Provincial data shows firefighters in Hamilton are filing work-related cancer claims at twice the Ontario-wide rate.

But 10 years after legislation was introduced to make it easier for them to get compensation, there are still hundreds who have to fight to get their illness recognized.

According to data provided by Ontario's Workplace Safety and Insurance Board, for every 100,000 people in Hamilton, 22 firefighters were considered for work-related cancer benefits under the board's presumptive legislation.

We're exposed to so much every day. And before we had masks, we used to drink up the smoke. - Ken Cole, retired firefighter battling cancer

That's double the provincial per capita rate of 11 per 100,000 people in Ontario.

A more direct comparison to similar medium-sized cities also shows Hamilton claims at a high rate:

Ottawa's rate is 10 per 100,000 while Mississauga's is seven.

Fuelled by the fears arising from the 1997 toxic chemical fire at Plastimet, Hamilton firefighters were instrumental in the push for the 2007 legislation that made it easier for firefighters in Ontario to claim work-related cancers.

While Hamilton's high claim rate may be a result of fighting toxic fires like Plastimet in the heavily industrialized city, it may also be a result of efforts by Hamilton's firefighter union local, which, because of that history, has been proactive in both detecting and claiming its work-related cancers.

About 80 Hamilton firefighters and former firefighters have had WSIB cancer claims accepted.

A huge fire rips through a Hamilton industrial complex in 2014. (Tony Smyth/CBC)

The new legislation was supposed to simplify and clarify the claims process, but the reality is many claims considered by the WSIB are rejected, and there are many cancers that appear to be work-related that the board won't even consider for review.

The result is 10 years after firefighters won the right to compensation for their cancers, hundreds in the city still aren't getting it.

"The majority of our claims still aren't accepted," said Dan Santoli, the WSIB compensation representative for the Hamilton Professional Firefighters Association, Local 288.

'A new normal'

More than 60 years ago, Ken Cole started a lifelong career saving homes, buildings, and businesses in Hamilton's industrial east end. He was a dedicated firefighter for almost three decades.

Ken Cole looks through old photos from his career as a firefighter in Hamilton. (Sarah Peterson/CBC)

Cole fought fires in steel, rubber, plastic and chemical plants.

"You'd come out [of a factory] and your nose would be running, you'd be coughing and spluttering, your eyes would be running" said Cole.

"In those places, all of our equipment had to be destroyed, you couldn't clean it."

Just a few weeks ago, Cole was diagnosed with bladder cancer and has filed a claim with the WSIB.

You never think it will happen to you — that's what they say about cancer. But Cole says he knew very well it could.

A 19-year-old Ken Cole in his firefighter's yearbook. (Sarah Peterson/CBC)

"We're exposed to so much every day," he said. "And before we had masks, we used to drink up the smoke."

Cole says battling cancer has become a new normal for retirees of the Hamilton force.

"I would say there's probably 18 of us in the past two years that have passed away from cancer," he said.

The Plastimet fire 20 years ago was one of the worst environmental disasters in Canada's history. (CBC)

Nineteenth-century industrialization created new dangers for firefighters — and Hamilton's rise as a major industrial hub likely put its firefighters at an increased risk of exposure.

"We're the industrial heartland of the country," said Dr. Mike Pysklywec, a physician and occupational health expert in Hamilton.

Screening program

Dr. Pysklywec is part of a group of physicians who run Hamilton's occupational health screening program for firefighters. He says repeated exposure to things like burning plastic, heavy metals and asbestos can add up.

Data provided by WSIB and the Hamilton Professional Firefighters Association (Sarah Peterson)

"There's potential for a lot of carcinogens to be released when all these materials are heated," said Dr. Pysklywec.

In July of 1997, almost 300 Hamilton firefighters were deployed to the four-day Plastimet fire, and most were there for days in a row. Many firefighters suffered both short and long-term health effects in its wake.

"Once we realized what was burning, there was a lot of concern about what we were exposed to," said Rob D'Amico, a firefighter deployed to Plastimet.

According to Dr. Pysklywec, it often takes 15 to 20 years for cancer to develop from that kind of exposure, so there's a good chance some of the cancers surfacing now are linked to that fire.

