Cancer Screening for Firefighters

Private Members' Business – in the Northern Ireland Assembly at 3:45 pm on 12th October 2021.

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Photo of David Hilditch David Hilditch DUP 3:45 pm, 12th October 2021

I beg to move

That this Assembly recognises the urgent need to protect firefighters from cancer; acknowledges the increasing evidence highlighting the serious health risks to firefighters and their families following exposure to carcinogenic fire effluents; further recognises that, as a result of their profession, firefighters can be up to four times more likely to develop cancer and other illnesses than other members of the public; and calls on the Minister of Health to introduce annual cancer screenings to monitor and manage the health status of serving firefighters.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

The Business Committee has agreed to allow up to one hour and 30 minutes for the debate. The proposer of the motion will have 10 minutes in which to propose and 10 minutes in which to make a winding-up speech. All other Members who are called to speak will have five minutes. As an amendment has been selected and is published on the Marshalled List, the Business Committee has agreed that 15 minutes will be added to the total time for the debate. Please open the debate on the motion.

Photo of David Hilditch David Hilditch DUP

Thank you, Mr Deputy Speaker. I hope that my lungs and throat and my voice will hold out for this.

Recently, I have had conversations with colleagues, friends and constituents to ask how they think a firefighter most commonly dies as a result of their work in the fire service. The common answer given is that they have been caught in a fire or died from smoke inhalation. People are shocked when I point out that the vast array of scientific literature shows that, when compared with the general public, firefighters are at significantly higher risk of being diagnosed with and subsequently dying of cancer, and that that is fundamentally related to and caused by the service work that they do.

Running into the face of a fire is not the only major threat that firefighters face. Men and women on the front line of Northern Ireland's Fire and Rescue Service (NIFRS) are often exposed on a daily basis to toxic smoke, asbestos and other chemicals and substances.

As a result, the rate of cancer diagnosis among those responders is statistically higher than that among the general population, according to an independent University of Central Lancashire (UCLan) report, commissioned by the Fire Brigades Union (FBU) and led by fire chemistry and toxicity expert Professor Anna Stec.

The study, which involved over 10,000 firefighters, found that firefighters can be up to four times more likely to develop cancer and other illnesses than other members of the public. Three quarters of the firefighters had served for at least 10 years before receiving a diagnosis, more than half were under 50, and a fifth were under 40. Of those diagnosed, 26% had skin cancer, which is the most common type for them; 10% had testicular cancer; 4% had head and neck cancer; and 3% had non-Hodgkin lymphoma.

That work is a UK first and is the latest in a growing body of international evidence from North America, Europe and Australia suggesting that firefighters are at an increased risk of developing cancer and other diseases. In parts of Canada and the United States, presumptive legislation has already been introduced that recognises certain cancers as occupational diseases amongst firefighters. In the UK, it has so far been concluded that there is not enough evidence to link occupational exposure to carcinogenic fire effluents with a higher risk of cancer. That means that, if a firefighter believes that their illness is work-related, they are required to prove it in each case. That is an almost impossible retrospective task. The reality is that UK research has been significantly underfunded, allowing the UK to fall further and further behind in the treatment of our serving firefighters.

Today is a major opportunity for Northern Ireland to be proactive rather than reactive and to lead the way in the United Kingdom. No longer should firefighters be undervalued, and, as a government, we should no longer allow them to become disproportionately affected by cancer solely due to the career that they have chosen.

We are quite happy to support the amendment that has been proposed to the motion, as, based on the shocking finds from the University of Central Lancashire's report, scientists have already created a best practice guide for fire and rescue services, putting forward a number of urgent recommendations to minimise firefighters' exposure to toxic fire effluent and simple changes that could be made protect the lives of firefighters and their families. With that, the DECON campaign was born. That has recently been introduced to make small changes to the health and safety of all firefighters and their families. It provides training to educate and inform firefighters of the dangers of contaminants, challenges old habits and creates a change in mindset in the service. That involves firefighters washing dirty clothes, showering after incidents, cleaning what they carry and decontaminating before driving. Whilst the campaign is extremely positive, the luxury of time may not always be afforded to on-call firefighters, who are often leaving places of employment and managing the time expectations of their main employer.

A UK firefighters cancer and disease registry (FCDR) has been established to help researchers to study the long-term risk of firefighting. The more firefighters who register, the better we can understand and respond to the health risks that the profession faces. The registry collects information on firefighters' work routines, exposure to fire effluents, lifestyle and health. It will enable scientists to identify and recognise the most common cancers and diseases related to firefighters' work, and, in the future, it will offer preventative health screening, education and support.

Whilst both DECON and the firefighters cancer and disease registry are essential, the Finance and Health Ministers must explore practical ways of enhancing awareness among firefighting personnel and their families about the health risk of toxic chemicals and the urgent need for better detection and regular check-ups. Annual health screenings and evaluations are essential, as early detection is the key to survival for our retired, current and future firefighters. Staff in the Northern Ireland Fire and Rescue Service perform an essential and often life-saving role. They make up our families and communities, and we owe it to them to ensure that they are afforded appropriate, robust levels of protection.

In closing, I would like to dedicate the debate to all firefighters, particularly those who are battling cancer or who have lost their battle with cancer. As some of you may know, I have personal experience of the topic, and I wish to do all that I can to protect the lives of those who give so much to protect us all.

Some Members:

Hear, hear.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party 4:15 pm, 12th October 2021

Glaoim ar Colm Gildernew leis an leasú a mholadh. I call Colm Gildernew to move the amendment.

Photo of Colm Gildernew Colm Gildernew Sinn Féin

I beg to move the following amendment:

At end insert: ", and to engage with the Fire Brigades Union on implementing best practice procedures regarding post-incident decontamination, adequate personal protective equipment, and fire kit laundry and replacement, in order to prevent firefighters, their families and colleagues being exposed to harmful contaminants."

