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Firefighters are more likely to die of cancer than accidents or flames, but for the past 10 years, the nationally recognized Sylvester Firefighter Cancer Initiative (FCI) at Sylvester Comprehensive Cancer Center, part of UHealth – the University of Miami Health System, has been working to cut that risk.
“Firefighters risk their lives every day to protect our communities, and we are deeply grateful for their courage and service. Our commitment at Sylvester is to advance research and education that can help protect these everyday heroes from the health risks they face,” said Stephen D. Nimer, M.D., Sylvester director.
The ambitious effort to harness science to protect firefighters from cancer has resulted in changes to policy and practices that reduce cancer risk, and FCI is now recognized as a national model, collaborating with fire departments in virtually every county in the state of Florida.
Miami-Dade firefighter Claudine Buzzo has been diagnosed with cancer three times during her 23-year career. In August 2024 the 53-year-old was diagnosed with two types of breast cancer. While she was being treated for intraductal carcinoma, a secondary tumor was found and removed during surgery.
Susan Kesmodel, M.D., a breast surgical oncologist at Sylvester who conducted Buzzo’s lumpectomy, says studies show firefighters face a higher risk of developing cancer.
Introducing innovative programs designed to reduce risks to first responders, help them better understand their risks, and take protective measures to mitigate them continues to be the focus of the FCI.
“They implemented the green buckets,” said Buzzo. “After a fire, we’re going to take the bucket, fill it up with the solution, and we’re going to scrub our gear down to get all of those toxins off of our gear. The department also implemented the shower within the hour. They also implemented the wipes that they gave us. We’re wiping our necks down. We’re wiping, if we can’t run to get to the shower, at least we’re getting that off of us as quickly as we can.”
Eric Johnson’s story took a different tack. As president of his station, he worked passionately with the FCI to ensure passage of the Florida presumptive cancer bill, which smooths workplace-injury protocols and provides critical, up-front financial support for firefighters facing cancer-related copays and deductibles. He never thought it would apply to himself until he was diagnosed with metastatic colorectal cancer. After years of difficult treatment, Sylvester physicians told him last year that he was in remission.
Buzzo and Johnson are not isolated cases. Firefighters have a higher rate of cancer than the general population. They face a 9% increase in cancer diagnoses and 14% increase in cancer-related deaths compared to the general U.S. population, according to a study by the National Institute for Occupational Safety and Health.
And researchers are beginning to grapple with health and safety threats to women who increasingly fill the ranks of the 1.2 million U.S. firefighters, according to the Federal Emergency Management Agency. In fact, the International Agency for Research on Cancer classifies the occupation itself as a cancer risk, like smoking or diesel exhaust or many radioactive materials.
According to Nimer, programs like the FCI are crucial to cancer-risk-reduction efforts and need to be bolstered with additional outreach services to ensure firefighters’ long-term health and well-being, especially as wildfires become increasingly common.
FCI Infographic - FINALLaunched in 2015, FCI is made up of a team of dozens of researchers, fire departments, government agencies and healthcare professionals who collaborate to reduce exposure to contaminants and develop safety regimens for firefighters. Through these collaborations, the FCI has successfully instituted many new best practices that are currently being implemented. These include:
- Wash downs for firefighters after incidents
- Firehouse health inspections
- Efforts to secure workers compensation benefits for Florida firefighters diagnosed with certain types of cancer
“Our pledge is to protect those who protect us,” said Alberto Caban-Martinez, Ph.D., D.O., M.P.H., deputy director and investigator at FCI. “Through groundbreaking research and life-saving education, we’re giving firefighters the tools to fight cancer as fiercely as they battle fires, because their health is our greatest victory.”
Since 2015 when the FCI was launched, it has advanced a full spectrum of innovative technologies and programs. These include:
- Silicone-based wristbands and body sensors to monitor exposure to hazardous substances
- Distribution of thousands of decontamination kits to provide protection to nearly every fire department in Florida
- Mobile clinics to bring cancer screenings and health assessments directly to fire departments
- Annual firefighter cancer surveys and ongoing evaluations of sleep, nutrition and lifestyle to ensure a holistic understanding of risk factors
- Environmental testing and firefighter gear sampling to identify hazardous materials at fire sites and stations, reinforcing safety measures
Many of the measures were developed through the collaboration of scientists and firefighters.
“There’s a recognition at Sylvester that we have the scientific and clinical expertise, and firefighters have the day-to-day occupational expertise. If we want to ask the right questions and get the best answers, we need to incorporate their perspectives and insights into what we do. That partnership is saving lives, and it will continue to save lives,” said Erin Kobetz, Ph.D., M.P.H., FCI director and principal investigator.
FCI - fact sheet - FINALState funding is key
At its genesis, Sylvester teamed with Jeanette Nunez, then a new member of the Florida House of Representatives and now Florida’s lieutenant governor, to obtain foundational state funding for what would become the FCI. Ten years on, the state of Florida funding remains a vital source of support.
“FCI has developed an amazing reputation for the quality of their research and support efforts,” said JoAnne Rice, director of the Florida Division of State Fire Marshal, the state’s highest-ranking firefighter. “We are pleased to partner with them to increase awareness, reduce risk and promote longevity in the brave men and women who keep us safe from fires.”
In coming weeks, multiple events are on tap in Florida to raise awareness of firefighter health and continue to find solutions. For example, hundreds of experts from across the globe will convene Feb. 20 and 21 at the University of Miami for the 2025 International Fire Service Cancer Symposium. After, the FCI team will kick off its 10-year anniversary celebrations by recognizing the many people who have helped make an impact throughout the years, driving a wrapped state firetruck from Miami to Tallahassee.
But the people who have the greatest impact are the firefighters whose lives have been saved or improved – largely through the efforts of the FCI – and Buzzo now encourages her fellow firefighters to be aware of their increased cancer risk and to access the FCI programs.
“We always tell them, ‘Hey, Sylvester has this program.’ The fact that they go around every single day to different departments and they put on these trainings, and they put out all this information is completely crucial for every firefighter,” Buzzo said.
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