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Lavender Ribbon Report – Best Practices for Preventing Firefighter Cancer

Lavender Cancer Report cover

The fire service is faced with one of the most important cultural changes in our history. This change will dictate the way we do business and the way we take care of ourselves on the fireground and at our stations. It starts with the realization that cancer is an epidemic that is currently decimating our profession.

Fortunately, there are specific actions that individuals and departments can take to protect themselves. As the realization of the magnitude of firefighter cancer is becoming more and more evident, the International Association of Fire Chiefs’ Volunteer and Combination Officers Section and the National Volunteer Fire Council, along with the Fire Service Occupational Cancer Alliance, Firefighter Cancer Support Network, with support from California Casualty, developed the 11 Best Practices for Preventing Firefighter Cancer. This report is an expansion of these best practices in order to provide specific guidance on how to adopt these actions into the everyday culture of fire departments.

11 Actions to Mitigate the Risk of Cancer

  1. Full protective equipment (PPE) must be worn throughout the entire incident, including SCBA during salvage and overhaul.
  2. A second hood should be provided to all entry-certified personnel in the department.
  3. Following exit from the IDLH, and while still on air, you should begin immediate gross decon of PPE using soap water and a brush, if weather conditions allow. PPE should then be placed into a sealed plastic bag and placed in an exterior compartment of the rig, or if responding in POVs, placed in a large storage tote, thus keeping the off-gassing PPE away from passengers and self.
  4. After completion of gross decon procedures as discussed above, and while still on scene, the exposed areas of the body (neck, face, arms and hands) should be wiped off immediately using wipes, which must be carried on all apparatus. Use the wipes to remove as much soot as possible from head, neck, jaw, throat, underarms and hands immediately.
  5. Change your clothes and wash them after exposure to products of combustion or other contaminants. Do this as soon as possible and/or isolate in a trash bag until washing is available.
  6. Shower as soon as possible after being exposed to products of combustion or other contaminants. “Shower within the Hour”
  7. PPE, especially turnout pants, must be prohibited in areas outside the apparatus floor (i.e. kitchen, sleeping areas, etc.) and never in the household.
  8. Wipes, or soap and water, should also be used to decontaminate and clean apparatus seats, SCBA and interior crew area regularly, especially after incidents where personnel were exposed to products of combustion.
  9. Get an annual physical, as early detection is the key to survival. The NVFC outlines several options at “A Healthcare Provider’s Guide to Firefighter Physicals” can be downloaded from
  10. Tobacco products of any variety, including dip and e-cigarettes should never be used at anytime on or off duty.
  11. Fully document ALL fire or chemical exposures on incident reports and personal exposure reports.

Download the full report (pdf)

Published by International Association of Fire Chiefs (IAFC) and National Volunteer Fire Council (NVFC)