FEDERAL FIRE FIGHTER PRESUMPTIVE
DISABILITY
The IAFF supports the Federal Firefighters Fairness Act and encourages Members of Congress to
cosponsor the legislation.
BACKGROUND
Fire fighters are exposed on a daily basis to stress, smoke, heat and various toxic substances. As a result, fire
fighters are far more likely to contract heart disease, lung disease and cancer than other workers. And as fire
fighters increasingly assume the role of the nation's leading providers of emergency medical services, they are
also exposed to infectious diseases. Heart disease, lung disease, cancer and infectious disease are now
among the leading causes of death and disability for fire fighters, and numerous studies have found that these
illnesses are occupational hazards of fire fighting.
)
.
In recognition of this link, more than 40 states have enacted "presumptive disability" laws, which presume that
cardiovascular diseases, certain cancers and certain infectious diseases contracted by fire fighters are jobrelated for purposes of workers' compensation and disability retirement unless proven otherwise. No such law
covers fire fighters employed by the federal government.
Under the Federal Employee Compensation Act (FECA), federal fire fighters must be able to pinpoint the
precise incident or exposure that caused a disease in order for it to be considered job-related. This burden of
proof is extraordinarily difficult for fire fighters to meet because they respond to a wide variety of emergency
calls, constantly working in different environments under different conditions. As a result, very few cases of
occupational disease contracted by fire fighters have been deemed to be service-connected.
CURRENT LEGISLATION
U.S. House:
H.R. 948. the Federal Firefiahters Fairness Act
Sponsors:
Representative Lois Capps (D-CA)
Representative Todd Platts (R-PA)
U.S. Senate:
The Federal Firefiahters Fairness Act (to be introduced in the near future)
Sponsors:
Senator Tom Carper (D-DE)
Senator Susan Collins (R-ME)
Summary:
The Federal Firefighters Fairness Act would create a rebuttable presumption that cardiovascular
disease, certain cancers and certain infectious diseases contracted by federal fire fighters are
job-related for purposes of workers' compensation and disability retirement.
CONGRESSIONAL ACTION
.e
On February 10, 2009, H.R. 948 was introduced in the House of Representatives and referred to the House
Committee on Education and Labor.
Senators Carper and Collins plan on reintroducing the Senate version of the Federal Firefighters Faimess
Act in the near future.
2009 Alfred K. Whitehead Legislative Conference
FEDERAL FIRE FIGHTER PRESUMPTIVE
DISABILITY
Our nation's federal fire fighters have some of the most hazardous and sensitive jobs in the
country. While protecting our national interests on military installations, nuclear facilities, VA
hospitals and other federal facilities, they are routinely exposed to toxic substances, biohazards,
temperature extremes and stress.
Fire fighters who are forced to separate from service due to a disability sustained in the line of
duty receive enhanced retirement benefits over those who are injured off the job.
Occupational illnesses should be considered job-related disabilities, but unlike most states, the
federal government does not presume that illnesses associated with fire fighting were
contracted in the line of duty.
To qualify for disability retirement, a federal fire fighter who suffers from an occupational illness
must specify the precise exposure that caused his or her illness - an almost insurmountable
burden.
,-
The Federal Firefighters Fairness Act creates a rebuttable presumption that federal fire fighters
who become disabled by heart and lung disease, certain cancers and certain infectious
diseases contracted the illness on the job.
Because the presumption is rebuttable, illnesses would not be considered job-related if the
employing agency can demonstrate that the illness likely has another cause. For example, a fire
fighter who smokes would not be able to receive line-of-duty disability for lung cancer. But the
burden of proof would be on the employer, rather than the injured employee or his or her family.
The Congressional Budget Office has found the cost of implementing the Federal Firefighters
Fairness Act to be quite low: approximately $26 million over ten years.
*
It is fundamentally unfair that fire fighters employed by the federal government are not eligible
for disability retirement for the same occupational diseases as their municipal counterparts. This
disparity is especially glaring in instances where federal fire fighters work along side municipal
fire fighters during mutual aid responses and are exposed to the same hazardous conditions,
such as the responses to Hurricane Katrina and the California wildfires.
If the federal government wants to be able to recruit and retain qualified fire fighters, it must be
able to offer a benefits package that is competitive with the municipal sector, including having
occupational illness covered by worker's compensation.
<-
Congress has provided presumptive disability benefits to other groups of individuals, such as
Peace Corps volunteers, military veterans and public safety officers who die in the line of duty.
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2009 Alfred K. Whitehead Legislative Conference
Increased Health Problems Among Fire Fighters
Fire fighting, by its nature, is inherently dangerous to health. Everyday exposure to smoke,
stress, chemicals, carcinogenic agents, extreme temperatures and bodily fluids puts fire fighters
at an increased risk to develop cancer, heart disease, infectious diseases, and lung and
respiratory diseases. Numerous studies provide evidence of the link between fire fighting and
these and other health problems.
Fire fighters tend to enter the profession much healthier than the general population, and
participate in a mandatory fitness regimen. Therefore, when a study finds a mild to moderate
increase in cancer or heart disease in fire fighters compared to the general population it is
very likely an underestimate.
Cancer
A number of studies have identified and established increased risk of cancer in fire fighters
and identified associations with carcinogenic occupational exposures. The majority of these
studies that examined these cancers found markedly elevated risks for fire fighters, and there
were usually no alternative viable hypotheses that could readily explain their increased
prevalence.
A 2008 study by Kang et al. of male Massachusetts fire fighters from 1987-2003 found
increased risk among such fire fighters for numerous cancers, including colon and
brain cancer;
A 2006 study conducted by the University of Cincinnati found that on-the-job exposure
to soot and toxins creates an increased risk for various cancers among fire fighters;
A 1992 study by Demers and coworkers in the British Journal of Industrial Medicine of
4546 fire fighters found that brain cancer rates showed statistically significant increases
among fire fighters compared with U S . males with 2.07 times the risk;
A 1987 study of 1867 fire fighters from Buffalo, New York, Vena and Fiedler in the
American Journal of lndustrial Medicine found a statistically significant increase of colon
cancer risk for fire fighters that was 1.83 (or almost double) that of the general population.
