Smoke Gets In Your Lungs

These are not good times for those who care about workers’ safety and health. Democrats and labor feel frustrated, powerless and impotent about the damage being done to this country by the Trump administration and the other two branches of government that are controlled be controlled by anti-worker heathens. But happily for this country — especially the workers of this country — we still have a free press.  For now.

And that free press can tell stories and effect change.  Here is one recent example that concerns an unfortunately growing industry: wildland firefighters who battle on the front lines of climate change, without health protections.

It seems obvious. Inhaling large amounts of wildfire smoke isn’t good for you.   And with climate change and a growing number of wildfires, fighting fires is an growing occupation. About 40,000 Americans fight wildfires for a living — from New Mexico to California to Idaho to Alaska — and points between. The largest share of woodland firefighters work for the U.S. Forest Service.

It’s not easy work:

Crews bushwhack deep into the forest, carrying upward of 50 pounds of gear, to create what is called the fire line. They cut and burn anything that might feed the flames, and using specialized axes, scrape past roots to reach layers of mineral soil that won’t ignite. Firefighters can work 24 hours straight building this line. Afterward, they often crawl into sleeping bags laid out in dirt. Every two weeks, they take a mandatory short break, and then can be sent back in.

Interspersed with the intense work are long, quieter stretches when crews watch the fire to make sure it doesn’t jump the line.

High heat, flying embers, falling trees and possibly burning to death are the most obvious hazards that woodland firefighters face. But smoke is a major — if unaddressed — problem for the health of these workers — a deadly problem — that hasn’t really been addressed. Until recently, thanks to intrepid investigative New York Times journalist Hannah Dreier.

Dreier published the first of a series of articles on the hazards facing America’s wildland firefighters(In Hannah’s name sounds familiar, she also wrote a series on child labor in the U.S. — a series that led to major changes in how the federal government deals with the problem.)  Because you’re all time-constrained, I summarize Dreier’s articles below. But I would suggest you read them all, and I’ve linked “gift links” to get you over the paywall.

Smoke Can Kill

Everyone has heard of people dying in fires from “smoke inhalation” where the body is quickly overcome by large amounts of suffocating smoke. But even inhaling much small amounts of smoke can cause deadly lung disease and cancer:

The smoke from the wildfires that burned through Los Angeles in January smelled like plastic and was so thick that it hid the ocean. Firefighters who responded developed instant migraines, coughed up black goo and dropped to their knees, vomiting and dizzy.

Seven months later, some are still jolted awake by wheezing fits in the middle of the night. One damaged his vocal cords so badly that his young son says he sounds like a supervillain. Another used to run a six-minute mile and now struggles to run at all.

Fernando Allende, a 33-year-old whose U.S. Forest Service crew was among the first on the ground, figured he would bounce back from his nagging cough. But in June, while fighting another fire, he suddenly couldn’t breathe. At the hospital, doctors discovered blood clots in his lungs and a mass pressing on his heart. They gave him a diagnosis usually seen in much older people: non-Hodgkin lymphoma, an aggressive cancer.

Allende’s diseases is not just bad luck. It’s a result of his occupation and his exposure to smoke:

For decades, studies have consistently linked higher wildfire smoke exposure to increased cardiovascular and lung issues, cancer and premature death. The Forest Service’s own researchers have warned for years about the effects of smoke, calling on the agency to provide masks, monitor exposures and track long-term health outcomes for firefighters….Researchers have found at least 31 carcinogens in wildfire smoke, along with other harmful particles.

So how do you protect firefighters? Protecting workers from inhalation hazards is not rocket science, but it is industrial hygiene — a science that focuses on protecting and enhancing the health and safety of workers by identifying, evaluating, and controlling workplace hazards. An according to industrial hygiene best practices, if you can’t eliminate a hazard or ventilate the area, just about the only protective measure left is respirators. And that doesn’t mean cloth bandanas, which shield against heat and flying ash.  Cloth bandanas are easy to breathe through, but they don’t filter out the most dangerous part of smoke: fine particulate matter that can travel deep into lungs, enter the bloodstream and harm the body.

Respirators can protect firefighters, but check out these photos: The first is of a firefighter fighting a house fire in Tempe, AZ. The second is of a firefighter in Greece. And the third is an American woodland firefighter. What’s the difference. Only the woodland firefighter is not wearing a respirator.

This is a problem that most urban firefighters don’t have.

It would be unthinkable for urban firefighters — those American icons who loom large in the public imagination — to enter a burning building without wearing a mask. But across the country, tens of thousands of people who fight wildfires spend weeks working in toxic smoke and ash wearing only a cloth bandanna, or nothing at all.