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

The Member will have 10 minutes to propose and five minutes to make a winding-up speech. All other contributors will have five minutes.

Photo of Colm Gildernew Colm Gildernew Sinn Féin

It is extremely worrying that cancer rates are, on average, four times higher amongst firefighters because of their dangerous work. Contact with toxic materials that are released during fires, and even some of the materials that are used to fight fires, are only some of the dangers that are faced by firefighters and, indeed, of further concern, by their families.

The dangers of life-threatening contaminations due to the work that they do is the reality of every firefighter's life. Firefighters are worthy of every tribute that is paid to them in the Assembly. They are front-line workers who put themselves at considerable risk to protect the rest of us. Honestly, I do not think that we can ever do enough to repay them for the sacrifices that they make every time that the siren rings and they put on their uniforms to rush to the scene of an accident or a burning building. That type of work presents unique challenges.

Therefore, I welcome David and Jonathan's motion, which calls on the Department of Health to provide annual screening of all firefighters to detect early signs of cancer and other illnesses. As we know, the early detection of illnesses is often the key to recovery and, perhaps, particularly when it comes to cancer. That is the very least that we can do for these workers. Sinn Féin's amendment takes the prevention idea a step further by asking the Department to look at other ways in which we can help to protect the lives of firefighters and those of their families. After all, firefighters put themselves and, by extension, their families at additional health risk just by doing their job and doing it well.

If better equipment saves the lives of our firefighters, they should have better equipment. If upgraded decontamination procedures and better PPE protects our firefighters from further risk and disease, they should have those. In their everyday work lives, firefighters take considerable risks on our behalf. However, a chairde, the risks to their lives do not end at the scene of an accident or when the fire has been extinguished. The potential for contamination from the toxic materials that they encounter in their job poses considerable additional and ongoing risk to firefighters and their families.

During the COVID pandemic, we saw how important PPE became in keeping our healthcare workers safe. Modern and effective PPE equipment is also needed by firefighters as they try to go about their work and keep themselves safe. The Sinn Féin amendment addresses the preventative measures that the Department of Health can take to ensure better health for firefighters. One of the key issues is the decontamination of kit and equipment. A firefighter recently told me that more kits and better, more efficient processes for laundering and replacing PPE are required if they are to reduce their risks.

While cancer screening is obviously worthwhile and should be offered to firefighters given the increased risk that they face — we all support it — we should do much better in reducing the risk and preventing cancer in the first instance. That is why the Minister, the Department and the Fire Service should engage with the Fire Brigades Union and firefighters to interrogate international best practice and ensure that we are putting in place the best procedures for decontamination and fire-kit laundry and replacement in order to protect firefighters, their families and their colleagues. I support the motion and the amendment.

Photo of Cara Hunter Cara Hunter Social Democratic and Labour Party

I welcome the opportunity to speak in the debate, and I thank the Members who proposed the motion and tabled the amendment.

Firefighters are undoubtedly amongst the most selfless people in our society. I can recall the bravery and selflessness that we all witnessed in New York City during 9/11 and, more recently, in London following the Grenfell tower fire. Both incidents were heartbreaking and both had a profound negative impact on firefighters' physical health. In particular, 9/11 has left a devastating, decades-long imprint in the form of mental and physical illness that, for first responders especially, has proven deadly. As has been mentioned, many of those who did not die on the scene that day developed deadly chronic illnesses such as cancer and respiratory and gastrointestinal conditions. As of 6 September 2021, it was listed that 250 New York City Fire Department deaths have taken place since 2001, resulting directly from 9/11-related illnesses. Those are real people who made great sacrifices and who have left loved ones behind. Research reveals that those firefighters developed those conditions as a direct consequence of breathing in toxic fumes ejected by the collapsing World Trade Center.

That leads me to the wording of the motion. It is deeply worrying that studies reveal that firefighters have a higher risk — four times higher — from environmental contamination from fires, leading to great concern about their health. We welcome the fact that the Fire Brigades Union has launched new training that aims to fight the threat of cancer to our firefighters. That is intended to help them to reduce the effects of toxic substances released in fires, with actions such as taking showers soon after fires being advised. The SDLP wholeheartedly agrees that introducing additional annual cancer screening to monitor and manage health will greatly assist in assessing the health status of our firefighters and better serve them. The inclusion of the amendment on post-incident decontamination is also warmly welcomed, as it will ensure that family members are also prevented from being exposed to those harmful contaminants.

The SDLP strongly supports the motion and the amendment, and it strongly supports our firefighters.

Photo of Robbie Butler Robbie Butler UUP

At the outset, I declare a bit of an interest in this topic as a former firefighter of 16 years. Also — I have to check this, Mr Deputy Speaker — I think that I was an honorary member of the FBU up until very recently. I think that my membership has expired, but I will check that to be sure. I stand in support of the motion and the amendment. I particularly thank David Hilditch for tabling the motion. It will have been a very difficult topic for him to speak on, given his personal story. Some of us know a little bit about that, so I thank him so much for that. Thank you also to the party opposite for its amendment, which adds to the topic.

I will give a bit of context to this, as I have a bit of insider knowledge of what goes on. The Fire and Rescue Service performs a very particular and peculiar emergency response. As the Member from East Londonderry pointed out, firefighters go into the danger zone when everybody else is heading out. That should never be undervalued or played down. It does not matter what part of the world you are in. I have spent some time with firefighters from all over the world, including the west coast and east coast of America, Sweden, Europe and Australia, and they have a camaraderie around trying to protect people. Today, we collegiately pay tribute to firefighters all over the world, and particularly to our own Fire and Rescue Service in Northern Ireland — each of those men and women serve selflessly, whether they are whole-time or retained — but also to their families. When a firefighter goes out on an appliance or responds to their Gartan — the wee bleeper — when it goes off in a part-time retained area, their families do not know what is going to happen, how long they will be away for or what danger they will be in. It is an uncertain job and it is a dangerous job.