Further, they found that the risk increased to a statistically significant 4.71 (or almost 5
times) higher for fire fighters with the longest employment;
A 1994 study by Tornling in the American Journal of lndustrial Medicine found that both
stomach cancer incidence and mortality increased with duration of employment and
number of fires fought. Stomach cancer incidence was statistically significantly elevated
by 2.89, almost three times, for those with more than 30 years employment;
A 1993 study of more than 3300 Canadian fire fighters by Guidotti in the American
Journal of lndustrial Medicine found a 3.16 (greater than three fold) increase in the risk
of bladder cancer compared to the general population; this same study reported a
greater than four fold, or 4.14, increase in risk for kidney cancer;
In 1994: NIOSH, combining mortality data from 27 states, found an excess risk of 1.71
for fire fighters younger than 65 to develop leukemia.
2009 Alfred K. Whitehead Legislative Conference
IV. 3
Heart Disease
Known associations exist between fire fighting and cardiovascular disease. Exposure to toxic
chemicals, increased physical demands and increased psychological demands - conditions
regularly experienced by fire fighters - have been shown to negatively affect heart health.
T
A 2007 Harvard study published in the New England Journalof Medicine found that fire
fighters face a risk of death from heart attack up to 100 times higher when involved in
fire suppression as compared to non-emergency duties;
A recent study by Ma in the American Journal of Industrial Medicine found the risk of
death due to cardiovascular disease was 3.85, or almost four times higher for female
fire fighters than females in the general population.
Infectious Diseases
Fire fighters and emergency medical personnel are often exposed to bodily fluids during the
course of duty. Exposure to blood and sharp surfaces at vehicle accidents, and emergency
medical treatment procedures including intravenous line insertion and blood drawing put fire
fighters at risk of contracting a bloodborne contagious disease through a puncture wound,
skin abrasion or laceration that becomes contaminated with infected blood from the patient.
A U.S. Federal Government study conducted during the development of the OSHA
Bloodborne Pathogen Standard shows that 98% of Emergency Medical Technicians
and 80% of fire fighters are exposed to bloodborne diseases on the job;
The National Fire Protection Association estimates in their 2006 Report on U.S.
Firefighter Injuries that there were 11,890 exposures to infectious diseases (e.g.,
hepatitis, meningitis, HIV, others) among fire fighters in 2006.
T
Luncr and Res~iratorvDisease
The smoke from most fires contains gases and particles that can be irritating and toxic to the
respiratory system. A number of studies have demonstrated increased symptoms. transient
hypoxemia, hyper-responsive airways and changes in pulmonary function tests.
A 1989 study by Markowitz in the Archives of Environmental Health of fire fighters
exposed to hydrochloric acid during a large PVC fire showed that 9.4% of fire fighters
were diagnosed with asthma and 14.3% suffered from bronchitis;
A 1974 study by Peters et al. in the New England Journal of Medicine that measured
pulmonary function over a year in 1430 Boston fire fighters found that both lung capacity
and expiratory volume decreased more than what would normally be expected. The
rate of loss was significantly related to the number of fires fought:
A 1990 study by Large in Chest found significant declines in lung function in fire fighters
following exposure:
A 1993 study by Kern in the American Review of Respiratory Distress found fire fighting
to be significantly associated with one marker of immune system activation suggesting
that fire fighters may be at increased risk for the development of sarcoidosis, a lung
disease.
IV. 4
1
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2009 Alfred K. Whitehead Legislative Conference
Carcinoaenic Exposures in Fire Fiahters
-
Fire fighters are routinely exposed to a variety of chemical substances, many of which have
been classified as known or possible carcinogens by the International Agency for Research
on Cancer (IARC). Unfortunately, personal protective equipment and respiratory protection
equipment are only partially effective in protecting fire fighters from such substances.
The mixture of hazardous chemicals is different at every fire and the combined effects of
these substances are unknown.
A few of the common toxic substances encountered by firefighters include:
Classified as Carcinoaenic to Humans by the IARC
Benzene
used in the manufacture of a variety of products (plastics, synthetic fibers, dyes,
rubbers) and as a solvent
found in over 90% of fires
known to cause cancer in humans, especially leukemia
P
Asbestos
has been used widely in buildings for insulation
known to cause cancer in humans, especially lung, laryngeal, and gastrointestinal
cancers
Vinvl chloride
used in the manufacture of plastics and present in building materials and consumer
goods
known to cause cancer in humans, especially cancer of the liver, brain, lung. blood,
lymphatic system, gastrointestinal system. and malignant melanoma
Soots
contain a variety of chemicals including polycyclic aromatic hydrocarbons (PAH)s;
firefighters often have direct skin contact with soot that penetrates their clothing
found in a//fires
known to cause cancer in humans, especially cancer of the skin, scrotum, lung, liver,
esophagus, and leukemia
Classified as Probablv Carcinoaenic to Humans by the IARC
Formaldehvde
used in manufacture of textiles, plastics, adhesives, wood products, insulation, paints,
leather, rubber
known to cause cancer in animals and probably humans, especially Hodgkin's disease,
leukemia, and cancers of the mouth, pharynx, lung, nose, prostate, bladder, brain.
colon, skin. and kidney
P
Diesel exhaust
a complex mixture of PAHs, benzene, formaldehyde, and other chemicals; released
from fire engines
2009 Alfred K. Whitehead Legislative Conference
IV. 5
known to cause cancer in animals and probably humans, especially lung and bladder
cancer
Acrvlonitrile
used in textiles and rubber for clothing, building materials, and household products
converted in the body to cyanide; known to cause cancer in animals and probably
humans, especially cancers of the lung, prostate, stomach, colon, brain, blood, and
lymphatic system
Classified as Possiblv Carcinoaenic to Humans by the IARC
Carbon monoxide
a natural product of combustion; it blocks the body from being able to carry and use
oxygen
found in all fires
likely causes cancer in animals and possibly humans, especially liver and kidney cancer
IV. 6
2009 Alfred K. Whitehead Legislative Conference
P
Arguments Against Establishing a Presumptive Benefit
for Federal Fire Fighters
"There is no scientific proof that these diseases are directly related to fire fighting. "
Answer: Fire fighting, by its nature, is inherently dangerous to health. Everyday exposure to smoke,
stress, chemicals, carcinogenic agents, extreme temperatures and bodily fluid put fire fighters at an
increased risk to develop certain diseases. Numerous scientific studies have found heart disease,
lung disease, certain cancers and other infectious diseases to be occupational hazards of fire fighting.