Unions representing wildland firefighters have lobbied for years for greater protections.  So why aren’t most American wildland firefighters using respirators? Because until recently, the US Forest Service didn’t allow US forest fire fighters to wear respirators.

Year after year, the Forest Service sends crews into smoke with nothing to prevent them from inhaling its poisons. The agency has fought against equipping firefighters with masks. It issues safety handbooks that make no mention of the long-term hazards of smoke exposure. And its workers are not allowed to wear masks on the front line, even if they want to.

The agency said in a statement that it wanted to protect its crews but masks posed too great a risk that firefighters would overheat while doing the strenuous work needed to contain a wildfire. Instead, supervisors are supposed to move them out of heavy smoke and set up sleeping camps in cleaner air when possible.

“Respirators are a potential tool to reduce smoke exposure, but regulatory and logistical challenges make widespread use impractical,” the statement read.

Somehow, those regulatory and logistical challenges aren’t so impractical in other countries. :

Countries with major wildfire seasons, including Canada, Australia and Greece, have begun to hand out half-face respirator masks with replaceable filters, like those worn by painters and demolition teams. In laboratory tests, they block about 99 percent of the toxic particles in smoke. Disposable N95 masks are nearly as effective.

And then there’s the heat problem.

The agency said in a statement that it wanted to protect its crews but masks posed too great a risk that firefighters would overheat while doing the strenuous work needed to contain a wildfire. Instead, supervisors are supposed to move them out of heavy smoke and set up sleeping camps in cleaner air when possible.

But somehow heat doesn’t seem to be a problem in other countries either:

Researchers in countries already using masks told The New York Times that they had not seen an increase in cases of heatstroke. Firefighters will slow down or remove the masks when they get too hot, they said. The Forest Service said it “continues to monitor international practices and research.”

So smoke is clearly hazardous, other countries and American urban fire departments find it possible to equip their firefighters with respiratory protection. So what’s the problem?

The Times reviewed dozens of scientific papers and spoke with more than 250 wildland firefighters, supervisors and agency officials. Nearly all said the same thing: Smoke damage isn’t the exception — it is part of the job.

As with most health and safety issues, the failure to protect workers comes down to cost — to the employer.

Internal records, studies and interviews with current and former agency officials reveal another motivation: Embracing masks would mean admitting how dangerous wildfire smoke really is.

That could lead to a cascade of expensive changes. The agency, already underfunded and understaffed, might have to add crews to allow for more breaks, or pay for them to sleep in hotels. Recruitment for the grueling, low-paying jobs could become harder. Spending could increase on an extensive range of health issues among workers and veterans.

The concern was evident, for instance, in a 2014 Forest Service internal presentation that listed pros and cons of masks. At the top of the pros: “Protects respiratory system.” The con list began: “Heat stress/work reduction” and continued, “20% Work Reduction.”

Like other industries whose workers are exposed to toxic materials, the Forest Service tends to deny the hazard:

In public comments and conversations with advocacy groups, the Forest Service has tended to dismiss cases like this as tragic outliers. The agency did not act on 25 years of recommendations that it track the long-term health of its crews, so there is no definitive tally of wildland firefighters who have suffered smoke-related illness.

But narrower studies repeatedly have shown a connection between wildfire work and illness. Some new studies have begun to document harms at the cellular level, like cancer markers and immune system abnormalities.

The Times reviewed dozens of scientific papers and spoke with more than 250 wildland firefighters, supervisors and agency officials. Nearly all said the same thing: Smoke damage isn’t the exception — it is part of the job.

And then, of course, there’s the fear that if firefighters really knew about the hazards, they’d find other jobs:

“They treat you like cannon fodder,” said Zack MacMillan, who said he went to the emergency room in Colorado at age 27 after working in smoke so thick that he needed a flashlight to see where he was walking. He left firefighting and said he now has trouble catching his breath.

“Imagine the shortage of workers if they were being completely honest about the hazards,” Mr. MacMillan said.

One former firefighter, George Broyles, who became a smoke researcher for the Forest Service, concludes that “They didn’t want to know, because then they’d have to do something.”

Regulatory Inertia: Something Must Change

As noted (and pictured) above, urban firefighters routinely use respiratory protection.  But not without a fight:

Until the 1970s, those firefighters rarely wore masks. Then the Labor Department began requiring sealed masks and compressed air tanks. Firefighters immediately protested, according to Jonathan Szalajda, who helped oversee the regulation of masks at the C.D.C. until he retired this year.

“They said, ‘It’s going to destroy the industry,’” he said. “But then they just modified their way of working.”

Since the requirement went into place, elevated cancer rates in urban firefighters have dropped. “But you need the requirement first,” Mr. Szalajda said. “Until there’s a requirement, things are going to stay pretty much the way they are.”

