The National Firefighter Registry for Cancer: Understanding the Link Between Firefighting and Cancer

Posted on by Kenny Fent, PhD, CIH; Miriam R. Siegel, DrPH, MPH; Andrea Wilkinson, MS, LAT, ATC; Alexander C. Mayer, MPH; and Greg W. Hartle, MA


Firefighting is a demanding profession that presents many risks from acute injuries on the fireground to long-term illness, like cancer. Firefighters can encounter cancer-causing chemicals by breathing them in, getting them on their skin or in their eyes, or by ingesting them. Exposure to these chemicals can occur while being near burning materials, from wearing turnout gear that is not properly cleaned or stored, and from residual contaminants in areas where firefighters work and live.

Research on firefighters from three large U.S. cities reported higher-than-expected rates of certain types of cancer as compared to the general U.S. population.1 It is important to note that past research has not included enough women or firefighters from minority racial and ethnic groups to make strong conclusions about cancer risks for all firefighters.

Firefighter Cancer Registry Act of 2018

Downloadable poster to share with the fire service and encourage them to join the NFR.

To better understand and track on-the-job exposures to cancer-causing agents across all types of firefighters, Congress established the Firefighter Cancer Registry Act of 2018. This Act directed NIOSH to develop an online registry of firefighters. To do this, NIOSH and its partners developed the National Firefighter Registry for Cancer (NFR), which will support NIOSH researchers in studying NFR data to identify trends in

  • cancer patterns
  • exposures
  • demographic characteristics
  • protective practices
  • workplace characteristics

This data will not only help to inform future interventions and best practices for the fire service to prevent cancer, but ultimately aid in understanding the relationship between firefighting and cancer.

How the NFR Works

Every time someone is diagnosed with cancer, details about their cancer are reported to the cancer registry in their state. Information about work and work exposures is not routinely included in the records shared with state cancer registries. Firefighters who provide information about themselves and their work in the fire service will allow researchers to match NFR information with cancer diagnosis information. This will help researchers to better understand cancer and its risks in the fire service. Watch this video to learn more about how the NFR works.

Join the NFR

Join at NFR.CDC.GOV 

To sign up, firefighters complete the NFR survey from their phone or computer. The survey takes about 30 minutes to complete.

All U.S. firefighters, with or without cancer, no matter their length of service can join the NFR. This includes:

  • active and retired firefighters
  • career, paid-on-call, and volunteer firefighters
  • structural firefighters
  • wildland firefighters
  • instructors
  • fire investigators
  • other fire service members

Participation in the NFR is voluntary but having many different types of firefighters join is critical to understanding cancer. The more female firefighters and those with diverse racial and ethnic backgrounds who join, the more questions we can answer about firefighting and cancer.

The NFR is a long-term project. NIOSH researchers may reach out to those who join the NFR about once a year with voluntary, but important follow-up questionnaires.

Firefighters who join the NFR, can help:

  • Protect the next generation of firefighters from cancer
  • Pave the way for new safety measures to protect others in the fire service
  • Protect firefighter families and their communities from experiencing the impact of cancer on their loved ones
  • Improve our understanding of cancer risk among groups that have been underrepresented in research, such as women, volunteers, and firefighters from some racial and ethnic groups

NFR Communication Materials

Several shareable materials – including fact sheets, posters, videos, and social media posts – are available to support firefighter enrollment in the NFR. These materials and much more are available on the NIOSH NFR page.

Will you be a trailblazer in this groundbreaking effort to understand and reduce cancer among firefighters? Will you join? Will you encourage others in the fire service to join?


Kenny Fent, PhD, CIH, is an Industrial Hygienist and Lead of the National Firefighter Registry in the Field Research Branch of the NIOSH Division of Field Studies and Engineering

Miriam R. Siegel, DrPH, MPH, is an occupational health epidemiologist in the NIOSH Division of Field Studies and Engineering

Andrea Wilkinson, MS, LAT, ATC, is a health scientist in the NIOSH Division of Field Studies and Engineering

Alexander C. Mayer, MPH, is a health scientist in the NIOSH Division of Field Studies and Engineering

Greg W. Hartle, MA, is a health communication specialist in the NIOSH Division of Field Studies and Engineering



Posted on by Kenny Fent, PhD, CIH; Miriam R. Siegel, DrPH, MPH; Andrea Wilkinson, MS, LAT, ATC; Alexander C. Mayer, MPH; and Greg W. Hartle, MA

2 comments on “The National Firefighter Registry for Cancer: Understanding the Link Between Firefighting and Cancer”

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    My husband of 30 years recently passed away from caner, all work related, he worked for Cal Fire for 30 plus years. I would love to help and advocate for all FireFighters and their families so they don’t hav to go through what I have. How can I HELP?? and where can I post my husbands story to help others???? Thank you, Esther

    We are very sorry to hear about your loss. We appreciate your passion on this important issue and you can help the National Firefighter Registry for Cancer by spreading the word among firefighters. You can also continue to raise awareness about the risk of cancer among firefighters and exposure reduction practices. There are resources available on reducing the risk of cancer from the International Association of Fire Fighters and Firefighter Cancer Support Network and the National Volunteer Fire Council and International Association of Fire Chiefs’ Volunteer and Combination Officers Section.

    For wildland firefighting specifically, there are a few available resources related to medical examination standards, safety and risk management standards, and researchers’ recommendations for reducing exposures from scientific literature (such as those published in manuscripts by Navarro, 2020 and Reisen et al., 2010).

    Lastly, if you have not done so already, you can consider reaching out to the Firefighter Cancer Support Network to get involved with their organization. They provide cancer awareness and support for firefighters (including family members of firefighters) dealing with cancer.

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Page last reviewed: May 15, 2023
Page last updated: May 15, 2023