And, because fire fighters enter the profession healthier than the general population and participate in
mandatory fitness programs, when a study finds a mild to moderate increase in cancer or heart
disease in fire fighters compared to the general population it is very likely an underestimate. Asummary
of numerous scientific studies of the link between fire fighting and certain diseases can be found in the
document "Increased Health Problems among Fire Fighters." A summary of known carcinogens and
probable carcinogens to which fire fighters are exposed on a regular basis can be found in the document
"Carcinogenic Exposures in Fire Fighters."
In recognition of the linkage between firefighting and certain diseases, 40 states have enacted
presumptive disability laws for municipal fire fighters.
"There is no need for this legislation; federal fire fighters are not being rejected for FECA benefits at
rates disproportionate to other occupations."
r
Answer: Several IAFF members employed by the federal government have had their claims for jobrelated disability rejected. For example, Captain James Warman, a fifteen year veteran of the fire
service, was serving at Fort Leonard Wood, Missouri when he was diagnosed with colorectal cancer.
He filed a claim with the Office of Workers' Compensation but was denied benefits because he could
not prove the exact incident that caused his cancer.
The total number of these denials remains small only because many fire fighters don't bother seeking
benefits knowing that their claims will be rejected. Even in the rare instances in which the service
connection is so apparent that the Department of Labor has little choice but to award benefits, the
absence of a presumptive disability law means that the fire fighter must spend years fighting the
bureaucracy to receive the benefits to which he or she is entitled.
"No other group of federal workers is entitled to presumptive benefits under FECA. Why should
federal fire fighters be treated any differently than other federal workers?"
Answer: The very nature of fire fighting makes it impossible pinpoint the cause of a disease. Unlike
other federal workers for whom one can investigate specific work sites and look for disease clusters
among employees at such sites, federal fire fighters respond to a variety of emergencies at numerous
varied locations, making it impossible to identify the source of exposure.
P
Congress has extended presumptive benefits to various groups of individuals through benefit programs
other than FECA. Peace Corps volunteers, military veterans and public safety officers who die in the
line of duty are all covered by presumptive laws. For example, service connected disability benefits
are provided to Vietnam veterans whose cancers are presumed to be caused by herbicide exposure.
Similarly, a public safety officer who dies of a heart attack or stroke within 24 hours of responding to
an emergency call is presumed to have died as a direct and proximate result of the emergency
response, enabling their survivors to receive benefits under the Public Safety Officer Benefit program.
2009 Alfred K. Whitehead Legislative Conference
IV. 7
INTERNATIONAL ASSOCIATION OF FlRE FIGHTERS
STATEMENT OF
STATEMENT OF JAMES B. JOHNSON
16TH DISTRICT VICE PRESIDENT
BEFORE THE
SUBCOMMITTEE ON WORKFORCE PROTECT'IONS
OF THE
HOUSE COMMITTEE ON
EDUCATION AND THE WORKFORCE
H.R. 697
FEDERAL FlRE FIGHTERS FAIRNESS ACT
MAY 26,2005
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2009 Alfred K. Whitehead Legislative Conference
Mr. Chairman. Ranking member and members of the committee. my name is James
Johnson and I am the 16th District Vice-president of the International Association of Fire
Fighters (IAFF), representing federal fire fighters.
On behalf of General President Harold A. Schaitberger and the 267,000 men and women
of the IAFF it his my honor to testify before you today on I4.R. 697. The Federal Fire
Fighters Fairness Act. a bipartisan bill introduced by Representatives Joann Davis and
Lois Capps. The bill would bring a much-needed benefit to the fire fighters that I
represent in the federal sector.
Introduction
Since the events of September 1 1. 2001. Americans have become increasingly aware of
the role that fire fighters serve as our nation's domestic defenders. These courageous men
and women protect the lives and property of their neighbors in communities throughout
the country.
Federal fire fighters, although not as well known as their counterparts in the nlunicipal
sector, play an essential role in protecting the vital interests of the United States. The over
15,000 federal fire fighters face some of the most difficult and hazardous working
conditions in the country guarding military installations. nuclear facilities. and VA
hospitals. And their 72 hour work week is unparalleled. Without their dedicated service,
our nation would be less secure.
The job of federal fire fighters is unique in many ways. Far more often than other
occupations within the federal sector. they are routinely exposed to carcinogens.
infectious diseases. and other occupational hazards.
Federal fire fighters respond to all of the same types of emergencies as their counterparts
in the municipal sector-including medical emergencies. hazardous material incidents,
structural fires, and aircraft emergencies. But they also face unique hazards involving
incidents at weapons depots. facilities conducting classified work and research. and
emergencies aboard naval vessels.
And they respond to these incidents often without adequate information about the dangers
they may encounter. An EMS call can actually turn out to involve a chemical spill. and a
structural fire can be the result of a research or ammunition test failure. Although fire
fighters take precautions and wear protective gear, as with all aspects involving
occupational protection. exposures happen.
Fire fighters are exposed on an almost daily basis to stress. smoke. heat and various toxic
substances. As a result. they are far more likely to contract heart disease. lung disease and
cancer than other workers. And as fire fighters increasingly assume the role of the
nation's leading providers of emergency medical services, they are also exposed to
infectious diseases.
2009 Alfred K. Whitehead Legislative Conference
Heart disease, lung disease, cancer, and infectious disease are now among the leading
causes of death and disability for fire fighters, and numerous studies have found that
these illnesses are occupational hazards of fire fighting.
Under the Federal Employees Compensation Act (FECA), compensation and/or
retirement benefits are not provided to federal employees who suffer fi-om occupational
illnesses unless they can specify the conditions of employment to which the disease is
attributed. In order to qualify for these benefits under current law. federal fire fighters
must be able to pinpoint the precise incident or exposure that caused a disease in order for
it to be determined job-related.
As I will explain further in my testimony. this burden of proof is extraordinarily difficult
for fire fighters to meet because they respond to a wide variety of emergency calls,
constantly working in different environments under varied conditions.
As a result, very few cases of occupational disease contracted by fire fighters have been
deemed to be service connected.
State Laws
In recognition of the linkage between firefighting and certain diseases. 30 states have
enacted some sort of "presumptive disability" laws. which presume that cardiovascular
diseases. certain cancers and infectious diseases are job-related for purposes of workers
compensation and disability retirement unless it can be shown otherwise.
