Female firefighters found to have high levels of carcinogenic chemicals

Spate of breast cancers in SFFD in 2012 led to first study of health of women in the profession

Female firefighters in San Francisco have higher concentrations of certain cancer-linked chemicals in their blood than women in other occupations, according to the first study to investigate how women in the profession are exposed to chemicals in the line of duty.

When the San Francisco Fire Department suffered a shocking spate of breast cancers in 2012, it prompted a collaborative effort to investigate the exposure among women to hazardous chemicals, specifically chemicals called per- and polyfluoroalkyl substances, or PFAS. These “forever chemicals”

“I remember when I raised my hand to swear in (to the fire service), thinking ‘please be safe, don’t get hurt in a fire.’ I never thought about cancer.”

— Anita Paratley, battalion chief for the San Francisco Fire Department

can bioaccumulate in tissues and persist over lifetimes and are linked to several types of cancers, including breast cancer, and other diseases.

“We know running into a burning building — there’s some occupational hazards there,” said Heather Buren, a lieutenant and paramedic at the San Francisco Fire Department who co-authored the study. “But the idea that we were being exposed to chemicals that were causing cancer … it’s not as sexy.”

Buren said that from 2011 to 2012, five of her co-workers were diagnosed with breast cancer. She said that number may be higher because not everyone was vocal about having the disease.

“Being female in a maledominated profession … it was a really private thing for them,” she said.

The women were in their 40s, getting breast cancers that scientists and doctors say they don’t usually see in women younger than 60.

“For the first time, I started thinking of (cancer as an) occupational disease,” Buren said. “Could our job actually be part of the reason this is happening?”

Anita Paratley is a battalion chief for the San Francisco Fire Department. She developed breast cancer in 2003, when she was 46.

“I remember when I raised my hand to swear in (to the fire service), thinking ‘please be safe, don’t get hurt in a fire,’” she said. “I never thought about cancer.”

After the diagnosis, Paratley tried to learn if the disease may have been caused by her job. But she couldn’t find any information on

women in the fire service.

“Frankly, they need to be studying, in general, about women’s health,” she said. “Do we absorb things at a greater rate than men — who knows?”

Buren said watching so many of her friends suddenly develop cancer made her worried about herself. She knew that being exposed to cancer-causing chemicals was part of firefighting. Was she going to be next?

“(When) people who look like you, who are doing your job, who are your friends, are getting a disease, you start to ask: ‘Could that be me? Could I be the next one?’ ” Buren said.

Women make up about 5% of the firefighters across the country, according to the U.S. Bureau of Labor Statistics.

Because their numbers are so few, they’re often excluded from studies about the health risks of firefighting. But of the 1,600 firefighters in San Francisco, nearly 300 are women — the highest percentage in the nation.

“Having a large group of women in San Francisco and interest from the community to answer these questions — that’s why (this study is) important,” said Jessica Trowbridge, a researcher at UC Berkeley and the lead author of the study. “Their exposure and risk has not been characterized in the scientific literature.”

PFAS chemicals are in many household items, including food packaging, furniture, carpets, and they can even be detected in drinking water.

Because the chemicals degrade slowly, they persist in the environment and in human tissue.

A National Health and Nutrition Examination Survey in 2003 found that more than 98% of the population surveyed had several types of PFAS in their bodies.

PFAS are a major component of the foams firefighters use to put out fires.

The researchers said

“It’s this whole idea where the dirtier the gear is ... the more experience you have. That’s sort of ingrained into this masculine culture, and it’s taken a little bit of time to start to change that.”

—Heather Buren, lieutenant and paramedic at the San Francisco Fire Department

contact with the foam, and breathing particulates in the air from burning buildings, might contribute to the firefighters’ higher exposure levels of carcinogenic chemicals.

It also might help explain why firefighters have higher levels of cancer.

Through a network of groups, including the San Francisco Firefighters Cancer Prevention Foundation, Buren said a groundswell of concern from firefighters, advocates and scientists led to the creation of the Women Workers Biomonitoring Collaborative (WWBC), a group determined to fill the knowledge gaps between male and female firefighters.

“They’re very active, driven people,” Trowbridge said of the female firefighters in the collaborative. “They weren’t going to sit around and wait for somebody to come save them. They were going to do something to solve this problem.”

The results show that most firefighters had significantly higher concentrations of three PFAS chemicals compared with the office workers who were tested.

Each of the 86 firefighters involved in the study was given results and information about how to prevent exposure.

“I can’t speak to their breast cancer risk,” Trowbridge said. “But I can speak to the level of chemicals that we found in their body, and that they had higher levels of some of these compounds than the non-firefighters.”

Buren said she has visited departments across the country to educate firefighters about how to reduce their exposure — cleaning their gear, washing their hands and showering as soon as possible after a fire.

“It’s this whole idea where the dirtier the gear is, the saltier you are, the more fires you’ve fought, the more experience you have,” she said. “That’s sort of ingrained into this masculine culture, and it’s taken a little bit of time to start to change that.”

As battalion chief, Paratley said it’s her job to make sure her crew is safe, and that now includes an awareness of carcinogenic particulates that are in the air after a fire and that coat the crew’s work gear.

“I’m responsible to make sure these changes are enforced,” she said. “That’s part of safety, even though the fire is out.”

The study provides evidence that cancer is an occupational hazard for firefighters, something that both firefighters said can help people receive workers’ compensation claims when they get sick.

When Paratley filed her claim in 2003, she initially was denied.

“They asked me what I was exposed to, and I said, ‘I’m a firefighter, I’m not a chemist,” she said. “Is this a test? I didn’t know about flame retardants.”

Luckily, California has presumptive laws that assume if a firefighter develops cancer, it’s likely due to exposure through the job. Paratley’s claim was approved because of those laws, but not every state has those protections.

“This gives people solid support, scientific evidence, to go to these legislators” and add cancers to these lists of occupational hazards, Buren said.

“You shouldn’t have to fight for your benefits as you’re fighting for your life,” she said.