[Congressional Record (Bound Edition), Volume 163 (2017), Part 10]
[House]
[Pages 13786-13789]
[From the U.S. Government Publishing Office, www.gpo.gov]




                FIREFIGHTER CANCER REGISTRY ACT OF 2017

  Mr. WALDEN. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 931) to require the Secretary of Health and Human Services 
to develop a voluntary registry to collect data on cancer incidence 
among firefighters, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 931

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Firefighter Cancer Registry 
     Act of 2017''.

     SEC. 2. POPULATION-BASED REGISTRY FOR FIREFIGHTER CANCER 
                   INCIDENCE.

       (a) In General.--The Secretary of Health and Human 
     Services, acting through the Director of the Centers for 
     Disease Control and Prevention, shall develop and maintain, 
     directly or through a grant or cooperative agreement, a 
     voluntary registry of firefighters (referred to in this 
     section as the ``Firefighter Registry'') to collect relevant 
     history and occupational information of such firefighters 
     that can be linked to available cancer registry data 
     collected by existing State cancer registries.
       (b) Use of Firefighter Registry.--The Firefighter Registry 
     shall be used for the following purposes:
       (1) To establish and improve collection infrastructure and 
     activities related to the nationwide monitoring of the 
     incidence of cancer among firefighters.
       (2) To collect, consolidate, store, and make publicly 
     available epidemiological information related to cancer 
     incidence and trends among firefighters.
       (c) Relevant Data.--
       (1) In general.--In carrying out the voluntary data 
     collection for purposes of inclusion under the Firefighter 
     Registry, the Secretary should seek to include the following 
     information:
       (A) Identifiable information from a representative sample 
     size, as determined by the Secretary under subsection 
     (d)(2)(A), of volunteer, paid-on-call, and career 
     firefighters, independent of cancer status or diagnosis.
       (B) With respect to individual risk factors and work 
     history of firefighters, available information on--
       (i) basic demographic information, including the age of the 
     firefighter involved;
       (ii) a listing of status of the firefighter as either 
     volunteer, paid-on-call, or career firefighter;
       (iii) the number of years on the job and a detailing of 
     additional employment experience that was either performed 
     concurrently alongside firefighting service, before, or 
     anytime thereafter;
       (iv)(I) a measure of the number of fire incidents attended 
     as well as the type of fire incidents (such as residential 
     house fire or commercial fire); or
       (II) in the case of a firefighter for whom information on 
     such number and type is not available, an estimate of such 
     number and type based on the method developed under 
     subsection (d)(2);
       (v) a list of additional risk factors, including smoking or 
     drug use, as determined relevant by the Secretary; and
       (vi) other physical examination and medical history 
     information relevant to a cancer incidence study or general 
     health of firefighters not available in existing cancer 
     registries.
       (C) Any additional information that is deemed necessary by 
     the Secretary.
       (2) Diagnoses and treatment.--In carrying out the data 
     collection for purposes of inclusion under the Firefighter 
     Registry, with respect to diagnoses and treatment of 
     firefighters diagnosed with cancer, the Secretary shall 
     enable the Firefighter Registry to link to State-based cancer 
     registries, for a purpose described by clause (vi) or (vii) 
     of section 399B(c)(2)(D) of the Public Health Service Act (42 
     U.S.C. 280e(c)(2)(D)), to obtain information on--
       (A) administrative information, including date of diagnoses 
     and source of information; and
       (B) pathological data characterizing the cancer, including 
     cancer site, state of disease (pursuant to Staging Guide), 
     incidence, and type of treatment.
       (d) Methods.--
       (1) In general.--For the purposes described in subsection 
     (b), the Secretary is authorized to incorporate questions 
     into public health surveys, questionnaires, and other 
     databases.
       (2) Required strategy.--The Secretary shall develop a 
     strategy, working in consultation with the stakeholders 
     identified in subsection (e), to maximize participation in 
     the Firefighter Registry established under this Act. At 
     minimum, the strategy shall include the following:
       (A) Identified minimum participation targets for volunteer, 
     paid-on-call, and career firefighters.
       (B) A strategy for increasing awareness of the Firefighter 
     Registry and maximizing participation among volunteer, paid-
     on-call, and career firefighters to meet minimum 
     participation targets.
       (C) Additional steps that may be required to ensure the 
     equitable representation of groups identified in paragraph 
     (5).
       (D) Information on how the Secretary will store data 
     described in subsection (c)(1) and provide links to relevant 
     health information described in subsection (c)(2).
       (E) Working in consultation with the experts described in 
     subsection (e), a reliable and standardized method for 
     estimating the number of fire incidents attended by a 
     firefighter as well as the type of fire incident so attended 
     in the case such firefighter is unable to provide such 
     information.
       (3) Report to congress.--The Secretary shall submit the 
     strategy described in paragraph (2) to the Committee on 
     Energy and Commerce of the House of Representatives and the 
     Committee on Health, Education, Labor, and Pensions of the 
     Senate not later than 30 days after the date of the 
     completion of the strategy.
       (4) Guidance for inclusion and maintenance of data on 
     firefighters.--The Secretary shall develop, in consultation 
     with the stakeholders identified in subsection (e), State 
     health agencies, State departments of homeland security, and 
     volunteer, paid-on-call, combination, and career firefighting 
     agencies, a strategy for inclusion of firefighters in the 
     registry that are representative of the general population of 
     firefighters, that outlines the following:
       (A) How new information about firefighters will be 
     submitted to the Firefighter Registry for inclusion.
       (B) How information about firefighters will be maintained 
     and updated in the Firefighter Registry over time.
       (C) A method for estimating the number of fire incidents 
     attended by a firefighter as