For example. Mr. Chairman. in your home state of Georgia fire fighters are protected by a
presumptive disability law that covers heart disease, lung disease. and certain infectious
diseases.
Many of the illnesses covered by state presumptive disability laws are debilitating and
often fatal. They place a great strain on the fire fighter and hisher family. Knowing that
they will not have to fight their state Worker's Compensation offices during trying times
for them and their families provides a degree of security for those who place themselves
in harni's way to protect the rest of us.
While presumptive laws are now the norni for municipal fire fighters, no such protection
exists for fire fighters employed by the federal government.
Fairness
HR 697 was named the Federal Fire Fighters Fairness Act because the main impetus for
the legislation is to treat federal fire fighters fairly. It is simply not right that federal fire
fighters are denied an important workplace protection that is routinely provided in the
municipal sector. This inequity is especially egregious in communities where federal fire
departments maintain a mutual aid agreement with a neighboring municipality.
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2009 Alfred K. Whitehead Legislative Conference
In such instances. federal fire fighters work side-by-side with municipal fire fighters
during mutual aid responses and are subject to the same occupational hazards as the
municipal fire fighter. However. if two fire fighters both contract an illness due to their
inutual exposure at an incident, the municipal fire fighter in most instances would be
covered by workers compensation but the federal tire fighter would not.
There simply is no valid justification for denying federal fire fighters comparable
protections.
Recruitment and Retention
Ln order for the federal government to adequately protect our nation's domestic military
installations, nuclear facilities and other sensitive agencies. the government must offer
fire fighters benefits that are competitive with those that are provided by municipalities.
Often. federal fire fighters leave the federal service for work in a municipal department
because the benefits are superior. For those same rcasons, municipal departments also
have a competitive advantage over the federals in the recruitment of new hires.
Being at a competitive disadvantage to recruit and retain fire fighters harms the federal
government in two ways. First, it makes it more difficult to recruit and keep the very best
our profession has to offer. Considering the vital national security role played by the
nation's fire fighters. it is important that the federal government is able to recruit and
retain the elite of the firefighting world.
Second. the federal government invests a significant amount of money to uniquely train
federal fire fighters. and it costs taxpayer dollars each time a federal fire fighter leaves for
the municipal sector. High turnover is costly and wasteful.
In order to address these problems. the federal government must offer a con~petitive
benefits package. and that includes having occupational illness covered by workers
compensation.
Case Studies
Admittedly, there are few examples of the Department of Labor's Office of Worker's
Compensation (OWCP) re-jecting applications for occupational illnesses, but that is due to
the fact that fire fighters simply do not apply for benefits they have been told are not
available to them.
When a fire fighter contracts a career-ending illness, they are given paperwork by their
local personnel office and told what benefits they are or are not eligible to receive. Those
who are suffering from diseases that have been linked to tire fighting are infornled that
such illnesses are not considered duty-related for Workers Comp purposes.
For example. Fire Fighter Leon Tukes of Warner Robins Air Force Base in your home
state of Georgia suffered a heart attack while on duty. After his heart attack. Fire Fighter
2009 Alfred K. Whitehead Legislative Conferencc
IV. 11
Tukes went to the Personnel Office at Warner Robins to enquire about receiving a
presumptive disability retirement. He was told to not even bother because no claim has
ever been granted for a heart attack. I-le never filed a claim and accepted the retirement
benefits provided to people who retire for non-work related reasons.
Unable to work and with no protection under FECA. Fire Fighter Tukes had to rely on his
fellow fire fighters to donate leave to him so he could retire with a full pension. He was
lucky to be near retirement age: most are not when they are stricken with these
occupational illnesses.
Occasionally an instance occurs in which the service connection is so apparent that
OWCP has little choice but to award benefits. But the absence of a presumptive disability
law means that in even these cases the fire fighter must spend years fighting the
bureaucracy to get what they are rightfully entitled to.
Fire Fighter Rick LeClair provides a tragic example of this delay. LeClair spent his career
protecting the critical naval facility in San Diego, California until he was diagnosed with
lung cancer. Doctors discovered that his cancer was caused by mesothilion~a,which was
attributed to the asbestos suits that fire fighters once wore. Fire Fighter Leclair tiled a
claim with the Office of Worker's Compensation. Before the claim was decided fire
fighter LeClair succumbed to the cancer that was ruled to be caused by an occupational
hazard. If this law would have been in place for fire fighter Leclair. his illness would
have been presumed and he would have received the benefit he died waiting years to
receive.
I t is for fire fighters Tukes. LeClair. and many others whose names we don't know. that
we urge passage of the Federal Fire Fighters Fairness Act.
Firefighter Health and Safety
The IAFF has been actively involved in the health and safety of fire fighters for more
than seventy years. Each year the IAFF conducts an annual death and injury survey with
the cooperation and participation of various tire department administrators. This survey
has shown that fire fighting is the most hazardous occupation in the United States. During
the latest ten-year period (1990-2000), the Death and Injury Survey has found that
professional fire fighters experienced 342 traumatic-injury deaths. 502 occupational
disease deaths, 343,861 injuries and 6,632 forced retirements due to occupationally
induced diseases or injuries.
Occupational diseases such as heart disease and cancer constitute a majority of all
reported fire fighter deaths.
Heart Disease
The very nature of firefighting places extraordinary strain on cardiovascular systems. Fire
fighters are constantly making transitions from the calm. peaceful environment of the
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2009 Alfred K. Whitehead Legislative Conference
firehouse to the hostility presented by fire. Within 15-30 seconds after the iire alarm
sounds. research studies have found that a fire fighter's heart rate can increase by as much
as 117 beats per minute. In addition, a fire fighter's heart can beat at twice its normal rate
throughout the entire fire fighting operation. These extreme physiological stresses lead to
severe coronary problems, which have been documented by numerous authorities.
Fire fighting involves stressful and strenuous physical activity that is made more
burdensome by the fact that the protective clothing and breathing apparatus a fire fighter
wears adds 45 to 65 pounds. The working environment can also mean a transition from
below freezing temperatures to temperatures between 100 degrees and 500 degrees
Fahrenheit at the fire itself.
The strain placed on the heart by this unique combination of factors is unlike that of any
other occupation. and leads to heightened risk of heart disease.
Cancer
Technology has created a distinct difference in the modern fire environment. Fire fighters
are exposed i n their work to extremely high concentrations of a large number of toxic and
carcinogenic chemical compounds.
