Capt. Glenn Resnick of the Pikesville Volunteer Fire Company still chokes up when he names those his station has lost: Bill, Murray and Lee, who died in 2012, Larry in 2019, and Sean just last year.

They were not lost to fires. They succumbed to cancer. More firefighters from the station were diagnosed but have survived.

New peer-reviewed research from the American Cancer Society is providing fresh evidence of what firefighters have long understood: Cancers like these are often the result of repeated exposures to toxins while trying to put out fires.

“We have all these exposures; we hope that if there is something, we catch it early,” Resnick said just after giving a blood sample at his station that will be tested for 50 kinds of cancers.

Cancer has become a major issue for firefighters, whose national advocates now call it the top cause of job-related death, surpassing heart attacks and traumatic injuries. Representatives are working with the American Cancer Society on better detection, treatment and prevention.

Multiple studies have suggested, and experts have accepted, that firefighters have a higher risk of developing cancer because they are repeatedly exposed to carcinogens released in a fire. But the definitive proof to different kinds of cancers hasn’t been easy.

Cancers can take years or decades to develop and are influenced by other factors such as genetics, behaviors like smoking and even income and education, said Dr. Lauren Teras, a senior scientific director at the American Cancer Society.

She is lead author of a new study that provides another layer of evidence. The study, published in July in the International Journal of Epidemiology, used data going back to the 1980s to show an increased risk of death for firefighters for most cancers, with the strongest tie to skin and kidney cancer.

“We know it’s a major concern for this group,” Teras said. “We know enough to know it’s multiple types of cancer. It’s still hard to study.”

Teras said the majority of firefighters are not likely to die from cancer, but repeated exposures pose dangers. It’s not just toxins at the scene, but exposure to the trucks’ exhaust and possibly the waterproofing chemicals in their gear.

Using 36 years of data collected on hundreds of thousands of people with different occupations who did not have cancer at the start, the researchers found a higher risk for skin, kidney, prostate and colorectal cancer in male firefighters than for those in other occupations.

The study’s unusual length of time was key. Teras said lung cancer only showed up after three decades.

Teras said the findings could, for example, help establish universal screening schedules for firefighters, given their increased risk, as more research is done.

Teras said she also hopes the study’s conclusions would prompt development of improved firefighting gear. That’s because equipment can be so heavy that firefighters don’t always wear all of it or remove it too soon, while toxins are still in the air.

A priority for firefighters is development of gear free of “forever chemicals,” which help to waterproof the gear but have been linked also to certain cancers. While there is already an effort underway to remove it from foam used to extinguish fires, the chemicals remain in personal protective equipment.

At the Pikesville station, most of roughly 60 active volunteers signed up for screening, including those like Resnick with decades on the job, plus a few who have retired. The station is one of Baltimore County’s busiest, with more than 3,000 calls a year.

Gray’ce Hill-Loyal, a nurse who took Resnick’s blood sample, explained that the tests can’t predict who will get cancer, only if the disease is present.

Next, Resnick went behind a screen where an ultrasound tech used a probe to scan his body, starting at the thyroid gland in his neck and then moving to his abdomen and pelvic area.

On this day, the fight against possible cancer was a family affair. His wife, a nurse and fellow volunteer firefighter, had just been scanned. One of their sons, who is another volunteer firefighter in the company, went through the process the day before.

Kathleen Resnick, who also is president of the firefighting company, said she appreciates the growing recognition that there is risk of cancer from the job and the efforts to tackle the threat.

“It used to be a badge of honor if your gear was burned and covered in soot,” she said. “Now we wash everything. We vent the exhaust from the trucks in the garages. We’ve learned a lot. I hope this kind of screening becomes routine too.”