If you will indulge me, Mr Deputy Speaker, it would be remiss of me not say this. Over the past three years, two of my colleagues, who were serving firefighters, passed away. In July of this year, a friend of mine Andy McLucas died of cancer. So did Kenny McEwan. They were both fantastic firefighters who died too young from cancer. That is what we are talking about today.

As has been pointed out, firefighters carry out a range of very dangerous operations. A lot of that centres around fire, whether that is putting out car fires, grass fires or house fires. Each of those brings different levels of risk. To be fair, however, the Northern Ireland Fire and Rescue Service has high levels of supervision and training. It also has good levels of PPE. I am going to be honest. I started in February 2000. To be honest, what has happened to its approach to managing risk between February 2000 and today is quite remarkable, but that is not to say that we cannot do better. That is why we support the motion. We should always strive to improve on the levels of safety that our front-line services and responders are exposed to.

The other thing that was mentioned is that a lot of the things that our firefighters are exposed to are not just dangers to their physical health. Their mental health can also be stressed and stretched, because they respond to life-or-death scenarios.

I put it on record that I hope to bring forward a private Member's Bill that will look at protecting our first-line responders from PTSD and mental ill health as a result of their exposure. That is much like the motion. Some of our illnesses are physical, while some are mental. We need to do all that we can to protect our firefighters from both.

I looked at some of the studies that were included in the research pack and at some other studies worldwide. There is conflicting evidence about the types of cancer and their prevalence. The motion refers to firefighters being "four times more likely" to develop cancer: that depends on what region the research is taken from, but there is no doubt that there is an increased risk. From my background, I know that, when you come back from a fire — I will be honest and tell it like it is — and blow your nose into a handkerchief, you should see what comes out at times. Such issues have perhaps not been at the forefront of the actions taken, which have focused on limiting your exposure time, increasing your distance from what is on fire and having a reasonable amount of protection. There is more that we can do, and I put on record my thanks to the Fire Brigades Union for being proactive and creating a training video.

If it is OK, Mr Deputy Speaker, in the final few seconds of my contribution, I want to send a message to my compatriots in the Fire and Rescue Service. A cultural shift needs to happen. Our firefighters are very brave, but they need to look after themselves.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

I ask the Member to draw his remarks to a close, please.

Photo of Robbie Butler Robbie Butler UUP

We in the Chamber will do everything that we can to support them.

Photo of Paula Bradshaw Paula Bradshaw Alliance

I support the motion as the Alliance Party's health spokesperson. We will also support the amendment. I am chair of the Assembly's all-party group (APG) on cancer.

I will be interested to hear from the Minister what concrete steps will follow, particularly in the context of ongoing budgetary pressures and the need to make proposals to fund this step. I have been concerned about this broad issue for some time and have had discussions with the Fire and Rescue Service, most recently about the University of Central Lancashire's 'Minimising firefighters' exposure to toxic fire effluents' report. I also raised that report with the Minister. The report is primarily about prevention rather than screening, but the point about the enhanced risk is also clear.

The figures presented in the motion give a stark warning. As has already been said, depending on the exact nature of the situations that they face, their specific duties and whether they are part-time or full-time, firefighters can be up to four times more likely to develop cancer, not least because they are more exposed to carcinogens. Let us remember that, in the past few days, we have been talking about the danger of smoking in cars and vehicles in which children are present and the associated long-term health risks, particularly of cancer. If we elevate that danger to working at the scene of a serious fire, it is not hard to imagine the heightened risk involved.

We must do all that we can to prevent cancer. Training has been undertaken, other means of reducing exposure have been explored and, in general, prevention is thankfully now being taken more seriously. The next complementary thing that we can do, however, is to ensure that heightened risk is met through heightened monitoring so that early intervention becomes not just a possibility but the norm. That is where the motion comes in. For long-term prognosis, the benefits of identifying cancer at an earlier stage are obvious to us all. Annual cancer screening would not be an easy undertaking, but it is surely a worthy one. Given the clearly heightened risk experienced by at least some of our firefighters in some contexts and our knowledge of that risk, screening could make a significant difference. It would be a useful way of assuring public servants that they are valued and that the public sector is available and, indeed, responsive to them. A further question is whether screening should be extended to former firefighters, given that they will have experienced risks.

I look forward to hearing what steps, including on funding, will be taken following the debate on the motion, which, I am sure, will enjoy unanimous support. I put it on record that the all-party group on cancer stands ready to support whatever comes forward from here.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

Before I call Fra McCann, I am sure that he will not mind my saying a few words. Like everyone else, I have read the newspapers and know that he is, unfortunately, leaving the Assembly, and I may not be in the Chair to avail myself of the opportunity again before he does.

Fra, I have always found you to be a good and respectful person as we have worked together on the common interests of our people. I thank you for that and for the contribution that you have made to the Assembly.

I wish you and Janette all the very best for a happy and restful retirement. You have been in elected office since 1987, and that is some time to have been serving the community. I thank you for your input to the Assembly. Go n-éirí leat, a chara.

Photo of Fra McCann Fra McCann Sinn Féin 4:30 pm, 12th October 2021

Go raibh míle maith agat, a LeasCheann Comhairle.

It was interesting to listen to Robbie, who has first-hand experience of what firefighters go through. To have someone like that speaking in the debate is invaluable.

I am pleased to support a motion and amendment that provide additional health security to vital workers. The risks of being a firefighter are clear. Every day, these workers put themselves at considerable risk as they go about protecting, and often saving, the lives of people in our communities. I honestly do not know how we could ever go about thanking them adequately for all that they have done on our behalf. However, there are small measures that we can take.

