There’s a pervasive myth that firefighters die in a “blaze of glory.”
The reality, according to the Fayetteville Fire Department’s David Richtmeyer, is often much darker.
“We don’t die like that,” Ritchmeyer, the department’s deputy chief, told CityView. “We typically die old, in a hospital bed or at home withering away from cancer. And that, to me, is a little bit scarier.”
Plug the words “firefighter” and “cancer” into an online search, and you’ll find a range of unsettling statistics about the profession, stories of young people dying from rare cancers and grieving families looking for answers and solace
Firefighter occupational cancer is the leading cause of death while on duty in the fire service, according to the International Association of Firefighters. Firefighters not only face a risk of injury from their regular firefighting duties, but they have a 9% greater chance of being diagnosed with cancer and a 14% higher chance of dying from the disease than the general population, according to the National Institute for Occupational Safety and Health. The risk for specific cancers is also much higher; firefighters are more than twice as likely to be diagnosed with testicular cancer, for example, than the average person, according to the Firefighter Cancer Support Network.
“It’s not something you think about when you’re younger and you like the adrenaline rush of running the calls and doing all the crazy life-saving things,” Ritchmeyer said. “But as you start to get a little bit older, you start to think about the other side of that. What’s going to get me in the end?”
In 2023, a working group of international scientists at the World Health Organization found sufficient evidence that exposure to firefighting causes cancer in humans.
In Fayetteville, you don’t have to look that far.
This research aligns with years of anecdotal experiences that Fayetteville firefighters have seen — or experienced firsthand — on the job. In 2022, Fayetteville Fire Department Battalion Chief John Bowen died of colon cancer, at age 35. His mother, Betty Bowen, told CityView there was no history of bowel cancer in their family. He died within six months of getting diagnosed.
Bowen’s death was ruled a line-of-duty death in January of this year, but only after his former colleagues had to provide evidence to the N.C. Industrial Commission that his cancer could be considered of the small intestine, Richtmeyer said. N.C. Industrial Commission, a state agency, administers workers’ compensation. According to state statute, the agency only recognizes a cancer death of a firefighter as line-of-duty if it’s one of six types of cancer: mesothelioma, testicular cancer, cancer of the small intestine, esophageal cancer, oral cavity cancer and pharynx cancer.
“In order for the industrial convention to rule, they had to go back and get the doctor’s clarification on that, to say that it was colorectal, intestinal and small intestine, but they had to have that word, ‘small intestine’ in there specifically, for it to be recognized by the law,” Richtmeyer said.
Firefighter David Sharp’s passing in 2000 was the last line-of-duty death of a Fayetteville Fire Department member. He died at the age of 31 when the fire truck he was driving was hit by a train.
Addressing a group of students at the Fayetteville Fire Academy on Wednesday, John Leonard — a recently retired fire captain who served the Fayetteville department for three decades — was candid about the risks of joining the fire service.
“Just be aware,” he told the students, “firefighters are four to five times more likely to develop cancer than the average person. And we’re not here to scare you. We’re not here to change your mind. We don’t want no resignations today, don’t expect any.”
Six Fayetteville firefighters have died from cancer since 2008, but Leonard said there’s probably more than that, especially with retired firefighters. In his 30-year career, Leonard said he’s seen cases of cancer in his department that get brushed off.
“‘Well, Junior died, he had cancer. Where’d it come from?’ That sort of thing,” he said. “… I call it occupational cancer. If you’ve been here a day and you’re a firefighter and you get cancer, it’s occupational cancer.”
Leonard said he’s personally been diagnosed with every major type of skin cancer over the years — melanoma, basal cell carcinoma and squamous cell carcinoma — each time undergoing treatments and surgery to remove the tumors. What might otherwise be perceived as bad luck, Leonard said, is nothing outside of the normal in the firefighting world.
“It’s exposure from the fire service,” Leonard said. “That’s what it is.”
The data reflects Leonard’s experiences; firefighters have a 1.39 times increased risk of developing skin cancer compared to the general population, according to the Firefighter Cancer Support Network.
What’s causing the cancer?
