Firefighters’ PFAS Levels Are Highest of All Emergency Response Workers: Study

PFAS exposure from firefighting foam and protective gear has been linked to a risk of testicular cancer, liver cancer, kidney cancer, thyroid cancer, ulcerative colitis and other injuries for first responders.

A new study warns that firefighters have the highest levels of exposure to toxic “forever chemicals” among all first responders, so much so that researchers indicate that participating in the profession alone should be considered a cancer risk.

Firefighting has long been associated with increased cancer risks, largely due to exposure to smoke, toxic gases and other hazardous materials. However, a growing body of research has found that a significant contributor may be per- and polyfluoroalkyl substances (PFAS), a group of synthetic chemicals that are known to resist grease, oil and water, but can build-up in the environment and human body.

According to the findings of a study published in the May issue of the Journal of Exposure Science and Environmental Epidemiology, researchers indicate that prolonged exposure to PFAS may play a major role in the elevated cancer risk faced by firefighters.

PFAS include a group of over 9,000 man-made substances widely used for decades in aqueous film-forming foam (AFFF), which are used to fight fuel-based fires, as well as in the protective turnout gear used by firefighters. However, there is now significant evidence that exposure to the chemicals may cause various cancers, liver damage, thyroid disease, decreased fertility, high cholesterol, obesity, hormone suppression and other injuries.

While most of the attention on the chemicals in recent years has focused on PFAS water contamination problems impacting communities nationwide, particularly around military bases, airports and firefighting training locations, first responders are also often directly exposed to the chemicals during training and response exercises.

As a result the failure to warn firefighters about the potential health risks, manufacturers of the chemicals and firefighting safety gear now face thousands of AFFF lawsuits, alleging that exposure to the chemicals directly caused testicular cancer, liver cancer, kidney cancer, thyroid cancer, ulcerative colitis and other injuries.

The International Association of Fire Fighters (IAFF), along with the Metropolitan Fire Chiefs Association, issued a warning in August 2022, calling on firefighters to reduce their PFAS exposure by limiting the use of turnout gear. However, the groups acknowledged at that time that firefighters will not be able to fully avoid the PFAS cancer risk until the chemicals are removed entirely from protective gear and AFFF foam, calling for the development and widespread availability of such PFAS-free gear.

Firefighter PFAS Cancer Risks Study

For this new study, researchers from the University of Arizona looked at PFAS blood serum concentration levels among 1,960 of the state’s emergency response workers, including firefighters, EMTs, healthcare professionals and other first responders. They looked for 14 specific PFAS, collecting samples when the person first enrolled and then periodically testing their blood over time between July 2020 and April 2023.

According to the data, firefighters consistently had the highest levels of PFAS in their blood. Specifically, firefighters tended toward higher levels of perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), and perfluoroheptanesulfonic acid (PFHpS).

Healthcare workers also showed somewhat elevated levels of PFAS as well, the researchers noted. They indicated that, for other essential worker categories, PFAS levels actually declined during the three-year study.

“We found that firefighters have higher concentrations of certain PFAS chemicals and the odds of detecting other PFAS chemicals are higher among healthcare workers compared with people in other occupations,” the researchers concluded. “Our findings highlight the importance of further action to reduce PFAS exposure within highly exposed occupational groups, such as firefighters, and the need to expand evaluation of exposure among other occupations, including healthcare workers.”

June 2025 Firefighter PFAS Lawsuit Status Update

The findings come as chemical and safety equipment manufacturers face hundreds of firefighter PFAS exposure lawsuits in federal courts nationwide, alleging that they developed testicular cancer, liver cancer, kidney cancer, thyroid cancer, ulcerative colitis and other adverse health effects following exposure to AFFF and their turnout gear.

Given common questions of fact and law presented in the claims brought throughout the federal court system, all AFFF lawsuits are currently centralized before U.S. District Judge Richard M. Gergel in the District of South Carolina, for coordinated discovery and a series of early bellwether trials.

While the outcome of early bellwether trials in the MDL will not have any binding impact on other claims, the average lawsuit payouts awarded by juries for different categories of injuries may affect the outcome of PFAS exposure and AFFF settlements. If no such settlements are reached during the bellwether trials, thousands of claims may be remanded back to federal courts nationwide for individual trial dates.