Two years and $100,000 later, no one can say for sure how widespread cancer is among Arizona's firefighters. And, just as important, no one knows whether firefighters contract cancer on the job. The mystery seems so difficult to solve that even the firefighters who pushed for the study aren't angered at the slow going.
The usually stingy Arizona Legislature doled out the hundred grand in 1988 after lobbyists presented studies done in Los Angeles, Seattle, New York City, and Toronto that indicated a much higher rate of cancer in firefighters than in the rest of the population. (For instance, one in three firefighters in Los Angeles is expected to develop cancer by the age of sixty, according to that city's study, compared with one in five people in the general population.)
The studies also indicated that the types of cancer that strike firefighters may be linked to the chemicals they inhale, touch or swallow during long careers of battling blazes.
New Times reported in 1988 that there seemed to be an unusually high number of firefighters stricken by cancer, but that records of exposures to toxic materials were sketchy, buried in warehouses, or nonexistent.
The story focused on three veteran Phoenix firefighters who had contracted cancer. Since then, one has died, one still is in remission and the other, Gary Pykare, recently learned that his cancer has returned.
Mike Bielecki, president of the Professional Fire Fighters of Arizona, an umbrella group for the state's fire unions, says three retired Phoenix firefighters have died of cancer in the past year, and one of the widows plans to ask the state for workers' compensation benefits.
"The trouble is, showing an absolute causal connection is a tricky business," says Bielecki, who is a Phoenix firefighter. "We've had a guy try it before, and it didn't fly."
James Schamadan, the doctor in charge of Arizona's $100,000 study, says he may be ready to issue a report by the end of this year. But don't expect any bombshells. The results of the Arizona study, says Schamadan, may be akin to those in the other cities: intriguing and troubling, but certainly not definitive.
"We haven't pushed back the frontiers of science in the area, but we have done a lot of work," says Schamadan, an occupational-health specialist who is chief executive officer of the Scottsdale Memorial Hospital system--and whose son is a Phoenix firefighter. "I have no idea yet what the numbers statistically are going to tell us. They may come back and tell us that, at least as far as we can determine statistically, it's just plain vanilla. This is a very tough area to deal with, and we knew that coming in."
Fires involving plastics, solvents, PCBs, pesticides and asbestos routinely emit known or suspected carcinogens. But scientists admit they don't know exactly what happens when chemicals burn in fires. Firefighters may be at the greatest risk when they "overhaul" (a cleanup procedure) after the fire is contained and is smoldering. National occupational-health experts also note the trouble in general of trying to estimate mortality trends, especially when using often inaccurate or incomplete death certificates.
Another major hurdle for Schamadan and company has been the lack of available data to work with. Fire departments everywhere have been late in recognizing the dangers in today's chemical environment. Even the nationally respected Phoenix Fire Department didn't keep close tabs on the exposures its firefighters had to toxic substances until the last few years.
Schamadan's study has concentrated on questionnaires to a few thousand retired and active firefighters who are or were members of the Arizona Public Safety Retirement System. The questionnaires ask about possible exposures to hazardous chemicals and whether the firefighters have used the SCBA (self-contained breathing apparatus) masks that have been considered mandatory in most fire departments for the past decade or so.
"Another technical problem in getting valid statistical data," says Schamadan, "is that we don't know what the dead firefighters did in their spare time--how many of them breathed smoke--because they're dead. As far as the living firefighters, I don't think it's possible to put a 24-hour time clock on somebody for twenty years. We don't know everything."
Schamadan does say that "if the guys wear their SCBA equipment, especially during the fire overhaul stages, they're really in pretty good shape." He adds, "I'm more concerned about their exposures to AIDS and to some of the hazardous materials than I am with the products of combustion and the relationship of cancer."
The $100,000 appropriation is enough only for the preliminary gathering of statistics. No one knows if the legislature will be in the mood to fork over any more dollars, especially with an "oversight" committee preparing to jump into the Mobile hazardous-waste plant mess. (Schamadan also has been named to head the ENSCO committee.)
"We've been watching this very closely, and we're pretty pleased with the way things are going," says firefighter Bielecki. "The only problems have been mechanical--collecting the information and putting it in order. We expected that. If we see that the cancer rates are way up there, we'll ask for more money to look into it. If the rates aren't there, we'll have a hard time justifying it."
The big question of cancer is a tough one for firefighters because of their camaraderie--it's one of the few careers in which the workers live with one another on the job. One of Bielecki's closest friends is Gary Pykare, the Phoenix fire captain whose cancer recently returned.
"It's gonna be a tough go for the poor guy," Bielecki says.
Pykare first contracted soft-tissue cancer in 1977 at the age of 36, more than a decade after he had joined the department. Long-buried fire department records indicated that he was exposed several times to carcinogenic pesticides and other hazardous materials while fighting fires. In 1988, after radiation treatments and remissions, Pykare filed a workers' compensation claim with the state for what he considered job-related cancer.
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"When you mix some of these concoctions under the heat," Pykare told New Times in 1988, "you come up with chemicals that no one's ever seen before. If you tell me I didn't get this on the job, you're nuts."
But the Industrial Commission of Arizona--the agency that rules on compensation disputes between workers and employers--rejected Pykare's claim. Proving the direct cause of cancer is a lot more difficult than, say, determining how a leg got broken.
"We have a very difficult problem of proof in the workers' comp setting," says Pykare's lawyer Sandra Day. "Doctors can't make the same leap of faith in disease cases that they can in other cases."
"If we see that the cancer rates are way up there, we'll ask for more money to look into it. If the rates aren't there, we'll have a hard time justifying it.