PFAS and Firefighters: What the Research Actually Shows

When I started in the fire service, nobody talked about PFAS. We used the foam, we wore the gear, and we didn’t think much about what was in either one. That’s changed, and if you’re entering the fire service today, you need to understand why.

PFAS, or per and polyfluoroalkyl substances, are a class of synthetic chemicals that don’t break down in the environment or in the human body. That’s why they’re called “forever chemicals.” For firefighters, exposure isn’t hypothetical; it’s built into the job.

How Do Firefighters Get Exposed to PFAS?

There are two main pathways, and both are part of routine fire service work.

Aqueous Film Forming Foam (AFFF)

AFFF is a firefighting suppressant used on flammable liquid fires, including fuel spills, aircraft fires, and industrial incidents. It works extremely well, but it’s also saturated with PFAS compounds. Every time a crew trains with AFFF or deploys it in the field, there’s direct exposure through skin contact and inhalation. Military bases, airports, and industrial sites that used AFFF for decades have become Superfund cleanup sites because of the contamination that spread into surrounding groundwater.

Turnout Gear

The outer shell and moisture barrier of structural firefighting gear have historically been treated with PFAS based coatings that provide water and chemical resistance. When gear gets contaminated with soot and combustion byproducts, which frequently contain PFAS leached from burning synthetic materials, those chemicals can absorb through the skin during and after suppression activities. Research has found that skin absorption through contaminated gear can actually be a more significant exposure route than inhalation during some incidents.

What Are the Health Risks of PFAS for Firefighters?

Studies have consistently found elevated PFAS blood levels in firefighters compared to the general population. The documented health effects include:

• Increased cancer risk: Kidney, testicular, bladder, and thyroid cancers have been documented at higher rates in firefighter populations with high PFAS exposure
• Thyroid disruption: PFAS compounds interfere with thyroid hormone function, with downstream effects on metabolism, energy, and mood
• Immune suppression: High PFAS exposure is associated with reduced antibody response to vaccines and increased susceptibility to infection
• Liver effects: Elevated liver enzymes are common in high exposure populations
• Reproductive issues: Including reduced fertility and pregnancy complications in both men and women

The International Association of Fire Fighters (IAFF) formally classifies certain cancers as presumptively occupational for career firefighters, and many states have passed presumption laws extending workers’ compensation coverage to fire service cancer cases.

What’s the Fire Service Doing About PFAS?

Movement is happening, but slowly:

• PFAS free turnout gear: Several manufacturers now offer gear with fluorine free outer shells. The price premium is real, but demand is growing as more departments prioritize the switch.
• AFFF phase outs: The EPA has established PFAS maximum contaminant levels in drinking water, and many jurisdictions are moving toward fluorine free foam (F3) alternatives for training and non critical applications.
• Decontamination protocols: The IAFF and NFPA have published guidance on on scene gross decon to reduce PFAS absorption after fire suppression. Shower at the station. Don’t bring contaminated gear home.
• Ongoing litigation: Manufacturers including 3M, Chemours, and DuPont have faced significant legal exposure. 3M’s settlement on PFAS water contamination claims reached up to $10.3 billion. Individual firefighter health claims continue to work through the courts.

What Should Firefighters and Candidates Do?

PFAS is a known occupational hazard. The difference from previous generations is that we know about it now, early enough to take protective action.

Follow your department’s decon protocols after every fire. Shower at the station before going home. Don’t eat, drink, or touch your face with contaminated gloves. Ask your department what their protocol is for retiring contaminated gear, and find out whether your state has cancer presumption laws that cover you.

And if you’re hiring into the fire service right now, ask departments what their PFAS mitigation program looks like. It’s a reasonable question, and a good department will have a real answer.