OSHA is finally on the case, working on a new standard that would protect emergency responders — and require the use of respirators by all firefighters. The initiative comes partly from OSHA’s experience during the World Trade Center cleanup after 9/11 where workers were reluctant to wear respirators. OSHA did not force the issue.  Within a few years hundreds became sick. Congress set up a program to provide surveillance, and compensate and treat those workers. Today, 125,633 living members are enrolled in the program.

OSHA is finally on the case, working on a new standard that would protect emergency responders — and require the use of respirators by all firefighters.

The other event that spurred OSHA action to protect emergency responders was the 2013 West, Texas ammonium nitrate fertilizer explosion that killed 15 persons, 12 of whom were emergency responders.

But the road to an OSHA standard is not fast or easy. The OSHA proposal has met enormous resistance from volunteer fire departments who claim that the new standard will put them out of business.  And the Forest Service isn’t very happy either:

In a series of tense video meetings that have not been previously reported, Forest Service officials pushed to kill the mandate, according to three people with knowledge of the meetings who spoke on the condition of anonymity because they were not authorized to discuss internal deliberations.

The National Wildfire Coordinating Group, an association made up of state and federal wildfire agencies and steered in part by the Forest Service, noted that the new safety standards might be ruinously expensive.

In its statement, the Forest Service said it wanted the rules to be more “flexible” and “reflect the unique conditions of wildland firefighting.”

Joe Perez, a California firefighter who was forced to stop wildfire work in his 30s because of lung damage, followed the proceedings closely and urged the Labor Department in a letter not to back down. “We work, eat and rest in these toxic environments with little to no protection,” he wrote. “Something must change.”

Not Our Fault

Dreier’s second article, “If I Live to 25, I’ve Lived a Good Life” is a heartbreaking story that addresses the failure of private sector firefighting employers to provide workers compensation for diseases clearly acquired on the job. It’s a story of Joel Eisiminger, a woodland firefighter who loved firefighting, but started feeling weak and disoriented while fighting a fire in northern California in 2024.  “On the eve of his 25th birthday he received a diagnosis: acute myeloid leukemia, an aggressive, often fatal blood cancer that usually strikes people more than twice his age.”

But facing possible death and hundreds of thousands of dollars of medical costs to fight his cancer, he discovered a troubling fact: unlike Forest Service firefighters where there is a “presumption” that certain diseases — cancers, chronic obstructive pulmonary disease and certain coronary events are work-related, private sector firefighters don’t have that presumption.

About two-thirds of the country’s 40,000 wildland firefighters work for state and federal agencies. By law, many of their cancers are assumed to be job-related, and their workers’ compensation benefits are automatically approved.

The other firefighters — about 14,000 — are like Joel. They work for private companies that the government hires to shore up its ranks against a growing wildfire threat. Reliance on these contract crews has more than doubled since 2019, as climate change drives more extreme fire seasons. They have fought alongside federal workers in every major fire of the last decade.

So what’s the problem?

On the front line, all crews take orders from the same command structure and breathe the same smoke. But the laws that cover government workers do not extend to contractors. To get benefits when they fall ill, contract firefighters must prove that smoke exposure caused their cancer — an all but impossible task.

Some go without needed chemotherapy and radiation. Others take on so much debt their families become homeless. Some return to fighting wildfires even while sick.

Why? You ask. Privatization of government services.

This work was once done almost exclusively by government crews, but in the 1990s, after a series of staffing cutbacks, the U.S. Forest Service turned to logging and forestry companies for help. The contracts were so lucrative they launched a new industry. Hundreds of companies — including Pacific Oasis — refashioned themselves into wildfire operations. A political backlash against the practice of sending inmates to fight wildfires for dollars a day has further accelerated this trend in places like California, where the use of contract crews has tripled in recent years.

In the heavily forested strip of southern Oregon where Joel lived, fighting wildfires had become some of the best-paying work available to a person without a college degree.

But their training was limited to safety hazards: Making sure you don’t get burned and nothing falls on your head or gets in your eyes.

He took care to teach new recruits about wearing hard hats and goggles. He didn’t give much guidance about respiratory protection, though, because there was little protocol for that. There had been nothing in his training about the long-term health risks of smoke inhalation.

Like most wildland firefighters, Joel had been taught to wear a bandanna in bad air. This has been standard practice for years, even though bandannas offer no barrier against carcinogens.

After the cancer diagnosis and the bills started pouring in, Joel and his father went to talk to his employer, Steve Dodd, President of Pacific Oasis, about filing a claim:

He went to Pacific Oasis headquarters to ask about filing a claim. He was too weak to drive, so his father, Matt, took him. They both remember Steve’s response the same way: “There’s no way that you can prove this is work-related.”

