Guarding Lifeguards : Legislation: A bill would grant the legal presumption of job-related illness to beach sentinels who contract skin cancer. Cities and counties say it would needlessly increase taxpayer liability.

She was born within a block of the beach, a quintessential California girl. Blonde, bronzed, athletic, robust, she seemed bred to a life of sand and sun--and to her job as a Los Angeles County lifeguard.

Then one day, just below her breasts, on the tan line that never seemed to fade, Patricia Brouwer discovered a tiny mole that had begun to bleed.

Skin cancer, the doctors told her. Occupational hazard, the other lifeguards said. Six years later, on June 6, Brouwer’s on-the-job injury claimed her life.

It is, lifeguards say, one of the most common hazards in the trade: the little flake, the unusual mole, the rash that signals the onset of skin cancer.

“You talk to any lifeguard, and he or she’ll have two or three pieces of cancer cut out in the course of a career,” said Ira Gruber, president of the Los Angeles County Lifeguard Assn., which represents the 120 full-time and 600 part-time sentinels who safeguard swimmers along the county’s coast.

And that’s not all, Gruber adds.

“Other lifeguards have died from leukemia, or stomach or colon cancer,” he said. Although such tragedies have never been definitively linked to pollution in Santa Monica Bay, he said, “we’ve had lifeguards get obnoxiously sick after working next to the storm drains.”

But unlike firefighters--who face similar cancer risks from toxic chemicals and carcinogenic smoke--lifeguards who contract cancer must prove they got it on the job or risk losing their worker’s compensation benefits. Lifeguards do not enjoy the legal presumption that any cancer-related injury they receive arose because of their jobs, although the law extends such protection to other public safety workers.

Now two veteran lifeguards--Lt. Conrad Liberty of El Segundo and Gruber of Marina del Rey--are working with state Sen. Art Torres (D-Los Angeles) to change that. A bill sponsored by Torres would give lifeguards the same presumptive cancer benefits already guaranteed under previous legislation to firefighters and law enforcement officers whose duties require providing aid or assistance in water areas at ocean beaches. His bill would force cities and counties to prove that cancer contracted by lifeguards was not caused by on-the-job exposure to toxins in the ocean or ultraviolet rays.

Although the vast majority of cancer claims by lifeguards involve some form of skin cancer, Torres said, he is also concerned with the potential health effects of pollutants in Santa Monica Bay. At hearings held last November in Malibu before the Senate Toxics and Public Safety Management Committee, which Torres chairs, lifeguards’ testimony focused on the threat posed by chemicals discharged from storm drains and other sources into the bay and ocean.

“Even when the beaches are closed, emergency personnel must go into the contaminated water,” Torres said. “This bill recognizes the risk from chemical exposure for all emergency response personnel, including lifeguards.”

The bill passed the state Senate this month and is pending in the Assembly. It is being fought by insurance companies, cities and counties, which argue that it will needlessly increase government liability--and the liability of taxpayers.

“Lifeguards get left out because people think we’re all 6-foot-2 and tan and young and looking for girls while we work a summer job,” Gruber said. “But there are certain things that happen to you on this job.

“This is something that we deserve. A lifeguard shouldn’t have to prove he got skin cancer from the sun.”

But Steve Keil, lobbyist for the County Supervisors’ Assn., said that the worker’s compensation law is already liberally construed and that lifeguards with cancer--particularly those with skin cancer--are rarely challenged when they apply for medical benefits.

Moreover, Keil said, the inclusion of lifeguards would encourage other municipal workers to demand presumptive cancer benefits, broadening the taxpayers’ liability on an issue that, so far, has been fairly limited in scope.

“The arguments for lifeguards aren’t really different from those faced by, say, the (hazardous materials) folks, agricultural inspectors, road crews, weed abatement crews or people involved in any type of pesticide spraying,” Keil said, noting that those groups too are excluded from presumptive cancer benefits. “Currently, they have to prove some kind of . . . job connection,” he said. “This (law) would make it a slam dunk for the employee.”

