Too Young to Be Diagnosed
Too Young to be Diagnosed: Aaron Booker Firefighter Cancer Screening Act highlights prevalence of early cancer
in firefighters
As published in Wyoming Medicine Fall 2024 - by Elizabeth Sampson
Click here to view the article PDF.
As a young fireman, Kevin Reddy was supposed to receive a prostate cancer screening as part of an annual physical, but his screening doctor refused, saying there was no reason to examine anyone under the age of 35 for prostate cancer.
Luckily, Reddy did not have cancer, but he now knows firefighters face constant exposure to chemicals that lead to cancer diagnoses earlier than the rest of the population. Working to make sure no other firefighter is refused a cancer screening, Reddy, who is president of Federated Firefighters of Wyoming and a Cheyenne firefighting veteran with more than 20 years of experience, testified before the Wyoming Legislature on behalf of the Aaron Booker Firefighter Cancer Screening Act.
The act, which was sponsored by Rep. Landon Brown, R-Cheyenne, ensures no other firefighter misses out on what could potentially be a lifesaving cancer screening. After going into effect July 1, any employed or volunteer firefighter in Wyoming with at least 10 years of experience can have cancer screening tests covered by the state’s workers’ compensation fund. Firefighters are eligible for the screenings 10 full years after retirement as well.
“The medical providers who deal with these patients can rest assured that their bills are going to get paid, especially if they have any indication that there may be some level of cancer anywhere in these individuals’ bodies,” Brown said. “The state of Wyoming has billions of dollars in our state workers’ comp account, and that is where the claims will be paid from. That was a big portion of why I developed this law the way I did – to ensure that the bills will be paid. There is zero concern about that. We want these providers to know they have every tool and every resource available to them to save these people’s lives earlier and earlier and reduce the cost of expensive treatment for late diagnoses and late treatment plans.”
Brown also wanted to make sure doctors and their patients are not hindered by yearly testing time limitations, meaning if a test is medically indicated, it will be covered by workers’ compensation. He said that was important to include in the act because of the experience his friend Aaron Booker went through.
Booker was a Cheyenne firefighter who died from job- related colon cancer at the age of 47 in 2023. Brown met him at church on the day Booker had been diagnosed with stage IV colon cancer.
Brown noted his friend had a colonoscopy early in the year where polyps were removed, but when symptoms continued he had to fight against the notion that a young man is not a likely candidate for colon cancer – and thereby did not qualify for a second colonoscopy in a single calendar year. When he did finally get a second colonoscopy, his doctors found another polyp and realized his cancer had spread.
“He had gone through the rigmarole of being too young to be diagnosed in most medicinal processes with colon cancer,” Brown said. “Once they found that polyp and realized his cancer had spread, it was already too late.”
During one of Booker’s last days, Brown was sitting with him out on his porch.
“He told me, ‘Do me a favor, and make sure that this never happens to anyone else,” Brown said.
That's when Brown got to work pushing for legislation that would help protect the firefighters who protect others. In 2017, former governor Matt Mead signed into law the presumptive disability for firefighters bill. The bill guaranteed that if a firefighter gets one of a specific list of diseases or conditions, it is presumed it was caused by his work. Brown expanded on that language to ensure these conditions can be caught early and treated effectively, thereby saving money and lives and making sure firefighters can return to the workforce.
He said the legislation received incredible support in both houses of the legislature. It passed out of the house with a 62-0 vote in favor of the bill and passed through the senate with 28 ayes, 2 excused and only one nay.
“It was the most amazing thing I’ve ever experienced,” Brown said. “For me being as polarizing of a figure as I have been in the legislature, I’ve never had a bill pass out of the house with a 60-plus vote majority.”
Firefighters face cancer earlier and more frequently than the general population
According to Reddy, cancer is the leading cause of line-of- duty death across the world for firefighters. Colon, bladder, testicular, ovarian and various skin cancers are common in firefighters, as are brain, lung, throat and esophageal cancer.
"The list is quite extensive—it’s pretty wide open,” Reddy said. “Just the occupation of firefighters is considered a class 1 carcinogen,” Reddy said. Today’s firefighters are exposed to many more petroleum-based chemicals than previous generations face. While in the past building and furnishings were made mostly of natural materials like wood, cotton and wool, now many items are made with synthetic materials and then are laced with flame retardant chemicals which become highly toxic once they eventually start to burn.
“Everything you can imagine is filled with petroleum- based chemicals, and to keep the volatility of these petroleum products from starting on fire, they lace them with more chemicals in the flame retardants,” Reddy said. “All of these combined, once they start on fire, form this toxic soup that firefighters are exposed to when they go into these superheated
environments.”
The extreme heat makes their pores open up trying to cool them down, which makes the firefighters even more susceptible to absorbing the chemicals into their bodies. Even their protective gear absorbs the toxic chemicals during a fire and may continue to off-gas chemicals for several days after a fire, Reddy indicated.
Paul Juergens, Wyoming state director of the Firefighter Cancer Support Network, said that in the last year, he has heard of three Wyoming firefighters who died from cancer. He said firefighters are nine percent more likely than the general population to get cancer, and have a 14 percent higher mortality rate. Additionally, they are 129 percent more likely than the average person to get mesothelioma, 102 percent more likely to get testicular cancer and 62 percent higher than average to get esophageal cancer. He said a recent study of women firefighters in San Fransisco – a department with the nation’s highest percentage of women on their force – showed they had a breast cancer rate six times higher than the national average.
Juergens said while the pool of women studied was a small sample of 300, it’s still a frightening statistic.
He knows doctors probably don’t see firefighters every day in their practice, and they often come in appearing to be healthy and fit. But that can be deceptive.
“It’s easy to say, ‘I see him running down at the park or at the gym working out, so he’s healthy,’” Juergens said. “But that same person has a high risk of cancer. Almost be a hypochondriac in a way. If they have something weird, dig a little deeper.” Knowing that the Aaron Booker Firefighter Cancer Screening Act covers the cost of any testing, Juergens hopes doctors lean in to additional testing if something seems off.
While fire departments are now encouraging their employees to quickly shower off when they return from a fire, and then making an effort to wash down their gear and their trucks as well, they are still facing health threats each time they go to work. Juergens explained that beyond the carcinogens they face from smoke and burning chemicals, they face additional risk that means their cancer risk goes up.
“Firefighters don’t get good sleep – we don’t get that REM sleep so we don’t get a chance for our body to boost our immune system, and the stress that comes with our job,” Juergens said. “These three factors compound and give firefighters a greater cancer risk.”
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