Riva Duncan was overjoyed when Congress in 2022 approved better support for federal wildland firefighters during their cancer battles. As a retired fire officer of the US Forest Service (USFS), Duncan had spent years fighting for the friends and colleagues who disproportionately fell ill.
The 2022 law gave firefighters so-called “presumptive cancer coverage” – meaning they were eligible for workers compensation and the process to receive federal financial support for disability and death was streamlined. Finally, she thought, firefighters wouldn’t have to prove cancer and other illnesses, including lung and heart diseases, had derived from their hazardous and carcinogenic work to receive needed funds.
But then, she looked closer.
Missing from the list of cancers that would be covered were many that disproportionately affect women. While a range of cancers, including testicular and prostate cancers were included, breast, ovarian, cervical and uterine cancers still carried the burden of proof.
“It just felt like a slap in the face,” she said. “Why do we still have to remind people that women fight fire?”
Duncan now serves as the vice-president for the advocacy organization Grassroots Wildland Firefighters, which has made the issue a top priority. Joining 16 other organizations, including the National Federation of Federal employees, the National Fallen Firefighters Foundation and the International Association of Wildland Fire, the group has called on Julie Su, the Department of Labor secretary, to add those cancers to the list by 15 December, before a new administration takes office.
According to data provided by Grassroots, roughly 16% of the federal firefighting force is female, and federal agencies are working hard to recruit more women into the service. Meanwhile, the already high-risk work is becoming more hazardous.
As the climate crisis fuels more fast-moving, catastrophic blazes and development leaves more homes and communities in their paths, the smoke firefighters breathe and the soot that covers their clothes and gear carries dangerous toxins.
Firefighters have long known that they are at risk; high exposure to smoke, chemicals, exhaust and ash is part of the job. For those battling flames in remote or mountainous terrain, opportunities to wash contaminants off their clothes and skin or take breaks from the conditions to recuperate are scarce. These firefighters are often on the fire line for weeks at a time, even sleeping outside in the smoke.
They have seen for themselves when the risks turn into reality. The firefighting community is small but most know folks in the field who have gotten rare or early-age diagnoses. Last year, roughly 72% of line-of-duty deaths in the firefighting service were due to occupational cancers, according to The Firefighter Cancer Support Network, an organization that helps emergency responders and their families.
Still, the science has lagged.
“Few statistics are available specifically for wildland firefighters,” according to a page about reducing cancer exposure posted online by the Forest Service, the agency that employs the largest number of federal firefighters.
Without studies directly showing the occupational hazards wildland firefighters face, policy has lagged too.
It took years of advocacy and several failed legislative attempts before the 2022 bill passed, instructing the Department of Labor to streamline claims for federal firefighters battling “occupational diseases”, including cancer, lung disease and heart disease.
The list of covered cancers would include: esophageal, colorectal, prostate, testicular, kidney, bladder, brain, lung, buccal cavity/pharynx, larynx, thyroid, multiple myeloma, non-Hodgkin’s lymphoma, leukemia, mesothelioma, or melanoma.
“It was almost disbelief,” federal firefighter Pete Dutchick said about the joy of learning that the bill had passed. As part of the advocacy team working on the issue for Grassroots Wildland Firefighters, he said the move was a century in the making, marking the first time the risks were officially acknowledged. “We were extremely pleased and we still are,” he added, but with female-specific cancers left off the list, there was more work left to do, he said.
“It is a matter of ethically doing what’s right. It is a matter of equity, he said. “We made a promise that we would continue to fight for these things,” he added, noting that a win at the federal level could pave the way for better coverage in state and local levels.
Those with non-qualifying cancers have been instructed to file claims, a process Dutchick said adds an exhausting layer of bureaucracy “that might not go your way” for those already fighting for their lives.
The Department of Labor, meanwhile, is intent on waiting for the data.
“Presently, there are no new published papers to support the presumption that fire protection and suppression activities cause an increased risk of female reproductive cancers,” Nancy Griswold, an official at the Department of Labor said in an emailed response, adding that the office of workers compensation programs will continue to review scientific evidence to determine if additional conditions, including female reproductive cancers, qualify.
“We know that in general health women have not been studied like men have been,” Duncan said. “But we have been connecting those dots for a long time. We have seen our young friends get cancers that are supposedly rare – and then you know four people who get it.”
Beyond the obvious added burden put on firefighters who get female reproductive cancers in the line of duty, Duncan said this only creates more divisions and hurdles for women in the field who already face many. “Women shouldn’t have to fight for the recognition and the same equal coverage as men.”
Kaleena Lynde was a 22-year-old member of a hotshot crew – an elite force of specialized wildland firefighters that are tasked with some of the most difficult and physically demanding work – when her life was turned upside down by cancer.
Despite being young, fit and healthy with no familial or genetic ties to her condition, doctors found a 5.4lb tumor and she was diagnosed with stage III ovarian cancer that had spread into her lymph system.
“It is a very rare type of cancer but even more rare to be in somebody not in menopause,” she said. Another officer out of the same station would succumb to his cancer, a similar type to hers that sprouted in a different part of his body. Two other firefighting friends would be diagnosed with thyroid cancer. “I always see GoFundMe’s pop up for firefighters,” she added.
Her recovery would take years but she worked hard to return to the job. Lynde has now devoted 21 years to the profession and hopes her experience will help others dedicated to fighting fire despite the challenges.
The agencies have come a long way in support of female firefighters and she hopes they will heed this call. When she started there weren’t even firefighting clothes for women.
“The crotch went down to our knees because we aren’t built the same way,” she said, adding that many took to the sewing machine to ensure their nomex pants and jackets fit correctly. “Unless there is a woman in the process or on the panel, they just don’t think about women being part of it,” she said.
But flexibility and support will be essential to ensure firefighters are able to do this dangerous work into the future. Advocates say offering equal coverage is an important first step.
“With the environment we are in when we are fighting fire,” she said, “the smoke we live in, the burning chemicals we inhale, the strain we are putting on our bodies and the adrenal fatigue of being in a constant state of fight or flight – we are probably going to learn in the future that there are a lot more ailments linked to the job we do.”
