Senate committee hears bill to add cancer and cardiac screenings to firefighters' annual physicals

CARSON CITY — The Senate Committee on Commerce and Labor heard emotional testimony and policy arguments on Senate Bill 170, which would expand the statutory content of annual physical examinations for firefighters (and certain law-enforcement personnel covered under NRS 617) to include additional cancer screenings, cardiovascular testing and other diagnostics.

Sen. John Steinbeck, sponsor of SB 170, told the committee the measure "adds cancer screenings to the annual physical exam for firefighters among other changes." He was joined at the hearing by Ryan Beeman, who identified himself as representing Professional Firefighters of Nevada and the executive board of Clark County IAFF Local 1908.

Nut graf: Supporters — including local fire captains, union leaders, public-safety organizations and medical providers — said expanded, standardized annual exams would detect occupational cancers and cardiovascular disease earlier and could reduce fatalities among first responders. Several active and retired firefighters described late-stage cancer and near-fatal cardiac events they said might have been detected earlier with more comprehensive screening.

The bill lists a broad set of additional tests and screenings to be included in an annual examination: tuberculosis screening (TST or blood test), posterior-anterior chest x-ray, pulmonary function testing (spirometry), cardiac testing including stress electrocardiography and coronary artery calcium scoring, blood tests for hepatitis A/B/C and prostate-specific antigen (PSA), urinalysis, thyroid-stimulating hormone (TSH), cortisol screening, vision testing (distance, near, peripheral and color), dermatologic skin exams, mammography, Pap smear, testicular exams, fecal occult blood testing and colonoscopy, and options to include multi-cancer early detection (blood-based) tests and imaging where appropriate.

Multiple witnesses cited peer-reviewed research and federal analyses. Beeman referenced a large NIOSH/CDC cohort of U.S. firefighters and said that study and other analyses show elevated incidence and mortality for several cancers among firefighters. "Occupational cancer has become the leading cause of firefighter line of duty deaths," Beeman said. He and multiple witnesses described higher rates of specific cancers — including prostate, thyroid, bladder, breast and colorectal cancers — and higher cardiovascular risk among first responders.

Several firefighters shared personal accounts. Capt. Rochelle Rowell of the Clark County Fire Department described a mammogram ordered through a work clinic that led to an early-stage breast cancer diagnosis in 2021; she said, "Getting early screening saved my life." Capt. Nick Radef described a near-fatal heart attack in November 2023, which he said occurred months after he had passed a departmental treadmill test and an annual physical. Israel Wilkinson, a Henderson Fire Department engineer undergoing radiation and chemotherapy, described a stage-3 oropharyngeal cancer he said likely relates to diesel exhaust and combustion byproducts.

Nut graf (policy detail): The proposed statutory language refers to NRS 617 provisions that currently require annual physicals but do not specify these detailed screenings. Supporters said the change would standardize physical contents across departments; opponents cautioned about cost and implementation specifics. An amendment presented during the hearing clarifies that examinations should be performed by a physician or an advanced practice registered nurse "knowledgeable about the physical demands of firefighting and law enforcement" and allows female personnel to obtain certain examinations from their regular provider if they submit the results within the annual period.

Cost and implementation questions were raised. Sen. Lang asked how the bill would work amid physician shortages; witnesses pointed to the amendment permitting appropriately trained advanced practice registered nurses to conduct the exams in some settings. Dalton Hooks of the Nevada Self Insurers Association registered opposition to the bill in its current form and said his group wanted to meet with the sponsor to discuss concerns about cost and implementation; other unions, medical providers and chiefs testified in favor.

No committee vote was taken during the hearing. After testimony, the chair closed the hearing on SB 170; the bill may be amended or scheduled for future action.

Ending: Advocates urged standardized, expanded screening to detect occupational cancers and cardiac disease earlier. The bill drew broad support from firefighter unions, some medical groups and public-safety organizations and a single recorded opposed party seeking further negotiation on costs and implementation.