image: The state of Texas awarded UTHealth Houston School of Public Health $5 million over two years for early detection and research, led by principal investigator Jooyeon Hwang, PhD.
Credit: UTHealth Houston
The state of Texas awarded UTHealth Houston School of Public Health $5 million over two years for early detection and research, led by principal investigator Jooyeon Hwang, PhD, associate professor in the Department of Environmental and Occupational Health Sciences, on cancer risk among firefighters in Texas.
Repeated exposure to harmful chemicals in fire smoke, common in the work of firefighters, can cause long-term chronic health problems including cancer, according to previous work by Hwang. Firefighters have a 9% higher risk of being diagnosed with cancer and a 14% higher risk of dying from cancer, according to research from the Centers for Disease Control and Prevention and National Institute for Occupational Safety and Health.
Between 2019 and 2023, the number of firefighters in Texas diagnosed with cancer increased nearly five times from 19 cases to 91, according to the Texas Commission on Fire Protection annual report. While other studies have looked at cancer risks in firefighters across the U.S., none have focused specifically on Texas, where more than 55,000 firefighters live and work, Hwang said.
“This is a groundbreaking opportunity because we are looking at cadets, active firefighters, and retired firefighters to understand the impacts of firefighting on their lifelong health. Despite the effects of repeated exposure to toxic fire smoke, firefighters remain committed to their profession, driven by a strong sense of purpose and camaraderie,” Hwang said. “Investigating fire smoke carcinogens, cancer biomarkers, and the effect on their long-term health will provide insight and help contribute to developing protective measures for this essential workforce.”
Hwang expressed gratitude for sponsors of the study. “We are thankful to everyone in the Legislature who supported this research,” she said.
UTHealth Houston worked with the Texas State Association of Fire Fighters and the Houston Professional Fire Fighters Association on the appropriation request.
“Texas firefighters are grateful for the support of our state Legislature as we all work to prevent occupational cancer and other exposure-related diseases,” said John Riddle, president of the Texas State Association of Fire Fighters. “We are proud of our legislative team in our work with Sen. Brandon Creighton and the UTHealth Houston team, as they all made this a priority this session. Texas firefighters appreciate the support of legislators committed to helping reduce the terrible consequences of occupational cancer in the fire service – including Sen. Creighton, Rep. Jared Patterson, Rep. Stan Kitzman, and Rep. Armando Martinez, particularly Sen. Creighton’s doubling of the funding.”
“This research is deeply personal to every firefighter in Texas,” said Patrick M. “Marty” Lancton, president of the Houston Professional Fire Fighters Association. “We’ve all lost colleagues and friends to cancer, and we know the risks we face every time we respond to a call. What makes this project so important is that it’s not just about statistics — it’s about finding answers for our past, present and future firefighters. I’m proud to represent the Houston Professional Fire Fighters Association in this effort, and we’re grateful to UTHealth Houston and the state lawmakers who made it possible.”
Along with looking at the work history of new, active, and retired firefighters from the Houston Fire Department, the team will take air samples from fires to measure exposure to cancer-causing chemicals. Researchers plan to collaborate with local partners to offer free annual screenings for firefighters to detect early signs of cancer.
“This study is a great first step toward realizing a change in the culture of firefighter safety,” Houston Fire Department fire chief Thomas Muñoz said. “Too many times, I have attended the funerals of dedicated public servants who lost the battle to cancer. I am hopeful that the work being done by UTHealth Houston will pave the way for meaningful change in occupational safety of our members.”
Data from active firefighters in other cities will also be collected.
The ultimate goal is to identify which groups of firefighters are most at risk for cancer and recommend policies and programs that will protect their health. The program will include cancer data from the Texas Cancer Registry and other sources.
The Houston Fire Department is the third-largest fire department in the country, with nearly 4,000 firefighters. According to research by Hwang, from 2022 to 2024, firefighters from 96 stations responded to nearly 25,000 fires across Houston.
Hwang said essential collaborators from the fire department include district chief and chief of the Health and Safety Office Michael A. Marino and Capt. Gabe Dominguez, HPFFA director position 5.
The research builds on previous studies by Hwang, an occupational health researcher and industrial hygienist certified by the board for Global Environmental Health Services. Hwang was most recently lead author on a 2024 paper published in the journal Science of The Total Environment, about identifying potential carcinogenic effects of fire-induced smoke through urinary protein profiles on firefighters.
Co-investigators on the study from the School of Public Health are Kristina Mena, PhD, professor, regional dean, chair of the Department of Environmental and Occupational Health Sciences, and the Jane Dale Owen Chair in Environmental Health Protection, and Miryoung Lee, PhD, MPH, associate professor in the Department of Epidemiology. Administrative support will be provided by the Southwest Center for Occupational and Environmental Health at the School of Public Health. Hwang is deputy director and director of the Industrial Hygiene Program at the center.