The motion to introduce annual cancer screening is welcome, but more is needed. The statistics tell us, as Members have said, that firefighters are four times more likely to develop cancer due to their regular exposure to pollutants in the work that they do on behalf of society. Further preventative measures are obviously needed, and that is what the Sinn Féin amendment addresses.

As my colleague said earlier, we have been informed by firefighters that, here in the North, only two kits are issued to them. When a kit is contaminated at a fire or another incident, it is supposed to be laundered to decontaminate it. However, that can sometimes take weeks, and firefighters often reuse contaminated kits, shift after shift, putting themselves, their co-workers and their families at considerable risk.

The Assembly needs to send a message that that is not an acceptable way to treat front-line workers who put their lives on the line day and daily. The Department of Health needs to look at what is being done in other jurisdictions in regard to best practice when it comes to the decontamination of kits and vehicles used by firefighters. For example, in the United States, firefighters remove their kit immediately after an incident. In fact, after an incident, to reduce the risk of further contamination, they do not even get back into the fire truck while wearing their kit.

We must do everything that we can to protect the lives of those who, all day, every day, put their lives on the line for us. Better decontamination measures and modern, accessible facilities will improve the working lives of firefighters and help to reduce their risk of cancer and other illnesses.

I thank the DUP for bringing the motion to the Assembly, and, in conclusion, the Sinn Féin amendment strengthens what is a good motion.

Photo of Pam Cameron Pam Cameron DUP

I also put on record my best wishes to Fra McCann on his retirement. I feel quite jealous. I wish you all the best, Fra, for the future.

I commend my colleagues David Hilditch and Jonathan Buckley for bringing the motion to the House. David does so not only as an MLA but as a father who carries a heavy heart after the loss of his son Stuart. David, what you do today is a fitting tribute to your son, and I know that it will be felt by his colleagues who continue their incredible work.

This is an emotional subject for many, but the motion is about an issue that really matters to hundreds of firefighters and their families. As a community, we are reliant on our firemen and firewomen to keep us safe, so we must step up to protect them as they step up, each and every day, to protect us.

Sadly, despite the recognition of the incredibly complex and dangerous nature of the situations in which firefighters must place themselves, there is not enough recognition that these conditions have long-term impacts, due to the chemicals and toxins that firefighters are exposed to.

In areas of Canada and the USA, presumptive legislation recognising certain cancers as occupational diseases amongst firefighters has been introduced. However, to date, the UK has concluded that there is not enough evidence to link occupational exposure to carcinogenic fire effluents with a higher risk of cancers.

Sadly, that lack of recognition means that, if a firefighter were to receive a cancer diagnosis that they believed to be work-related, the onus would be on that firefighter to provide evidence to prove the link in order to secure financial and practical support. Given the nature of their work, it is understandable why the general secretary of the Fire Brigades Union has described this as "an almost impossible retrospective task". That means that many fire personnel are without the vital support to which they should be entitled during the most difficult period of their lives. It is simply not good enough. Rather than being driven by evidence, the policy is driven by a lack of research into the effects of firefighting on the long-term health of those on the front line.

In response to this need, the Fire Brigades Union commissioned independent research from the University of Central Lancashire. The research surveyed more than 10,000 serving firefighters and found that 4·1% of respondents had already been diagnosed with cancer compared with less than 1% of the general population. More than half were under the age of 50, and a fifth were under 40. Those are deeply alarming statistics that the Assembly and the Department of Health cannot ignore. They are devastating to young lives and young families, and we absolutely must protect those lives. The FBU interim best practice report, published in response to the research, provides guidance to minimise the risk to which firefighters are exposed. The guidance emphasises the need to provide health screening to any staff member who is regularly exposed to fire effluent. Early screening and early evaluation will lead to early detection and will save lives.

Today's proposal is sensible. It serves a life-saving purpose. It shows that we as legislators and the community at large take seriously the health and well-being of those who give their professional careers to protect us, regardless of the extreme dangers and horrendous situations that they face. It would not have a huge financial implication, but, my goodness, it would have massive implications for firefighters and their families. Furthermore, research from Mind shows that 85% of those in fire and rescue services experience stress and poor mental health. That shows the need to do more to support those essential front-line workers.

The nature of the job results in increased exposure to carcinogens, and we need to ensure that other extremely important measures are in place to give firefighters the best protection. We need to ensure that best practice standards are implemented in the use of PPE, respiratory equipment, risk assessment, decontamination procedures and, vitally, training. That must be enabled by adequate resourcing and funding.

Our firefighters put their lives on the line to ensure our safety, and the least that we can do for those brave individuals is to ensure not only that their work is recognised but that the risks that they endure every day are recognised. That applies for the present and for the lifelong impacts that those can have. Annual cancer screenings for serving firefighters are essential.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

I ask the Member to draw her remarks to a close, please.

Photo of Jonathan Buckley Jonathan Buckley DUP

Does the Member recognise that, alongside the very personal nature of the issue for Mr Hilditch, it is equally important that, as Ms Hunter pointed out, the needs of our firefighters have reached the global stage, taking into account the tragedy and the devastating scenes that firefighters in the United States rushed to following 9/11?

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

The Member has up to six minutes.

Photo of Pam Cameron Pam Cameron DUP

I thank my colleague for his intervention. I agree with that wholeheartedly.

I will conclude. Devolution can make a real difference in areas like this. I urge the Minister to take the issue forward as a matter of urgency and to make that difference for the well-being of all those who serve our community in the Fire Service. I support the motion and the amendment.

Photo of Alan Chambers Alan Chambers UUP

I am pleased to hear the improved health news about Fra's wife. They are both living proof of the benefits of double vaccination.