Some of these chemicals -- for example. carbon monoxide and soot containing polycyclic
aromatic hydrocarbons -- are natural products of combustion and have always been
present at fires. However, the combustion of modern synthetic and plastic materials
produces many highly toxic and carcinogenic compounds that were not found in fires
even three or four decades ago. Exposures today commonly include benzene.
formaldehyde, polycyclic aromatic hydrocarbons (PAH), asbestos and the complex mix
of carcinogenic products that arise from combustion of synthetic and plastic materials.
These chemical compounds are conlmonplace ingredients in our environment as
components of household furniture, plastic pipes. wall coverings, automobiles. buses,
airplanes. and coverings for electrical and other insulation materials.
While the initial health effects of such exposures can be short-term or even nonexistent.
these exposures can and do result in long-term illnesses involving the cardiovascular
system, the respiratory system. the central nervous system and other body organs.
Practically every emergency situation encountered by a fire fighter has the potential for
exposure to carcinogenic agents. I-Iowever. fire fighters can also be exposed to
carcinogenic agents when the protective clothing they wear is exposed to high heat or
bums. Fire fighters have even been exposed to carcinogens through the fire-extinguishing
agents they utilize. The list of potential carcinogenic agents that tire fighters can be
exposed to is almost as long as the list of all known or suspected carcino,oens.
Nevertheless, fire fighters constantly enter potential toxic atmospheres without adequate
protection or knowledge of the environment.
2009 Alfred K. Whitehead Legislative Conference
IV. 13
Research has clearly shown the following specific linkages established between cancer
and chemicals encountered in fire fighting:
Leukemia is caused by benzene and 1.3-butadiene.
Lymphoma and multiple myeloma are caused by benzene and 1.3-butadiene.
Skin cancer is caused by soot containing PAH.
Genitourinary tract cancer is caused by gasoline and PAH.
Gastrointestinal cancer is caused by PCBs and dioxins.
Angiosarcoma of the liver and brain cancer are caused by vinyl chloride.
Leukemia. lymphoma, multiple n~yeloma.cancer of genitourinary tract, prostate cancer.
gastrointestinal cancer. brain cancer and malignant melanoma are among the cancers that
have been observed consistently with increased frequency in epidemiologic studies of fire
fighters. It is likely that additional associations will be idenhfied between chemicals
encountered iu the fire environment and cancer in fire fighters. Nevertheless, the
available data are sufficient to conclude that excess risk of cancer is a distinct hazard of
fire fighting.
Lung Disease
In the course of their work, fire fighters are exposed to numerous substances that irritate
the respiratory tract - ammonia, chlorine, formaldehyde, hydrogen sulfide and hydrogen
chloride to name just a few. Toxic substances can cause acute (immediate) effects,
chronic effects noted months or years afterwards. or both. The acute effects of inhaling
smoke are familiar to every fire fighter. Some of these agents may not cause immediate
irritation. but instead, cause damage that doesn't become apparent until years later when it
may be difficult to prove cause and effect.
Infectious Diseases
Lnfectious diseases have become a hazard to fire fighters too big to ignore. Fire fighters
and emergency medical responders can be exposed during motor vehicle accidents in
which blood and sharp surfaces often are present. by rescuing bum victims. and through
the administration of emergency care. The victim may require extrication from a
difficult-to-access accident scene. such as a motor vehicle accident or poorly accessible
building. There may be broken glass or other sharp objects at the scene that are poorly
visualized, and the lighting at the scene may be minimal. In addition. if the victim is
exsanguinating and needs to be extricated quickly to save his life. the emergency provider
may act in haste. with disregard for his or her own safety. Fire fighters are also involved
in emergency medical treatment at the scene, including intravenous line insertion and
blood drawing. The fire fighter almost never knows the infectious disease status of the
victim while he or she is rendering emergency services. All of these factors combine to
place the fire fighter at increased risk of contracting a blood bome contagious disease
through a puncture wound. skin abrasion or laceration that becomes contaminated with
infected blood from the victim.
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2009 Alfred K. Whitehead Legislative Conference
Every fire fighter's education now includes use of Universal Precautions, such as the
wearing of protective gloves. safety glasses, and masks. But in the chaotic environment
of an emergency scene, these precautions can and do fail. Exposures happen. A
government study conducted during the development of the federal OSl IA Blood borne
Pathogen Standard found that 98 96 of EMT's and 80% of fire fighters are exposed to
blood borne diseases on the job.
Nest Steps
Mr. Chainnan. as I have previously stated, nearly 40 states have some form of a
presumptive disability law on the books. There is no such law for federal fire fighters.
In order to qualify for a disability retirement. a fire fighter who suffers from an
occupational illness must specify the precise exposure that caused their illness. As my
testimony indicates those are nearly insurmountable odds.
H.R. 697. The Federal Fire Fighters Fairness Act would create a rebuttable presumption
that fire fighters who become disabled by heart and lung disease, certain cancers and
infectious diseases contracted the illnesses on the job. H.R. 697 would shift the burden of
proof to the employer to prove that the illness was caused by some factor other than the
duties of the fire tighter.
This does not mean that every fire fighter who contracts a disease named in the
legislation automatically would qualify for benefits under FECA. For example, lung
cancer is unlikely to be determined to be occupational if it is contracted by a fire fighter
who was also a long-term smoker. But the burden of proof would no longer be placed on
the tire fighter to prove the cause of the disease.
Precedent
Although FECA currently does not provide presumptive disability benefits, Congess has
enacted such presumptions in other benefit programs. Peace Corps volunteers. military
veterans. and public safety officers who die in the line of duty are all covered by
presumptive laws.
Service-connected disability is provided to Vietnam veterans whose cancers are
presumed to be caused by herbicide exposure. Like fire fighters. Vietnam Veterans found
it extremely difficult to pinpoint precise exposures. and as a result. thousand of veterans
were denied a benefit to which they were entitled. After years of lobbying by veteran
groups. Congress responded by enacting a law that established a presumption of serviceconnection for certain diseases.
More recently, the Congress passed and President Bush signed into law the Hometown
I Ieroes Act (PL 108-182). Under the new law, Public Safety Officer Seneti t (PSOB) will
be paid to the families of fire fighters and police officers who die as a result of heart
attack or stroke suffered within twenty-four hours of responding to an emergency call or
2009 Alfred K. Whitehead Legislative Conference
IV. 15
participating in a training exercise involving "unusual physical exertion." It is now
presumed that the death was "a direct and proximate result" of the emergency response.
