'The science is there': N.L. firefighter advocates for more cancer insurance coverage

For a little over 20 years, Jim O'Toole has been a firefighter with the St. John's Regional Fire Department.

It's a job he loves.

"It's been a great career. I can't say anything negative. I've enjoyed every morning that I've gotten up to go to work over the last 20 years," said O'Toole.

But in 2018, his life changed, after getting two medical diagnoses in five months.

First, kidney cancer. Then melanoma, a type of skin cancer — something O'Toole still deals with today.

He isn't the only firefighter with this story.

Paul Demers, director of the Occupational Cancer Research Centre in Toronto, says possible causes are exposure to smoke and gases from fires, and to asbestos in old buildings — but also 24-hour shifts.

"Firefighters now are much better protected than they were in the past. There actually is equipment that will provide them with oxygen and will prevent them from breathing in things," said Demers, who researches firefighters' cancer risks.

"At the end of a fire, often firefighters have to remove their masks to breathe easier, and sometimes there's still different types of gases … in the air."

According to Demers, firefighters' cancer risk has been the subject of about 50 different studies but it's still difficult to make generalizations.

"Depending upon what's being burned, that smoke can contain different things. It's not necessarily the same for every fire," he said.

"We often look at the number of years people have spent fighting fires. But some firefighters work at stations where they only rarely go out for a fire," said Demers. "Some firefighters fight industrial fires, which are … much more complex and scary."

Colon, prostate and testicular cancer, but also melanoma and mesothelioma, a cancer caused by exposure to asbestos, are more commonly seen in studies of cancer in firefighters, said Demers.

O'Toole's kidney cancer is covered under provincial legislation, but his melanoma wasn't — until he fought and won to get it for himself.

That coverage is something he wants for others now. 

O'Toole, who is also a member of the International Association of Firefighters, has been advocating for compensation since 2006, long before his own diagnosis.

In 2017, it yielded results when legislation to cover 11 cancers as work-related injuries for firefighters took effect, allowing them to seek wage-loss benefits, medical aids and other benefits through WorkplaceNL.

Health-care costs arising from treatment are covered by the provincial Medical Care Plan.

Both Manitoba and the Yukon recently updated their legislation to include more types of cancer in their coverage — both now cover 19 work-related cancers for firefighters.

In Manitoba, a firefighter's cancer is now also assumed to be caused by their job, unless the opposite is proven.

While Newfoundland and Labrador isn't at the bottom of the list, only New Brunswick and Nova Scotia cover fewer types of cancer — 10 and six, respectively.

O'Toole wants four more types of cancer — including cervical, ovarian and prostate cancer, along with heart injury occurring during or within 24 hours of an emergency call — to be covered by the province.

The government is reviewing the Workplace Health, Safety and Compensation Act, and the addition of four cancers and cardiac events was recommended in a report released in June.

"The science is there, and now it's time that we get brought up to the rest of the country," said O'Toole.

"I'd like to see us be leaders in this, not always trying to play catch up like we've done in the past. I'd like to see us be out front and really be proud of our legislation."

There are about 5,900 volunteer and 450 career firefighters in the province, according to the Department of Justice and Public Safety.

Since 2017, 27 claims from both volunteer and career firefighters have been paid, according to WorkplaceNL, which refused to say how many claims have been rejected, stating privacy concerns due to the small number.

Among the accepted claims, kidney and lung cancer are the most common.

O'Toole says the number doesn't reflect the number of firefighters with cancer and he believes he knows why.

"There's still a lot of people throughout the province that don't even know the legislation exists. And I see it dealing with claims here, especially with retirees that I've been dealing with," said O'Toole.

O'Toole works to increase not only awareness of the legislation but also of the proper protection for firefighters.

"People need to know that cancer is affecting firefighters, and it doesn't matter whether you're a volunteer or career in this province," said O'Toole.

O'Toole emphasizes the importance of following proper decontamination procedures, such as showering within an hour after a fire, or cleaning gear and the cabin of the truck.

And O'Toole's advocacy doesn't stop there.

With four firefighters from B.C. and Ontario, he is starting a charitable organization as an affiliate of the Canadian Firefighter Cancer Support Network, a U.S. non-profit organization, to support firefighters and their families in Canada.

"I've been affected by it. And I see what it does and I've dealt with families who've lost loved ones to this, so you see how they're affected," said O'Toole.

"It really pushes me every day."

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