The International Myeloma Foundation issued the first guidelines for firefighters for the prevention and treatment of myeloma, a cancer of cells in the bone marrow that affects production of blood cells and weakens bones. Studies have shown firefighters are at higher risk for myeloma, and the risk increases with length of service. Most recently, studies linked an increased risk of myeloma to exposures at the World Trade Center site following Sept. 11.

“At the International Myeloma Foundation, our own research demonstrates a link between myeloma and toxins in the environment including dioxins, chemical contaminants produced by combustion,” said Dr. Brian Durie, chairman and co-founder.

The IMF guidelines recommend that:

• Fire departments should review and update guidelines for use of personal protective equipment.
• Firefighters should have their turnouts professionally cleaned routinely. The frequency of cleaning depends on their level of activity. Firefighters also should avoid wearing or storing their turnouts in fire station living areas, which can spread the contamination.
• Firefighters should shower as soon as they return from each fire to remove the soot and ash. Firefighters can return from a fire exhausted, so thoroughly scrubbing off the soot may not be a top priority, but an immediate shower can limit the exposure to toxins and reduce the risk.

“For firefighters, safety doesn't end when the fire is over,” said Michael Dubron, president and founder of the Firefighter Cancer Support Network and a cancer survivor. “We believe firefighters should take some basic steps to reduce their exposure to the extent possible — if not for themselves, then for their families.”

It is advised that departments equip fire stations with exhaust removal systems. If the department doesn't have such a system, firefighters should avoid idling the engines indoors without adequate ventilation. There is evidence that chemicals in diesel fumes may be linked to cancer, and multiple exposures in closed quarters can increase the risk and leave potentially toxic residues behind.

Firefighters should complete annual medical exams. They should discuss possible cancer risks with their physicians. If diagnosed with myeloma, firefighters should seek expert medical care.

“The last guideline, seeking expert care, resonates with me personally,” said Tom Bay, motivational speaker, IMF board member and a myeloma survivor. “When I was diagnosed I was handed a paper describing multiple myeloma as an incurable and terminal cancer. It was my association with firefighters that led me to the International Myeloma Foundation, where I was told the diagnosis is not a death sentence. Thanks to advice from the experts, I learned about the new treatments available today that have kept me alive and feeling well with the possibility of long-term remissions.”

The guidelines grow out of numerous studies. IMF's gene bank, Bank on a Cure, has found possible links between myeloma and genes responsible for processing dioxins and related chemicals.

The Journal of Occupational and Environmental Medicine identified an elevated risk for multiple myeloma among firefighters along with potential associations with non-Hodgkin's lymphoma, testicular and prostate cancers. This spring an interview accompanying an article in the New England Journal of Medicine said it was troubling to find cases of multiple myeloma in very young individuals who worked at the World Trade Center site after Sept. 11.