The leading cause of death among firefighters is not dying in the line of duty while fighting a structural fire or wildfire. It’s cancer. 

According to a 2024 National Institutes of Health publication, “Occupational cancer is now the leading cause of death among firefighters, with firefighters having a 9% greater risk of being diagnosed with cancer and a 14% higher risk of dying from cancer than the general population. The occupational exposure of firefighting (for both career and volunteer and both men and women) was recently classified as carcinogenic to humans.”

That’s why Utah firefighters teamed up with health professionals and legislators to blaze a new trail toward early detection and acknowledgement of many types of cancer that plague people in their profession. Draper Fire Chief Clint Smith was heavily involved in crafting HB 65. 

“There’s been a handful of us that have really been the drivers behind getting this bill put together and passed this legislative session. I was lucky enough to be on the senate floor when that bill passed unanimously. It was a very emotional moment to see that and to be there with my close friends who are currently battling cancer,” Smith said.

HB 65 does two things: First, it expands the number of “presumptive cancers” for firefighters from four to 15. A 2015 legislative bill previously recognized four presumptive cancers. “We knew there were many more cancers that needed to be added to that list,” Smith said. Identifying presumptive cancers means that if a firefighter is diagnosed with one of those 15 cancers, it is presumed they got it as a result of their job. They don’t have to prove it for Workers Compensation to cover cancer treatment. Without that, those costs would come out of the individual’s pocket or from their personal health plan. 

Secondly, it makes cancer screening more accessible for Utah firefighters, leading to better outcomes. “We knew the cancers existed, but we weren’t finding them until they were symptomatic and usually late-stage, often times, once an individual retired from the fire service. Once you find a late-stage cancer, your prognosis isn’t very good…and that isn’t acceptable. We started to look for avenues for firefighter cancer screenings, to find it early and treat it early. We’re going to have much better outcomes and hopefully allow these members of the fire service, who have dedicated so many years, to have long and healthy retirements as well,” Smith said. 

The bill, sponsored by Rep. Casey Snider (a volunteer with the Paradise Fire Department) and Sen. Mike McKell, was one of the early bills passed this legislative session. It allocates $3.7 million for each of the next three years to establish and run the cancer screening clinic for firefighters within the Rocky Mountain Occupational Health and Safety Clinic in Salt Lake City. Smith hopes they’ll find funding sources to make the clinic sustainable beyond the first three years.

For Smith, it’s all about saving lives through early detection. “Every firefighter knows either somebody that has already died of cancer or is battling cancer. We need to learn from what they have endured and we need to make changes to improve our long-term health. This bill and the work we’ve done is in honor of those that have already given that sacrifice of battling or dying from cancer,” he said.

The bill has taken several years to craft. In February 2024, a group from Utah journeyed to Arizona to see and experience a clinic run by grant funds. The results astonished those who went. 

“We took this group to Arizona and six firefighters went through testing. Five of the six had some type of finding. That’s a very high number. Quite honestly, we anticipated one, maybe two. It was really a defining moment for each of us. We found out just how prevalent occupational cancers are in our members,” Smith said. Among those tested in Arizona was Lehi Fire Chief Jeremy Craft who was diagnosed with two different types of cancer and has spent the last year going through procedures and treatments. Accompanying the Utah group was Dr. Kurt Hegmann who oversees occupational safety for the state of Utah. “He was a champion for us,” Smith said.

Draper’s Fire Chief explained some of the reasons cancer is so prevalent among firefighters. “Everything in our homes these days is made from petroleum-based products; your carpet, furniture, drapes, etc. When they burn, they put off very toxic fumes. PFAS, which gives our gear the protective qualities we need like temperature control and water resiliency, is a forever chemical and a carcinogen. Simply wearing our gear exposes us to some of those carcinogens. It absorbs into our bodies just by wearing the gear. Diesel exhaust is another known carcinogen. For years and years, we stored our gear in the apparatus bay. The gear would absorb that exhaust and then we’d absorb it into our skin,” Smith said. 

Sandy City is constructing a new fire station with upgrades to safeguard firefighters, including a distinct divide between the fire truck entry point and the living space. According to Smith, some protections have been put in place for Draper City fire stations. 

“We are taking as many of those proactive steps as we can to decrease risks. It’s something that needs to be done in new construction, and there are a lot of things we can do in current stations to help reduce that risk,” he said. 

Smith has been a firefighter for 32 years. “I’ve told many people since the bill passed that being part of it will probably be the most significant piece of legislation I will ever have the opportunity to be part of, throughout my entire career,” Smith said. “Our bill is now becoming the model for other states around the country to look at and try to duplicate.” λ