If you were to ask me what the leading cause of death for firefighters was, I’d answer “fires,” naturally.
But it’s not.
In fact, a very high percentage of our nation’s firefighters are dying from cancer and other forms of preventable illness.
“Cancer continues to be the leading cause of death,” says the feature article on occupational cancer in the 2019 winter issue of Fire Fighter Quarterly, the trade magazine of the International Association of Fire Fighters. This isn’t just by a small amount: The article states that 65% of firefighters placed on the Fallen Firefighter Memorial Wall of Honor from 2002 to 2018 died of cancer, and in September 2018, 164 of the 249 names added to the wall were cancer deaths.
Much of this comes by way of occupational hazards. Carcinogens are vaporized in a fire, requiring firefighters to wear a breathing apparatus anywhere near a fire, but toxins are also absorbed through the skin. Then there’s daily exposure to exhaust, fumes, and other unknown dangers. With a recent slew of research linking the profession to higher rates of cancer and other preventable diseases like heart disease and diabetes, there’s an urgency to focus attention on developing best practices that reduce risks in firefighters’ work environments.
But, there’s another factor of health that hasn’t received the attention it deserves: It turns out, many firefighters have very poor eating habits due to time constraints at work as well as the cost and availability of grocery stores in close proximity to the fire station.
A small contingent of firefighters at San Diego Fire-Rescue Station 40 in Rancho Peñasquitos are working with others from around the world to change that. Fire Captain Justus Norgord and engineer Jeri Miuccio are trying to take diet awareness to the national level.
Miuccio was quick to greet me with a firm handshake upon a morning visit, leading me through the apparatus bay as I ogled all of the engines and equipment reminiscent of my boyhood fantasies.
“I’ve been here for 72 hours,” she says as she shows off the dorms where firefighters can rest during chaotic schedules.
Off to the right, a small nook displays several pictures of firefighters along with folded flags and memorabilia. It’s a memorial. One man looked very young to be there.
“Who is that?” I ask her.
“That’s Ryan Lee.”
“Did he die in a fire?”
I follow her to the kitchen, a large communal space that seems to be the heart of the station, as she introduces me to a culture that she and other colleagues are trying to change.
Miuccio heads to finish making her breakfast of eggs, vegetables, and locally raised pork at the cooktop as Captain Ed Jones prepares an acai bowl. Norgord sits across from the island at one of two large tables with a list, a pen, and a few 10-dollar bills scattered in front of him. Miuccio and some of the crew join us to eat.
She explains that of the leading causes of death amongst firefighters, all can be better prevented through diet—not eliminated, but at least prevented.
Norgord points to Jones, “He brings all his stuff from home. Organic.”
A group of younger firefighters sit at the next table eating bagels with various toppings and discussing the merits of corn versus flour tortillas while chugging Monster Energy drinks. “I mean, this everything bagel is healthy, right? It’s got everything!” jokes Jeff Lowe, a younger member of the firehouse crew.
The divide between food interests felt like a chasm.
The makeup of a firehouse is complicated. A single house with one engine has four firefighters; a double (like this one) runs an engine and truck with eight firefighters, plus two or three paramedics. Work shifts are organized by an intricate schedule of 24 hours on, 24 off, with a rest period after four shifts—and mandatory overtime is a regular reality. Firefighters work an average of more than 112 hours every two weeks.
Contrary to popular belief, firefighters must pay for and prepare their meals daily. They’re also restricted to shopping for groceries from markets in their service area. Food deserts or affluent neighborhoods can add stress to their conservative budgets, and habits in the kitchen have placed comfort and ease over a more consciously healthy diet.
A will-working (substitute) firefighter tends to buy snacks like chocolate muffins or ice cream. If firefighters miss a meal because of an emergency call, they have to grab one on the road, often fast, often greasy. If they get a call while cooking, then there goes the meal and in comes the convenience food.
“Cancer and heart disease are modifiable. We can’t control the fires. We can control diet,” Miuccio says.
Norgord elaborates: “Each year, approximately 100 firefighters die in the line of duty. Of that, 50% die of sudden cardiac arrest. More from cancer. Of that 50%, one in five are under the age of 42. We have some bad habits and traditions—sweets, starches, etc.—in the fire service that we are trying to change. Firefighter and all emergency responders’ bodies are under attack from the stresses of the job, like lack of sleep and hazardous gasses. It’s just not enough to be well in the moment. We are teaching that for a better outcome in this career and of this life, we need to be fit and eat healthy to be less susceptible to sickness.”
Spearheading this effort, Miuccio and Norgord will speak at the annual Firehouse World Conference about the effects of diet and health outcomes within the firefighting community. Miuccio spoke earlier this year about the topic in Los Angeles. They have a simple plan: Better diet equals better health. But Norgord illustrates how hard it is to change a firmly cemented culture with a joke: “It’s like 100 years of tradition unimpeded by progress.”
Breakfast is followed by a grocery run with Captain Norgord, engineer Charles Osterhout, and firefighters Santiago Reccia and Lowe, the foursome responsible for meals that day. Ironically, it’s Lowe, the firefighter with the comment about bagels, that suggests spinach salad with Osterhout’s famous chipotle chicken for lunch. Dinner plans include smoked burgers, but with a lot of veggies and lettuce wraps.
The firefighters run all over Costco looking for ingredients, debating prices and quality. People thank them for their service, but I also witness the challenge of trying to balance cost over health with such a strict budget—especially in public.
“When people think their dollars are paying for this, it sometimes gets a little nerve-wracking. I remember one time when we were talking about getting organic cheese versus the cheapest option, someone told us we better get the cheapest because it was their tax dollars paying for it. It became very awkward,” explains one of the firefighters.
They shop in groups in case there is a call for service while they’re is in the store. On this day, the call comes in while the crew are in the checkout line. They rush to their truck, tucking food into any space that would take it only to find out the call was canceled.
When contrasting this workday scenario with corporate wellness practices where gourmet coffee bars and organic boxed lunch deliveries are included in the work perks, one thing is for certain: Our first responders need more support. The San Diego Fire Department has a health and safety division that educates firefighters about physical and behavioral wellness and diseases like cancer. Firefighters train endless hours to save lives—shouldn’t they save their own?