VANCOUVER — Jenn Dawkins remembers the spring day in 2016 when she joined four other female firefighters at British Columbia's legislature to lobby for the inclusion of breast cancer as a presumed occupational illness covered by the province's health and safety agency for workers.
Dawkins was diagnosed with breast cancer three years later.
"I went through a mastectomy and four months of chemotherapy during the early stage of the pandemic," she said. Reconstructive surgery followed.
"This is an actual result of simply going to work and doing my job," said Dawkins, who has since returned to fighting fires in Vancouver, where she has been employed for 22 years.
Dawkins now wants other firefighters to be protected with legislation that makes cancer a presumed occupational hazard because of exposure to known carcinogens. Her counterparts in Quebec have the least protection of any jurisdiction in Canada.
Dawkins was covered for workers' compensation benefits because a year after her trip to the legislature, B.C. added breast cancer, along with prostate cancer and multiple myeloma, to the list of presumptive cancers affecting firefighters. That meant they no longer had to prove their disease was directly linked to a high-risk job.
British Columbia recently amended the Workers Compensation Act to include three more cancers — ovarian, cervical and penile — on a list that now totals 16 presumptive cancers.
Cancers affecting the reproductive system are being added across much of the country, as more women take on firefighting.Benefits kick in after a certain number of years on the job, between five and 20 years in B.C., for example, depending on the type of cancer.
Each province and territory has its own list of cancers that are presumed to be linked to firefighting because workers' compensation legislation is not federally enacted.
The International Association of Fire Fighters and the Canadian Association of Fire Chiefs are supporting Quebec member of Parliament Sherry Romanado's recent introduction of a private member's bill focusing on national standards for occupational cancers linked to firefighting.
It says raising awareness is crucial to helping firefighters identify early signs of cancer for testing and treatment and calls for regular screening for the disease.
Chris Ross, president of the Montreal Firefighters Association, said he's hoping momentum from the bill that has garnered wide political support will help push the Quebec government to add more presumptive cancers.
The province did not recognize cancer as a high occupational risk for firefighters until last year.
Quebec has listed nine cancers as being related to firefighting, the lowest number in the country, and Ross said the association faced opposition to adding more cancers like leukemia, brain and breast cancer.
The association launched legal action against its workers' compensation agency on behalf of firefighters diagnosed mostly with brain, testicular and esophageal cancers as well as leukemia, Ross said. It has won all of its cases, about 10 so far, in Quebec's labour law tribunal, and a dozen settlements have been made outside that process, he added.
"We decided about eight years ago that every single cancer that was recognized elsewhere we would litigate," he said, adding that scientific evidence from multiple studies related to cancer among firefighters had paved the way to victory.
Quebec has convened a medical committee to recommend which cancers could be included in future legislation, he said.
However, Ross said that's an unacceptable substitute for the "courage of politicians" to take action in a province that treats firefighters like "second-class citizens."
"Ultimately, fires don't burn differently in Gatineau compared to Ottawa. It's not like you cross the bridge and suddenly they're more cancerous," he said.
In Ontario, 17 cancers are presumed to be linked to firefighting.
About 55 firefighters in Quebec are believed to have died of cancer in the last 12 years, but the figure is likely higher, Ross said.
Alex Forrest, captain of the Winnipeg Fire Department, said Manitoba was the first in Canada in 2002 to include five presumptive cancers for firefighters. It now lists 19 cancers, the same as Nova Scotia and Yukon.
Forrest, who is also a lawyer, helped draft the legislation in all three jurisdictions before moving on to Alberta and beyond as presumptive legislation expanded across the country.
He was invited to Australia in 2011 to present scientific evidence on the link between firefighting and cancer and said he had also educated governments and organizations in Europe about the firefighters' exposure to carcinogens like arsenic, benzene and cadmium.
In 2012, Australia became the third country in the world, after Canada and most jurisdictions in the United States, to adopt such legislation.
Forrest said there's a lack of knowledge amongepidemiologists about dangerous levels of carcinogens, including the highly flammable chemical benzene, which is present at most fires, whether they are garbage, kitchen or large-structure blazes.
Firefighters' protective gear can withstand upwards of 1,000 degrees Celsius, but it does not protect them from cancer-causing agents because their clothing has to "breathe," Forrest said.
It's not inhalation or ingestion of chemicals, but absorption of particulates through firefighters' skin and into their bloodstream that is most dangerous, he said.
"Firefighters, over a career, will go to hundreds of fires. And you see cell manipulation start occurring after three to five years, which predicts cancer outcomes."
Tim Baillie was diagnosed with two cancers after he retired from his 27-year career as a firefighter in Surrey, B.C.
"I was through customs, getting on a plane going to Mazatlan. And it was like someone stabbed me in my right abdomen," he said of his experience in 2016, when he learned he had kidney cancer. "I ended up going to the emergency ward and had a five-centimetre fully encapsulated cancer growth in my right kidney."
In 2021, he was diagnosed with prostate cancer, which, like the first cancer, was listed under presumptive legislation.
Baillie is hoping all provinces move forward to acknowledge the reality that cancer is a top killer of firefighters.
"It always comes down to money," he said.
Municipalities that employed firefighters pay only marginally higher workers' compensation rates to protect those who put their lives at risk just by going to work, he said.
Firefighters must also take on provincial governments that are often slow to act, Baillie said.
This report by The Canadian Press was first published May 5, 2022.
Camille Bains, The Canadian Press