Held on November 18, 2020
Chairs/Co-Chairs:
Amy Hanifan, President, Women in Fire
Ed Klima, Managing Director, First Responder Center for Excellence
Sara Jahnke, Ph.D., Director & Senior Scientist, Center for Fire, Rescue & EMS Health Research
Playlist
Sex, Gender & Sexual Orientation
Health Disparities among Sexual Minority Women Firefighters
Christopher Kaipust
Considering Sex and Gender in Firefighter Research
Joy McDermid
Discrimination and Harassment
Sara Jahnke
Sara Jahnke PhD is the Director and a Senior Scientist with the Center for Fire, Rescue & EMS Health Research at the National Development & Research Institutes – USA. With over a decade of research experience on firefighter health, she has been the Principal Investigator on ten national studies as well as dozens of studies as a co-investigator. Her work has focused on a range of health concerns including the health of women firefighters, behavioral health, risk of injury, cancer, cardiovascular risk factors, and substance use with funding from the Assistance to Firefighters Grant R&D Program, the National Institutes of Health and other foundations. She has more than 100 publications in the peer reviewed medical literature.
Safety
Women as Agents of Safety Change: Past, Present, and Future Research
Jennifer Taylor
Structural and Wildland Female Firefighters regarding the Comfort, Mobility, and Fit Issues of Their Firefighting PPC
Meredith McQuerry & Cassandra Kwon
Insights from the Inside: A Window into the Experience of Female Firefighters in Ontario
Pike Krpan
Exposure
PFAS, Flame Retardants, and Biological Measures in the Women Workers Biomonitoring Collaborative
Jessica Trowbridge
Cassidy Clarity
Occupational exposures to per and polyfluoroalkyl substances (PFAS) and flame retardants (FR) are of particular concern for firefighters as they are commonly found in consumer products, have been detected in fire station dust and firefighter gear, and have known deleterious health effects. Thyroid hormone levels and telomere length are two biological measures that are themselves associated with health outcomes and may be affected by such exposures. These measures may therefore serve as useful markers of effects. We assessed differences in PFAS and FR levels between women firefighters and office workers, and analyzed the association between these chemicals and thyroid hormone and telomere length. Firefighters had higher levels of PFHxS, PFNA, and PFUnDA compared to office workers. Both occupational groups had higher levels of PFBuS, PFHxS, PFDA, and PFUnDA than the general US population of adult women as measured in the National Health and Nutrition Examination Survey (NHANES). Firefighters also had higher levels of the urinary FR metabolites BCEP, BDCPP, and DBuP. Thyroid hormone analyses revealed that increased BDCPP, a metabolite of the flame retardant TDCPP, was significantly associated with decreased thyroid hormone (T4) in firefighters. Analyses of telomere length found significant positive associations between certain PFAS and telomere length, with larger effects seen among firefighters as compared to office workers. The OPFR metabolites BDCPP and BCEP were also associated with telomere length in firefighters and office workers.
Jessica Trowbridge, former Coordinator for the WWBC study and post-doctoral scholar at UCSF’s Program for Reproductive Health and the Environment. Dr. Trowbridge is a postdoctoral scholar with UCSF’s Program for Reproductive Health and the Environment (PRHE). She received her PhD and MPH in Environmental Health Sciences at the University of California, Berkeley. Her research interest is in examining environmental exposures in women and their offspring. Her current research with PRHE will focus on prenatal flame retardant exposure and neurodevelopmental outcomes in infants of the Environmental Influences on Child Health Outcomes (ECHO) cohort. Previously, as a PhD student at UC Berkeley’s Sustainability and Health Equity Lab, she coordinated the Women Workers Biomonitoring Collaborative (WWBC).
Reporting Personal Exposure Results in a Recent Biomonitoring Study of Women Firefighters in San Francisco
Ruthann Rudel
Katie Boronow
Heather Buren
The Women Workers Biomonitoring Collaborative measured chemical exposures and biomarkers of effects in blood and urine collected from women firefighters in San Francisco. Participants have the option to receive the results of their tests through an interactive web tool — Silent Spring Institute’s Digital Exposure Report-Back Interface (DERBI)–that shows how their own result compares with others in the study and with the general population. The DERBI report also summarizes overall findings of the study to date and provides information about health effects of the chemicals and tips for reducing exposures. The report is personalized so that each participant gets a summary that highlights her own most important findings. In this presentation, Captain Buren walked attendees through a sample report as an example of how we are engaging our women firefighter participants in this research and as a way to share high level findings with the audience.
