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Cancer, Trauma, and the Toll of Service: What 15 Years of Claims Data Tell Us About Firefighter Health in Canada

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CHASI is proud to maintain a longstanding partnership with the National Indigenous Fire Safety Council (NIFSC). The NIFSC supports Indigenous communities in the development of their internal capacity to enhance community safety and resiliency. As part of this partnership, CHASI is pleased to amplify their articles on our blog.

CHASI’s collaboration with the NIFSC, and many of their other research work, can be found on our NIFSC Publications page. For questions about the NIFSC and their work, please visit their contact page.

Cancer, Trauma, and the Toll of Service: What 15 Years of Claims Data Tell Us About Firefighter Health in Canada

By Len Garis and Mandy Desautels

Introduction

It’s no secret that firefighting is one of the most dangerous jobs in Canada. But a comprehensive new study from the University of British Columbia reveals just how serious—and complex—those risks are. Drawing on 15 years of accepted workers’ compensation claims, Firefighter Occupational Injuries and Fatalities: Analysis of Accepted Claims, 2007–2021 by Al-Hajj, Samar; Thomas, Larry; Garis, Len; Pike, Ian paints a sobering picture of firefighter health in the modern era.

From cancer and psychological trauma to respiratory illness and age-related risks, the report challenges long-held assumptions and provides crucial evidence for shaping future health, safety, and policy decisions in fire services across the country.

Cancer: The Leading Killer

The headline finding is clear: cancer is now the leading cause of firefighter fatalities in Canada. According to the report:

– 84.6% of firefighter fatality claims were due to malignant neoplasms and tumors (cancers, carcinomas, sarcomas).
– This trend reflects a growing recognition of the occupational link between toxic exposure and long-term health outcomes for firefighters.
– Deaths due to cancer were most commonly claimed among older firefighters—particularly those aged 65 and up, who represented 54.7% of all fatality claims.

Thanks to stronger advocacy and research, many provinces have expanded presumptive coverage legislation, allowing firefighters diagnosed with certain cancers to more easily access workers’ compensation. However, the study emphasizes that variations between provinces mean firefighters are not equally protected across the country.

Traumatic Injuries and Cardiovascular Events: Still Present, Still Deadly

While cancer dominates the fatality statistics, traumatic injuries and cardiovascular events still contribute to firefighter deaths:

  • 6.5% of fatality claims were caused by trauma—ranging from falls and crush injuries to vehicle collisions.
  • 4.2% were attributed to cardiovascular diseases, including heart attacks and strokes, often occurring during or just after physically demanding calls.

These causes, though smaller in proportion, remain significant because of their sudden onset and potential for prevention through fitness, screening, and operational safeguards.

Mental Health: Rising Awareness, Rising Claims

One of the most significant trends observed between 2007 and 2021 is the sharp increase in accepted psychological injury claims, particularly post-traumatic stress disorder (PTSD).

  • The study shows a substantial uptick in mental health-related claims post-2015, aligning with the passage of presumptive PTSD legislation for first responders in many provinces.
  • This legislative shift allowed firefighters to access compensation without having to prove causation—a critical barrier before the laws were passed.

While the report does not quantify psychological injury claims as a proportion of fatalities, the volume and rate of accepted claims have increased steadily and now constitute a notable share of overall disability claims. This trend reflects both growing awareness and reduced stigma, but also the intensifying psychological burden of the profession.

Respiratory Illness and COVID-19: A New Chapter in Occupational Risk

The COVID-19 pandemic introduced an entirely new dimension to occupational risk in the fire service, and the report captures its effect:

  • Respiratory system diseases saw a significant rise in 2020 and 2021, coinciding with the peak of the pandemic.
  • Claims under this category include viral infections, long-COVID, and COVID-related pneumonia.

While these conditions were not the leading cause of fatalities, the spike in respiratory illness claims represents a critical inflection point. It underscored the need for better PPE standards for non-fire emergencies, clear infection control protocols, and mental health support for the added stress and exposure during the pandemic.

Injury Trends: Musculoskeletal Injuries Still Common

While the focus of the report is rightly on long-term illness and fatalities, acute injuries remain the most common type of non-fatal claim:

  • Sprains, strains, and musculoskeletal injuries dominated the injury landscape, often resulting from heavy lifting, slips, trips, and falls.

These injuries, while rarely fatal, contribute significantly to lost time, long-term disability, and early retirement. The report highlights that injury rates are highest among younger firefighters (ages 25–34), likely due to their higher operational exposure and training demands.

Policy Recommendations: Turning Research Into Action

Based on these findings, it is recommended that a series of actions need to be taken:

  1. Expand and harmonize presumptive legislation and screening across all provinces.
  2. Strengthen mental health infrastructure within fire departments.
  3. Improve infectious disease protocols.
  4. Continue monitoring long-term health outcomes.

Conclusion: Protecting the Protectors

The 2024 UBC report stands as one of the most comprehensive analyses of firefighter health risks ever conducted in Canada. It leaves no doubt that while fire and trauma remain present dangers, the deadliest threats often emerge long after the sirens have faded.

For fire departments, policymakers, and associations across Canada, this report offers a roadmap. The risks are now well documented; the next step is clear: invest in prevention, improve protection, and deliver care that reflects the true toll of the job.

Authors

Len Garis is director of research for the National Indigenous Fire Safety Council, Ret. Fire Chief for the city of Surrey, B.C., associate scientist emeritus with the B.C. Injury Research and Prevention Unit, and adjunct professor in the School of Criminology and Criminal Justice and associate to the Centre for Social Research at the University of the Fraser Valley. Contact him at lwgaris@outlook.com. 

Mandy Desautels is Chief Administrative Officer at the National Indigenous Fire Safety Council, a project of the Aboriginal Firefighters Association of Canada. Prior to joining NIFSC, she worked for BC Emergency Health Services and prominent NGOs. Contact her at mandy.desautels@indigenousfiresafety.ca