Breast cancer rate alarms SFFD female firefighters

Mike Koozmin/The S.F. ExaminerFighting: San Francisco Fire Department firefighter Jeanine Nicholson

For four grueling months last year, San Francisco firefighter Denise Elarms underwent chemotherapy for breast cancer, an experience she could only compare to one thing.

“I’ve never been to hell,” Elarms said, “but I can’t imagine it’s any worse than chemotherapy.”

The chemo eventually cleared traces of her cancer, but the 53-year-old underwent a mastectomy and now suffers from neuropathy, a nerve ailment that causes extremities to lose sensation and function. While her doctors didn’t indicate what might have caused her cancer, the 10-year Fire Department veteran has her own suspicions.

“We work around a lot of stuff we shouldn’t be around,” Elarms said.

According to a recent department study, 10 out of 117 female San Francisco firefighters between the ages of 40 and 50 said they had contracted breast cancer, and one has died. At 8.5 percent, the breast cancer rate among female firefighters here is nearly six times the national average for women in that age bracket.

Pinpointing the exact cause of any cancer cluster is difficult, but firefighters’ exposure to harmful chemicals is a major factor, said Tony Stefani, a retired Fire Department captain who founded the San Francisco Firefighters Cancer Prevention Foundation.

After all, Stefani said, dangerous toxins are everywhere when a firefighter is on duty — from exposure to diesel fumes aboard firetrucks to harmful chemical substances found in homes and household furniture.

“We basically work in a toxic chemical soup,” said Stefani, who has fully recovered from transitional cell carcinoma, a rare form of cancer he was diagnosed with in 2001.

Stefani’s foundation has been a tireless advocate for safety reforms, from supporting California Senate Bill 137, which sought to update flammability standards for chemicals, to working with UC Berkeley on a grant application to the Federal Emergency Management Agency for further study on the firefighters’ high cancer rates. The results of the FEMA application are still pending. The group also will work with the Centers for Disease Control and Prevention on a landmark study set for next year that will analyze cancer rates for firefighters in San Francisco, Chicago and Philadelphia.

SB 137 was ultimately defeated by the state Legislature following heavy opposition from chemical industry lobbyists. However, the bill’s author, state Sen. Mark Leno, said

Gov. Jerry Brown has agreed to update archaic flammability requirements in household furniture, a move that could cut down on the levels of harmful carcinogens emitted during fires. Leno said he was hopeful that the administration would release the new regulations by the end of the year.

San Francisco fire Lt. Karen Heald, who sits on the foundation’s board of directors, said behavioral and cultural changes at the Fire Department are helping to address the issue of cancer.

Years ago, it was standard practice for firefighters to remove their self-contained breathing apparatus after a blaze was squelched, even though dangerous chemicals were still in the air. Now more firefighters are keeping their devices on for longer periods of time, Heald said.

The department’s brass is working with the foundation to generate more awareness about the dangers that firefighters face on the job. Firefighters are encouraged to screen themselves frequently for cancer, and several active members of the department sit on the foundation’s board, fire Chief Joanne Hayes-White said.

Another major boost will come later this year, when the Fire Department receives new breathing apparatus for all 1,400 of its uniformed officers as part of a $2.9 million federal grant program. Hayes-White said the new devices will be lighter and less cumbersome.

Help comes slowly for ailing first responders

As if battling infernos weren’t difficult enough, San Francisco firefighters are squaring off against another tough, but unexpected, foe: The City’s Human Resources Department.

Several female firefighters recently diagnosed with breast cancer say they have had difficulty securing workers’ compensation leave from San Francisco’s employee relations department.

Under state workers’ compensation guidelines, cancer diagnoses among firefighters are presumptive, meaning that human resources departments must prove that working conditions do not cause cancer, a burden that is nearly impossible to prove, according to Karen Heald of the San Francisco Firefighters Cancer Prevention Foundation.

Despite this, San Francisco’s Human Resources Department has routinely denied claims by firefighters with cancer, Heald said. That forces the firefighters to hire lawyers to appeal their cases — a process that almost always results in eventual workers’ comp payments, but one that is unnecessarily arduous given the health
difficulties the employees are facing.

“They throw roadblocks after you in the hopes that you just give up,” complained Jeanine Nicholson, an 18-year veteran with the Fire Department who was diagnosed with breast cancer in July. “They’ve asked me to record every single fire I’ve ever fought. That can be a little difficult to do considering I’m undergoing chemotherapy right now.”

Firefighter Denise Elarms, who was diagnosed with cancer in April 2011, said the Human Resources Department made her feel like a criminal.

“They sent private investigators to my house and had them look through all my possessions,” Elarms said. “They made me feel more like a crook than a firefighter.”

Susan Gard, an operations manager at the Human Resources Department, said it’s not common for the agency to deny firefighters’ workers’ comp claims, although she could not discuss specific cases due to confidentiality laws.

Still, the department has to be fiscally prudent because the workers comp’ claims come directly from city coffers.

“We have a fiduciary responsibility to The City, so we have to carry out our proper investigations,” Gard said.

But Gard said she didn’t believe there was a conflict between the Human Resources Department and the firefighters.

“San Francisco is self-insured, so the firefighters are our colleagues — we have the same employer,” Gard said.

“They protect us and we want to make sure that they are compensated for their work. It may just be that we need to sit down and have a conversation so everyone knows how the process works.”

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