Other Members have acknowledged the debt of gratitude that we owe to members of the Northern Ireland Fire and Rescue Service, and I concur with all those comments. Fortunately, we as members of the public are not onlookers to the work that firefighters routinely carry out daily. Their skills extend to many scenarios other than fighting fires.

We see them cutting free victims from bad traffic collisions or evacuating people from areas. We have even seen them rescuing farm animals that are stuck in a sheugh. However, we do not see, at close quarters, their core function of fighting fires. They enter business premises with, perhaps, only scant information on what chemicals or products are stored in the building. They may also be unaware of the asbestos dangers in properties, particularly older buildings, many of which have been adapted for storage.

With all the best protection and training in the world, it is entirely possible for a firefighter to be exposed to toxic fumes or dangerous particles in the air. Other Members have spoken about the experiences of firefighters and first responders in New York City during the 9/11 attacks. Over a very compact period of weeks, they selflessly worked through the ruins of those buildings to recover the remains of victims and were exposed to a lot of dangerous, toxic materials. Of the first responders present in the direct aftermath, 45% now suffer from upper airway and digestive tract conditions and 16% have cancer. Not all of those medical conditions can be attributed to their duties, but it is a reasonable assumption that the roots of many of those conditions were in the ruins of the World Trade Center.

Over a 20-year career, our local firefighters may not match the intense experience of the New York firefighters, which was felt over a few weeks. However, given the conditions in which their duties dictate that they must operate, they could develop many of the conditions now suffered by the first responders in New York City. Routine annual cancer screening, if practical, can only be a good thing and, hopefully, it will offer some degree of reassurance to firefighters and their families.

Photo of Gerry Carroll Gerry Carroll People Before Profit Alliance

I wish Fra McCann all the best on his retirement that probably will not be a retirement. I am sure that he will be as busy and active as ever. He has always been courteous to me, and I want to wish Fra all the best.

I fully endorse the motion. I thank the Members who brought the motion and the amendment before the House today. The Assembly needs to do more to combat cancer rates among firefighters, but it also needs to do more to expand cancer screening for women, men, children, the elderly and every person in our society and to recognise the importance of front-line workers throughout COVID, especially firefighters.

The figures are alarming, as Members have mentioned. The published research states:

"4.1% of survey respondents had already been diagnosed with cancer, compared with less than 1% of the general population."

Obviously, that is alarming and showcases the urgent need for regular health screening to detect the early changes that could lead to cancer and other illnesses that relate to their work. Public health authorities and the Fire and Rescue Service must put the necessary provisions in place urgently to keep firefighters safe from cancer and other illnesses.

Those workers are exposed to fires that produce a cocktail of toxic irritant and carcinogenic chemicals in the form of aerosols, dusts, fibres, smoke, fumes, gases, vapours and other elements. Indoor air testing at a number of fire stations and training centres highlighted that firefighters across Britain and the North are still being exposed to high levels of toxic contaminants during and after a fire, because cancer-causing chemicals remain on PPE, clothing, equipment and elsewhere at the fire ground.

As others have said, the research stated:

"Test samples revealed carcinogens inside firefighters’ helmets, on PPE, and even on breathing apparatus mask filters."

One survey, which was conducted on 10,000 people currently serving as firefighters, asked questions to:

"better understand UK decontamination practices and the prevalence of illness".

The research shows that three-quarters of firefighters serve for at least 10 years before receiving their diagnosis. Those are really startling figures, with more than half of those diagnosed being under the age of 50 and a fifth were under 40. Of those diagnosed, 26% had skin cancer, which was the most common illness; 10% had testicular cancer; 4% had head and neck cancer; and 3% had non-Hodgkin’s lymphoma. Half of the respondents did not think that their fire services took decontamination practices, such as cleaning PPE equipment, seriously. That is a crucial point for the Minister and the Fire and Rescue Service to act on. One in five of the survey respondents said that they store their fire gloves in their boots or pockets and one in 10 in their helmets, risking the transfer of toxic contaminants directly to skin.

Scientists have created a best practice guide for fire and rescue services, putting forward a number of urgent recommendations to minimise firefighters' exposure to toxic fire effluence. Those include every fire and rescue service having to implement fully risk-assessed decontamination procedures en route to, during and after fire incidents and ensuring that all relevant staff are trained in implementing those procedures. Fire and rescue personnel should receive regular and up-to-date training on the harmful health effects of exposure to toxic fire effluence and how those exposures can be reduced, minimised or eliminated. Firefighters should wear respiratory protective equipment at all times while firefighting, including after a fire has been extinguished but is still gassing off. PPE should be cleaned and thoroughly decontaminated after every incident in order to avoid a build-up of toxic contaminants. Firefighters should shower within an hour of returning from incidents. Regular health screening and recording attendance at fire incidents over a firefighter's career are strongly advised and will be key to the longer-term monitoring and management of their health.

One of the last points, which is in many ways the most important, is that we need an expansion of screening and investment in the NHS that targets firefighters as well as other workers who may be at risk on the front line.

In closing, I will say that Matt Wrack, general secretary of the FBU, stated, I believe in the report:

"Firefighters risk their lives every day to keep their communities safe. But it's clear that the risk to their health doesn't stop when the fire has been extinguished. Sadly we often see serving and former firefighters suffer from cancer and other illnesses. Every firefighter knows the fear that, someday — ".

Photo of Robbie Butler Robbie Butler UUP

Will the Member give way?

Photo of Robbie Butler Robbie Butler UUP

I thank the Member for giving way. Thank you, Mr Deputy Speaker.

You covered a lot of ground. It was really good, Mr Carroll. One of the realities in the fire service is that our firefighters are attending a lot fewer fires than they used to, so the fire safety education message is getting through. Does the Member agree that we need to keep that fire safety education going so that we minimise the number of fires, which will minimise the amount of exposure for our firefighters in the first place, and try to get that upstream as well?