Heather Buren, Co-principal Investigator for the WWBC; Captain and Paramedic, San Francisco Fire Department. 
Heather Buren joined the SFFD in 1997, and since has worn many hats in the department, including firefighter, paramedic, lieutenant, training instructor, co-primary investigator of Women Firefighter Biomonitoring Collaborative and Women Workers Biomonitoring Study. Heather is currently a Captain at an Engine Company in the outer Richmond district of SF. Her interest in health and wellness coupled with her grave concern regarding the staggering cancer rates among firefighters became a catalyst for Heather to study and work to reduce the toxic chemical exposures that effect frontline workers in her profession. Heather is a long time member (past president and current board member) of the United Fire Service Women. The UFSW is an employee advocacy group that is committed to being directly involved in recruitment, retention, promotion and education of women in the San Francisco Fire Department
Removing Toxic PFAS from Firefighting Foam in the U.S.: A Legislative Update
Nancy Buermeyer
Toxic ‘forever’ PFAS (per- and poly-fluoroalkyl substances) chemicals in firefighting foams put firefighters’ health at risk for cancer and numerous other health problems. These aqueous film forming foams (AFFF) are also a major source of PFAS contamination in our drinking water.
Called ‘forever’ chemicals because they never break down in the environment, this family of synthetic chemicals has been linked to many health problems including breast cancer, other cancers, hormone disruption, kidney and liver damage, thyroid disease, and birth defects and other harm to developing fetuses. PFAS chemicals can be harmful at extremely low levels and can be detected in the blood of nearly every American. The Women’s Firefighter Biomonitoring Collaborative found that female San Francisco firefighters had higher levels of PFAS in their blood compared to female office workers and that, among firefighters, certain PFAS chemicals were present at higher levels in firefighters and officers than in drivers.
Four states have passed legislation to ban the manufacture and sale of PFAS containing foams for certain uses (Washington, Colorado, New Hampshire and New York). This year there were 20 bills in 14 states with provisions relating to PFAS in firefighting foams.
This presentation will provide a legislative update on these bills and highlight California’s PFAS-Free Firefighting Foam Act (SB 1044) which bans the manufacture, sale and use of AFFF foams containing PFAS, replacing them with safer, effective and affordable alternatives. The bill also requires purchasers of firefighter gear to be notified if the gear contains PFAS, an important right to know provision for firefighters. The California bill, in concert with other state laws, is an important step in reducing both cancer risk for firefighters and environmental pollution by lowering our exposure to toxic ‘forever’ chemicals.
Nancy Buermeyer, Senior Policy Strategist for Breast Cancer Prevention Partners (BCPP). 
As BCPP’s Senior Policy Strategist, Nancy works at the state and federal levels to advance public policy to reduce exposures to toxic chemicals. Before joining BCPP, Nancy spent over 20 years in Washington DC advocating for numerous causes, including civil rights for women and the GLBT community. She graduated from the University of Pittsburgh with a Bachelor of Science in Biology and earned a Masters degree in Biological Oceanography from the University of Connecticut. Nancy is an avid outdoors person, spending her spare time hiking and birding in Northern California and beyond.
Non-Targeted Analysis and Exposomics to Identify Novel Chemical Exposures and Associated Biological Changes in a Cohort of California Women Firefighters
Ruthann Rudel
Vincent Bessonneau
Ruthann Rudel, Co-principal Investigator for the WWBC; Research Director at Silent Spring Institute. 
Ruthann Rudel is the Research Director at Silent Spring Institute, where she leads major exposure and toxicology research programs focusing on hormonally active chemicals and biological mechanisms by which chemicals may influence breast cancer. Her innovations in “breast cancer toxicology” include major peer-reviewed articles that identify chemicals that cause breast tumors or alter breast development in animal models, and she is developing a database of methods for measuring these chemicals in women. Rudel leads a program to develop breast cancer-relevant chemical safety tests for green chemistry. She also directs the Institute’s Household Exposure Study, which has been described as the “most comprehensive analysis to date” of exposures in homes and is widely cited. She serves on the US EPA Scientific Advisory Committee on Chemicals, has served on the U.S. National Toxicology Program Board of Scientific Counselors, and is an adjunct Research Associate in the Brown University School of Medicine.
