Peter Czulinski never thought cancer would deliver the fatal blow.
Like all firefighters, he thought he might die — if he thought about death at all — in a roaring blaze, working side by side with his colleagues, fighting to save lives.
"Near the end, when we had some quiet moments together, he kept saying the same thing: 'I can't believe I am going down this way,'" says Mark Daniels, a close friend and colleague and acting captain at Toronto fire station 332.
Czulinski died May 3, four months after being diagnosed with an unknown cancer that spread, quickly and dangerously, throughout his abdominal cavity. He was just 45.
A funeral service for the Toronto firefighter will be held Wednesday in his hometown of Mississauga.
His friends, family and the firefighting community believe the strong, otherwise healthy man — an acting captain with 22 years of service as a firefighter, an avid runner, a proud husband and father of three — died of cancer that he got while on the job.
Officials are not yet convinced that this is the case.
Five years after Ontario introduced legislation to make it easier for firefighters to qualify for compensation for job-related cancers, the firefighting community continues to push for further recognition of cancer as an occupational illness.
Currently, the legislation covers eight types of cancer, including brain, bladder and esophageal cancers. The Ontario Professional Fire Fighters Association is lobbying to have six more cancers included in the province's Workplace Safety and Insurance Act — a move they say would reflect the most recent science.
While any update to the legislation would be welcome to the province's firefighters, changes will probably not help Czulinski's family.
The veteran firefighter's case, currently before the Workplace Safety and Insurance Board (WSIB), is complicated, though not uncommon in Ontario.
Doctors believe the liver cancer that ultimately killed Czulinski was not the original tumour that set off the disease. So far, physicians have not been able to pinpoint the primary cancer, though a partial autopsy was conducted after his death.
Czulinski's wife, Heidi, says it is still early in the WSIB process and she knows a conclusive diagnosis will not guarantee their claim will be accepted.
Still, she is convinced her husband died of an occupational cancer. It is what she has started to tell their daughter, Emily, 9, and their 7-year-old twin boys, Adam and Colin.
"One of the questions I get every single day is, 'Why did Daddy have to get cancer?'" she says. "I've started to tell them that the smoke Daddy was breathing in was too much for his body."
Friends and family are still shocked Czulinski died of cancer. They say the 6-foot-2, broad-shouldered man was always the epitome of health. He ate well, exercised diligently, never smoked and enjoyed the occasional cold beer — Smithwick's was his favourite — with friends at the pub. No one on his side of the family had a history of cancer.
It was a surprise, then, when it turned out the cause of sudden abdominal pain, which struck Czulinski just days into the new year, was large, aggressive tumours growing among his abdominal organs.
Over the coming months, Czulinski, a member of the Queen's Own Rifles of Canada, an infantry regiment of the Canadian Forces Reserve, stoically endured the treatments and pain and the growing realization little could be done to save his life. He spent his final two weeks in the palliative care unit at Credit Valley Hospital, a constant flow of friends and family at his side.
He died at 7 a.m. on May 3 — coincidentally the same hour that his two closest firefighting colleagues finished their 24-hour shifts at the fire station.
Heidi Czulinski says she hopes her husband's death will help the public understand the range of risks firefighters accept as part of their job.
"There needs to be a heightened sense of awareness of what these men and women are taking on," she says. "It's not any more about having buildings collapse on you. It's more of a long-term and agonizing way of dying."
During his more than two decades as a firefighter, Czulinski fought hundreds of fires that exposed him to dangerous chemicals and toxins. His friends estimate he attended more than 200 car and structure fires, which firefighters believe are especially dangerous because of toxic smoke from burning plastics commonly used in construction.
Research has found firefighters are more likely to develop cancer than the general population. According to Paul Atkinson, a member of the Ontario Professional Fire Fighters Association's occupational disease committee, the risk is two-fold higher for firefighters.
He says there have been approximately 1,700 claims for cancer-related illnesses due to the job since 1998 — the year in which Atkinson and his colleagues proactively started filing claims. In those 14 years, he says, about 40 per cent of the claims have been allowed.
A spokesperson for the WSIB says 233 claims for cancer were allowed between 2006 and 2010 for full-time and volunteer firefighters. Of those claims, 58 were for colorectal cancer, 57 for leukemia and 38 for bladder cancer. The remaining 80 allowed claims were for all other cancers.
Since 2007, Atkinson says new scientific research has shown links between the occupational hazards of firefighting and six additional cancers currently not covered by the Ontario legislation. Other provinces, including Manitoba, Alberta and B.C., have updated their insurance acts, he says.
In February, Atkinson and his colleagues spoke to MPPs at Queen's Park about including more cancers in the legislation. The Toronto firefighter and longtime advocate for workplace safety says all three political parties seemed receptive to the proposed changes, prompting hope that updates will soon be implemented.
According to a spokesperson for the Ministry of Labour, the ministry is aware of the request and the "WSIB and the government are reviewing the relevant scientific literature in the field in considering any potential amendments to the regulation."
The families of firefighters ruled to have died from job-related diseases receive compensation, which could include funeral and burial expenses, a survivor's pension and support for children younger than 18.
Firefighter Chris Irwin, acting captain at fire station 233, spent 18 years working side-by-side with Czulinski and Mark Daniels. The trio, who faced countless fires together, were known by colleagues as the three amigos.
The pair desperately miss their friend — a brother, really, they say — and believe his legacy will be encouraging fellow firefighters to protect their health and watch for signs of work-related disease.
"He wanted to make sure, at the very least, that Mark and I were getting ourselves screened," Irwin says. "And he wanted the guys to remember him and to get themselves checked."
Irwin and Daniels say their families now worry that cancer may be lying in wait for them, too.
"For 18 years, whatever fire one of us was at, we were in it together," says Irwin. "If his cancer is exposure-related, we are definitely concerned.
"There will always be a little knot in the back of our heads about that until the end of our careers."
OCCUPATIONAL DISEASES FACED BY FIREFIGHTERS
The 2007 amendment to Ontario's Workplace Safety and Insurance Act sets out the conditions, such as years of service, by which eight cancers are presumed to be work-related.
Full-time, part-time and volunteer firefighters are covered under the act, which also covers heart injuries suffered within 24 hours of fighting a fire or participating in a training exercise of a fire emergency.
The eight cancers currently covered in the legislation, and criteria:
Brain cancer (10 years' service required)
Bladder cancer (15 years)
Kidney cancer (20 years)
Colorectal cancer (diagnosed before 61st birthday)
Non-Hodgkin's lymphoma (20 years)
Certain types of leukemia (15 years)
Ureter cancer (15 years)
Esophageal cancer (25 years)
The six cancers the Ontario Professional Fire Fighters Association wants included in the legislation are: Multiple myeloma, testicular cancer and cancers of the skin, breast, lungs and prostate.
Click the links below in order to hear podcasts from CBC Radio, featuring Paul Atkinson and Colin Grieve, with regards to fire fighter cancers:
Firefighters Fight for WSIB on CBC Radio