Cancer Prevention with the Boston Fire Department

Emily SparerResearch spotlight with SBS Postdoc and Cancer Prevention Fellow, Emily Sparer.

How did you get involved in firefighter research?

The collaboration with the Boston Fire Department (BFD) started in 2015, when the BFD reached out to my mentor, Dr. Glorian Sorensen, expressing concern about cancer.  They were worried that firefighters in Boston were being diagnosed with cancer at alarmingly high rates and at ages much too young.  They knew something had to be done and wanted to collaborate with researchers to investigate.  I had just started working with Dr. Sorensen as a post-doc, and this project built off of my interests and expertise in the ways in which environmental, behavioral, and organizational factors interact in the workplace to impact health outcomes.  It was a great opportunity to lead a project that involved working closely with a community partner, learning about a new industry and complex mixture of exposures, and (hopefully) improves the health and safety of firefighters.

Why did you specifically choose the fire station to conduct an exposure assessment as opposed to in the field?

I started the project by first talking to members of the BFD and the Firefighters Local 718 Union to understand more about their concerns and questions.  I also went to the scientific literature to find out what others had found on the link between firefighters and cancer.  What I found was that most of the epidemiologic literature exploring the exposure/outcome relationship among firefighter and cancer has focused on short-term, high-intensity exposures encountered while fighting fires.  Little information exists on the potential contribution to firefighter cancer risk of chronic low-level exposures, such as what firefighters experience during time spent at the fire station (including poor air quality and off-gassing of contaminants from fire-exposed gear).  Previous studies have also not accounted for other factors that may influence cancer risk such as exposure from second jobs or the contribution of behavioral factors such as diet, exercise, and sleep.  For firefighters, the fire station is a second home.  Not only do they work there, but they sleep, eat, exercise, and experience long periods of down time in the stations.  They may even spend the majority of their 24-hour shift at the station itself.  As researchers trying to understand the elevated cancer rates seen in firefighters, we need to learn more about the role of the fire station.

How can organizational policies and practices influence the environment of the firehouse and in turn the outcomes of cancer prevalence among firefighters?

An organization’s policies not only indicate how actions related to health and safety may be carried out, but they can also say a lot about the organizations priorities (how important health and safety are relative to other factors).  Organizational practices may be quite similar to the policies – but this is not always the case.  Practices are known as “how it’s done around here”.  That is, just because an organization has a written policy about something doesn’t mean it is carried out in practice.

As part of our work investigating how activities at the fire station may influence cancer risk and identifying possible interventions, it is crucial to examine the BFD’s organizational policies and practices at the fire station.  For example, diesel exhaust from idling trucks in the fire stations may contribute to poor air quality in the stations, and in turn, impact firefighter health and cancer risk. By understanding both the organizational policies and practices related to ventilation, we can learn about the working conditions at the fire station and the variability that may exist between stations, as well as help to identify potential intervention targets for the future.  Another example relates to the potential off-gassing of chemicals from bunker gear (the clothes firefighters wear) after fires. The policies and practices that relate to how and when the gear is cleaned, as well as where it is stored, and can help us learn about potential adverse exposures firefighters encounter and where we may be able to make effective and sustainable change.

-Interview by Whitney Waddell

 Read more about Emily Sparer’s work here: