By Rose Hoban

Hundreds of years ago, doctors noticed that young men working as chimney sweeps were prone to developing cancerous lesions on their genitalia. The “chimney sweeps carcinoma” or “soot warts” were the earliest known examples of an occupation-related illness.

Modern firefighters continue to struggle with health consequences caused by the products of combustion, as evidence grows that firefighters are prone to higher rates of many forms of cancer. Last year, President Donald Trump signed legislation setting up a system to track the cancers diagnosed in firefighters after the National Institute of Occupational Safety and Health completed studies finding that firefighters had higher rates of nine types of cancers.

For Joy Ponder, however, the issue of cancer in firefighters is personal. A career firefighter for 21 years, she spoke to legislators Tuesday morning to describe her own experience.

woman in a formal firefighter's uniform stands at a podium
Firefighter Joy Ponder told lawmakers Tuesday of her and her co-worker’s fights with cancer. Photo credit: Rose Hoban

“In 2017, I was diagnosed with cancer, I immediately had surgery to have tumors and lymph nodes that the cancer affected removed,” she told the House Health Committee, which was discussing a bill to have firefighters covered by workers’ compensation if they are diagnosed with one of the suspect diseases.

“There was a suspicion of occupational risk and exposure immediately,” Ponder said of her cancer, which also required radiation and chemotherapy that year.

Soon after, one of her colleagues, a friend, also was diagnosed with Stage IV cancer.

“We searched the nation for possible treatments, but it was too little too late,” she said. “I stayed with her for her last days and nights in the hospital. We tried to figure out why this was happening to firefighters everywhere across the nation and across North Carolina.”

Ponder asked her friend what she could do to help.

“Go out and talk to the people who can change this. Go out and explain to them why this is happening,” her friend instructed her.

Toxic atmospheres

The Firefighters Fighting Cancer Act would create a presumption that if a firefighter who’s been serving for more than five years in a local department is diagnosed with one of the nine cancers, then the care and treatment for that cancer would be covered by workers’ compensation.

Cancers covered by HB 520: esophageal, intestinal, rectal, testicular, brain, Non-Hodgkin lymphoma, multiple myeloma, Mesothelioma, oral cavity
One suspected cause of the cancers is exposure to toxic substances that get onto a firefighter’s skin as he or she is exposed to fumes.

“I think there is a known increase in the toxic atmospheres due to a lot of these hydrocarbon-based plastics and chemicals and fire retardant treatments, on a lot of these fabrics, versus days past where there was wood, and cotton, and wool,” said Durham firefighter Mark Urbano, who came to the legislature with a group of his co-workers. “Everything’s treated chemically, fortunately, to reduce the chance of fire spread but is giving off toxic atmospheres that is collecting on our gear and on our skin.”

Urbano said that reality has forced some behavior change among his peers. Now, firefighters either buy or are issued a second set of gear, so that they can get accumulated chemical salts cleaned off of the materials more frequently.

“Any little step we can take, especially if it’s a no-cost thing for us,” he said.

That can take the form of showering first when returning to the fire station, before cleaning up the firetrucks. “Because sometimes we get the truck ready to go back into service and you can end up running multiple more calls before you’re able to decontaminate yourself,” he said.

Rough path forward

But there are opponents to the bill.

Sarah Collins, the legislative counsel for the North Carolina League of Municipalities, got up at Tuesday’s committee hearing and appeared self-conscious to be opposing a bill that had such emotional weight.

NC Board of Nursing licenses more than !57,000 nurses each year.

“We’ve have heard that there have been a lot of solutions for this in other states, that look at this outside the workers’ compensation,” Collins said.  “We think finding a solution that makes the most sense for these occupational diseases would be best.”

She explained that making an exception for only one class of workers might fall afoul of the North Carolina constitution’s emoluments provisions.

In addition, in prior years, similar bills have had difficulty passing the Senate side of the legislature, which has historically not been kind to laws that might cause insurance rates to climb.

But bill sponsor Rep. Jason Saine (R-Lincolnton) said he believed those prior bills have laid the groundwork for a more receptive audience in the Senate this year.

“I think there’s been a pretty steady campaign to make sure that all members of the Senate understand these issues and that it’s important to their constituents, to the men and women who work in the fire service,” he said. “So I think they will be receptive.”

“Despite every effort and every technological step forward, firefighters still are exposed through the normal course of their duties to things that can and often do kill them,” said bill sponsor Rep. David Lewis (R-Dunn). “No other profession is expected to brave alone, to brave that without the support of their employers.

“That’s what workers’ compensation is for if you’re hurt at work, if you get sick at work, then your work helps restore your health.”

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Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...