Officials say there are no firm figures on the cancer rates among lifeguards, but they predict that Los Angeles County would be the entity most likely to feel the impact of the law, because it employs 750 of the state’s estimated 3,000 full- and part-time ocean lifeguards.

A study by the legislative analyst for the Senate Appropriations Committee projected the additional worker’s compensation costs of Torres’ bill at less than $150,000 a year, which counties and cities could bill to the state.

Lifeguard Liberty acknowledges that the extra cost would be low, in part because the county is already generous in compensating lifeguards whose condition is diagnosed as skin cancer.

“It’s true that L.A. County has not questioned it much in the past, but that’s been a magnanimous act on their part,” Liberty said.

Added Bill Richardson, a Huntington Beach lifeguard and secretary of the California Surf Lifesaving Assn.: “Even though the cities are very responsive, we’d all be relieved to have the burden of proof be on the employer. As it is, the employee still has to make the initial expenditure (for medical care) out of pocket.

“And let’s face it,” Richardson said, “municipal finances aren’t getting better anywhere. So far, they haven’t taken an attitude that they would save money by denying claims, but there’s always that possibility.”

Rick Brouwer, Patti’s brother and a part-time lifeguard, said his 32-year-old sister--a lifeguard since 1979--lived for six years with her skin cancer, running marathons, working full time as a nurse and keeping her part-time summer job as a lifeguard at Venice Beach.

“They told her (the mole that had been removed) was malignant, but they said if she kept up her follow-up checkups, she would be OK,” her brother said. Although she continued to monitor swimmers, he said, she always used sunscreen, “and I don’t think I ever saw her just lying out (to get a tan).”

Remaining on the job after being treated for skin cancer is not uncommon, lifeguards say, because some forms of cancer--basal cell, for example--are less life-threatening than others and are easily treatable. Connie Sullivan of the county’s risk and insurance management office said lifeguards routinely submit claims for the removal of moles and warts that they suspect may be cancerous, and for treatment of various forms of skin cancer.

Malignant melanoma, the cancer that was eventually diagnosed in Brouwer, is the most serious form of skin cancer, since it can spread to other parts of the body. Named for the melanin or pigment cells in which it originates, melanoma usually first appears as a mole that enlarges, bleeds, changes color, grows lumpy, itches or develops a black edge or scab.

But doctors say that even melanoma can be treated if detected early.

“People have had skin cancer and continued to work,” said county Lifeguard Capt. Bob Buchanan. “They’re just told to keep using sunscreen and stay out of the sun as much as they can.”

But in February, Brouwer’s brother said, his sister began suffering from a persistent earache that marked a turn for the worse. At first, he said, doctors tried to treat her pain with antibiotics, believing that it was the result of an infection. When weeks passed without improvement, she underwent a CAT scan and a malignant tumor was found near her ear canal.

“The doctor said it didn’t look good for Patti, but he cut out the tumor anyway,” Brouwer said. The nerve damage from the surgery paralyzed one side of her face, blinded her in one eye and made it difficult for her to balance and walk.

But the worst news came after the second round of tests: The cancer had spread not only to her brain, but also to her spine, kidneys and lungs.

Further surgery on her spine left her paralyzed from the waist down, her brother said. She spent the last month of her life at home.

Her medical bills were more than $200,000.

Brouwer said his sister never had an opportunity to apply for worker’s compensation benefits from the county because her cancer progressed so quickly in its final months. Most of the medical bills, he said, were paid by the insurance provided to her through her full-time job as a nurse.

Still, he said, the family supports the Torres bill, and he said he hopes that Patti Brouwer’s death will help prompt a change in the law.

And Brouwer himself has a vested interest in the matter: Not long ago, he too discovered that his tan had been marred with a new--and bleeding--mole. So far, the diagnosis is benign.