Cost
While we believe that the merits of the Federal Fire Fighters Fairness Act warrant
congressional action. we are mindful that in this tight budget environment we must be
sensitive to the cost of even the most compelling initiatives. Although no formal cost
estimate has been done by the Congressional Budget Office, we believe the cost of
inlplementing H.R. 697 will be minimal.
The number of federal fire fighters is relatively small compared with other occupations in
the federal sector. and the vast majority do not retire due to an illness. Based on the
experience of states with similar presumptive disability laws, as few as 15-20 people are
likely to qualifL for the benefit each year.
Moreover, because fire tighters are generally on the lower end of the GS pay scale,
benefits based on their salary would not have a significant impact on FECA's balance
sheet.
In short, an important protection can be provided to the nation's federal fire fighters at
little expense to the federal treasury.
In conclusion, Mr. Chairman, I would like to thank you and the Committee for holding
this hearing today. I look forward to working with the committee to see this legislation
move forward.
IV. 16
2009 Alfred K. Whitehead Legislative Conference
State Presumptive Disability Laws
The following states have presumptive disability laws which recognize that fire fighters
are at increased risk for certain illnesses. The laws create a presumption that the
specified diseases are job-related. Because the laws vary greatly from state to state.
readers should review the specific state laws to determine the law's application.
Alabama
J
J
J
Alaska
J
J
J*
J*
J*
Arizona
Arkansas
I California
I
J
I
J
Colorado
J
Connecticut
J
Delaware
District of
Columbia
Florida
J
Georgia
J
J
Hawaii
J
J
Idaho
J
J
Illinois
J
J
Iowa
J
J
Kansas
J
./
J*
Louisiana
J
J
J*
Maine
J
J
Maryland
J
J
J*
Massachusetts
Michigan
J
J
J*
J
J
Minnesota
J*
J*
1 Indiana
J*
J*
J*
4
J*
J*
1
Kentucky
J*
J*
J*
J
I Mississippi
2009 Alfred K. Whitehead Legislative Conference
IV. 17
J
J
Missouri
J*
Montana
J
Nebraska
Nevada
New
Hampshire
New Jersey
J
J
J*
J
J
J*
J*
J
New Mexico
1 New York
I
1 ~ o n Carolina
h
1
I North Dakota 1
J
1
J
I
J
I
1
J*
I
I
I
J *-
I
I
J
Ohio
J
J
Oklahoma
J
J
Oregon
J
J
Pennsylvania
J
J
J
J*
-
J
Rhode Island
South Carolina
J
J
South Dakota
J
J
I Tennessee
Texas
J*
1
J
I
J
J
J
J
J
J*
J*
I
J*
Utah
Vermont
J
Virginia
J
J
J*
J*
Washington
J
J
J
J*
J
J
J*
J*
West Virginia
Wisconsin
Wyoming
* Indicates that on!\* specified diseases in these caregories are cm~ered
**Applies onlj. to certain localities
IV. 18
-
2009 Alfi-ed K. Whitehead Legislative Conference
e
CURRENT COSPONSORS:
I 1lth
CONGRESS COSPONSOR REPORT
H.R. 948 FEDERAL PRESUMPTIVE DISABILITY
Arizona
Illinois
Nebraska
Grijalva, Raul
Costello, Jerry
Gutierrez, Luis V.
Hare, Phil
Schakowsky, Janice
Teny, Lee
Arkansas
Ross, Mike
California
.*
Baca. Joe
Berman, Howard
Capps, Lois
~ a r r Sam
;
Filner, Bob
Lofgren, Zoe
Matsui. Doris
Miller, George
Richardson, Laura
Sanchez, Linda
Schiff, Adam
Sherman, Brad
Woolsey, Lynn
Colorado
DeGette, Diana
Indiana
Carson, Andre
Iowa
New Jersey
Andrews, Robert
Holt, Rush
LoBiondo, Frank A.
Rothman, Steven R.
Sires, Albio
Smith, Christopher
Boswell, Leonard
New Hampshire
Massachusetts
Shea-Porter, Carol
Lynch, Stephen
Markey, Edward
~ c ~ o i e rJames
n,
Lujan, Ben Ray
Maine
New York
Michaud, Michael
Pingree, Chellie
Arcuri, Michael
Bishop, Timothy
Hinchey, Maurice
Maloney, Carolyn B.
McHugh, John
McMahon, Michael E.
Towns, Edolphus
Maryland
New Mexico
Courtney, Joe
Murphy, Christopher S.
Curnmings, Elijah
Edwards, Donna F.
Sarbanes, John
Van Hollen, Chris
Florida
Minnesota
Hastings, Alcee
Ros-Lehtinen, lleana
Ellison, Keith
Mclntyre, Mike
Miller, Brad
Shuler, Heath
Missouri
Ohio
Lewis, John
Scott, David
Carnahan, Russ
Clay, William Lacy
Emerson, Jo Ann
Kaptur, Marcy
Sutton. Betty
Hawaii
Michigan
Hirono. Mazie
Conyers, John
Levin, Sander M.
McCotter, Thaddeus
Miller, Candice
Stupak, Bart
Connecticut
Georgia
2009 Alfred K. Whitehead Legislative Conference
North Carolina
Oregon
Blumenauer, Earl
IV. 19
Pennslyvania
South Dakota
Virginia
Brady, Robert
Carney, Christopher
Doyle, Michael
Holden, Tim
Murphy, Patrick
Murphy, Tim
Murtha, John
Platts, Todd
Sestak, Joe
Herseth Sandlin,
Stephanie
Gordon, Bart
Boucher, Rich
Connolly, Gerald E.
Moran, James
Nye, Glenn C., Ill
Wittman, Robert J.
Wolf, Frank
Texas
Washington
Gonzalez, Charles
Poe, Ted
Reyes, Silvestre
McDermott, Jim
Rhode Island
Kennedy, Patrick
Tennessee
West Virginia
Rahall, Nick
Wisconsin
Kagen, Steve
IV. 20
2009 Alfred K. Whitehead Legislative Conference
e
PAST COSPONSORS:
1loth CONGRESS COSPONSOR REPORT
H.R. 1142 FEDERAL PRESUMPTIVE DISABILITY
Please Note: Members in BOLD have yet to renew their cosponsorship for the
current Congress.