Photo of Gerry Carroll Gerry Carroll People Before Profit Alliance

Thank you. I thank the Member for his intervention. I agree with his point. He brings a lot of expertise, as others said, so I fully accept that.

Just to finish the quote:

"Every firefighter knows the fear that, someday, they and their family could receive the devastating news – but we're determined to do all we can to reduce the risk of firefighters developing these terrible diseases as a result of their job."

Hopefully, if the motion passes today, that will be a reality. I am happy to support the motion and amendment.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

I now call the Minister to respond, and the Minister has up to 15 minutes.

Photo of Robin Swann Robin Swann UUP

Thank you very much, Mr Deputy Speaker, for the opportunity to respond to the motion, the amendment and Members' remarks.

I thank Mr Hilditch for tabling the motion on what is a practical and political issue but also for him a deeply personal one. I pay tribute to his son Stuart, who was a part-time firefighter. I not only know how much Stuart meant to David but how much Stuart meant to the Fire and Rescue Service and the commitment that he gave to it. David, please take that as a personal thanks, and take it back to your family as well.

The Assembly will undoubtedly agree that firefighting is a dangerous occupation. We heard that from many contributors. Firefighters put themselves in danger to help those most in need. The bravery, dedication and commitment shown by our firefighters often go unseen. For the past 20 months, our health and social care workers have been to the fore, and rightly so, but it is often forgotten and overlooked that our firefighters here in Northern Ireland are part of our health family, and they are a key part. It has been an honour and privilege for me as Minister to meet many of them on lots of occasions since coming into office.

It is as Minister of Health that I assure Members that I am committed to protecting our dedicated firefighters. Furthermore, supported by my Department and the Northern Ireland Fire and Rescue Service, I can say that we are fully committed to safeguarding our employees. The Fire and Rescue Service in Northern Ireland has, like all employers, a statutory duty to ensure the health, safety and welfare of its employees. The Health and Safety Executive for Northern Ireland (HSENI) is responsible for enforcing health and safety at work. The Control of Substances Hazardous to Health Regulations 2002 (COSHH) require employers to assess the risk to their employees in relation to substances that are hazardous and "to prevent or adequately control" those risks.

The motion asks:

"That this Assembly recognises the urgent need to protect firefighters from cancer".

Members will welcome assurances provided to me by the Chief Fire and Rescue Officer that, as an employer, the Northern Ireland Fire and Rescue Service is compliant with Health and Safety Executive requirements. Furthermore, the occupational risks that firefighters face are continually assessed by the Fire and Rescue Service, and action is taken to mitigate known risks, including risks associated with exposure to contaminants, as has been mentioned.

Given the work that firefighters do, Members will accept that options to eliminate exposure to harmful substances are limited. For that reason, the Northern Ireland Fire and Rescue Service, like most fire services in the United Kingdom, has focused efforts on adopting preventative measures to reduce exposure whilst on operational duties. Researchers in that area have created a series of best practice guidance for fire and rescue services. They have put forward a number of recommendations to minimise firefighters' exposure to toxic fire effluents. I advise the Assembly that the Northern Ireland Fire and Rescue Service has a well-established contaminants working group that takes forward those recommendations. The contaminants working group works to ensure that the Fire and Rescue Service follows national best practice to protect our firefighters against exposure to harmful substances. That group works collaboratively to consider the wider sector's position through the National Fire Chiefs Council and with the Fire Brigades Union.

The Fire and Rescue Service is working in partnership with the Fire Brigades Union, following the launch of its training and awareness package, DECON, which Mr Hilditch spoke of in his opening comments. The purpose of the package is to prevent and protect firefighters from the risks associated with exposure to contaminants. That campaign encourages firefighters to take practical steps before, during and after every fire incident to help to reduce exposure to contaminants.

As mentioned, the Fire Brigades Union commissioned the University of Central Lancashire to research firefighters' occupational exposure to toxic fire effluents. That report, which was published in November 2020 and entitled 'Minimising firefighters’ exposure to toxic fire effluents', detailed the dangers faced by firefighters from breathing and ingesting contaminants and how those toxic fire effluents can be absorbed by the skin. The report found that 4·1% of survey respondents had already been diagnosed with cancer, compared with less than 1% of the general population. Members referenced that particular statistic in the debate.

Members should be aware that, more recently, in March 2021, in response to a request by the House of Commons Environmental Audit Committee, the Industrial Injuries Advisory Council published 'Firefighters and cancer: position paper 47'. It reviewed the evidence concerning the risk of cancer in firefighters, and it served as an update to earlier publications on cancer prevalence in firefighters. The paper stated:

"Concern about skin exposure to chemicals and contamination of equipment and clothing needs further scientific investigation and additional control measures".

The Industrial Injuries Advisory Council has recognised increased risks associated with firefighters for specific cancer sites. However, the types of cancer and the magnitude of risk vary considerably between studies, countries, the date of the studies and the length of employment of the firefighters. The Industrial Injuries Advisory Council did not find consistent evidence that the risk of any type of cancer, besides one specifically connected to exposure to asbestos, was more than doubled as a result of firefighting.

In March, the Industrial Injuries Advisory Council, again, decided against recognising cancer as an occupational disease for firefighters. Members should be aware that research in that area is ongoing. The Industrial Injuries Advisory Council is committed to continuing to monitor ongoing research and remains open to the possibility of reviewing its position as the research evidence base grows.

