Years after firefighters extinguish a blaze, after the smoke has lifted and ashes have cooled, the people who risked their lives to contain the fire face another danger: cancer and cardiovascular disease resulting from exposure to smoke and heat.

Government and academic studies have shown firefighters are 9% more likely to develop cancer and 14% more likely to die from it, due to their exposure to smoke and toxic chemicals. That is not the danger firefighters and their families anticipate when they take the job. And federal law does not account for that increased risk, though a bill the U.S. House has passed would change that.

“When you are a firefighter wife, you never expect cancer,” said Audrey Watt, whose husband, Matthew Watt, died from esophageal cancer in March after nearly 10 years as a firefighter with an elite Forest Service unit.

“You expect that call from the U.S. Forest Service that says ‘I’m so sorry, we lost your husband while he was doing his job,’” she said. “Yes, he loved his job, but his job also gave him this cancer that he couldn’t do anything to prevent.”

Although every state but Delaware has laws that recognize a causal link for the purposes of workers’ compensation claims, there is no such benefit for federal firefighters with the U.S. Forest Service and other agencies.

“This is wrong and fundamentally unfair,” the bill’s lead sponsor U.S. Representative Salud Carbajal, a California Democrat, said on the House floor.

The situation has also created a sense of unfairness among firefighters and their families.

“It’s just not OK for them to be like, ‘Oh, I’m sorry your husband has cancer but that’s not our fault,” Watt said. “Yes, it is. Your job is what caused that.”

The U.S. House passed the bill overwhelmingly, 288-131, on May 11, more than two decades after it was first introduced.

The bill would create a presumption that federal firefighters who are diagnosed with 16 medical conditions, including several cancers, developed the conditions because of their work fighting fires, making it easier to apply for and receive workers’ compensation. That is broadly similar to how nearly every state treats cancer risk among firefighters.

“Creating the presumption that those who became disabled from serious diseases contracted the illness while serving in fire protection activities, ensures these emergency first responders will receive treatment and benefits that would normally not be covered,” Representative Don Bacon, a Nebraska Republican who was an original co-sponsor of the bill, said in a release.

Representative Teresa Leger Fernandez, a Democrat who represents a district of northern New Mexico that is home to the largest active fire in the country, said on the House floor that the firefighters in her district would be battling smoke and toxic chemicals for months. The federal firefighters working alongside state and local ones should receive the same benefits, she said.

First vote in 20 years

The House vote represents a major step forward for a legislative effort that has languished since it was first introduced in 2001. It was reintroduced every two years but had not received a vote in the House until Carbajal’s latest version.

A bulletin last month from the Labor Department’s Office of Workers’ Compensation Programs noted that firefighters are more at-risk for certain illnesses and called for expedited federal workers’ compensation processing claims for firefighters.

Firefighter advocates praised that action but said codifying the benefit in law would be more significant and permanent.

“It does not have the force of law,” said Greg Russell, a governmental affairs representative at the International Association of Firefighters. “So the next administration could come in and wipe that out immediately.”

In the Senate, a companion measure is sponsored by Delaware Democrat Thomas E. Carper and Maine Republican Susan Collins.

A spokesperson for Carper said the senator “is working to include his bill in the next markup at the Homeland Security and Governmental Affairs Committee.” Carper is a former chairman of that panel, which has not scheduled its next markup. A spokesperson for the committee did not return messages.

Bipartisan support

The bill attracted bipartisan support on the House floor. Bacon and Brian Fitzpatrick, of Pennsylvania, were original cosponsors and 71 Republicans voted to pass the bill.

Under a last-minute amendment dealing with workers’ compensation claims that involve lawsuits against a third party, the bill was made budget neutral, possibly adding more Republican support. The nonpartisan Congressional Budget Office estimated the bill as introduced would have cost $22 million over 10 years.

But all 131 no votes on the floor came from Republicans, and some did raise objections during debate.

House Education and Labor Committee ranking Republican Virginia Foxx, of North Carolina, said the bill was broader than most state regimes and was unfair to other federal workers.

“By singling out federal firefighters, this bill is not fair to postal workers with skin cancer or federal nurses with lung cancer,” she said.

She added that the bill should have an exemption to make tobacco users ineligible for a presumption that their cancer was caused by workplace exposure.

U.S. Representative Marjorie Taylor Greene, R-Ga., said she opposed the bill because it came too close to “Medicare for all,” a policy favored by some liberal Democrats to give every American access to government-funded health care.

House Natural Resources Committee ranking Republican Bruce Westerman, of Arkansas, said the bill’s language could be made to exclude part-time and seasonal firefighters.

Russell said Westerman mischaracterized how many workers would be covered under the bill. Some workers who are not primarily firefighters and are dispatched to help in an emergency may not receive the benefit, but seasonal and temporary firefighters sent to the front lines would.

“If you show up to the scene on a U.S. Forest Service or a Department of Interior fire engine, you’re covered,” he said. “If you show up on a brush truck that’s a pickup with a pump on the back of it and a fire hose, you’re covered. Because those are the things that are operated by people that are, you know, they’re doing it.”

‘A first step’

Federal firefighters, including those who battle increasingly large and dangerous fires in the West, deal with a host of poor working conditions.

Matthew Watt would often be away from home for weeks at a time and his team would routinely “sleep in the black,” Audrey Watt said, meaning camp in areas that had already burned, even as state and local crews got motel rooms.

The $1.2 trillion infrastructure law enacted last year raised wildland firefighter pay from as little as $13 per hour.

Still Max Alonzo, a business representative with the National Federation of Federal Employees, said crews sometimes live in encampments because they cannot afford housing in areas they are supposed to protect.

“They’re completely forgotten. They’re not treated as first responders,” Alonzo said. “There’s so many issues, and this (presumption of work-related illness) is one of them.”

Andrew Robinson, a former wildland firefighter for eight years with the Oregon Department of Forestry, said the bill was important to make wildland firefighting an attractive career.

In 2019, at the age of 32, Robinson was diagnosed with urothelial cell sarcoma, a type of bladder cancer. Seeking payment for his medical care was “frustrating and a lot of work,” he said. Although his cancer is in remission, he still has thousands of dollars in medical bills a year, he said.

The bill, he said, “is a first step towards a much larger goal of making the wildland fire industry into a career industry on par with municipal fire departments.”

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