Soot and Cancer by Gregory Havel Photos As Noted February 8, 2018
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Construction Concerns: Soot and Cancer by Gregory Havel Photos as noted February 8, 2018 In this 21st century, most firefighters are very aware of the connection between firefighting and certain types of cancer. They should also be aware of the need for decontamination and laundering of personal protective equipment (PPE) after each exposure to combustion products, and of the need for showers and a change into clean clothing as soon as possible after the exposure. The connection between soot and cancer was first made more than 240 years ago; and the chemical compound in soot that is primarily responsible was first isolated more than 80 years ago. “The history of cancer is long, but our recognition of the agents that produce it has been slow to mature. The first awareness that external or environmental agents could produce malignant change dawned in the mind of a London physician nearly two centuries ago. In 1775 Sir Percivall Pott declared that the scrotal cancer so common among chimney sweeps must be caused by the soot that accumulated on their bodies. He could not furnish the "proof" we would demand today, but modern research methods have now isolated the deadly chemical in soot and proved the correctness of his perception.” (Silent Spring, by Rachel Carson. Boston MA: Houghton Mifflin Harcourt, 1962; Chapter 14) In 18th century England, chimney sweeps were employed to clean the soot and creosote from fireplace chimney flues after burning solid fuels such as wood and coal. This population included both adults and small boys who were sent inside the flues with wire brushes to scrub loose the soot and other deposits. Weekly bathing was considered excessive in that era; and clothes washing was done by hand and infrequently. Sir Percivall Pott (1714-1788) was a London physician and surgeon who was a pioneer in setting broken bones rather than amputating, as well as in surgical procedures and early cancer research. In 1775, he published Chirurgical Observations Relative to the Cataract, the Polyplus of the Nose, the Cancer of the Scrotum, the Different Kinds of Ruptures, and the Mortification of the Toes and Feet, the first publication attributing an occupational source to cancers. His treatment of scrotal cancer began with the excision of the cancerous skin, although he recognized that the cancer was likely to reappear in the testicles or lymph nodes and spread into the abdominal organs, eventually causing a painful death. To reduce the probability of a chimney sweep’s getting the cancer, he February 8, 2018 Page 1 of 4 proposed daily washing of the genital area and a weekly change to clean clothing. His recommendation was followed by an Act of Parliament in 1788, which required that chimney sweeps be at least eight years of age, bathe at least once a week, and be supplied regularly with clean clothes. Although these procedures may have reduced the incidence of the cancer, they did not eliminate it. Further research followed during the next centuries, seeking to identify the component in soot that was responsible for these cancers. There were also studies of cancers in workers at coke ovens, which separated the volatiles from coal by heating. In 1933, biochemist James D. Cook of the Research Institute of the Cancer Hospital of London isolated benzo[α]pyrene as the most carcinogenic compound in coal tar and soot. This compound is a polycyclic aromatic hydrocarbon and appears to damage the cellular DNA, causing broken or defective chromosomes. This can lead to unregulated cell growth and cancer. Benzo[α]pyrene today is known as a potent carcinogen and toxic chemical. It is produced by the incomplete combustion of organic fuels like wood and coal at temperatures between 300 °C (572 °F) and 600 °C (1,112 °F). It is also found in exhaust from internal combustion engines, especially diesels; cigarette smoke; coal tar and its products; char-broiled foods; pyrolysis products of fatty acids and carbohydrates; soot; smoke; creosote; petroleum asphalt; and shale oil. Perhaps the incidence of testicular cancer in firefighters who began their career more than 30 years ago is due in part to the widespread use at the time of three-quarter-length boots and long coats (photo 1), which would have left the genital area protected only by the skirts of the long coats, trousers, and underwear. Today, better protection is provided by the short boots, bunker pants, and shorter coats, as seen in photo 2 (next page). Photo 1 courtesy of Sturtevant Volunteer Fire Department (now combined with Mount Pleasant Fire Department to form South Shore Fire-Rescue in Wisconsin). The author is at left in 1977, with Chief Wayne Legois (deceased of pancreatic cancer at age 80 in 2012). February 8, 2018 Page 2 of 4 Photo 2 by author. Perhaps the incidence of testicular and other cancers in firefighters today is also due to inadequate decontamination and laundering of PPE, as well as to inadequate personal hygiene and changing of clothing after exposures at fire incidents. Regardless of age, today’s firefighter cannot afford to wear contaminated and soiled PPE, street clothing, or underwear, or neglect to shower and change clothes as soon as possible after returning from a fire incident. Today’s firefighter must take the time to read and understand the use and care instructions included with each set of PPE; the NFPA and other standards for PPE maintenance; the recommendations on cancer prevention that can be found on the Centers for Disease Control website at https://www.cdc.gov; the Firefighter Cancer Support Network at https://firefightercancersupport.org; and http://www.lexipol.com/firefighter-cancer-prevention These recommendations are especially critical since today’s firefighter is exposed not only to the soot and benzo[α]pyrene from the combustion of wood and similar fuels but also to additional toxins and carcinogens from the decomposition and combustion of synthetic fabrics, plastics, manufactured lumber, adhesives, and electronic components. The toxins and carcinogens to which firefighters are exposed today include carbon monoxide, cyanides, isocyanates, acids, chlorine, plasticizers, acrolein, formaldehyde, February 8, 2018 Page 3 of 4 acetaldehyde, proprionaldehyde, butyraldehyde, and vapors of many other chemicals and metals. We must remember that the neglect to care for ourselves while we are young cannot be undone after we have a diagnosis of cancer. “And what makes these thoughts all the more disturbing is the knowledge that our fate could perhaps be sealed in the twenty or more years before the development of symptoms." (Dr. David E. Price of the U.S. Public Health Service, in Public Health Reports, Volume 74 (1959), #8, pages 693-699. Quoted by Rachel Carson in Chapter 12 of Silent Spring.) There is still truth to the statement made repeatedly by Francis L. Brannigan in another context, during the 1970s, 1980s, and 1990s: “The building is your enemy. Know your enemy.” For more information on this topic, internet search for • Sir Percivall Pott • benzo[α]pyrene or benzo[a]pyrene • polycyclic aromatic hydrocarbons • carcinogens Gregory Havel is a member of the Town of Burlington (WI) Fire Department; retired deputy chief and training officer; and a 40-year veteran of the fire service. He is a Wisconsin-certified fire instructor II, fire officer II, and fire inspector; an adjunct instructor in fire service programs at Gateway Technical College; and safety director for Scherrer Construction Co., Inc. Havel has a bachelor's degree from St. Norbert College; has more than 40 years of experience in facilities management and building construction; and presents classes at FDIC and other venues. February 8, 2018 Page 4 of 4 .