A UK firefighters cancer and disease registry database has been established by researchers to collect information on firefighters' work routines, exposure to fire effluents, lifestyle and health. Members will agree that it is critical that any link between occupation and cancer is properly defined. I advise the Assembly that, as Health Minister, I, of course, support that research. I remain vigilant in relation to any new data that would enable scientists to identify cancers common in firefighters and to establish whether those diseases are linked to occupation, because I have no doubt that ongoing research will better inform future advice, guidance and procedures in the Fire and Rescue Service.

In line with the direction from the Health and Safety Executive, under COSHH regulations, the Northern Ireland Fire and Rescue Service, like all employers, has an existing statutory duty to determine whether health surveillance is required where workers remain exposed to health risks, even after controls have been put in place.

Members should be aware that all operational Fire and Rescue Service employees in Northern Ireland are required to undertake health surveillance screening. Firefighters are re-examined at three-yearly intervals. That screening is carried out in accordance with the National Fire Chiefs Council's requirements, but the Northern Ireland Fire and Rescue Service carries out additional health screening for some operational staff, due to the risks associated with specific roles. For example, compartment fire behaviour instructors have additional screening every six months for the duration of the instructor's role and specialist rescue teams attend annual health screening. The service's contaminants working group continually reviews information sources on exposure to toxic fire effluents, with a view to identifying relevant health surveillance requirements.

I accept that screening for cancer and many other conditions is clearly desirable in order to manage any health effect at the earliest stage. However, the practicalities of that approach need to be risk-assessed by the Fire and Rescue Service as the employer. Members should be aware that the general population cancer screening policy across the UK is informed by the UK National Screening Committee's recommendations. All recommendations are evidenced-based following a robust review against criteria for improving the viability, effectiveness and appropriateness of a screening programme. The Assembly should be aware that currently there are no screening programmes targeted at a population group on the basis of occupation.

I reassure you, Mr Deputy Speaker, and the House that the Northern Ireland Fire and Rescue Service constantly strives to improve our firefighters' safety, utilising the evidence and knowledge that it holds. I am fully supportive of the ongoing studies of exposures and their health effects on firefighters and will continue to study the literature for future published reports. I will maintain a low threshold for reviewing the topic at any time in the future. I have sympathy with the concerns expressed by Members. I have spoken many times on the significant impact that the pandemic has had on our cancer services in Northern Ireland, and I have no doubt that the actions taken by the Northern Ireland Fire and Rescue Service and the associated surveillance help to protect firefighters in Northern Ireland. The Assembly will, no doubt, join me in thanking it for the hard work that it has undertaken to date.

I believe that I have clearly demonstrated that the issues raised by Members are being given serious attention by the Northern Ireland Fire and Rescue Service and my Department. Work is ongoing in the area, and every effort will continue to be made to ensure that firefighters' needs are met.

Before closing, Mr Deputy Speaker, I join you and other Members in thanking Fra McCann for his service to the House. As a new MLA, I joined the Employment and Learning Committee with Fra, Sammy Douglas and Pat Ramsey. On reflection, I often feel sorry for the Ministers and officials who appeared in front of the three of them together, because their questioning was precise, specific and well informed, and it was always done with the best intentions for the people of Northern Ireland. That is how I have worked with Fra during my time in the House. Thank you, Fra.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

Glaoim ar Órlaithí Flynn chun críoch a chur leis an díospóireacht ar an leasú. Beidh suas le cúig bhomaite agat. I call Órlaithí Flynn to wind up on the amendment. You have up to five minutes.

Photo of Órlaithí Flynn Órlaithí Flynn Sinn Féin

Go raibh maith agat, a LeasCheann Chomhairle. I will just do a quick review of some of the issues that Members have touched on. I will try to keep it specific to the content of my party's amendment, which was around best practice procedures, PPE, fire kit laundry and how, by putting more effort into those elements, some of the contamination issues affecting firefighters and their families can be prevented.

I am delighted that Mr Hilditch is happy to support our amendment. He spoke about the importance of the DECON campaign, to which the Minister also referred, and of challenging old habits. It was said that there was a culture in the fire service that having a dirty kit was the sign of a good job done, but, obviously, with the health repercussions and with more evidence and more research being done, as David said, it is really important to challenge some of those old habits. David also pointed out the reality of the time limitations placed on firefighters. That is an issue when they are trying to be more careful in changing their PPE and their uniforms and stuff, because they are limited in their time to carry out proper decontamination.

Probably his most important point was on the need to raise awareness among firefighters and their families by covering every aspect in order to prevent some of those health and social care staff from ending up with serious illnesses and, if they are carrying any, from passing contaminants on to their families. Thanks to Mr Hilditch for that.

Colm Gildernew, the Chair of the Health Committee, made the glaringly obvious point that the risk does not end for a firefighter at the scene of an incident. He talked about the importance of having the appropriate PPE. That is critical. The critical nature of PPE has been evidenced throughout the past 18 months of the COVID pandemic, so we need to work towards having the best possible PPE procedures in place, not just for dealing with COVID-19 but for our firefighters.

I turn now to Cara Hunter's contribution. I am delighted that there was strong support from the SDLP for my party's amendment. Cara raised the poignant example of the 9/11 experience and some of the awful outcomes for firefighters who attended the scene that day. A lot of those outcomes could have been the result of the PPE that they were wearing on that day. They may or may not have had enough protection, although I do acknowledge that they were dealing with a really extreme incident. As Robbie Butler said, there is no hierarchy of incidents to which firefighters respond. They could be putting out a fire on a grass lawn, but the quality of their PPE needs to be of high standard regardless of the incident that is being responded to.

Robbie also mentioned the mental health pressures placed on firefighters as a result of harmful exposure to different toxins. The important thing to come out of that is that, if we invest more in enhancing PPE, uniforms and the washing of kits, there could be a positive knock-on effect on our firefighters' mental well-being.

Paula Bradshaw, the chair of the APG on cancer, focused her remarks on prevention and made the point that thankfully the problem is being taken more seriously. Hopefully, Paula, our amendment can help with prevention.