[[Page 13787]]

     well as the type of fire incident so attended in the case 
     such firefighter is unable to provide such information.
       (D) Further information, as deemed necessary by the 
     Secretary.
       (5) Ensuring representation of underrepresented groups in 
     registry.--In carrying out this section, the Secretary shall 
     take such measures as the Secretary deems appropriate to 
     encourage the inclusion of data on minority, female, and 
     volunteer firefighters in the Firefighter Registry 
     established under this section.
       (e) Consultation.--The Secretary shall, on a regular basis, 
     seek feedback regarding the utility of the Firefighter 
     Registry established under this section and ways the 
     Firefighter Registry can be improved from non-Federal experts 
     in the following areas:
       (1) Public health experts with experience in developing and 
     maintaining cancer registries.
       (2) Epidemiologists with experience in studying cancer 
     incidence.
       (3) Clinicians with experience in diagnosing and treating 
     cancer incidence.
       (4) Active and retired volunteer, paid-on-call, and career 
     firefighters as well as relevant national fire and emergency 
     response organizations.
       (f) Research Availability.--The Secretary shall develop and 
     make public a process for de-identifying data from the 
     Firefighter Registry and making such data available without a 
     fee for research or other purposes. Such process shall 
     provide that such data shall be made available for such 
     research purposes only if there is an agreement to make 
     findings, journal articles, or other print or web-based 
     publications derived from such research public or available 
     to the relevant stakeholders identified in subsection (e).
       (g) Privacy.--In carrying out this Act, the Secretary shall 
     apply to the Firefighter Registry developed under subsection 
     (a) data security provisions and privacy standards that 
     comply with the best practices of the Centers for Disease 
     Control and Prevention and provide for data privacy and 
     security standards similar to those in the HIPAA privacy 
     regulation, as defined in section 1180(b)(3) of the Social 
     Security Act (42 U.S.C. 1320d-9(b)(3)).
       (h) Authorization of Funds.--To carry out this section, 
     there are authorized to be appropriated $2,000,000 for each 
     of the fiscal years 2018 through 2022.

     SEC. 3. CUT-GO COMPLIANCE.

       Subsection (f) of section 319D of the Public Health Service 
     Act (42 U.S.C. 247d-4) is amended by striking ``through 
     2018'' and inserting ``through 2017, and $128,300,000 for 
     fiscal year 2018''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from 
Oregon (Mr. Walden) and the gentleman from Texas (Mr. Gene Green) each 
will control 20 minutes.
  The Chair recognizes the gentleman from Oregon.