On the car ride home, Joel broke down. His father struggled to contain his outrage at Steve. “I couldn’t believe he’d spent thousands of hours working with Joel, but at the first sign of trouble, he changed completely,” Matt remembered.

Steve, 67, had his own frustrations. He sympathized with Joel’s plight and later said he was just trying to warn him that his claim was unlikely to succeed. A self-described hippie when he founded Pacific Oasis as a forestry company, he had only recently stopped leading fire crews himself and still believed strongly in universal health care.

But he felt no responsibility for Joel’s illness. He doubted that wildfire smoke exposure caused cancer, especially in someone who had spent so few years in the job. Steve was focused more on immediate dangers, like falling trees or chain saw injuries. “Cancer doesn’t even make my top-10 list of worries,” he said.

He also had the concerns of a business owner. Joel’s case might raise his insurance rates, already his largest expense behind payroll. Those who worked with him knew to expect both sides of his personality: He could be a paternal mentor who trained them and gave them second chances, but also a demanding boss who watched out for the bottom line.

Bad news

70 percent of patients died within five years of diagnosis. For him, that would mean dying before he was 30.

Wildfire smoke contains benzene, a known cause of acute myeloid leukemia, and studies have shown that firefighters die of blood cancers at higher rates. Joel’s oncologist, Dr. Curtis Lachowiez, said he tried to discourage firefighters in remission from going back to that work. “Inhaling all those chemicals is not good for them,” he said.

And then he got more bad news:

He spent September in and out of the emergency room with infections. His bones ached, and he was taking 15 pills a day to manage side effects from chemotherapy. One day, a letter came from the insurer. “Your work is not the major contributing cause of your claimed disease,” it read.

Joel was stunned. No more payments were coming. He had no savings left, and months of treatment ahead.

The good news is that Joel is in remission and has recovered his strength. The bad news is, he was broke, his old employer wouldn’t take him back and, failing to find other employment, he flew off to Alaska to try to find another firefighting job.

Journalists to the Rescue

We’ll end this on a high note. As we mentioned above, attempting to deal with Donald Trump’s rollback of worker protections and worker rights, despite the loud objections of Democrats and labor groups, has been difficult and generally not fruitful.

But good journalism is making a difference.

Progress protecting workers from occupational disease in this country is slow — far too slow.  And with the destruction of the National Institute for Occupational Safety and Health, we seem to be going backwards.  But somehow journalists like Dreier, who tell the moving and powerful stories of the workers suffering from preventable work-related disease — break through and make change.

In an update, Dreier reports that on September 8, the U.S. Forest Service “posted new guidance acknowledging for the first time that masks can protect firefighters against harmful particles in wildfire smoke.”

The move is part of a flurry of safety improvements in recent weeks as the government faces increasing pressure to aid firefighters.  In an about-face, the agency now says it has stockpiled some 80,000 N95 masks and will include them in the standard set of equipment for all large fires. It is encouraging firefighters to mask up and even suggesting that they shave their facial hair for a better fit. Previously, they were only allowed to wear bandannas, which offer no protection against toxins.

This is good news, although there are still problems. For example, the guidance does not approve respirator use “during the arduous work performed by wildland firefighters on the fireline,” but only for “light duty.”

They remain banned during arduous work, like digging trenches to contain wildfires, because the Forest Service says they may cause overheating.

But permission to wear them at all is a major step, [Timothy] Ingalsbee [executive director of the nonprofit group Firefighters United for Safety, Ethics and Ecology.] said, noting that his worst exposures as a Forest Service firefighter had come while traveling old logging roads choked with smoke. “I wish I’d had the option to wear a mask,” he said.

The guidance also notes that the use of N95 respirators is “voluntary,” not mandatory. This takes the burden of complying with OSHA’s respirator standard off of the Forest Service.  Using “negative pressure” respirators — where you have to work to draw air through a filter — is required under the standard where respirator use is required by and OSHA standard or by the employer.

But…

Voluntary use of the N95 respirator does not require a medical evaluation, a supervised fit testing, or a clean-shaven face. Beards and facial hair are allowed for voluntary respirator use, but they interfere with the seal of the respirator and significantly decrease its effectiveness. A clean-shaven face is recommended.

In other words, use them if you want to, and use them at your own risk.

More progress: The National Fire Protection Association, the organization that issues guidance for firefighting and fire prevention has issued new (voluntary) guidance,

rolled out an emergency rule on Tuesday to protect firefighters from smoke even while they are doing grueling fire line work. That group, the National Fire Protection Association, will now allow the certification of facial coverings that offer more protection than cotton bandannas but are not sealed respirators, like N95s. Fire agencies across the country generally prohibit gear that is not approved by the association, so the change paves the way for firefighters to use more-protective coverings, like neck gaiters with built-in filters.

Congress has also gotten in the act: