We often think of firefighters as people dedicated to protecting the communities they serve from the dangers of fire and other hazards. But did you know they also face significant risks from cancer? Skin cancer, in particular, poses a threat to firefighters. However, it’s not just firefighters who need to be aware of these risks – everyone can take steps to protect themselves from skin cancer.
It’s true firefighters are at a higher risk of developing and succumbing to cancer compared to the general population. However, there are simple actions both firefighters and the general public can take to reduce this risk. This article aims to shed light on why firefighters are particularly vulnerable to skin cancer, while also providing valuable information everyone can use to minimize their risk.
Early detection is crucial if cancer does develop, which is why this article also emphasizes the importance of recognizing the signs and symptoms of melanoma. Despite being one of the most commonly diagnosed cancers among firefighters, skin cancer is highly preventable – a fact which underscores the importance of awareness and proactive measures for everyone’s well-being.

“The fact is while skin cancer is one of the most commonly diagnosed cancers for firefighters, it is also one of the most preventable”.

Background
The International Agency for Research on Cancer (IARC), the cancer agency of the World Health Organization (WHO), has evaluated the carcinogenicity of occupational exposure as a firefighter. After thoroughly reviewing the available scientific literature, the Working Group classified occupational exposure as a firefighter as carcinogenic to humans (Group 1), on the basis of sufficient evidence for cancer in humans.
In summary, seven cancers were elevated from their previous status. The Working Group concluded there was “sufficient” evidence in humans for mesothelioma and bladder cancer and “limited” evidence in humans for colon, prostate, and testicular cancers, and for melanoma and non-Hodgkin lymphoma.
The bottom line is this. There is a quantifiable and real risk for firefighters in relation to skin cancer, specifically melanoma.

Skin Cancer – Melanoma
With more than five million cases diagnosed each year, skin cancer is the most common cancer in the United States. Skin cancer is the abnormal growth of skin cells. There are three major types of skin cancer, basal cell carcinoma, squamous cell carcinoma, and melanoma. Of the three, melanoma is the most serious type of skin cancer. Melanoma begins in the melanocytes, the cells which produce melatonin and give you your skin color. Skin cancer is one of the most preventable cancers.
While most melanomas develop on skin which has been exposed to sunlight. Typical areas of concern include the back, legs, arms and face. However, this is not always the case. Melanomas can also occur in areas that don’t receive much sun exposure, such as the soles of your feet, palms of your hands and fingernail beds.
To help firefighters identify characteristics of unusual moles that may indicate skin cancer think of your ABC’s – ABCDE that is.
A is for asymmetrical shape. Look for moles with irregular shapes, such as two very different-looking halves.
B is for irregular border. Look for moles with irregular, notched or scalloped borders — characteristics of melanomas.
C is for changes in color. Look for growths that have many colors or an uneven distribution of color.
D is for diameter. Look for new growth in a mole larger than 1/4 inch.
E is for evolving. Look for changes over time, such as a mole that grows in size or that changes color or shape. Moles may also evolve to develop new signs and symptoms, such as new itchiness or bleeding.

Potential signs of melanoma:
A large brownish spot with darker speckles
A mole that changes in color, size or feel which can bleed
A small lesion with an irregular border and portions appearing in red, pink, white, blue or blue-black
A painful lesion that itches or burns
Dark lesions on your palms, soles, fingertips or toes, or on mucous membranes
Often, the first sign of melanoma is a change in an existing mole or a new and unusual looking growth on the skin. It is also important to know melanoma can also occur on normal appearing skin.

Prevention
There are many proven preventive measures to reduce the risk of skin cancer. However, for firefighters in addition to the typical preventive measures, here are several additional considerations.
A consequence of wearing dirty gear may be skin cancer. Wearing dirty gear allows contaminants to be absorbed through the skin. This direct contact exposure can lead to an increased cancer risk. Maintaining your gear clean prevents harmful fireground containments (which contain carcinogens) from entering your body through your skin.
Properly wearing your gear also minimizes your skin’s exposure. Your protective hood and helmet ear flaps minimize contaminants from settling on the skin in the areas and then protect.
Following an exposure use cleansing wipes to remove as much soot and harmful contamination as possible quickly. Research has demonstrated a greater than 50% reduction of contaminants from the skin by taking this simple action. Remember, the sooner we remove the contamination, the less the exposure will be.
For a firefighter, showering as soon as possible following an exposure limits the time contaminants are in contact with the skin. The shorter the time from exposure to showering, the shorter the exposure.
Especially during the warmer months of the year, firefighters spend a great deal of time outdoors. This includes performing apparatus maintenance, training, and, of course, operating at alarms. When performing apparatus maintenance, training, and other non-emergency activities, position yourself in shady areas when possible. This is especially true when conducting these activities during the times of the day when the sun’s rays are strongest between about 10 a.m. and 4pm
Even in winter or when the sky is cloudy, you are still exposed to the sun’s harmful rays. Clouds offer little protection from damaging rays. Remember, sun exposure accumulated over time may also cause skin cancer.
Wear sunscreen all year round. Use a broad-spectrum sunscreen with an SPF of at least 30 and reapply at regular intervals. As stated previously, the sun’s rays are harmful even in the winter and on cloudy days. Apply sunscreen even on cloudy days and in the winter.
It is important to prevent unnecessary exposures when operating outside for extended periods of time. Wear protective clothing that covers your arms and legs. Hats can also be useful, especially a large-brimmed hat, which provides more protection than a baseball hat.
Become familiar with your skin so that you’ll notice changes. Examine your skin often for new skin growths or changes. You should also see a dermatologist regularly for a routine checkup.

Mollies Fund, Skin Cancer Awareness, and the FDNY
In the summer of 2021, the FDNY partnered with Mollies Fund to bring skin cancer awareness to incoming and veteran FDNY firefighters. The partnership included recording a training video for firefighters featuring New York University dermatologist Dr. Elizabeth Hale. The training video teaches skin cancer awareness, how to identify its signs and symptoms, and stresses the importance of sun safety and prevention.
In addition, Mollies Fund donated six sunscreen dispensers for the Randall’s Island Fire Academy and additional dispensers and sunscreen to the training facilities at: FDNY EMS Training Academy Fort Totten Park, FDNY Rockaway Tactical and FDNY Staten Island Tactical.
Today, several years after the initial FNDY partnership, Mollie’s Fund has collaborated with the New Jersey Commission of Fire Academies, the Connecticut Fire Academy, and Fort Worth Fire Academy to launch similar programs. They are currently in discussions with firefighter training programs from other states to support more firefighters. Connect with Mollies Fund: https://molliesfund.org/

Conclusion
There are many simple actions you can take to minimize your chance of skin cancer, a common yet preventable cancer. Remember, you don’t have to be a firefighter to be skin-aware and protect yourself. Your future self will thank you for your simple actions today to preserve your future health. ❦

About the Author

Frank Leeb is a Deputy Assistant Chief in the Fire Department of New York. During his 31-year career, he has held several senior staff positions, including the Chief of the Fire Academy, Chief of Training, and the Chief of Safety. Frank has also been an East Farmingdale Fire Department member since 1983 (Long Island, NY).
Frank Leeb’s career has been defined by his unwavering commitment to fostering growth through training and development, a central tenet of his leadership philosophy. He has lectured nationally and internationally on motivation, preparedness, leadership, strategy, and tactics.
He holds a bachelor’s degree in fire service administration from SUNY Empire State and a master’s in security studies from the Naval Postgraduate School, Center for Homeland Defense and Security (CHDS).

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