State investment in cancer screenings spotlights firefighting’s high personal cost

Firefighters formed a solemn corridor along the streets outside St. Joseph Cathedral, dressed in crisp navy coats and standing at attention as the casket of retired Manchester Fire Chief Andre Parent was carried slowly into the church. 

The wail of bagpipes pierced the air. Bound by years of shared service and brotherhood, the firefighters raised their hands one by one in a final salute, paying tribute to a man they deeply respected and and whose dedication they would never forget.

Among them was Lieutenant T.J. Burkush, who worked alongside Parent for ten years and counts him as one of his first mentors.

“He was a man that everybody looked up to,” Burkush said. “He was the guy that would show up on the scene and everybody would know that it’s gonna be okay.”

Parent, 62, died on April 7 after a battle with stomach cancer, an occupational disease.

His death came just one day after the state launched a pilot program to screen firefighters for cancer and provide early treatment.

According to the Centers for Disease Control (CDC) and Prevention, firefighters face a significantly elevated risk of cancer due to repeated exposure to toxic chemicals, including benzene, “forever chemicals” and other carcinogens released when materials burn, as well as compounds found in firefighting foam.

While it’s often assumed firefighters are most vulnerable to lung cancer from inhaling smoke during fires, research reveals a more complex picture.

Firefighters face heightened risk for a range of cancers, including aggressive forms such as mesothelioma, a rare cancer affecting the lining of the lungs, abdomen or heart.  It is most commonly linked to asbestos exposure. A CDC study found that firefighters develop mesothelioma at roughly twice the rate of the general U.S. population.

They are also at increased risk for testicular cancer, with studies showing about an incidence twice as high as the general population.

Mark Wholey, director of the state’s fire academy, said New Hampshire’s $5 million investment in cancer screenings for firefighters is a step in the right direction.

“It is the number one cause of line-of-duty deaths in the profession,” he said. “ It was something for years that people just assumed was a high frequency of people that we work with who passed away.”

The first phase of the statewide pilot program includes 1,203 cancer screenings. 

Wholey said the slots filled within 48 hours of opening, which he called evidence of the “willingness and excitement” among the state’s firefighters to participate.

The two-year pilot screening program is only open to active firefighters and those participating in the New Hampshire retirement system. It is not open to volunteer firefighters.

After Parent’s cancer diagnosis, Burkush said the retired chief advocated for early cancer screenings, and there was also a stronger push for prevention within the department.

“It was instilling, especially in our younger members, our newer people, that there are ways to do what you can to lower your risk, but also just to maintain healthy lifestyles and to advocate for that care with your own primary care doctors,” Burkush said. “We can’t just focus on the cancer screenings that we get from the state, albeit fantastic. We want everyone, when they’re not in there for those cancer screenings, they’re still taking steps and advocating for it.”

Frontline exposure

Reducing firefighter deaths from cancer depends not only on early detection but also on everyday practices within the profession, since there is virtually no environment free from exposure to carcinogens.

Wholey said that many common materials, such as carpets, couches, televisions, curtains and automobile parts, contain plastics that become carcinogenic when burned.

“Every single one of those is the same threat to a firefighter,” said Wholey.

Since the link between firefighting and cancer was established in recent years, departments across the country have taken their own steps to limit toxic exposure.

Concord Fire Chief John Chisholm said his department explored the ‘clean cab’ model, in which contaminated turnout gear and breathing apparatus are kept outside the fire truck, rather than riding alongside firefighters. 

But that approach has created operational challenges, particularly around keeping air packs accessible.

He said the department had to move the air packs back inside the truck, but he hopes to find a workable solution soon.

Many newer firehouses minimize contamination by having separate washers and dryers dedicated solely to turnout gear, and a growing number of departments have replaced PFAS-laden firefighting gear with safer alternatives, despite the steep cost.

PFAS-free protective gear can cost around $5,000, compared to approximately $1,000 to $2,000 for standard gear.

Wholey acknowledged that supporting firefighters places a high financial burden on municipalities but said the investment helps improve their overall well-being.

“With the funding available, the possibilities to modernize and make advancements in our profession truly are endless,” he said.