Arizona
Georgia
Minnesota
Grijalva, Raul
Pastor, Ed
Lewis, John
Marshall, Jim
Scott. David
Ellison, Keith
Oberstar, James
Walz, Timothy J.
Hawaii
Missouri
Abercrombie, Neil
Hirono. Mazie
Carnahan, Russ
Clay, William Lacy
Cleaver, Emanuel
Emerson, Jo Ann
Arkansas
Ross, Mike
California
Baca, Joe
Berman, Howard
Capps, Lois
Davis, Susan
Eshoo, Anna
Farr,
Filner, Bob
Matsui, Doris
McNerney, Jerry
Napolitano, Grace
~anchez,Linda
Schiff, Adam
Sherman. Brad
Tauscher, Ellen
Woolsey, Lynn
Illinois
Colorado
Lynch, Stephen
Markev. Edward
M C G O ; ~James
Neal, Richard
am
DeGette, Diana
Bean, Melissa
Costello, Jerry
Hare, Phil
Schakowsky, Janice
Indiana
Hill, Baron
Kansas
Moran, Jerry
Michigan
Conyers, John
Kildee, Dale
Levin, Sander M.
McCotter, Thaddeus
Miller, Candice
Stupak. Bart
Nebraska
Terry. Lee
Massachusetts
Connecticut
Courtney, Joe
~ u r p,-~hristopher
h ~
S.
Maine
Florida
Maryland
Buchanan, Vern
Hastings, Alcee
Meek, Kendrick
Ros-Lehtinen, lleana
Cummings, Elijah
Ruppersberger, Dutch
Sarbanes, John
Van Hollen, Chris
Nevada
Berkley, Shelley
New Jersey
Andrews, Robert
Garrett.
Scott
Holt, ~ " s h
LoBiondo. Frank A.
Pallone, Frank
Payne, Donald
Rothman, Steven R.
Sires, Albio
Smith, Christopher
-
Michaud, Michael
2009 Alfred K. Whitehead Legislative Conference
New York
Oregon
Texas
Arcuri, Michael
Bishop, Timothy
Higgins, Brian
Maloney, Carolyn B.
McCarthy, Carolyn
McHugh, John
Nadler, Jerry
Towns, Edolphus
Blumenauer. Earl
Cuellar, Henry
Gonzalez, Charles
Jackson Lee, Sheila
Poe, Ted
Reyes, Silvestre
North Carolina
Butterfield, G. K.
Etheridge, Bob
Jones, Walter B., Jr.
Mclntyre, Mike
Miller, Brad
Price, David
Shuler, Heath
Ohio
Kucinich, Dennis
Ryan, Tim
Space, Zachary
Sutton. Betty
Oklahoma
Boren, Dan
Pennslyvania
Altmire, Jason
Brady, Robert
Carney, Christopher
Dent, Charles
Doyle, Michael
Gerlach, Jim
Holden, Tim
Murphy, Patrick
Murphy, Tim
Murtha. John
Platts, Todd
Rhode Island
Kennedy, Patrick
South Carolina
Wilson, Joe
Virginia
Goodlatte, Bob
Moran, James
Wittman, Robert J.
Wolf, Frank
Washington
Dicks, Norman
Inslee, Jay
Larsen, Rick
McDermott, Jim
Smith, Adam
West Virginia
Rahall, Nick
South Dakota
Herseth Sandlin,
Stephanie
Wisconsin
Kagen, Steve
Tennessee
Cohen, Steve
Cooper, Jim
Gordon, Bart
IV. 22
2009 Allked K. Whitehead Lcgislativc Conference
PAST COSPONSORS:
1loth CONGRESS COSPONSOR REPORT
S. 1924 FEDERAL PRESUMPTIVE DISABILITY
Connecticut
Missouri
Dodd, Chris
Lieberman, Joseph
McCaskill, Claire
Delaware
Carper, Thomas
New Jersey
Menendez, Robert
Georgia
New Mexico
Isakson, Johnny
Bingaman, Jeff
Udall, Tom'
Illinois
Durbin. Richard
Louisiana
Landrieu, Mary L.
Massachusetts
Ohio
Brown, Sherrod
Pennsylvania
Casey, Robert P., Jr.
Rhode Island
Kennedy, Edward M.
Keny, John
Whitehouse, Sheldon
Maine
Vermont
Collins, Susan
Snowe, Olympia
Sanders, Bernie
Washington
Cantwell, Maria
Murray. Patty
* Cosponsored while in U.S. House of Representatives
2009 Alfred K. Whitehead Lcgislativc Confcrcnce
IV. 23
HOUSE COMMITTEE
EDUCATION AND LABOR
I
Name
State
George Miller
*(Chairman)
[ Statt
Name
Howard P. "Buck McKeon
"(Ranking Member)
Thomas E. Petri
Peter Hoekstra
Michael N. Castle
Mark E. Souder
Dale E. Kildee
Donald M. Payne
Robert E. Andrews
Robert C. Scott
Lynn C. Woolsey
Ruben Hinojosa
Carolyn McCarthy
John F. Tiemey
Dennis Kucinich
David Wu
Rush D. Holt
Susan A. Davis
Raul M. Grijalva
Timothy H. Bishop
Joe Sestak
Dave Loebsack
Mazie Hirono
Jason Altmire
Phil Hare
Yvette Clarke
Joe Courtney
Carol Shea-Porter
Marcia Fudge
Jared Polis
Paul Tonko
Pedro Pierluisi
Gregorio Sablan (I)
Dina Titus
Vernon J. Ehlers
Judy Biggert
Todd Russell Platts
Joe Wilson
John Kline
Cathy McMorris Rodgers
Tom Price
Rob Bishop
Brett Guthrie
Bill Cassidy
Tom McClintock
Duncan D. Hunter
Phil Roe
Glenn W. Thompson
HOUSE EDUCATION AND LABOR SUBCOMMITTEE ON WORKFORCE
PROTECTIONS
State ( Name
Name
Lynn Woolsey
*(Cha~rwoman)
Carol Shea-Porter
Donald Payne
Raul M. Grijalva
T~mothyH. Bishop
Phil Hare
Gregor~oSablan (I)
IV. 24
I
,
CA
NH
NJ
AZ
NY
IL
MP
state
Tom Pnce
*(Ranking Member)
Peter Hoekstra
Joe W~lson
John Kline
I
I
GA
1
I
MI
SC
MN
2009 Alfi-ed K. Whitehead Legislative Conference
SENATE COMMllTEE
HOMELAND SECURITY & GOVERNMENTAL AFFAl RS
1 Name
State
Name
Susan M. Collins
'(Ranking Member)
Tom Coburn
John McCain
George V. Voinovich
John Ens~gn
Lindsey Graham
Joseph Lieberman (ID)
'(Charman)
Carl Levin
Daniel K. Akaka
Thomas R. Carper
Mark L. Pryor
Mary L Landrieu
Claire McCaskill
Jon Tester
Roland Burns
Michael Bennet
State
ME
OK
AZ
OH
NV
SC
SENATE HOMELAND SECURITY & GOVERNMENTAL AFFAIRS
SUBCOMMITTEE ON OVERSIGHT OF GOVERNMENT MANAGEMENT, THE
FEDERAL WORKFORCE & THE DISTRICT OF COLUMBIA
Name
Daniel K. Akaka
*(Chairman)
Carl Levm
Mary L. Landrieu
Roland Burris
Michael Bennet
2009 Alfred K. Whitehead Legislative Conference
State
Name
George V. Voinovich
'(Ranking Member)
Lindsay Graham
State
OH
SC
IV. 25
To amend chapter 81 of tititle 5, Unikd L%at.mCde, to mste a pmmnptron
that. a &abilitJ. or death of a Federal employe in £ire prvbzthu aetiFitiee eaneed bg my of certain dia2aaea is the r&
d ths performance
of such ernp1o.e'~duty.