                              {time}  1330


                             General Leave

  Mr. WALDEN. Mr. Speaker, I ask unanimous consent that all members may 
have 5 legislative days in which to revise and extend their remarks and 
insert extraneous material into the Record on the bill.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Oregon?
  There was no objection.
  Mr. WALDEN. Mr. Speaker, I yield myself such time as I may consume.
  H.R. 931, the Firefighter Cancer Registry Act of 2017, introduced by 
my friend and colleague on the Energy and Commerce Committee, 
Representative Chris Collins from New York, who we will hear from 
shortly, will create a national registry to collect information to 
better understand cancer incidence in firefighters.
  These heroic first responders experience occupational health risks 
every day. In my district, it is oftentimes from forest fires, like we 
are having all summer long. This past weekend I saw firsthand what our 
firefighters face as they battle a number of fires raging in Oregon, 
putting themselves in harm's way to save property, infrastructure, 
lives, watersheds, habitats, and our forests.
  I was deeply reminded yesterday morning, as I watched some of the 
news coverage that took us back 16 years ago to 9/11, and seeing the 
scenes of the buildings collapsing and burning and the people emerging, 
individual citizens, first responders, caked in dust and toxins and 
dealing with smoke, you realize just the peril that our first 
responders often find themselves in. They rush into buildings to save 
lives, and we deeply appreciate what they do. That is why this 
legislation is an important step to help them.
  Nationwide, we have this problem with our firefighters. They came to 
us and said: We need this registry.
  Again, going back to the West and what we face, and I saw it when I 
flew across the country to come here, not only are there fires and 
smoke throughout Oregon, but also all across the West: Colorado, 
Montana, Wyoming, hill and valley choked with smoke.
  Close to 8 million acres burned in wildfires so far this year; more 
than half a million in Oregon on both public and mostly private lands. 
Thousands of residents have had to be evacuated. Firefighters, of 
course, stayed behind. They do what they do.
  Multiple studies have shown a correlation between firefighting and 
cancer. However, the reasons behind this are not fully understood. We 
owe it to these first responders to understand the causal link to 
cancer. Having better data to identify why firefighters are at an 
increased risk for some cancers will hopefully lead to better 
protective measures and ultimately reduce some of the hazards that they 
face when putting their lives on the line.
  Mr. Speaker, I thank my colleague from New York (Mr. Collins) for his 
good work on this measure, and I reserve the balance of my time.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield myself such time as I 
may consume.
  Mr. Speaker, I rise in support of H.R. 931, the Firefighter Cancer 
Registry Act of 2017. Yesterday we recognized the sixteenth anniversary 
of the September 11 terror attacks. The tragic events on that day 
exhibited the heroism our firefighters and other first responders 
display as they run toward disaster while everyone else runs away.
  The long-term health consequences on September 11, including several 
forms of cancer and chronic respiratory conditions among first 
responders, also serve as a reminder of the unique health risks 
firefighters face. As firefighters run into burning buildings and other 
environments, they often do not know whether carcinogens or hazardous 
materials are present. Such exposures have resulted in cancer becoming 
the leading cause of line of duty death among firefighters. My 
grandfather was a captain in the Houston Fire Department and died of 
cancer.
  We still do not fully understand the relationship between 
firefighters and cancer risk. That is why a more comprehensive approach 
is needed to understand this relationship. H.R. 931, the Firefighter 
Cancer Registry Act, will create a voluntary cancer registry of 
firefighters to collect data on their cancer risks and outcomes related 
to their job exposures. This registry will inform research into the 
health risks facing firefighters, as well as ways to mitigate such 
risks. That evidence will allow us to implement new practices and 
develop new tools to protect the health of individuals who courageously 
put their lives at risk to protect the public.
  Mr. Speaker, I urge my colleagues to support this legislation, and I 
reserve the balance of my time.
  Mr. WALDEN. Mr. Speaker, I yield 3 minutes to the gentleman from New 
York (Mr. Collins), the author of this very important legislation and 
an important member of our committee.
  Mr. COLLINS of New York. Mr. Speaker, I come before you in support of 
my bill, H.R. 931, the Firefighter Cancer Registry Act.
  Sixteen years ago yesterday, on September 11, 2001, we witnessed a 
horrible tragedy that will leave an impression on generations of 
Americans forever. Through this tragedy, we witnessed the heroic 
actions of America's brave first responders working and volunteering in 
the days and weeks that followed.
  We lost many first responders during those attacks of 9/11, and we 
continue to lose more every year from ongoing health effects.
  All firefighters across our Nation sacrifice their health every day 
to face the dangers of smoke inhalation and toxic chemicals. These 
dangers cannot be entirely avoided, which is why this bill, H.R. 931, 
is so important. This bipartisan legislation takes an important first 
step towards addressing the detrimental health impacts faced by our 
Nation's firefighters.
  The career of firefighting is a dangerous one. There are nearly 1.2 
million

