The science
The research on firefighter occupational risk is settled and public. What has never existed is the individual record: the number for you, not the profession. OHPAH is that record.
The carcinogen reclassification
In 2023, the International Agency for Research on Cancer classified occupational exposure as a firefighter as a Group 1 carcinogen. That is its highest category, reserved for agents established as carcinogenic to humans, and it rests on sufficient evidence for mesothelioma and bladder cancer. The pooled risk elevations from the meta-analysis behind that review:
+16% elevated bladder cancer risk among firefighters.
DeBono et al. 2023; IARC Group 1 basis.
+21% elevated prostate cancer risk.
DeBono et al. 2023 (IARC: limited evidence).
+58% elevated mesothelioma risk.
DeBono et al. 2023; IARC Group 1 basis.
Sleep & physical load
Carcinogen exposure is not the only cost the job carries. Two of the most common are how often firefighters lose sleep and how often they carry musculoskeletal injury. Those are the burdens OHPAH’s Sleep Debt Index and Work Intensity Index are built to track.
51% poor sleep quality prevalence among firefighters.
Khoshakhlagh et al., Heliyon 2023.
41% musculoskeletal disorder prevalence among firefighters.
Khoshakhlagh et al. 2024.
These are population prevalence figures from peer-reviewed research: how common the burden is across the profession, not a prediction about any one person. OHPAH does not diagnose, predict, or assess fitness for duty. It documents.
Your log is your evidence
Presumption shifts the burden. Documentation carries the rest.
48 states and the District of Columbia have enacted firefighter cancer presumption laws. These statutes presume certain cancers are duty-related rather than making the firefighter prove it. But the laws vary: many still require documentation of exposure, and only about half extend to volunteers.
A presumption assumes the job caused the illness. Your exposure history is how you show the job. The record a presumptive claim asks for is the exposure history you were never able to produce, until it was being kept for you, call by call.
National Volunteer Fire Council, state presumption-law survey, 2024.
Sources
The evidence exists. Now the record does too.
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