Chimney Sweeps and Occupational Diseases
By Jack Bleeker of Mesothelioma Center Research Coordinator
Anyone who has practiced this trade will tell you that the realities of being a chimney sweep have little to do with magical stories and dancing co-workers. Truly, the duties of a chimney sweep aren’t a walk in the proverbial park. The work is hot, dirty, and unhealthy and experts have realized for centuries that the chimney sweep is indeed putting his health at risk with each day spent on the job.
Early Findings
In 1775, English surgeon Percivall Pott was the first to describe a link between a particular environmental substance and the development of cancer. Specifically, his findings concerned the environmental toxins encountered daily by the chimney sweep, a profession that was quite common in Old England.
Pott had found an extraordinary number of cases of scrotal cancer among his male patients and discovered that the common link for all of them was the fact that they worked as “climbing boys” during their young lives. Traditionally, master sweepers would hire climbing boys – small male children who were orphans or from very poor families – to climb up inside of the flues and brush them clean. They would also use metal scrapers to remove the tar that was deposited by wood smoke. The children that did this task were often as young as seven years old and were generally tied to this occupation for life, treated more like slaves than like employees. They were given no safety clothing and there were no safety regulations in place to protect the boys, many of whom died of suffocation due to dust and soot inhalation. Others died after they got stuck in narrow flues and suffered catastrophic injuries.
After studying a large number of these former climbing boys, Pott ascertained that the malignancy found in these men was most likely connected to prolonged exposure to soot. Pott’s findings sparked similar reports by other doctors and research scientists and eventually – nearly 100 years later – the practice of using climbing boys in the United Kingdom was outlawed.
The Dangers
Though Pott’s findings prompted reform for chimney workers in the U.K., the profession was and is still deemed a dangerous one, even for modern day chimney sweeps whose methods of sweeping have changed greatly over the years.
Sweeps are exposed to any number of dangerous substances and chemicals during their work, including carbon; carcinogenic metals like arsenic, nickel, and chromium; toxic minerals such as asbestos, found in old fireplace mortar and firebricks; and products of fossil fuel combustion. Exposure to birds, particularly pigeons, also present a problem as encounters with those avian creatures carries an increased risk of contracting histoplasmosis, a fungal disease that primarily affects the lungs.
The most comprehensive contemporary studies on chimney sweeps and occupational diseases have been conducted in Sweden during the last two decades. Sweden boasts an excellent chimney sweeps guild that has made it their duty to keep track of the health of its guild’s members. With the assistance of the guild, more than 5,000 chimney sweeps were studied for incidence of cancer. These individuals worked in their profession for various lengths of time between 1918 and 1980.
The study, penned by P. Gustavsson, A. Gustavsson, and C. Hogstedt of the Division of Occupational Medicine/National Institute of Occupational Health, and Karolinska Hospital, demonstrated that those with a long history of employment as a sweep showed an increased incidence of cancers of the lung, pleura, esophagus, and liver, and also a much higher incidence of leukemia than the general public. A similar Danish study showed an increased risk of ischemic heart disease and a parallel study in Yugoslavia demonstrated a high mortality rate from cancer of the larynx and various types of lung cancer.
The doctors who conducted the Swedish study concluded the following:
“There was a significant excess of cancers of the lung, esophagus, and bladder and the total incidence of cancer was also significantly raised. There wasa nearly significant increase of hematopoietic malignancies, relating both to leukemia and multiple myeloma. The excess of lung cancers was caused by an excess of squamous cell and undifferentiated/small cell carcinomas. Two cases were registered as pleural mesotheliomas.”
The studies do indicate that other factors, including smoking, may have contributed to the high incidences of lung and esophageal cancer but still note that the percentages of various types of cancer are much higher among chimney sweeps than the general public.
Chimney Sweeps and Asbestos
Though the U.S. halted most uses of asbestos in the late 1970s, chimney sweeps that continue to practice their profession in older homes or buildings may still be at risk for exposure. Asbestos may have been used as insulation or could be found in chimney cement or in the mortar that was used to hold the fireplace materials together. While soot is probably more dangerous to chimney sweeps than asbestos, encounters with the toxic mineral shouldn’t be taken lightly. Experts have proven that even a small amount of exposure to asbestos could cause serious lung problems in the future, including the cancer mesothelioma. Mesothelioma is a rapidly-spreading, aggressive form of cancer that still carries a definitive death sentence. All precautions should be taken to avoid inhalation when asbestos is potentially present.
Taking Care
When reports of high levels of cancer among chimney sweeps surfaced a few centuries ago, doctors recommended some simple measures to help reduce the chances of developing a fatal disease. One of those recommendations was very simple. Sweeps were changed with the task of bathing daily, a chore most of us probably take for granted these days. However, a reduction in the cancer rate was indeed seen after chimney sweeps followed that simple rule.
Next came the use of protective equipment while on the job. In the 19th and 20th centuries, certain new laws governed the use of such equipment, including face masks and, later, more sophisticated respirators through which more minute particles could not pass. All of this keeps exposure to soot and other carcinogens to a minimum.
Chimney sweeps, however, should be ultra aware of the potential of developing cancer and other occupational diseases and should exercise precaution by doing a few simple things. First of all, chimney sweeps should inform their doctor as to their occupation. This allows the doctor to be attuned to certain things that might indicate an occupational disease. Any good doctor takes the time to compile a comprehensive medical history on his/her patients and occupation should be part of that information.
Sweeps should also be diligent about the warning signs of certain cancers for which they carry a higher risk. Often, the symptoms of certain kinds of cancer can be mistaken for the symptoms of more common diseases, so awareness of these symptoms is paramount. Chimney sweeps should, in particular, be on the lookout for symptoms of scrotal cancer, which include a small sore on the scrotum that may ulcerate. They should also be attuned to symptoms that may indicate lung cancers, including malignant pleural mesothelioma. These symptoms may include shortness of breath or difficulty taking a deep breath, coughing, chest pain, hoarseness or husky voice, difficulty swallowing, fatigue, and sudden weight loss. Many of these symptoms could be associated with the common cold or other less serious illnesses, but extra precautions should be taken to ensure an accurate diagnosis and prompt treatment.