I could devote the next half hour to talking about Fra McCann. Big congratulations to you for all your years in service: I completely respect you, and you inspire me every day. I will move on to your remarks on the motion, because, otherwise, I would go on and on. Fra spoke about the importance of firefighters' first-hand experience . We tried to base our amendment on some of the feedback that firefighters had given us on their uniforms and their PPE. Fra talked about reusing the contaminated kits shift after shift after shift, which is clearly very dangerous and something that we need to do all that we can to avoid.

Like Pam, the Deputy Chair of the Health Committee, I acknowledge the proposer's personal and emotional attachments to the motion, of which I was not aware. I commend Mr Hilditch for his work and for all his energies in tabling the motion. I thank him very much for that.

Photo of Órlaithí Flynn Órlaithí Flynn Sinn Féin

I am very sorry that I am out of time. I had notes on the contributions from Alan, Gerry and the Minister. Thanks very much to everyone for their input. I am really happy to support the motion.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

I call Jonathan Buckley to conclude and wind on the debate and the motion. The Member has up to 10 minutes.

Photo of Jonathan Buckley Jonathan Buckley DUP

I thank all the Members who contributed to today's debate. It is fair to say that there is unanimity in the Chamber in our appreciation for, and recognition of, the selfless effort that is made by the Fire and Rescue Service in pursuit of protecting lives. Those brave, brave men and women are the first line of response to fires, road traffic collisions and specialist rescue incidents, and we call on them in the most volatile and compromising scenarios imaginable. Sometimes, when one is winding on a motion, it can be difficult to reflect and summarise in full Members' thoughts and feelings across the political parties, but it is quite easy for me to do so today because Members are unified on the need to step up and support our firefighters.

I pay special tribute to my friend and colleague Mr David Hilditch for tabling today's motion. Many will know of the very personal circumstances in which he does so. David has always, in the time that I have known him, been a vocal advocate for firefighters across this country. We have all looked on in admiration at how he has conducted and carried himself following the very difficult, sad and tragic circumstances of Stuart's passing. Stuart proudly and diligently served in the Fire and Rescue Service. Unfortunately, like so many other firefighters, he was diagnosed with cancer and lost his battle. Many of us know of similar circumstances. I am sure that our colleague Robbie Butler can also testify to that happening to colleagues whom he served with. Thank you, David, for your dedication and the continuation of your fight to protect firefighters across this country.

Firefighters, while on duty and enduring the elements, can be exposed to chemicals that are currently classified, as Members mentioned, as definite or probable human carcinogens. First and foremost, it is essential that exposure to those harmful toxins is minimised and that the Fire and Rescue Service carefully control risks to the health of its employees from exposure to hazardous substances. The risks are currently minimised by the provision and maintenance of suitable PPE, the facilitation of storing and cleaning equipment, and the provision of training for employees on all risks. To that end, the Health and Safety Executive continues to monitor the progress of all current research that seeks to improve the working environment of firefighters.

Members right across the House talked about the challenges that our firefighters face, whether they be time pressures, the circumstances and dangers, PPE, or their mental well-being. Firefighters encounter such a range of issues. It is important that appropriate steps and mechanisms are put in place to protect them. Although I welcome the steps that have been taken to minimise their exposure to harmful chemicals while on duty and the ongoing research that is being conducted on a national level to explore the health risks and effects from contaminated equipment, we must acknowledge the growing body of research over the past decade, as mentioned by Mr Hilditch, on the occurrence of cancer in firefighters.

In 2010, the National Institute for Occupational Safety and Health in the United States of America began a multi-year study of nearly 30,000 firefighters. The resulting evidence was that cancer diagnoses and cancer-related deaths were notably higher among firefighters than in the general population, particularly for forms of respiratory, digestive, urinary and oral cancers. Given the data and evidence that have been compiled, we should not hesitate to provide a framework to manage and monitor the health status of firefighters.

I will not prolong my comments. We have all spoken proudly about our firefighters and the Fire Service, but it is clear that the motion is about much more than words. My party, including Mr Hilditch, welcomes the amendment, which strengthens the motion. The motion has a very clear ask, and we, as Members, must follow up on that. The motion:

"recognises the urgent need to protect firefighters from cancer".

All Members recognised that. The motion also recognises:

"as a result of their profession, firefighters can be up to four times more likely to develop cancer".

Members acknowledged that. I know that the Minister responded to the debate, but the motion also:

"calls on the Minister of Health to introduce annual cancer screenings" for those in the profession. Although I recognise that more work needs to be done to see how screening will be implemented, we must hold fast to that. It is the collective will of the House, so it is something that, collectively, we can all push for.

In closing, I thank Mr Hilditch for tabling the motion, and I thank Members for their support. In times of vulnerability and helplessness, firefighters risk their lives to help us. It is, I believe, time for us to help them.

Question, That the amendment be made, put and agreed to.

Main Question, as amended, put and agreed to. Resolved:

That this Assembly recognises the urgent need to protect firefighters from cancer; acknowledges the increasing evidence highlighting the serious health risks to firefighters and their families following exposure to carcinogenic fire effluents; further recognises that, as a result of their profession, firefighters can be up to four times more likely to develop cancer and other illnesses than other members of the public; and calls on the Minister of Health to introduce annual cancer screenings to monitor and manage the health status of serving firefighters, and to engage with the Fire Brigades Union on implementing best practice procedures regarding post-incident decontamination, adequate personal protective equipment, and fire kit laundry and replacement, in order to prevent firefighters, their families and colleagues being exposed to harmful contaminants.

Photo of Patsy McGlone Patsy McGlone Social Democratic and Labour Party

I ask Members to take their ease while we prepare for the next item of business.