I N THE HOUSE OF KEE'lUZSJZNTATIT'-ES
2009 Alfred K. Whitehead Legislative Conference
IV. 27
A BILL
To amend ehaptcr 81 of title 5. 'Clnited States C'ode, to
create a presninption that a disal~ility 01. death of a
Federal
in fir? protection aeti~itiescaused 1qan)- of vertwii~diseases is the result of the performance
of such einplo~~ee's
dutj-.
~~~~~~~~~~~ee
7
LATED CAUSE OF DISABILITY OR DEATH FOR
8
FEDERAL EMPLOYEES IN FIRE PROTECTION
9
ACTIVITIES.
10
( a ) L ) E F I I \ ? T I ~ N . - - & ~81~01
~ ~ of
~ title 5, Ul1itc.d
1 1 States Clock, is amenclecl by striking "and" at the eiicl of
12 p a i ~ a g ~ a p(19).
h
113' stiaiking the 1)eriod at the end of para-
IV. 28
2009 Alfred K. Whitehead Legislative Conference
the elniromlellt is at risk: a~itl
"(D) pwfor~nssncli activiticis as a primary
r e s p o i d d i t y of his or her job.
(I)) P I W S ~ P T I O
RELITIS(:
S
14'1ll~
T(
...
E ; \ I I)TEES
~
IS
PKOTM;TIOS
, i ~ ~ n ? ~ ~ E s . - S e c . t i o$1
l ~02 of title 5,
I - ~ i i t c ~States
tl
Code, is aincndcd I,? atldilig a t lllc end the
following:
"(c.)( 1) 115th regard to ail emplo?-c~~
i 1 1 l'iw proteetioil
activities, a disease specified
ill
parag~a1)Il( 2 ) sliall I x l m -
sn~iwdto be proximat el!- caused
1 1 ~ -t
IN) ~ n i p l o y n e ~ iof'
t
sudl elnploye. sul?ject to tlie leiigtli of' scw-ice ~wluiretnwts sl)ec.ified. The t1isabilit~-or deatli of' all t.lnplo?-ee
ill
fire potectioii activities due to such a disease shall be
2 1 sunll )tioils llln?TIw relmtted 1):- a l)rel)~ll(lci1'i111~~'
of the evi22 c-lc~llec.
23
"
( 2 ) Tllcl hllowiug diseases sliall Iw 1)1*cs.u111~d
to I)e
24 l)~*osiillatelycallsed by the emplo;mc~lt 01' tlie c3liq)loyec:
2009 Alfred K. Whitchcad Legislative Conference
IV. 29
IV. 30
2009 Alfred K. Whitehead Legislative Conference
I
"(E) Regardless of the length of time an em-
2
p l o p e has beell eiiqhyecl, any niic.oilmoir infec.tious
3
disease. iilclncliilg 11nt not liiilitecl to tul)erc.dosis,
4
i
hepatitis A, B. or C', and the l m ~ n i i ~iimnu1o-
5
clef'iclieilcy ~ i m (HIT'),
s
the conti.ac.tioli of wllic.11 the
6
Secretary of Labor cleteimiues to bc related to the
7
ll:~sarcls to
8
t i ~ i t i e sn l q . bc snl?ject.".
9
( v ) K ~ ~ ' o r \ ~ . - n T olater
t
than 10 j-cars after the date
11-11ic.11
ail elnplo)-ee in fire 1)i.otection ac-
10 of eilactinent of this Act. the Natiollal Institute of Occupa11 tional Safety and IIealtli ill the Ctntcrs foi. Disease Con12 trol aud Prewilt.ioil shall exainine the ini1)leillelltatioi of
13 this Act, and qq)ropriate scientific. and metlical data re14 lated to the health risks associated with firefighting a i d
15 suhnlit to ('oi~gressa report n.llic.11 shall incluclc(1 ) ail aiialysis of the illjury claims made ~ u i d e r
16
17
this Act;
18
('1) ail t~ilalysisof the available researc:li related
19
to the health ridis associated with firefiglrtilq; and
20
( 3) reconlillcnclatio~isfor any acliilinistmtiw or
21
legislative actions nrcessaq- to ellsure that tliosc ilis-
22
eases most asswiated wit11 firefi'iplitiilg are ii~cl~~clecl
23
in the presumption created 1))- this - k t .
24
( (1)
E FFE( 'TI373 DATE.--The
allleilchcnt macle 1))-
25 tllis section applies to an injury t h a t is first cliagxosed,
-
2009 Alfred K. Whitehead Legislative Conference
IV. 31
1 or a death that ocdc:urs7on or aftel*the date of enactnlerlt.
2 of tllis Act.
0
IV. 32
2009 Alfied K. Whitehead Legislative Conference