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 bone. 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 9/11.

"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 of the IMF. "When firefighters leave a fire they may be covered with toxins that can lead to long-term risks. That is why it is essential for them to limit the exposure and seek expert medical help when they need it."

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

The IMF guidelines recommend:

• Firefighters should have their turnouts professionally cleaned routinely, and avoid wearing or storing their turnouts in fire station living areas. The frequency of cleaning depends on their level of activity. Turnouts in living quarters or private cars 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.
• Fire departments should review and update guidelines for use of personal protective equipment.
• It is advisable for departments to equip fire stations with exhaust removal systems; if not available, 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
• Firefighters diagnosed with myeloma should seek expert medical care.

"The last guideline, seeking expert care, resonates with me personally," says 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 in the body. IMF will submit its finding to a major cancer conference later this year. The Journal of Occupational and Environmental Medicine (volume 48, November 2006) identified an elevated risk for multiple myeloma among firefighters along with potential associations with non-Hodgkin lymphoma, testicular and prostate cancers. This spring an interview accompanying an article in the New England Journal of Medicine (May 31, 2007) said it was troubling to find cases of multiple myeloma in very young individuals who worked at the World Trade Center site after the 9/11 attacks.