[[Page 13788]]

men and women serving as firefighters in the United States. With every 
single fire they fight, these heroes take their lives into their own 
hands. Firefighters bravely risk their safety to protect our families, 
our homes, and our communities.
  Unfortunately, the risks of firefighting surpass the scene of the 
fire. These men and women are exposed to dangerous smoke and chemicals 
that often result in a lifetime of health trouble. We see firefighters 
all across the United States with higher rates of cancer than the 
general population, and it is vital that we learn more about this 
correlation.
  That is why I, along with my colleague, Representative Bill Pascrell, 
introduced the Firefighter Cancer Registry Act. This bill will require 
the CDC to establish a registry to track cancer incidence in the 
firefighting community. This comprehensive registry will work with fire 
departments across our Nation to include the important variables of a 
firefighter's career, including years of service, number of fires 
attended, and the types of fires attended. This information is 
essential to the development of future protocols, safeguards, and the 
development of equipment that will better protect these men and women.
  Firefighters put their lives at risk every day, and Congress should 
do all it can to shed light and reduce the health hazards they face. I 
would like to commend Chairman Walden and Ranking Member Pallone of the 
full committee, and Chairman Burgess and Ranking Member Green of the 
Health Subcommittee for a bipartisan showing of support during both 
markups of this legislation. I cannot think of a more relevant week to 
bring this legislation to the House floor. I urge the rest of my 
colleagues to support the Firefighter Cancer Registry Act, as we honor 
tragic losses of September 11.
  Mr. GENE GREEN of Texas. Mr. Speaker, I yield as much time as he may 
consume to the gentleman from New Jersey (Mr. Pascrell), a cosponsor of 
the bill.
  Mr. PASCRELL. Mr. Speaker, I rise today in strong support of H.R. 
931, the Firefighter Cancer Registry Act. I want to thank my partner, 
the gentleman from New York (Mr. Collins), for introducing this bill. I 
thank as well Chairman Walden, Ranking Member Pallone, Dr. Burgess, and 
Mr. Green for helping to shepherd our bill through the Energy and 
Commerce Committee and onto the floor day.
  As co-chair of the Congressional Fire Services Caucus and lead 
Democratic sponsor of this bill, I am proud to stand up for the brave 
men and women of our fire service. It is these individuals who put 
their lives on the line day in and day out to keep our communities 
safe.
  In addition to ensuring that our first responders are prepared in 
advance of disasters and other emergencies, we must also ensure that 
they receive the necessary medical care and services after answering 
the call of duty.
  When the courageous men and women in the fire services enter 
dangerous situations, they do not stop to ask whether they are 
subjecting themselves to long-term health risks.
  Yesterday, across this Nation, we honored the first responders that 
answered the call of duty after the terrorists attacked us on September 
11. Many of those brave men and women gave their lives, and many more 
are living with long-term health problems stemming from the time they 
spent at toxic Ground Zero.
  As evidenced on that day, many before and since, our first responders 
do whatever is necessary to keep our communities safe. That is why we 
must have their backs.
  While we know that firefighters are routinely exposed to a variety of 
known carcinogens in chaotic and uncontrolled environments, we do not 
have a good sense of the full picture of the negative impacts of the 
exposure.
  According to the Centers for Disease Control and Prevention, and the 
National Institute for Occupational Safety and Health, firefighters are 
at higher risk for certain kinds of cancer, including brain cancer, 
leukemia, lung cancer, and kidney cancer, when compared with the 
general population.
  Despite the knowledge we have gained through these studies, many have 
been limited by small sample sizes and an underrepresentation of key 
demographic groups.
  The first step to finding solutions is understanding the nature of 
the problem. Further public health research on this topic is needed so 
we can start working to find ways to alleviate this risk.
  I am pleased that H.R. 931 is on the floor today. It would create a 
national cancer registry for firefighters diagnosed with this deadly 
disease. The creation of a specialized firefighter cancer registry will 
provide scientists and medical professionals with the detailed national 
data that will allow them to study the relationships between 
firefighters' exposure to dangerous fumes and harmful toxins and the 
increased risk for several major cancers. In the future, this 
information could also allow for better protective equipment and 
prevention techniques to be developed.
  This bill enjoys strong support from major fire organizations across 
our Nation, including the International Association of Firefighters, 
the Congressional Fire Services Institute, the National Volunteer Fire 
Council, the International Association of Fire Chiefs, the National 
Fallen Firefighters Foundation, the New Jersey State Firefighters' 
Mutual Benevolent Association, and the International Fire Service 
Training Association.
  Taking care of the brave men and women of the fire service is an 
important task. We cannot delay in getting them the help they need. Mr. 
Speaker, I urge my colleagues in the House to pass this bill swiftly so 
we can work on getting it through the Senate and onto the President's 
desk.
  Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from 
Texas (Mr. Burgess), the chairman of the Subcommittee on Health, the 
gentleman who helped move this legislation forward, and leads our 
committee on matters of health.
  Mr. BURGESS. Mr. Speaker, I rise in support of H.R. 931, the 
Firefighter Cancer Registry Act.
  In 2015, a 5-year study of nearly 30,000 firefighters found that 
these individuals had a greater number of cancer diagnoses and cancer-
related deaths than matched controls in the general population.
  While this built upon prior studies that have examined the link 
between firefighting and cancer, our understanding of this connection 
is still limited. To improve our ability to alleviate the health risks 
that these public servants face, Representatives Collins and Pascrell 
introduced H.R. 931. This will authorize funding for the Centers for 
Disease Control and Prevention to create a national registry for the 
collection of data pertaining to cancer incidence among firefighters.
  This national registry will fill the void in our understanding of the 
health risks that our firefighters face and better prepare us to care 
for them.
  Yesterday did mark the 16th anniversary of the September 11 attacks. 
We are reminded of the firefighters' willingness to run toward danger 
to help anyone who is in harm's way. Across our country, firefighters 
answer the call whenever our families or our communities are in need. 
Supporting these important public health bills is one way we can give 
back to these heroes, and I urge all Members to join me in supporting 
H.R. 931.
  Mr. GENE GREEN of Texas. Mr. Speaker, I reserve the balance of my 
time.
  Mr. WALDEN. Mr. Speaker, I yield 2 minutes to the gentleman from New 
Jersey (Mr. Lance), another very important member of our Energy and 
Commerce Committee, who I know had many constituents horribly affected 
by the tragic events of 9/11.
  Mr. LANCE. Mr. Speaker, I rise today in very strong support of the 
Firefighter Cancer Registry Act sponsored by my close friends, 
Congressman Collins and Congressman Pascrell.
  Congressman Collins has been involved in this issue for many years, 
including as an Erie County executive in western New York. Congressman 
Pascrell has spent his entire public career in defense of firefighters 
as mayor of Paterson, as a member of the State

