Cancer: Asheville firefighters face job danger even deadlier than fire

ASHEVILLE - Will Willis signed up to fight fires and save lives as a volunteer at age 16.

Now 33, a husband and father of four, the Asheville Fire Department engineer has lived every day since then hyperaware of the job’s rewards and its deadly risks. He has dodged countless encounters with death, from smothering flames and smoke, to hazardous chemical spills to a bullet missing his heart by inches.

All in a day’s work.

But the job hazard Willis did not sign up for, what never crossed his mind, is what will most likely take his life – cancer.

Willis was diagnosed with a terminal form of kidney cancer in April. Friends and family say there is no treatment for the rare disease, known as translocation renal carcinoma. They believe he developed the disease through contact with carcinogens in the line of duty, making Willis one of the latest to succumb to an epidemic gripping the fire service.

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Cancer is now the leading cause of death among firefighters, according to the Firefighter Cancer Support Network and the International Association of Firefighters.

The sobering statistic has led to new national protocols on decontaminating uniforms to prevent prolonged skin absorption of cancer-causing chemicals, diesel exhaust control in fire stations, proper use of personal protective gear, cancer prevention and wellness education, medical cancer screenings, and a reversal of centuries-old firehouse attitudes among firefighters that they are near-invincible.

“We’ve got a pretty big bullseye on us when it comes to cancer,” said Josh Jenkins, 38, Willis’ cousin and fellow Asheville Fire Department firefighter. “Will is one of the healthiest, most in-shape people we have at the fire department. All of his doctors have said he probably has cancer because of a high introduction of toxins to his body while on the job.”

A landmark 2013 study conducted by the National Institute for Occupational Safety and Health, a division of the Centers for Disease Control and Prevention, found that firefighters have a 9 percent higher risk of being diagnosed with cancer and they are 14 percent more likely than the general U.S. population to die of cancer.

The study analyzed cancers and cancer deaths among 30,000 firefighters from the Chicago, Philadelphia, and San Francisco fire departments who were employed between 1950 and 2009.

It found that firefighters are more likely to develop cancer of the respiratory, digestive, and urinary systems and that firefighters in the study had a rate of mesothelioma two times greater than the rate in the U.S. population. The researchers said these cases were most likely associated with exposure to asbestos, a cause of mesothelioma.

Volunteer firefighters were not included in the study.

“Cancer diagnoses in four of our active Asheville Fire Department members in the last 12 months has brought home the seriousness of firefighter cancer exponentially,” said Scott Burnette, Asheville Fire Chief.

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“Three of (those diagnosed with cancer) have resulted in early medical retirements. There have been dozens of our retirees that have been diagnosed and passed away from cancer after retirement.”

The Asheville Fire Department has 260 firefighters, including 16 women. The average Asheville firefighter responds to more than 700 calls a year, including fires, medical, accidents, search and rescue and other emergency calls.

“The focus now is awareness through education, prevention through cleaning and decontamination, and early detection through cancer screening,” Burnette said.

Fighting deadlier fires, old traditions

Over the past few decades, homes and furniture have increasingly morphed from wood and natural fibers such as cotton and wool to synthetics and plastics, which release carcinogens such as benzene, formaldehyde and arsenic when they burn, according to fire agencies.

They lead to faster- and hotter-burning fires, said Keith Tyson, vice president of the national, nonprofit Firefighter Cancer Support Network, which increase the skin absorption rate of toxic chemicals.

Asheville Fire Department Division Chief Joy Ponder, 46, said she has seen the rapid change in fire composition in her 20 years as a firefighter. A native of Mars Hill, Ponder earned a bachelor’s degree in biology and a master’s degree in physiology. But a chance meeting with former Asheville Fire chief John Rukavina encouraged her to take up the noble professions of firefighting, a job she said she loves, but wants to make safer.

“The fires we go into now are made up of toxic smoke, plastic, TVs, computers, furniture. When they burn they break down into carcinogens - lead, cadmium, benzene, formaldehyde …,” Ponder said.

While firefighters have dramatically cut down on smoke inhalation through the use of self-contained breathing apparatus, skin absorption has become the biggest offender, she said.

Carcinogens naturally collect on the face, ears, neck, and underarms, seeping into skin. And chemicals left on turnout gear continue to off-gas for hours.

Adding to the mix is the hundreds-years-old tradition that a filthy, soot-soaked uniform was a firefighter’s badge of honor, and it has created the perfect recipe for health disaster.