Chiefs at the Fayetteville Fire Department said firefighters, here and elsewhere, are exposed to thousands of chemicals between their gear, firefighting foam and the combustion of synthetic materials when they arrive at the scene of a fire.
“Firefighting has changed a lot in the last 50, 60 years,” Richtmeyer told CityView. “When you look at the fires the firefighters were fighting back, let’s just say in the 40s, a lot of the materials that we lived with back then were natural.
“Furniture was made out of natural cotton fibers and actual wood and that kind of stuff. When you look at what all of our buildings are made out of and all of our furnishings now, there’s nothing natural.”
In addition to being exposed to particulate matter, carbon monoxide, carbon dioxide and other chemicals from fires, firefighters are also exposed to harmful chemicals used in their safety gear, said Assistant Fire Chief Adam Ferguson.
To make the protective “turnout gear” heat and flame-resistant, manufacturers use PFAS, or per- and polyfluoroalkyl substances, which can easily leach into wearers’ skin, Richtmeyer said, especially when blood vessels are dilated as temperatures increase and oxygen decreases while firefighting.
“We’re exposed to a lot more chemicals and carcinogens than the general public,” Richtmeyer said. “And then just having that PFAS in our gear just adds that extra little piece, that extra exposure that we don’t really need. We’re trying to reduce everything across the board as much as we can.”
PFAS, known for contaminating the Cape Fear River, are toxic, and exposure to the chemicals is associated with a number of cancers and diseases.
“They’re known as forever chemicals,” Ferguson said. “They don’t go away in the environment. When our bodies absorb them, our bodies don’t break them down. They literally don’t go away.”
Ferguson said PFAS are also used in firefighting foams to make them more effective.
“But in the firefighting community, it’s used in turnout gear and it’s used in the foams,” Ferguson said. “So in the turnout gear, it’s in all three layers of it. And then in the firefighting foams, it was used as a surfactant, basically to break the surface tension or make foam more effective.”
Progress being made
To protect themselves from being exposed to toxins from the fire scene and in their gear, firefighters must use a rigorous process to wash out their gear and clean themselves as quickly as possible, Fayetteville firefighters said. This includes, but isn’t limited to, washing their gear on-site with the fire hose from the truck and wipes, using a piece of equipment called an extractor to clean their gear at the station, and using specialized personal protective equipment while on duty.
Ferguson said the department has made progress in the past six or seven years, as more research and legislation has come out showing the heightened cancer risk firefighters face. For example, in recent years, the fire department has been able to take a number of steps to combat cancer risks:
- The city allocated funds for a second set of turnout gear for firefighters so that firefighters can swap out contaminated gear
- Purchased extractors for washing turnout gear with the help of the Fayetteville Firefighters Benevolent Fund, and installed by the city and fire departments at all stations
- Purchased hoods that can filter particulate matter for extra protection
- Including materials in fire trucks for on-scene decontamination
- Conducting department surveys to assess perceptions of cancer risk and decontamination procedures
- Including cancer awareness training at the Fayetteville Fire Academy
Captain Stephen Shakeshaft said Fayetteville Fire Chief Mike Dove was also committed to including advanced cancer screenings for Fayetteville’s firefighters in the city’s budget for the upcoming year.
“Y’all know we’re going through a lot of budget cuts,” Shakeshaft said. “There’s two things that he [Chief Dove] will not bend on, and that is pay increases and cancer screenings. We will cut anything else we need to cut, to not cut pay increases and cancer screenings.”
Richtmeyer doesn’t expect any drastic changes in firefighting that will eliminate exposure to carcinogens, but he thinks gradual change is possible, with an emphasis on adapting to the reality of man-made chemicals being pervasive in the modern world.
“The atmosphere — that is the building products, the furnishings, all the synthetic stuff that we deal with that are on fire, and we get exposed — I don’t think that’s going to change,” Richtmeyer said. “But I think our reaction to that can, right?”
“We can continue to make sure that we protect ourselves properly,” he said. “We continue to make sure that we decon [decontaminate] as soon as possible to get that stuff off of us. We can continue to make sure people have the proper PPE and gear.”
Contact Evey Weisblat at eweisblat@cityviewnc.com or 216-527-3608.
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