[[Page 13789]]

legislature, and for more than two decades as a Member of Congress.

                              {time}  1345

  This bill will direct the Centers for Disease Control and Prevention 
to collect data on cancer incidence among firefighters. We need this 
data to help save the lives of the brave heroes who put their lives on 
the line every day.
  The CDC will compile critical information like risk factors and the 
dangers to which firefighters are exposed. This information collected 
on a voluntary basis will help develop better protective equipment and 
prevention techniques that can be disseminated across the country.
  It is fitting that we consider this legislation this week as our 
Nation mourns the somber anniversary of the September 11 attacks. This 
country can never forget the images of firefighters, police, EMS, and 
other first responders initiating rescues and putting themselves in 
grave danger, both during and after the attacks.
  Many lives were lost that day and, in the years that have followed, 
from the rescue and recovery work. Let's do all we can to make sure 
this information and best practices are shared so that we can protect 
as many lives as possible.
  Mr. Speaker, I urge a ``yes'' vote.
  Mr. GENE GREEN of Texas. Mr. Speaker, I reserve the balance of my 
time.
  Mr. WALDEN. Mr. Speaker, I yield 1 minute to the gentleman from New 
York (Mr. Faso), who also had constituents who were very affected by 
the events of 9/11.
  Mr. FASO. Mr. Speaker, I appreciate the chairman's yielding of time.
  As we take this week to somberly remember those who lost their lives 
on September 11, 2001, it is equally important that we remember the 
first responders who bravely ran towards the tragedy of 16 years ago, 
who woke up the next day, on September 12, 2001, still beaten, tired, 
and bruised but, again, walked towards those tragedies. Still, today, 
these first responders heroically risk life and limb to run toward 
tragedies.
  As Americans, we owe our first responders a great debt. For this 
reason, I ask my colleagues to support Mr. Collins' bill, H.R. 931, the 
Firefighter Cancer Registry Act, which makes important first steps in 
lifesaving cancer research and future medical advancements for 
firefighters, who have disproportionately higher cancer risks.
  I would like to thank all of our first responders and urge passage of 
this important legislation, and I thank the bipartisan cosponsors of 
this legislation as well.
  Mr. GENE GREEN of Texas. Mr. Speaker, we have no more speakers, and I 
yield back the balance of my time.
  Mr. WALDEN. Mr. Speaker, we all join in thanking our first 
responders. This is the least of the things we can do to show how much 
we care about our firefighters, and I would encourage our colleagues in 
the House to support this very important legislation.
  Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Mr. McClintock). The question is on the 
motion offered by the gentleman from Oregon (Mr. Walden) that the House 
suspend the rules and pass the bill, H.R. 931, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

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