Future of Cancer Coverage for Women Federal Firefighters Uncertain Under Trump

It took practically three years to win presumptive staff’ compensation protection for breast, cervical, and different cancers that firefighters who work for federal companies might develop due to hazardous exposures on the job.

Now, simply weeks after the Labor Division added protection for these diseases, firefighters fear the positive aspects could also be in jeopardy after the Trump administration deleted details about the growth of protection for cancers that largely have an effect on girls and transgender firefighters from a federal webpage and ducked questions on whether or not it is going to uphold the coverage change made within the waning days of the Biden administration.

“It’s actually necessary to proceed to give attention to making certain that those that commit their lives to defending the general public and communities proceed to obtain protection by the particular claims unit,” mentioned Pete Dutchick, a federal firefighter and volunteer with the advocacy group Grassroots Wildland Firefighters.

The Labor Division’s particular claims unit, established in 2022, processes all federal firefighter claims and supplies a streamlined path for these with lined situations. Wildland firefighters and advocacy teams representing them celebrated that yr when federal officers moved to expedite staff’ compensation protection of cancers tied to their jobs. It was recognition that the risks of battling wildfires lengthen lengthy after a blaze is extinguished.

The record of cancers federal officers tagged for streamlined claims processes by the Labor Division’s Workplace of Employees’ Compensation Applications included esophageal, colorectal, prostate, testicular, kidney, bladder, mind, lung, thyroid, a number of myeloma, non-Hodgkin’s lymphoma, leukemia, mesothelioma, and melanoma.

However that preliminary jubilation soured when it turned clear that breast, ovarian, cervical, and uterine cancers had been excluded, making a protection hole for greater than 2,700 individuals, or about 16% of the greater than 17,000 federal wildland firefighters working for the Forest Service and the Inside Division. These are firefighters who’re dispatched to federal lands, like in nationwide forests and nationwide parks, and typically help county and state crews, as they did when fires swept into Los Angeles in January.

“At first look, we had been ecstatic,” Dutchick mentioned. “After which we’re like, ‘Nicely, the place are the feminine cancers?’”

Dutchick, who has an 8-year-old daughter, was upset. “I definitely need her to have equal protections relating to well being if she chooses to get right into a area of public service,” he mentioned.

Then this yr, because the Biden administration wound towards a detailed, federal officers addressed the exclusion, including the cancers to the record in a last-minute change earlier than Donald Trump took workplace.

“This coverage change acknowledges the distinctive occupational hazards confronted by girls firefighters and ensures they obtain the care and assist they deserve,” Christopher Godfrey, the now-former director of the employees’ compensation workplace, mentioned in a Jan. 6 assertion on the Labor Division’s web site.

In a press release to KFF Well being Information 4 days later, Godfrey mentioned the coverage change resulted in quick motion for firefighters with new claims.

However within the early days of the Trump administration, the January press launch asserting the most cancers protection growth was deleted from the Labor Division web site. When requested whether or not claims had been nonetheless being processed for the 4 just lately added cancers, a spokesperson for the employees’ compensation workplace, Frances Alonzo, instructed KFF Well being Information, “We would not have any further updates relating to your inquiry.”

Formalizing the coverage change by rulemaking will take months and assist from Congress.

Kaleena Lynde is amongst a era of girls firefighters who developed most cancers earlier than streamlined protection for staff’ compensation claims existed. In 2006, Lynde, then 22, was identified with small cell ovarian most cancers throughout her third fireplace season on the Shasta Lake Hotshots, an elite crew of firefighters in Northern California. Docs eliminated a 5.4-pound tumor virtually instantly that yr. She’s now cancer-free, however solely after a number of surgical procedures, chemotherapy, and an extra cervical most cancers analysis three years later. Lynde has since gone on to work varied jobs for the Forest Service, together with 16 years at Eldorado Nationwide Forest doing fireplace investigation, fireplace prevention, and dispatch heart jobs. She now coordinates wildfire apprenticeships for the company’s Pacific Southwest area.

