Firefighter Cancer Prevention: The Decontamination Habits That Save Lives

We are losing more firefighters to cancer than we are losing to fire. That is not a metaphor. It is a statistical fact that should make every one of us rethink how we operate. The fire service has a cancer rate that is significantly higher than the general population, and certain cancers like testicular cancer, mesothelioma, and non-Hodgkin lymphoma are appearing at rates that are impossible to ignore.

For decades, dirty gear was a badge of honor. A salty, smoke-stained helmet and filthy turnout coat meant you had been in the fight. We wore that contamination proudly, never thinking about what was actually soaking into our skin. Soot is not just soot. It is a cocktail of carcinogens including benzene, formaldehyde, hydrogen cyanide, and dozens of other chemicals that are generated when modern furnishings, synthetic materials, and building components burn.

The IAFF has been leading the charge on firefighter cancer awareness and prevention through their dedicated cancer initiatives at iaff.org/cancer/. They have pushed for presumptive cancer legislation, funded research, and developed resources that every firefighter should know about. If your department has not engaged with these resources, push for it.

Here is what needs to change, starting today.

Gross Decon on Scene

The moment you exit the structure, before you take a knee, before you grab a water bottle, before you do anything else, you need to perform gross decontamination. That means using soap and water or at minimum clean water to wash your face, neck, jaw, and hands. These are the areas where your skin is most exposed and where carcinogens are most readily absorbed.

Your department should have a gross decon setup at every working fire. A bucket with soap and water, clean rags or baby wipes, and a brush for gear. This is not optional equipment. If your rig does not carry a decon kit, build one. A five gallon bucket, dish soap, a scrub brush, and a pack of wipes costs less than twenty dollars and could literally save your life.

Remove Contaminated Gear as Soon as Possible

After a working fire, your turnout gear is contaminated. Get out of it as soon as practical. Do not ride back to the station in full gear. Do not wear your gear into the living quarters. Do not drape your contaminated coat over a chair in the kitchen. Every minute that contaminated gear is in contact with your skin or in an enclosed space with you, you are increasing your exposure.

The best practice is to bag your gear at the scene or immediately upon return to quarters and get it into the extractor as soon as possible. If your department does not have an extractor, push for one. If budget is the excuse, remind the decision makers that a commercial turnout gear extractor costs a fraction of what a cancer diagnosis costs, both financially and in human terms.

Second Set of Gear

Ideally, every firefighter should have two sets of turnout gear so that one can be cleaned while the other is available for service. I know that is a budget conversation many departments are not willing to have, but it is the standard that NFPA recommends and that many progressive departments have adopted. If you only have one set of gear, you are either responding to calls in contaminated gear or you are out of service while your gear is being cleaned. Neither option is acceptable.

Shower Within the First Hour

After every working fire, shower as soon as you get back to quarters. Not later that evening. Not after dinner. Immediately. Carcinogens that land on your skin begin to absorb quickly, and the sooner you wash them off, the lower your exposure. Use soap and water, scrub thoroughly, and pay particular attention to your neck, ears, groin, and underarms. These areas have thin skin and high blood flow, which means faster absorption.

Some departments have installed decon showers at the station specifically for post-fire cleanup. If yours has not, take a regular shower as soon as you can. The goal is to get contaminants off your skin within 60 minutes of exposure.

Keep Gear Out of Living Spaces

Your turnout gear should never be stored in sleeping quarters, kitchens, or common areas. Off-gassing from contaminated gear releases carcinogens into the air that everyone in the station breathes. Gear should be stored in a separate, ventilated room. Many newer stations are being designed with dedicated gear rooms that have exhaust ventilation. If your station does not have this setup, at minimum keep gear in the apparatus bay or a separate room away from living spaces.

The same goes for your personal vehicle. Do not throw contaminated gear in the back seat of your truck and drive home. You are contaminating your vehicle, and anyone who rides in it is being exposed.

Hood Exchange Programs

Your particulate blocking hood is one of the most important pieces of cancer prevention equipment you own. Modern hoods are designed to block carcinogenic particles from reaching the skin on your neck, ears, and face. If your department is still using older style hoods without particulate blocking technology, advocate for an upgrade. The cost per hood is relatively small, and the protection is significant.

After every fire, your hood should be washed or exchanged for a clean one before the next exposure. Some departments have implemented hood exchange programs where a clean hood is always available, and used hoods go into a washing rotation.

SCBA Discipline

Wear your SCBA during overhaul. I know this sounds obvious, but walk around any fireground after the fire is knocked down and watch how many firefighters pull their masks off during overhaul because conditions "look clear." The most concentrated carcinogenic exposure often happens during overhaul, when smoldering materials are being pulled apart and disturbed, releasing gases and particles directly into your breathing zone.

Wear your pack until the environment is confirmed safe through air monitoring, not through visual assessment. If your department does not own air monitoring equipment, that is another conversation worth having. But in the meantime, keep your mask on.

Diesel Exhaust in the Station

Apparatus exhaust is a known carcinogen. Every time an engine or truck starts up in the bay, diesel exhaust fills the space. If your station does not have a direct-capture exhaust system that connects to the tailpipe and vents the exhaust outside, you are breathing carcinogens every time a rig moves. Push for exhaust capture systems. They are not cheap, but they are effective and they protect every person in the station.

Until your station gets one, open the bay doors before starting apparatus and clear the bay quickly. Do not let rigs idle in an enclosed space.

Annual Cancer Screenings

Early detection saves lives. Firefighters should be getting annual physicals that include cancer screening appropriate for their age and exposure history. Blood work, urinalysis, chest imaging, and dermatological examinations should be baseline. Some departments have partnered with occupational health providers to offer enhanced screening programs that look specifically for the cancers most common in firefighters.

If your department does not offer annual screenings, seek them out on your own. Many cancer organizations offer free or reduced cost screening events. Know your risk factors and be proactive about monitoring your health. Do not wait for symptoms. By the time many cancers produce symptoms, they are already advanced.

Document Your Exposures

Keep a personal record of every significant fire you work, including the address, the type of occupancy, the materials involved, and the level of exposure. This documentation becomes critical if you are ever diagnosed with an occupational cancer and need to file a claim. Many states now have presumptive cancer laws for firefighters, but you still need to demonstrate a history of exposure. A personal exposure log, maintained consistently over your career, is powerful evidence.

The culture is changing, but not fast enough. Every firefighter who continues to treat dirty gear as a badge of honor, who skips decon, who removes their mask during overhaul, or who ignores the science behind occupational cancer is taking a gamble with their life. The evidence is overwhelming. The solutions are available. The only thing missing is the discipline to do it every single time.

StruckBox is committed to building a fire service that protects its own. Our training platform includes health and safety content alongside tactical skills because being a great firefighter means being alive to do the job. Learn more at struckbox.com.