Reproductive Health
Women Firefighters and Risk of Miscarriage: Preliminary Results from a National Survey
Alesia Jung
Studying Biological Markers of Ovarian Reserve among Female Firefighters
Leslie Farland
Injury
Injury among Women Firefighters
Brittany Hollerbach
While the field of firefighter health research has been expanding significantly over the past decade, nearly all of the published research has been focused specifically on health risks and health behaviors of male firefighters. With the support of Women in Fire, scientists at the Center for Fire, Rescue & EMS Health Research designed and received funding for multiple studies to understand the health risks, behaviors, and challenges facing women in the fire service. Focus groups and key informant interviews were conducted with current female firefighters, females in leadership positions, and males in leadership positions within the U.S. Topics included general health concerns as well as specific concerns related to topics such as cardiovascular disease, injury, cancer, and reproductive health. Subsequently, an epidemiologic survey was designed that was completed by more than 2,000 female firefighters. This session will highlight study findings related to injury among women firefighters as well as discuss future directions for research in this emerging field.
Brittany Hollerbach, PhD, is a Postdoctoral Research Fellow at the National Development and Research Institutes-USA, Inc., (NDRI-USA). She received her Ph.D. in Kinesiology from Kansas State University and recently completed a postdoctoral research fellowship at Skidmore College under the direction of Dr. Denise Smith where she focused on cardiovascular disease in the fire service. Dr. Hollerbach has extensive experience working with the fire service on a number of federally funded firefighter studies conducted by the Center for Fire, Rescue, and EMS Health Research and the Center for Military and Veteran’s Health Research. Her current work focuses on firefighter health and a military PTSD clinical trial. Dr. Hollerbach has an interest in firefighter health in general and female firefighter health specifically, given her background as a former firefighter. She also has experience teaching at the fire academy and is well-connected to the fire service community in Kansas City.
Women’s Health – International Health
Anthony Walkers
An International Approach to Understanding Women Firefighters’ Health concerns
Emily Watkins
Modifiable Risk Factors & CVD
Tobacco and Alcohol Use in Women Firefighters
Christopher Haddock
Cardiovascular Concerns for Women Firefighters
Denise Smith
Cancer
Addressing Cervical Cancer in Female Firefighters
Natasha Shafer Solle
Presumptive Cancer Laws and Data Requirements
Lori Moore Merrell
Presumptive laws link a particular occupation with a disease or condition that has been shown to be a hazard associated with that occupation. As a result of this linkage, if an individual employed in the occupation covered by the presumption contracts a disease or condition that is specified in the presumptive law, then that disease or condition is presumed to have come from that occupation. However, the difficulty is often in the details. There are multiple requirements (i.e. years of service, no smoking etc..) in each state. It is important to note that even though a state may have a firefighter cancer presumption law, it does not guarantee an approved claim should you contract cancer. Legal presumption always allows for an employer to rebut the claim.
Insurance companies including those that provide worker’s compensation have also rebutted firefighter cancer claims. The same holds true for firefighters filing for “on-duty” cancer disabilities in their retirement pension plans because pension board physicians and board trustees may challenge the on-duty claim. It is imperative that all firefighter track their exposures assuring they have a personal Career Diary that can stay with them for life, even into retirement. This presentation will focus on the requirement for exposure documentation and available means for tracking your exposures throughout your career.
Dr. Moore-Merrell is the President and CEO of the International Public Safety Data Institute. Lori began this role in 2019 after serving 26 years as a senior executive in the International Association of Fire Fighters (IAFF), responsible for frontline interaction with elected officers, executive board members, state, provincial and local chapter leaders and individual organization members throughout the U.S. and Canada. Lori is considered an expert in executive leadership, emergency response system evaluation, public safety resource deployment, community risk assessment, data collection and analysis, strategic planning, costs and benefits analysis, advocacy, consensus building, policy development and implementation and generational differences in the workplace.
