Taking a systematic approach to cancer risk reduction for firefighters

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By: Robert Avsec, Executive Fire Officer

The health and safety of firefighters has been a key area for continuous improvement for as long as there have been firefighters. Motorized fire apparatus, better pumps and hoses, SCBA, and the structural firefighting protective ensemble PPE are just a few examples of the hundreds. If not thousands of improvements that have played a role in reducing firefighter injuries and deaths.

Over the past decade, the risk firefighters for firefighters to develop cancers, at rates higher than that for the public they serve, has risen to the forefront of firefighter health and safety initiatives for most fire departments. And with good reason.

Solo Rescue SCBA Decon Washer: Cleaning all PPE elements is the key to firefighter cancer risk reduction

The increased risk faced by firefighters is grown exponentially with the proliferation of synthetic materials (many of which are hydrocarbon based) used in the construction and furnishing of today’s structures, particularly for single and multifamily residential dwellings. Consequently, today’s structure fires burn hotter, grow faster, and produce prodigious amounts of chemicals, chemical compounds, and carcinogens in both solid and gaseous states.

Hopefully, none of this is new information if you’re a firefighter. And equally important is that you and your fire department are taking the appropriate actions to reduce those risks on the fire scene, while returning to the fire station, and at the fire station.


A popular model for continuous improvement is the P-D-S-A model shown in Figure 1 below.

Figure 1. The P-D-S-A Model for continuous improvement.

Figure 1. The P-D-S-A Model for continuous improvement.

Plan. Identify what needs to be improved. Conduct research, along with data collection and analysis to understand why something needs improvement. Create a plan for improvement.

Do. Implement the plan. Depending upon the size and make-up of your department, this may be done as a pilot implementation (using a small control group) or as a department-wide initiative. The key factor in deciding which is best for your purpose is your capability to complete the next step.

Study. Collect and analyze how the plan is working. Therefore, the size of your implementation group is important because you want to be able to collect enough data about how things are working but not be overwhelmed in collecting and analyzing your data.

Act. If you’re not satisfied with your implementation results, go back to the DO phase restart the process. If you’re satisfied with your implementation results, then take action to formalize the improvement, using the applicable tool (policy, SOG, or process).

So, when it comes to your fire departments, cancer risk reduction efforts, do you have a system? Or is your current state that of several “moving parts” that may or may not be congruent with one another?


A good starting point is the blog I wrote several years ago, How Good are Your Organizational Risk Reduction Tools?

It’s been my experience, and I’ve learned from others over the years, that fire departments frequently develop policies, procedures, and processes as “reactive activities.” They develop them because things have happened, and the outcome was not good, and something needed to be “fixed. How many policies, SOGs, or processes in your fire department could be subtitled “The Firefighter Jones Rule?”

I submit that a better approach would be to use those documents proactively as the incident action plan for a new initiative. And that can be represented with the following graphic that outlines what a systematic approach to your fire department’s cancer risk reduction program should look like (Figure 2).

Figure 2. The center of the radial represents POLICY, while the satellites represent SOGs that specify what firefighters must do to comply with the policy.

Policy. Policy statements should clarify for the members of the organization What subject the policy is addressing and Why the organization needs this policy; the latter is the best place to describe the linkage between the policy and its applicable element in the strategic plan.  Effective policies have the greatest influence on the attitudes of the members of the organization.

Well-crafted policies should typically not exceed one page because they should be broad in scope.  Because they are broad in scope, well-crafted policy statements should not require frequent revision unless the “driving force” behind the policy (e.g., the department’s strategic plan or federal or state law, changes significantly and creates the need for policy revision). 

SOGs. Unlike policies, SOGs should undergo regular reassessment to keep them current with “outside influences” such as the examples shown in Table 1.

Table 1. The implementation of new rules, regulations, or standards can create the need to update SOGs. So, too, can the introduction of new technologies.

Looking back at Figure 2 above, a Cleaning and Decontamination SOG would describe what types of equipment require cleaning and decontamination following a structure fire, what equipment and cleaning solutions should be used for the cleaning and decontamination, and how equipment is properly returned to service following cleaning and decontamination.

Processes. A good process “drills down further” and provides the published step-by-step directions for complying with an applicable SOG.  Processes are essential for any task when:

  • The task must be done repeatedly;
  • The task will be performed by multiple people; and
  • Consistent outcomes are essential regardless of who does the task.

Why is your department still cleaning SCBA by hand?

The body of knowledge regarding the cancer risk to firefighters, along with guidance and direction on how to reduce that risk, continues to grow at a dizzying pace. But a well-designed system that uses policy, SOGs, and processes is an effective tool that all fire departments should have in place to reduce that risk for their personnel.

SoloRescue is Good for the Environment

Make the Solo Rescue SCBA Washer a part of your fire department’s “green” technology. Depending upon the degree of cleaning necessary for PPE, a firefighter can get three or four wash cycles completed using the recycled water from that 29-gallon reservoir, so the total amount of water used is minimized. And that’s good for the environment and for fire departments serving areas where water can become a scarce commodity.

To learn more about the Solo Rescue SCBA Washer, CLICK on our logo.

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About Robert Avsec, Executive Fire Officer

Battalion Chief (Ret.) Robert Avsec served with the men and women of the Chesterfield County (VA) Fire and EMS Department for 26 years. He’s now using his acquired knowledge, skills, and experiences as a freelance writer for FireRescue1.com and as the “blogger in chief” for this blog. Chief Avsec makes his home in Cross Lanes, WV. Contact him via e-mail, [email protected].