A good friend just lately despatched her a hyperlink to the Nationwide Firefighter Registry for Most cancers, a database monitoring the prevalence of ailments amongst all firefighters, each structural and wildland. It made Lynde marvel — may her cancers be linked to her work on the hearth line?

“I simply thought I had dangerous luck,” Lynde mentioned.

Searching for to repair the omission, greater than 15 wildland firefighter advocacy teams, representing Hotshot crews, smokejumpers, and others, signed a September letter to Julie Su, the appearing labor secretary on the time. They identified that different international locations, together with Australia, already included presumptive protection for cervical, ovarian, uterine, and breast cancers.

The Labor Division applied coverage modifications that eased the necessities for protecting wildland firefighters’ cancer-related staff’ compensation claims in April 2022 by a Federal Workers’ Compensation Act bulletin. The foundations had been codified in December 2022 when President Joe Biden signed the Nationwide Protection Authorization Act.

To qualify, firefighters should have labored for at the least 5 years and be identified inside 10 years of their final publicity. These with unlisted cancers may nonetheless file claims by a particular unit however wouldn’t obtain the identical streamlined adjudication for compensation. By September 2024, the employees’ compensation workplace had acquired 91 claims for qualifying cancers and coronary heart and lung situations. Of these, 89 had been adjudicated by the particular claims course of and 84, or 94%, had been accepted. Godfrey mentioned that previous to the laws, solely 29% of occupational illness claims for firefighters had been accepted.

Rachel Granberg, a wildland firefighter in Washington state, mentioned streamlined processing and reimbursements are necessary. “It actually offers individuals extra bandwidth to fret about how they’re going to handle their life after a most cancers analysis, slightly than simply combating for fundamental well being care.”

Too usually firefighters find yourself crowdsourcing for monetary assist after most cancers diagnoses, she mentioned.

George Broyles, retired firefighter and Forest Service researcher, mentioned that well being dangers are too usually seen as a part of the job. “Hazard pay isn’t going to cease most cancers,” he mentioned. Broyles needs federal firefighting companies to be sincere about most cancers dangers when hiring younger staff after which educate them on methods to guard themselves.

The current coverage change meant claims for federal wildland firefighters with ovarian, breast, or uterine most cancers had been instantly directed to the particular claims unit and expedited processing.

The Labor Division’s choice to alter course and increase presumptive protection to feminine reproductive cancers was sudden. In December, the company launched a press release to KFF Well being Information saying such a change was unwarranted.

Three weeks later — with out pointing to any new printed analysis — the company modified course, citing further session with the Nationwide Institute for Occupational Security and Well being and with Steven Moffatt, a physician who makes a speciality of firefighter diseases. The company conducts periodic critiques to contemplate including new situations to its protection.

The Labor Division’s preliminary exclusion of feminine reproductive cancers illuminated the repercussions of analysis on wildland firefighter well being wherein girls are understudied. One evaluate discovered that solely three out of 20 research evaluated girls firefighters’ most cancers danger.

However analysis has confirmed for years that firefighters are uncovered to poisonous risks. A research that adopted Florida firefighters for nearly 20 years within the Eighties and Nineties discovered that firefighting will increase the general most cancers danger in feminine firefighters. In 2022, the Worldwide Company for Analysis on Most cancers labeled firefighting as a cancer-causing occupation.

Latest analysis contributed to the company’s inclusion of feminine reproductive cancers, Godfrey mentioned. In 2023, a research decided a hyperlink between perfluorononanoic acid, a sort of PFAS, and uterine most cancers. PFAS, which stands for per- and polyfluoroalkyl substances, are a class of chemical compounds {that a} current research discovered within the protecting gear worn by wildland firefighters. Further analysis has additionally linked PFAS publicity to a rise in melanoma. A research printed in September recognized 12 chemical compounds that firefighters are uncovered to on the job linked to breast most cancers.

However now, it’s unclear whether or not the Trump administration will roll again the brand new protection, leaving some federal firefighters not sure whether or not exposures on the job will go away them scrambling for care.

KFF Well being Information is a nationwide newsroom that produces in-depth journalism about well being points and is among the core working packages at KFF—an unbiased supply of well being coverage analysis, polling, and journalism. Be taught extra about KFF.

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