Cancer Risk Reduction: Awareness is Not Literacy

January is Firefighter Cancer Awareness Month. In the spirit of this effort to continue raising, not only awareness, but literacy regarding those behaviors that firefighters must "make their own," I offer this article.

All emergency responses by firefighters have at least one thing in common: The unknowns.

Firefighters pride themselves on having an ingrained knowledge about many distinct aspects of the job. Most fire departments these days provide emergency responses for not just fires, but also medical emergencies, hazardous materials releases and spills, and situations where injured victims are trapped or entangled. Successful firefighters are truly “jacks of all trades, and master of one or two.”

This required firefighters to be knowledgeable about a vast array of things. Consider a response to a structure fire where a carpenter’s knowledge of building construction is invaluable because the more they know about how a structure was built, the better they can understand how it will react to a fire within it.

Of equal importance, however, is the scientific knowledge of how heated air and the gases produced by a fire travel within a structure.?It’s crucial to have both an understanding of a concept and the ability to apply it in each situation.

During an emergency response, where information must be gathered, analyzed, and processed into action—with usually only a few minutes to work with—that ability is crucial to making good decisions and taking the appropriate actions.

When fire departments began adding service deliveries like water rescues, firefighters had to acquire new knowledge and skills and the ability to apply both appropriately in a situation. Just having the knowledge or awareness was not sufficient.

When a firefighter learns how to fulfill a job responsibility, they are trained to standards established by the National Fire Protection Association (NFPA). Those training standards include three elements for each skill:

When a firefighter undergoes the written and practical examination to obtain their NFPA certification, they must demonstrate the knowledge, skill, and ability to apply both. Here’s an example JPR, Requisite Knowledge, and Requisite Skills, and Evaluation criteria for a task, overhaul of a fire scene, for which a firefighter must demonstrate their competency as part of earning their NFPA Firefighter I certification.

Nick Halmasy is a registered psychotherapist who previously served as a firefighter/ fire instructor who, in a recently published article, wrote:

When I was completing a HAZMAT awareness course, we had a tech level instructor who would give us a little extra during our training, which was a welcome, interesting change.

Here was a question he posed, “You are responding to a multi-vehicle MVC on the 401. You’re informed that a transport carrying an unknown liquid is on its side with a potential leak, placard reading 2789. What is it and how do you respond?”

As an eager student, I was already rifling through the CANUTEC (Canadian?Transport Emergency Centre)?handbook to find the relevant knowledge.

It turned out to be acetic acid. Scary stuff. So, I continued with naming all the relevant PPE required and potential procedures. This was – I thought, a successful answer to the question. But here was where my awareness ended, and I needed some more “literacy” in understanding chemicals.

In case you were like me, here is what acetic acid is: vinegar. That’s right, our instructor continued, while massive quantities could be dangerous and bad if you are swimming in it – a spill of this stuff would more likely require French fries than a Level A hazmat suit (the highest level of PPE for a hazardous materials response.

I was floored. But that’s what being a good firefighter is all about isn’t it? The difference between being aware and being literate in what we are doing.

Awareness is?knowing?rudimentary knowledge about something – like roughly knowing the difference between an A –frame or a balloon frame building construction. Literacy comes with understanding the real differences and understanding how an attack on such structures will change.

Nick said he always remembered that interaction as one that solidified his desire to earn Hazmat Technician level certification, though he never quite got there.

Awareness is Not Enough When It Comes to Firefighter Cancer Risk Reduction

Though Nick's article looked at this relationship between awareness and literacy in the context of firefighter mental health issues, I believe we--the fire service--have begun to be satisfied with an awareness level of the cancer risk when it comes to our firefighters. Awareness is good, but what is it that we are aware of exactly?

Read Next: Reducing firefighter cancer risk: How emotionally attached are you?

Would it not be a better alternative to have firefighters who possess cancer risk reduction literacy so that they not only know what the cancer risks are (awareness), but truly embrace the work behaviors necessary to reduce that risk?

What do I mean here? Well as any firefighter or fire official who has undergone the certification process, we understand that we are tested on fundamental understandings.

Here’s Nick again with some thoughts that should resonate with firefighters and officers.

When I was a fire instructor, the topic Ladders had twenty-one sign offs, that is, twenty-one required competencies that a candidate for certification had to demonstrate in front of a proctor who would then sign off that the process was completed. This supports and establishes ladders as a serious tool and component to the firefighting service.

To my understanding, there is not a single sign off required for firefighter cancer risk reduction understanding (literacy). This establishes the topic as an unimportant, insignificant component to the firefighter’s wellbeing and career success.

Instead, it might be beneficial to establish some recognized approach that allows?all?firefighters to undergo a certain level of literacy when it comes to cancer risk reduction.?Most importantly it establishes a baseline that firefighter cancer risk reduction is at least as important as ladders.

Taking firefighter cancer risk reduction seriously means approaching it seriously. And building a system where interested firefighters can hone that skill set is a way that the fire service can address a major potential danger to the job.

We have distinct levels of training and skill sets for every other aspect of a firefighter’s job. We have NFPA standards for operational requirements for firefighters and officers. Why should we not have similar levels that identify a firefighter’s cancer risk reduction literacy?

That would provide a feasible arena for firefighting to approach cancer risk reduction more seriously, an illness that's killing too many firefighters or forcing them off the job unwillingly.

I offer the following “snapshot” of what firefighters should know about to gain that cancer risk reduction literacy:

• How to set up and operate an Initial Contaminant Reduction Area.
• How to set up and operate a PPE doffing and equipment drop area.
• How to properly move from working in the hazard area to the on-site firefighter rehabilitation area.
• How to properly package contaminated PPE and equipment for return to the fire station.
• How to thoroughly clean and decontaminate PPE and equipment so it can be returned to service.

That's just the "short list," and I trust you get the gist of what I'm proposing. So, how is your fire department approaching the development of firefighter cancer risk reduction literacy?

Read More: Transforming our attitudes about occupational cancer risk reduction

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