While firefighters’ risk of contracting cancers linked to toxins in the smoke and soot they encounter has long been established, their chances of developing skin cancer, including melanoma, has only recently begun to attract attention.

“It’s sort of a newer risk,” Dr. Mary Ann Bentz, a dermatologist in private practice in Waterford and chief of the Department of Dermatology at Lawrence + Memorial Hospital in New London, said. “Nobody quite knows why, but there’s been a statistical bump in the number of melanoma cases (among firefighters.) It could be from the smoke, the suits they wear, the amount of sun they get on their time off. They’re exposed to a lot of chemicals in the foams they spray.”

“It’s the career guys, not the volunteers,” she said.

Bentz, who has firefighters as patients, was the driving force behind an effort that culminated last week in free skin cancer screenings for dozens of firefighters from the New London and Poquonnock Bridge fire departments. Bentz undertook the screenings at Yale New Haven Health’s Smilow Cancer Hospital in Waterford along with Drs. Mary Tomayko and Jacob Siegel of Yale Medicine’s Department of Dermatology and Ilsa Otero, a Yale Medicine clinical practice/operations manager.

Full-body visual examinations of some 40 firefighters resulted in recommendations that five of them be biopsied and referred to dermatologists for further investigation, Bentz said.

Providing such free screenings is part of Smilow’s “mission,” according to Mary Ann Nash, director of oncology services for L+M and Westerly hospitals, who said the screenings were funded by the family of Jackson King, the Mashantucket Pequot Tribe’s longtime general counsel, who died of melanoma in 2016 at the age of 72.

“The goal here is not necessarily to treat disease but to prevent it,” Nash said. “It can be difficult for community members, including firefighters, to get to a dermatologist, and primary care doctors don’t always have the eye for it (skin cancer) that dermatologists do.”

Nash said she was “shocked” to learn of the prevalence of melanoma and other cancers among firefighters.

The Firefighter Cancer Alliance has reported that cancer is the second leading cause of deaths for firefighters in the United States while National Institute for Occupational Safety and Health studies found firefighters face a 9% increase in cancer diagnoses and a 14% increase in cancer-related deaths compared to the general U.S. population.

“Here they are fighting for our lives, protecting people and putting themselves in harm’s way,” Nash said. “I thought about how they don’t think twice when they put that gear on and enter a burning building.”

Patrick Leonard, vice president of the New London firefighters union, was among the firefighters screened last week. His result was negative.

“Over the last five years, cancer has been at the forefront,” he said. “The IAFF (International Association of Fire Fighters) has been pushing for firefighters to get any kind of screening we can get.”

Leonard said about 100 active firefighters a year die with 72% of those deaths linked to cancer contracted on the job. He said the focus on skin cancer in recent years partly stems from the discovery that firefighters’ protective gear contains PFAS (per- and polyfluoroalkyl substances) and other potentially carcinogenic chemicals linked to increased risk of liver and kidney cancer.

As a result, the IAFF and the Metropolitan Fire Chiefs Association has advised firefighters to wear the gear only when absolutely necessary.

Leonard, a career firefighter since 2009, said a Poquonnock Bridge firefighter he worked with before joining the New London department died of cancer in his mid-30s. He’s known a few others who have contracted the disease and survived it, he said.

As is the case with many cancers, early detection is the key to successfully treating melanoma, which typically appears as a new mole or a mole that has changed in size, shape or color, and needs to be surgically removed, Bentz, the L+M dermatology chief, said.

“I tell my patients that when they’re checking for ticks during tick season they should look for moles and scabs that don’t heal,” she said.

b.hallenbeck@theday.com