Dr. Moore-Merrell serves on National and International Boards of Directors and advises elected officials, as well as chief executives at the national level and in local metropolitan jurisdictions in areas of her expertise while providing them scientific data to make fact-based decisions. She was recently awarded Honorary Membership in the Metropolitan Fire Chiefs Association for her expertise in areas of Fire Prevention, Fire Suppression, or other related disciplines. Lori is only the 4th individual to be presented this honor in the 54-year history of the organization.
Dr. Moore-Merrell is an international speaker, presenter and author. She has also been awarded the James O. Page Achievement award by the EMS Section of the IAFC (2001), twice awarded the IAFC President’s Award for commitment to Firefighter Safety (2009, 2019), the Dr. John Granito Award for Excellence in Fire Leadership and Management Research (2010), the Metropolitan Fire Chiefs President’s Award of Distinction (2013) and the Mason Lankford Award from the Congressional Fire Services Institute (2019). Lori served nine years as a Commissioner to the Commission for Fire Service Accreditation (CFAI) and three terms as a board member for the Center for Public Safety Excellence (CPSE). Dr. Moore-Merrell is a member of the International Fire Service Training Association (IFSTA) Executive Board, as well as the UL Fire Council. She has completed four terms as a gubernatorial appointee to the Commonwealth of Virginia EMS Advisory Board and has served on the Public Safety Committee of the Transition Teams for both the Mayor of New York City (2013) and the Mayor of the District of Columbia (2015).
During her 26 years at the IAFF, Lori spent more than 15 years leading a research team made up of international fire service organizations and other partners including the National Institute of Standards and Technology, the Underwriters Laboratory (UL), the Urban Institute, the University of Texas, Worcester Polytechnic Institute, and the Commission on Fire Accreditation International. As principal investigator and senior project manager on projects funded by FEMA/ Assistance to Firefighters Grants totaling more than $22 Million, she led the team to produce landmark reports and other tools to improve Residential and High-Rise Fireground Operations, Community Risk Assessment, Fire and EMS Resource Deployment, and ‘Big Data Analytics’… all to help drive executive decision-making. These reports and other resources have changed the face of fire and EMS deployment in countries throughout the world.
Dr. Moore-Merrell has also managed emergency response system evaluation project teams, including secure data procurement, geographic information systems (GIS) analysis, and work load analysis in hundreds of fire departments throughout North America.
Dr. Moore-Merrell, along with a small group of fire service leaders recently founded the International Public Safety Data Institute (IPSDI) with a mission to assure that every local public safety agency can show their response capability, reliability, and operational performance using their own local data. www.i-psdi.org
2019 International Survey of Cancer Incidence among Female Firefighters
Kenneth Kunz
The National Firefighter Registry (NFR)
Miriam Siegel
Andrea Wilkinson
The National Institute for Occupational Safety and Health (NIOSH) will present on the National Firefighter Registry (NFR). The NFR, created through the Firefighter Cancer Registry Act of 2018, will be a voluntary registry of firefighters that will help us better understand cancer among firefighters. Women have been understudied in past research on cancer in firefighters. And because women comprise almost a tenth of the career and volunteer firefighting workforce, cancer among female firefighters is one primary topic of interest to the NFR. This presentation will introduce the background and design of the NFR, which will be open to all firefighters, not just those with cancer. NIOSH encourages active and retired firefighters to register, as well as structural and wildland firefighters, and others. Firefighters’ voluntary NFR registration will take place through a secure web portal that includes a questionnaire. Registration will be simple, and firefighters can complete it on any computer, tablet, or mobile device. This presentation will include a facilitated discussion to allow attendees an opportunity to ask questions and provide feedback about the NFR.
Miriam Siegel, DrPH, MPH, is the Lead Epidemiologist for the National Firefighter Registry (NFR) at the National Institute for Occupational Safety and Health (NIOSH). She earned her Doctor of Public Health (DrPH) degree in occupational epidemiology from the University of Kentucky in 2016. Dr. Siegel joined NIOSH in 2017 as an Epidemic Intelligence Service Officer where she worked on a range of research topics related to occupational reproductive health, workplace violence, and firefighter safety and health. She now works as part of a team developing a national registry of firefighters to evaluate cancer incidence and risk factors within the U.S. fire service.
