Iain Barbour first noticed something was wrong when he started choking on a burger. ‘I realised I couldn’t swallow. And I had these chest pains that I thought was a heart attack,’ he recalls. 

When he went to the doctor in July 2020, he was told it was acid reflux. After weeks with no progress on medication, he was then told it was a fungal infection. In the meantime, he still couldn’t swallow, was living on liquid meals and had lost four stone. 

It was only in September, after a follow-up appointment, he was contacted by doctors who thought it might be something worse. One rushed endoscope later, and he had a diagnosis. 

‘They told me there and then, my oesophagus was 75% blocked with a tumour,’ he says. ‘They didn’t know if the cancer had spread.’

The next few months were filled with countless tests, one multiple-hour surgery, months of chemotherapy, a PTSD diagnosis, and getting infected with Covid while on a ventilator in hospital. In February 2021, on his son’s birthday day, the 39-year fire service veteran was told he was in remission.

It’s almost strange to say it, but in some ways, Iain was lucky. The type of cancer he has is terminal more often than not. Since finishing chemotherapy in May, he has even managed with intense physiotherapy and help from the fire service to get himself back in shape to rejoin active duty. 

But many others weren’t so lucky. A study conducted by researchers at the University of Central Lancashire on behalf of the Fire Brigade Union found firefighters were 1.6 times more likely to die from cancer than the general population. For certain cancers, including prostate, leukaemia and the oesophageal cancer Iain was diagnosed with, the mortality rate is between 2.4 and 3.8 times higher than the general population. The research also found that firefighters were dying from heart attacks at five times the rate and strokes at three times the rate of the general population. 

According to researchers, fire often produces a toxic mixture of carcinogens, including benzene and toluene, which are behind the deaths. Firefighters’ protective equipment and foam also contain the severely dangerous ‘forever chemical’ PFAS.

The problem is so severe the World Health Organisation’s recently deemed cancer in firefighters as a group 1 occupational hazard, the most serious classification, because of the incredibly high levels of carcinogens firefighters encounter on the job. Meanwhile, according to the FBU, the UK government and fire chiefs have yet to put forward nationwide plans to help the countless firefighters who die from cancer caused by their job each year. 

Kerry Baigant started in the fire service in 1993, working out of a fire station in Cambridge. ‘I joined at a time where we wore breathing apparatus a lot, but there was never really any kind of education about the toxicity that sits with you after the fire is out,’ she tells Tribune.

‘If you went back to the base, you probably had a cup of tea, probably had lunch; you wouldn’t have a shower unless you were at a job that was five hours or more of non-stop working. So you’d be sitting around in dirty uniform.’

‘Cancer never crossed my mind, not even slightly. And then, in 2020, I got diagnosed with breast cancer. I was 47 at the time, and it was a bit of a shock… I’m in remission now, so I feel really lucky, but other people aren’t too lucky,’ she adds. 

Even though she was younger than the age that most women are diagnosed with breast cancer, she never connected the diagnosis to the firefighting job she had left several years earlier. That was until she was contacted by the FBU as part of their research into the problem—and it clicked.

‘My first watch in 1993, there were 18 of us. And three of them died in their 40s and 50s from cancer. Then there were others who had cancer and who, fortunately, are in remission,’ Kerry says. ‘They were young men, they left families behind when they died.’

‘I don’t have that elsewhere in my life. I don’t know people outside the job who are my age and dying of cancer.’

For those working in the fire service, there’s no confusion over the scale of the problem. When speaking to firefighters for articles on their disputes over low pay and overwork, I was repeatedly told that I needed to write about the fact that, as one serving firefighter explained, ‘our jobs are killing us’. 

‘Anecdotally, there isn’t a firefighter who hasn’t been affected by cancer directly or indirectly—suffering it themselves, sat at a colleague’s bedside or doing paperwork for the families of those who die,’ says Ricardo La Torre, an FBU national officer. ‘But when we’ve gone to employers, fire chiefs and ministers, our fears just fall on deaf ears.’

The main aims of the FBU DECON campaign that La Torre leads are simple: compensation for firefighters affected, official acknowledgement for those that died that their occupation played a role, facilities and contracts to fully clean equipment and uniforms, and annual health monitoring for firefighters to try and catch these cancers before they become terminal. Some ideas are being implemented by firefighters themselves, including new procedures around cleaning and containing dirty kit, showering and never removing breathing apparatus when at a callout.

But even though the campaign has been running for a year and a half now, the pace of change from leadership is sluggish. While parts of the country are taking action—in Tyne and Wear, for example, the local service is already testing firefighters’ blood for cancer markers—it’s currently at the whim of services themselves to take action, rather than part of a national programme.   

And one thing that is striking about the crisis is how out of step with the rest of the world we already are. ‘If you look at the global fire sector, it’s big on the agenda in the US and Canada, Australia, New Zealand, and Scandinavia,’ says La Torre. ‘The Americans got to the point where they could say with proof the biggest in line of duty killer of firefighters was cancer. That’s how bad things have gotten.’

But whatever progress has been made is largely thanks to the grassroots work of firefighters and the FBU—who funded the ongoing research into the issue through fundraising from its own members. And that work was what helped turn the issue from something anecdotal mentioned by firefighters to a nationwide campaign backed by scientific research and with specific proposals. And the fact it was led by the FBU, is a testament to the power of trade unions to make change far beyond just pay and conditions. 

‘We decided no-one is going to do it for us, so we did it ourselves,’ as La Torre explains it. ‘Firefighters are angry, and rightly so. And we’re ready to turn that anger into action.’