Union representative Dan Santoli looks through boxes of WSIB claims filed for firefighters in Hamilton. (Sarah Peterson/CBC)

"It was a plastic-based industry with a lot of potential exposures. I'm sure that's contributing," he said.

But a lot was also learned from the Plastimet fire. Awareness increased, and the city started a screening program to catch cancers and other illnesses that might otherwise go unnoticed. Nowadays, firefighters in Hamilton talk about cancer more, they know the dangers they face, and their union makes it easy to file claims if they're diagnosed.

Fight continues, 10 years after Queen's Park victory

Plastimet was also a catalyst for the 2007 legislation. Twenty years ago, it was relatively rare for firefighters with cancer to win compensation for their illness in Ontario. Prior to Plastimet, evidence already showed firefighters were at an increased risk of many different types of cancer.

Those concerns finally made their way to Queen's Park after Plastimet.

In 2007, inspired in part by the death of Bob Shaw, a Plastimet first responder who died of cancer, the government acted. Now, if a firefighter is diagnosed with one of the board's approved cancers and meets the specific criteria, the disease is presumed to be caused by the nature of their job.

It's still difficult, but we're moving in the right direction. - Dan Santoli, WSIB compensation rep for Hamilton firefighters

The legislation was hailed as a victory, but the union says it still leaves many unprotected.

According to data provided by the WSIB, 116 claims have been filed for work-related cancer by firefighters in Hamilton under that presumptive legislation, and 68 per cent of those claims have been approved.

But Hamilton's union says the total number of claims they've filed is actually much higher.

According to their records, the union has filed more than 300 cancer claims, some dating back 25 years, of which only 25 per cent were approved.

"Just last week we filed four new claims for retired firefighters," said Santoli.

He says the reason his numbers are so much higher is because the board numbers only cover cases that qualify for consideration under its presumptive legislation — but he files cancer claims whether they're listed in the legislation or not.

"If there's evidence it was work-related, we file it," he said.

Dan Santoli is the WSIB compensation representative for the Hamilton Professional Firefighters Association, local 288. 0:59

Presumptive legislation doesn't guarantee approval

A year after the new legislation came into effect, Hamilton firefighter Brad Phillips was diagnosed with bladder cancer. Phillips filed a claim to the WSIB. It was approved without issue.

But as doctors worked to remove the cancer from his bladder, they noticed he also had cancer in his kidney. So he went back for treatment.

It was a tough year, but I'm one of the lucky ones. - Brad Phillips, Hamilton firefighter

Phillips had been working as a firefighter for over 17 years when he was diagnosed — just short of the 20-year minimum for kidney cancer to be considered presumptive — so his WSIB claim for that cancer was denied.

"That year I think I went to 26 different doctor appointments" he said. "I remember them telling me [at work], try to schedule them on your days off so you don't miss work."

But as a two-time cancer survivor, he doesn't dwell on the way it played out.

"It was a tough year," he said. "But I'm one of the lucky ones."

Santoli says there is a misconception that all cancers under their umbrella name are considered presumptive. "That's really not the case," he said.

Brain cancer, for instance, isn't considered presumptive if it's in the stem of the brain — likewise if a cancer starts somewhere else before it moves to a covered area.

The WSIB has approved about 80 claims from Hamilton firefighters for work-related cancers. (Sarah Peterson/CBC)

Santoli says colon cancer, which is considered presumptive, has been particularly tricky to get approved.

"Over the past 25 years, we've filed 49 colon cancer claims, and close to 80 per cent of those have been denied," he said.

Santoli also files claims for cancers that aren't covered in hopes they may be able to win a tribunal hearing.

"A number of our members have died from pancreatic and liver cancers. There's evidence it was work-related, but it's very hard to win."

Both Santoli and the WSIB agree around 80 firefighters' cancer claims have been approved in Hamilton.

The WSIB declined to comment on the union's records as they could not see them.

More claims filed and approved since amendments

Since 2014, the WSIB's coverage expanded to include lung, breast, testicular, prostate and skin cancer, as well as multiple myeloma.

The volume of claims has more than doubled in Hamilton since the legislation expanded.

Under the original legislation, only 30 claims in Hamilton were approved. Since 2014, 49 more have been approved.

"We were able to re-try a bunch of skin cancers that were denied before, many of those have now been approved," Santoli said.

"It's still difficult, but we're moving in the right direction."