As the nation’s fire service acknowledges the toll the disease is taking on its ranks, Boston emerges as a leader in establishing practices to protect firefighters against cancer
BY JESSE ROMAN
On a sunny New England afternoon last July, Boston firefighter Glenn Preston (pictured above) and his eight-year-old son, Jake, cracked jokes in the car on the way to Fenway Park for their annual father-son Red Sox game. As they pulled onto the highway, Preston’s phone started buzzing. The unfamiliar number on the caller ID made him brace for bad news.
Two days before, doctors at Dana Farber Medical Center in Boston had biopsied a grapefruit-sized growth in Preston’s chest. Not wanting to worry his family, he hadn’t told his wife or his four young children about the procedure. For weeks he had done his best to hide his shallow breathing and near constant exhaustion. He hadn’t mentioned the chest pains or how sometimes when he sneezed it felt like a harpoon had been shot through his chest, dropping him to his knees.
He answered his phone. The doctor on the line told Preston he had cancer, that it was advanced, and that he needed to come to the hospital immediately. “Good, good. OK, well, I’m on my way to Fenway now, so maybe we’ll catch up later,” he said, playing it so Jake would think he was talking to an old buddy. Although the doctor strongly advised against it, Preston kept the car pointed toward the stadium. He and Jake stayed for the entire game, and went out for pizza afterward.
A couple of days later, Preston checked himself into the hospital. Doctors told him he had advanced non-Hodgkin’s lymphoma, but he didn’t want to discuss his chances for survival; he didn’t want to know. As thoughts of his kids flashed through his mind, he was indignant but not surprised.
“Since 2000 I’ve been in a really busy company, going to fires and coming out of buildings covered in black, looking like crap,” Preston told me recently. “I thought I’d get cancer—that’s the job. I just didn’t think it would be now.”
With his diagnosis, Preston joins a growing list of sick Boston firefighters, poisoned over their careers by a toxic soup of carcinogenic chemicals absorbed through their lungs, eyes, nose, and skin. On average, a Boston firefighter is diagnosed with cancer every three weeks, according to the Boston Fire Department’s internal figures. Over the last few decades, the age of diagnosis has steadily dropped from the 60s to the 50s, and now, increasingly to the 40s. Preston was 39 when he was diagnosed.
This same reality is playing out in fire departments across the country. Firefighters are dying at alarming rates from an array of cancers, including colon, lung, melanoma, mesothelioma, prostate, rectal, stomach, non-Hodgkin’s lymphoma, and more, which have all been shown in studies to target firefighters in higher numbers than the rest of the population.
While it’s hard to pin down exact figures, the disease is taking a serious toll on the fire service. Sixty-one percent of firefighter line-of-duty deaths from 2002 to 2016 were cancer-related, according to the International Association of Firefighters (IAFF), which obtains its figures from local union reports. That amounts to 1,053 firefighters who have died over that span. Since there is no definitive registry, that figure is almost surely only a fraction of the total.
The lack of reliable data on firefighter cancer deaths illustrates just how overlooked the issue has been. For decades, cancer in the fire service has been discussed in murmurs and whispers, seen by many as the price for doing a dangerous but necessary job. But as the death toll rises and research reveals more about the extent of the problem and its causes, muted concern has given way to a full-scale awakening and mobilization.
“We have a full-court press going on, making sure we do what we can to protect our members—they aren’t always thinking about this, they’re just doing their jobs, but we need to make sure there is awareness and training,” said Pat Morrison, the assistant to the general president for health, safety, and medicine at the IAFF.
There is no more time to waste, Morrison said. “The reality is that cancer is now the leading cause of death for our members, and probably the most important issue we are working on today,” he said. “It’s an epidemic. The trend keeps climbing and climbing.”
Nowhere has the effort to combat cancer been more aggressive—and, in some ways, more unlikely—than in Boston, where the leader of the charge has been Fire Commissioner Joseph Finn.
Finn, a 56-year old mustached former Marine with steely blue eyes, is affable and at times chummy, with an accent and wit to match his working-class Boston upbringing. Though his personality can be disarming, it does little to mask a fiery determination simmering just below the surface, which suggests that Finn is not a man you’d want to disappoint. He has moved up through the ranks over 32 years with the department, becoming commissioner when Boston Mayor Marty Walsh was elected in 2014. Finn believes he has a moral obligation to stem the surge of cancer among his 1,500 firefighters, and since assuming the top job it’s been a full-on assault.
“Firefighting is a family sport, and everybody is tired of watching our family, the members of this department, get sick,” Finn told me in his office over a cup of coffee one snowy morning in early March. He counts nearly 200 friends and colleagues among the dead.
Aided by millions of dollars in financial backing from the city and dedicated labor support from union president Rich Paris, in just two years the Boston Fire Department has gone from barely recognizing cancer as a problem to being viewed as one of the most progressive national leaders in firefighter health and wellness. Finn is now in demand as a speaker at national fire service conferences, and in April he was named the Metropolitan Fire Chiefs Association’s Fire Chief of the Year for his part in transforming the Boston department’s health and safety culture. He is slated to deliver a talk on firefighter cancer on June 6 at the 2017 NFPA Conference & Expo in Boston, part of the event’s daylong First Responder Health Forum.
Under Finn, Boston’s approach to reducing cancer deaths has been multifaceted, but all means to the same end: limiting a firefighter’s exposure to cancer-causing chemicals. “We drill into every firefighter’s head, ‘take no smoke,’” Finn told me. “Think of smoke as being radioactive—every time you take it in needlessly you are shortening your life.”