Andrea Wilkinson, MS LAT/ATC is a Health Scientist for the National Institute of Occupational Safety and Health (NIOSH) specializing in work with First Responders. Currently, Andrea is working on the National Firefighter Registry to better understand cancer and exposures in firefighters. Previously, she was the Project Manager for the First Responder Health & Safety Laboratory at Skidmore College where she researched the cardiovascular effects of firefighting. Andrea spent nine years at Alfred University as the Head Athletic Trainer and Clinical Coordinator for Sports Medicine. She attended The University of Akron earning dual degrees in Sports Medicine for Athletic Training and Exercise Science as well as a Master’s of Science in Exercise Physiology with a special interest in cardiac rehabilitation. Andrea was named an honorary member of Outstanding Women in Education, is a member of the Iota Tau Alpha honors society, and an alumnus of Leadership Lorain County. She has extensive experience in sports medicine as well as cardiac rehabilitation through her work with St. Peter’s Health Partners in the Cardiovascular Intensive Care Unit. Andrea has a special interest in preventative medicine for the tactical athlete and first responder.
Removing Toxic PFAS from Firefighting Foam in the U.S.: A Legislative Update
Nancy Buermeyer
Called ‘forever’ chemicals because they never break down in the environment, this family of synthetic chemicals has been linked to many health problems including breast cancer, other cancers, hormone disruption, kidney and liver damage, thyroid disease, and birth defects and other harm to developing fetuses. PFAS chemicals can be harmful at extremely low levels and can be detected in the blood of nearly every American. The Women’s Firefighter Biomonitoring Collaborative found that female San Francisco firefighters had higher levels of PFAS in their blood compared to female office workers and that, among firefighters, certain PFAS chemicals were present at higher levels in firefighters and officers than in drivers.
Four states have passed legislation to ban the manufacture and sale of PFAS containing foams for certain uses (Washington, Colorado, New Hampshire and New York). This year there were 20 bills in 14 states with provisions relating to PFAS in firefighting foams.
This presentation will provide a legislative update on these bills and highlight California’s PFAS-Free Firefighting Foam Act (SB 1044) which bans the manufacture, sale and use of AFFF foams containing PFAS, replacing them with safer, effective and affordable alternatives. The bill also requires purchasers of firefighter gear to be notified if the gear contains PFAS, an important right to know provision for firefighters. The California bill, in concert with other state laws, is an important step in reducing both cancer risk for firefighters and environmental pollution by lowering our exposure to toxic ‘forever’ chemicals.
Nancy Buermeyer, Senior Policy Strategist for Breast Cancer Prevention Partners (BCPP). As BCPP’s Senior Policy Strategist, Nancy works at the state and federal levels to advance public policy to reduce exposures to toxic chemicals. Before joining BCPP, Nancy spent over 20 years in Washington DC advocating for numerous causes, including civil rights for women and the GLBT community. She graduated from the University of Pittsburgh with a Bachelor of Science in Biology and earned a Masters degree in Biological Oceanography from the University of Connecticut. Nancy is an avid outdoors person, spending her spare time hiking and birding in Northern California and beyond.
Non-Targeted Analysis and Exposomics to Identify Novel Chemical Exposures and Associated Biological Changes in a Cohort of California Women Firefighters
Ruthann Rudel
Vincent Bessonneau
Ruthann Rudel, Co-principal Investigator for the WWBC; Research Director at Silent Spring Institute. Ruthann Rudel is the Research Director at Silent Spring Institute, where she leads major exposure and toxicology research programs focusing on hormonally active chemicals and biological mechanisms by which chemicals may influence breast cancer. Her innovations in “breast cancer toxicology” include major peer-reviewed articles that identify chemicals that cause breast tumors or alter breast development in animal models, and she is developing a database of methods for measuring these chemicals in women. Rudel leads a program to develop breast cancer-relevant chemical safety tests for green chemistry. She also directs the Institute’s Household Exposure Study, which has been described as the “most comprehensive analysis to date” of exposures in homes and is widely cited. She serves on the US EPA Scientific Advisory Committee on Chemicals, has served on the U.S. National Toxicology Program Board of Scientific Counselors, and is an adjunct Research Associate in the Brown University School of Medicine.