“The sign of a good firefighter is a dirty uniform,” said Skyland Fire Department Chief Ryan Cole, who runs a station with 55 full-time and 30 part-time and volunteer firefighters. “They wash their turnout gear once, maybe twice a year.”

New safety protocols

The grime is coming to an end. The National Fire Protection Association reissued its “NFPA 1500,” a national code of standard for decontaminating gear, in response to the cancer crisis, Tyson said.

“Although these are considered standards, the reality is many fire departments say they are guidelines and don’t follow them.”

Skyland and Asheville fire departments, however, are falling in line. Cole said all firefighters must now do a quick decontamination as soon as they clear a fire, using baby wipes to clean their faces, heads, hands and necks, hosing off their uniforms, and bagging them up for the ride back in the truck.

Once back at the station, uniforms – pants and coat weighing about 50 pounds – are placed in an “extractor,” basically a commercial grade washing machine and dryer, before a firefighter can wear them again. The drawback is time – it can take four hours to clean one set. Cole said he hopes to have a second set for everyone within five years.

“The fire service has seen more change in the last 20 years than in last 200 years,” Cole said. “We are having to change our culture. We are accustomed to putting other people’s priorities in front of ours. But we have to ensure the long-term health and safety of firefighters to not only retire, but enjoy their retirement after they’ve given their service to the community. Their service should not end with their life ending.”

Asheville Chief Burnette said only a handful of the department’s firefighters have a second set of gear, which cost $3,000 a set. He is hoping the life-saving gear will be funded in the next city budget, and with a grant through the Department of Homeland Security.

In addition to cleaning uniforms, fire stations across the mountains are also installing “plymovents,” which suck the diesel exhaust out of the station when the trucks roll out, to reduce exposure to the harmful fumes. In decades past, the Asheville station’s walls would be black with diesel fumes, which would also bathe uniforms, gear, and firefighters standing in the line of exhaust pipes.

Today’s station smells clean and has whitewashed walls, thanks to the plymovents.

Ponder said she was once as guilty as anyone of sleeping next to her dirty turnout gear to throw it on as soon as the alarm sounded. But uniforms – clean or not - are no longer allowed in living quarters where firefighters eat and sleep. Firefighters are also told to shower as soon as clearing an incident involving smoke, chemicals or blood.

Asheville firefighters have an annual physical in which men are tested for prostate cancer, all are given a full chest X-ray, and they receive continual education on awareness and screening for other cancers.

Tyson said in addition to increased awareness and education, the Firefighter Cancer Support Network is pushing for a nationwide firefighter cancer registry to track types of cancers and those who are diagnosed with cancer after retiring from service.

The Firefighter Cancer Registry Act, coauthored by Reps. Bill Pascrell, Jr., D-NJ, and Chris Collins, R-NY, that would require the Centers for Disease Control and Prevention to develop and maintain a registry to collect data regarding the incidence of cancer in firefighters, addressing this massive information gap. The bill was passed by the House in September and is awaiting a vote in the Senate.

Cancer deaths will keep coming

The last Asheville Fire line-of-duty death was on July 28, 2011, when Capt. Jeff Bowen lost his life in a four-alarm arson fire at the 445 Biltmore Center medical building. The 13-year fire department veteran ran out of air and later died at Mission Hospital.

New safety procedures were put into place after Bowen’s death. But even with all the recently installed health safety protocols relating to cancer, the fire chiefs know they will continue to lose firefighters to cancer.

In March 2017, Ponder was diagnosed with breast cancer. It was not caught by mammogram. Instead, she noticed a “huge mass” herself and felt it grow by the day.

“It was very scary,” she said. “I went through extensive genetic testing, which came out clear. It’s a very distinct possibility that my cancer is related to firefighting.”

Ponder, who has a teenage son with her husband, Craig Oliver, underwent a double mastectomy, months of chemotherapy, and seven weeks of radiation, which she just completed in November. She said the disease brought her to her knees, but never stopped her love of firefighting. She continued to work as much as she could during treatment.

Ponder said her own family and her fire service family were supportive and rallied around her, coming to the hospital and calling her every day. She also planned fly-fishing trips after every chemo milestone.

Another motivator for her to keep going was Willis.

The two had known each other since childhood in Madison County, and have worked together for the past seven years. They were diagnosed with cancer at almost the same time and kept each other’s spirits up through calls and texts.

“We just say to each other, ‘Keep fighting.’ That’s what we do,” she said.

