CANCERINTHE FIRE SERVICE ~
Best Practices to Reduce Cancer in the Fire Service: At the Station
All fire incidents produce toxic smoke and combustion byproducts that can have negative short and long-term health effects on fire fighters. Exposures can continue after a fire fighter leaves the fireground, as these contaminants remain on turnout gear and equipment until they are cleaned off.
This can result in continuous exposures through inhalation, ingestion, and absorption of toxicants. Contaminants can also be inadvertently transported when a leaving a shift to head home when failing to clean or decontaminate tools, equipment, and personnel after each fire incident.
To reduce continuous exposures back at the fire station, the overall design of fire stations should be done with the reduction of exposures and cross contamination of fire fighters in mind.
Dividing the fire station into three hazard zones can reduce exposure to cancer causing chemicals at the fire station.
The gold standard to reduce exposures at the fire station is to divide it into a hot zone, warm zone, and cold zone.
Hot Zone:
This is the area with the highest risk of exposure.
This is the area of the station with the most contamination. You may treat the apparatus bay and adjacent areas as a hot zone because of diesel exhaust (a known carcinogen), traffic from contaminated PPE, tools, and equipment. Contaminated PPE and equipment include but are not limited to boots, gloves, helmets, turnout gear, SCBA, EMS equipment from medical calls, fire hoses, etc. This is where you will start the decontamination process.
Here is some additional guidance on the Hot Zone:
•Designated area for everything contaminated that needs to be decontaminated.
•Never use blowers or compressed air on apparatus floors (can make diesel soot particles airborne).
•Always use a direct source capture diesel exhaust handling systems for all vehicles and for every apparatus bay. This can be included in all new station designs and retrofitted into existing stations.
•When decontaminating, wear proper PPE, including EMS gloves to minimize exposure.
Items that should never be located in the Hot Zone due to diesel exhaust and particulates include but not limited to: Ice machines or refrigerators; Workout equipment; Recliners/loungers/couches or any porous furniture.
Yellow Zone:
This area should be designed for cleaning contaminated equipment, including SCBA, EMS equipment from medical calls, fire hose, turnouts, etc. Transition from hot (contaminated) and cold (clean) zones:
•PPE storage should be stored in a separate area with its own ventilation system.
• Washer/extractors should be placed in this zone.
•Cleaning of contaminated PPE and equipment (SCBA, radio, gloves, etc.) should occur in this zone. When cleaning, wear proper PPE, including EMS gloves to minimize exposure.
Green Zone:
Living areas and offices. “Keep it Clean in the Green”: contaminated EMS equipment, turnouts, etc., are never allowed in this zone.
•These are the living quarters of the fire station (e.g., kitchen, bathrooms, sleeping quarters, offices).
•Ventilation systems should not allow fireground contaminants or diesel exhaust to enter this area from the air, personnel, or equipment.
•Solid surface flooring should be installed as well. Carpet can act like a sponge for anything that may be on the feet.
•Furniture, countertops, etc., should all be solid surfaces for easy cleaning.
•No fireground contaminants or diesel exhaust should enter this area from the air, personnel, or equipment.
•Cleaned PPE should never enter cold zones.
•Do not prop open doors between living or office areas and the apparatus bay.
•The air pressure in the living quarters should be higher than that of the apparatus bay to prevent airborne contaminants from entering the living quarters or the Cold Zone in general.
Personal Best Practices
When it comes to reducing your exposure at the station, having a hot, warm, and cold zone is ideal, but if your station is not designed this way, then it is up to each fire fighter to advocate for themselves and make the personal choice to take steps to reduce and mitigate their exposures.
•Wash your hands after handling anything that could be contaminated (PPE, equipment, etc.) frequently, especially if you handled any equipment.
•Take a shower and change your clothes anytime you have been in a hazardous environment. Not just structure fires, but gas leaks, CO alarms, etc.
•Isolate hazard areas from living areas.
•Keep contaminated and cleaned gear/equipment out of the living areas (keep living areas clean).
•Keep doors closed between apparatus bay and living areas.
•Wash your hands after handling anything that could be contaminated (PPE, equipment, etc.) frequently, especially if you handled any equipment.
- IAFFand FCSN
All fire incidents produce toxic smoke and combustion byproducts that can have negative short and long-term health effects on fire fighters.
Exposures can continue after a fire fighter leaves the fireground, as these contaminants remain on turnout gear and equipment until they are cleaned off.