Still Unclear

The National League of Cities-commissioned report on cancer-presumption laws no longer may be in the headlines, but debate over the report remains. Sara Pyle's article "Clearing the Air" in the August issue prompted a response from the NLC report's authors.

TriData released a report in April 2009 to assess the current status of firefighter cancer presumption laws in all 50 states and review the available scientific literature evaluating firefighters and cancer risk. Your August issue carried an article by Sara Pyle. We were not given the opportunity to comment on the assertions made in the article, and many are not correct. For one, TriData did not state that there is no link between firefighters and cancer risk. We stated that there were indeed some associations seen among specific cancers and firefighters. Different cancer studies, however, have found different strengths of association for those risks.

Our primary research question was to determine what the current status was of cancer presumption laws in all 50 states. TriData found that cancer-presumption legislation varied greatly throughout the states and that the cancers addressed in the legislation did not align with the available science.

We did not do our own epidemiological study as to the significance of cancer risk [among] firefighters. We were collecting information on what was currently available. We were not offering any new scientific results to the fire service and other interested parties.

The value of our report, which was highlighted in Sara Pyle's article, lies within the in-depth explanation of the issues related to cancer presumption and our recommendations to the fire service to emphasize prevention, protection and a standardized method of evaluating cancer risk among firefighters through a national cancer registry. Our report provided guidelines for future collaborations and prevention efforts.

We urge everyone concerned about cancer and firefighters to read the actual report, instead of articles and press releases about it. We presented, with a clear criteria of inclusion, the scientific findings of published study authors. We reported on the current status of cancer-presumption laws in all 50 states. Our report led to the same conclusions stated at the end of the Fire Chief article, that more research is needed to further investigate the hazards of firefighting, the fire service should encourage firefighters to continue their vigilance when it comes to health and safety, and that more information is needed to understand the many aspects of firefighting and firefighter health.

— Harold Cohen, Ph.D., FACHE, NREMT-P;
Sweta Dharia, MPH;
Patricia Frazier
and Clara Kim, MPH

Ed:. FIRE CHIEF asked Sara Pyle to respond to the study's authors, which follows.

Dr. Cohen states that “TriData did not state that there is no link between firefighters and cancer risk.” Clearly, the statements made in the TriData report were not that definitive, and the article in your magazine did not assert that the TriData report made such a conclusive statement.

However, in reviewing the NLC press release, the organization states that the report “… found there is inadequate scientific research to determine a link between working as a firefighter and an elevated risk of contracting cancer” and that “… researchers from TriData Corp. independently concluded there is a lack of substantive scientific evidence currently available to determine that firefighters face risks greater than the general population.” They also state that “according to the report … no causal relationship can be found.” These conclusions are at odds with those discussed in the article, which are from two rigorously conducted studies published in peer-reviewed scientific journals — the established process for evaluating the integrity of a study or article that the TriData report did not undergo. Clearly, the intent of the press release was to lead people to conclude that cancer-presumption laws are not warranted.

The team also states, “we did not do our own epidemiological study as to the significance of cancer risk and firefighters. … We were not offering any new scientific results to the fire service and other interested parties.” While I agree with their statement, the NLC press release directly contradicts their assertion by referring to the report as a “study.”

While I appreciate the suggestion of Dr. Cohen and his team that people should read the entire report, and believe there is some useful information about cancer-presumption laws, it is clear that press releases and media stories will form the basis of opinion for most people. If Dr. Cohen and his team feel the NLC misrepresented their findings in the April press release, I am certain the fire-service community would appreciate their taking corrective action.

I and all the scientists interviewed for the article agree with the team's assertion that prevention and protection are important when it comes to minimizing risk, and that more research always is helpful to understand the specific mechanisms underlying the relationship between firefighting and cancer.

— Sara Pyle
Assistant Professor in the Departments of Preventive Medicine and Family Medicine
Kansas City University of Medicine and Biosciences

Related Stories

• Clearing the Air