A marathon runner for nearly 30 years, Ponder also kept running through her cancer treatments, even though she sometimes falls, losing feeling in her feet and toes, a side effect of chemo. To raise awareness of the new horrors facing firefighters, and to raise money for Willis’ cancer treatment, Ponder will run in the Black Mountain Marathon on Saturday.

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The sold-out 26.2-mile race starts in downtown Black Mountain and climbs some 3,000 feet in elevation over sometimes ice- and snow-covered trail to the Black Mountain Gap Overlook on the Blue Ridge Parkway, then back to Lake Tomahawk. It runs concurrently with the 40-mile Mountain Mitchell Challenge, which brings runners to the 6,684-foot peak of Mount Mitchell.

Ponder has run both races several times. She will run with training partner and physician assistant Annie Hawes, who both say it might take them all day. But they plan to conquer the mountain in honor of Willis, and his fearless battle with cancer, and to provide for his family.

Willis met Bonnie Steen in kindergarten at Mars Hill Elementary. By fourth grade, they were best friends. Will joined the Ebbs Chapel Volunteer Fire Department as a junior member at 16, Jenkins said, because it was just in his blood.

The fire station was built in the mid-1980s on land donated by Willis’ and Jenkins’ great uncle. Several family members, including Willis’ father, served on the board, and other family members have or are still serving as firefighters. Will is now the fire station’s deputy chief.

In June 2005, Will and Bonnie were married. Bonnie was a school teacher, but now homeschools their three sons and one daughter, ages 2-9.

In 2009, Will, who also co-owns an electrical business, became a paid firefighter, first at Swannanoa and then at Asheville.

“Will is a firefighter's firefighter. Everyone wants to work with him and around him. He focuses on his family and others above himself always,” Burnette said.

Jenkins said the stories of his cousin’s selflessness are endless. He recalled one incident in which Willis came upon the scene of a tractor-trailer accident where the driver was seriously injured.

“He was in the scene before it was known there was a hazardous chemical leaking from the truck. Will took care of the driver, held pressure on his wound and went all the way to the hospital with him, more than likely saving his life,” Jenkins said.

Once Willis was on a routine medical call from a woman worried that her elderly husband had had too much to drink. When Willis and another paramedic arrived, the man pulled out a pistol and shot at them, hitting the female paramedic.

“She lived. They were standing shoulder to shoulder. If the bullet had been a few inches over, it would have hit Will in the heart,” Jenkins said.

None of these incidents ever deterred Willis from putting his all into his job every day, just like any firefighter, Jenkins said.

But cancer has forced him off the job and at a loss for how to pay for alternative therapies. Friends and family have started a Go Fund Me page for Willis’ medical treatments, as well as to help his family. In North Carolina, cancer in firefighters is considered a line-of-duty disease, which qualifies for death benefits, but only for three types of cancer: mesothelioma, testicular, intestinal and esophageal.

Kidney cancer is not covered.

Asheville Fire Capt. Scott Mullins said 37 states have presumptive legislation relating to firefighter cancer, meaning that firefighters diagnosed with cancer in the line of duty are covered for workman’s compensation, medical and death benefits. North Carolina is not one of these states.

Mullins said the Professional Fire Fighters and Paramedics of North Carolina will petition for presumptive cancer legislation to be passed in the state, as well for more cancers to be added to the death benefits list.

Last month, Willis gave a talk to a rookie class at the Asheville Fire Department.

“He wanted them to know what they were getting into,” Jenkins said. “When someone asked if he would still become a firefighter, he said ‘Absolutely yes. The cost is absolutely worth it.’ He draws strength from God and his faith and his family. He is at peace with what he’s done.”

Want to help?

Donate to Asheville Fire Department firefighter’s cancer treatment fund at www.gofundme.com/willwillis.

Support Chief Ponder's run

Asheville Fire Division Chief Joy Ponder will run in the Black Mountain Marathon, starting alongside the 40-mile Mount Mitchell Challenge at 7 a.m. Feb. 24 on Cherry Street, downtown Black Mountain. Both races finish at the Lake Tomahawk Clubhouse.

For spectators: The first marathon finishers arrive at Lake Tomahawk about 10 a.m. and the 40-mile runners about noon. To check on Blue Ridge Parkway road conditions, visit www.nps.gov/blri. Mount Mitchell may not accessible from Asheville on the parkway due to icy road conditions.

For more on the races, visit www.blackmountainmarathon.com or find them on Facebook.