Firefighting is an occupation that comes with inherent risks.  

In addition to the physical demands, there are also health risks associated with the job. For instance, the rate at which firefighters develop cancer outpaces the general population by 9 percent, and their risk of dying from cancer is 14 percent higher, according to a study published by the National Institute for Occupational Safety and Health (NIOSH). 

It turns out, though, that some of the equipment used to keep firefighters safe also puts them at risk. 

Firefighters rely on turnout gear and other personal protective equipment, such as a breathing apparatus, to keep them safe when battling flames, high temperatures, smoke and other elements associated with firefighting.

Firefighting turnout gear is manufactured with fluorine, one of the compounds that makes the gear heat-resistant and waterproof. When fluorine is combined with carbon compounds the union creates “forever chemicals.” 

These chemicals pose environmental and human health risks. They’re the same chemicals that have been found to be fouling the Cape Fear River basin and have been implicated in tainted water at the Marine’s Camp Lejeune in Onslow County. 

North Carolina fire officials want to push down those cancer numbers for the more than 50,000 volunteer and career firefighters in North Carolina’s more than 1,200 fire departments. 

“I would like to see a law in place that says, ‘North Carolina firefighters will be in PFAS-free gear by 2025,’” said firefighter Scott Mullins, president of Professional Firefighters and Paramedics of North Carolina. “I think we’ve got to start cranking up the pressure on these gear manufacturers.”

‘If you touch it once, you’re exposed’

This year’s North Carolina Association of Fire Chiefs (NCAFC) 2022 Cancer Survey, which 15 percent of departments completed, revealed that roughly 44 percent of respondents said that there are people within the unit who have cancer. Prostate, skin, colon and brain cancers are the most common cited in the survey, said Wesley Hutchins, executive director of the NCAFC.

Globally, 75 percent of firefighters whose names appeared on the International Firefighters Association’s (IAFF) Memorial Wall between 2015-2020, died of cancer, according to the IAFF.

Research shows that firefighters’ cancer risks are related, in part, to extended exposure to per- and polyfluoroalkyl (PFAS) compounds, also known as forever chemicals because of their lasting presence in the environment. Since the 1940s, PFAS have been used in the manufacturing of oil and water-resistant products, as well as products that resist heat and reduce friction. 

There are more than 12,000 different PFAS compounds used in products such as non-stick cookware, cleaning products, water-resistant clothing and firefighting foam along with firefighting turnout gear.

Last month the IAFF and the Metropolitan Fire Chiefs Association (Metro Chiefs) released a joint statement, warning firefighters of the dangers associated with wearing firefighting turnout gear and encouraging members to only wear the gear in emergency situations. 

“This is the challenge of our generation, and if we don’t act, it will be the challenge of our children’s generation,” said IAFF General President Edward A. Kelly. “We can’t just salute in front of the church and fight for better benefits. We need to combat what’s killing us. 

“I am committed to making sure we do everything we can to extinguish cancer from the fire service. That starts with removing PFAS from our turnout gear and, until PFAS-free options exist, reducing our exposure as best we can.”

Mullins said he was pleased to hear Kelly’s comments. He also said that he and his colleagues welcome the opportunity to wear PFAS-free gear when they’re involved in non-firefighting duties such as community engagement activities. 

“If [we’re] doing events with the kids, we don’t need to be getting in our gear, or we don’t need to be having the kids getting into the gear or touching the gear, because we’ve seen that if you touch it once, you’re exposed.”

To address this issue, the state General Assembly passed the Firefighters Fighting Cancer Act of 2021 (HB 535) which provides supplemental insurance for firefighters who receive a cancer diagnosis “on or after January 1, 2022.”

Mullins and his colleagues pushed for the legislation for years

“We’re very proud of the Firefighters Fighting Cancer Act,” Mullins said.  “We think it’s one of the best pieces of legislation … in the nation.”

Aqueous film-forming foam also on its way out

More attention is going to the environmental impact and human health risks associated with aqueous film-forming foam (AFFF), used by firefighters, airport and military personnel to combat chemical fires. Some AFFF foams contain PFAS, which can seep into groundwater and contaminate wells in areas where it is used repeatedly, such as firefighting training facilities. 

Firefighting foams are some of the sources of the Camp Lejeune contamination

“AFFF gets into the groundwater and we all drink it, which North Carolina is painfully sensitive to [water contamination] these days,” said Graham Peaslee, professor of physics at the University of Notre Dame. “Every time you put a five-gallon bucket of [AFFF] to work, you’ve just contaminated 400 Olympic-sized swimming pools, and that’s at the 70 parts per trillion, so that’s just terrifying.”

Currently, there are at least 15 states where AFFF is banned. The U.S. military is expected to stop using AFFF at its facilities by 2024, according to a report published in the National Fire Protection Association Journal (NFPA).

Traveling particles

As the lead author of a study published in 2020, Peaslee and his colleagues found that in addition to aqueous film-forming foam (AFFF), turnout gear is a pathway to PFAS exposure. 

The study revealed that PFAS compounds can degrade over time and shed or form dust and can transfer from the turnout gear to hands and skin when handled by firefighters. This is true for both new and used turnout gear. 

Peaslee describes how he and his graduate students discovered that PFAS particles can shed and transfer.

“One of the graduate students said, ‘Hey, when I touch the gear with my gloves, my gloves get coated with fluorine.’ And I asked him to demonstrate it. And it’s true—a blank glove has no fluorine on it, and he rubs his hand on the gear, and his glove has fluorine.  We said, ‘okay, gloves for everyone.’”

Time to change standards

Turnout gear manufacturers are capable of producing PFAS-free gear, according to researchers and firefighters. However, the innermost part of the turnout gear is designed to keep moisture from getting in and adding weight to the gear. This is an important feature, because firefighters work in environments where temperatures can reach into the triple digits. 

Since 2006, those moisture barriers have been made with Teflon, a lightweight material manufactured with PFAS, according to Peaslee. Prior to Teflon, the moisture barrier was made of polyurethane, which is PFAS-free. 

But there was a problem. 

According to Peaslee, around the time that Teflon replaced polyurethane as the industry’s choice material for the moisture barrier layer, an ultraviolet light test for turnout gear was developed by a scientist. To pass the test, the material had to withstand direct exposure to the ultraviolet light for 15 minutes without cracking. 

Teflon was the only material that passed the test.

The puzzling part of this test for researchers and firefighters is that the only part of the gear subjected to the test is the moisture barrier.

“If you think about it, this is the undergarment of the jacket and pants that is lined with Teflon. It never sees UV light, it’s not  being exposed to sunlight,” said Peaslee. “Those firefighters, I assure you, do not glow light. 

“So why is this test there? It’s only because the manufacturer found a way to make this the preferred item.”

Jason Burns spoke at the Third National PFAS Meeting, held earlier this summer in Wilmington, about the loss of firefighters due to cancer. He was a part of a group that submitted a resolution during the 2021 IAFF convention.

“We said, ‘we want to break all relationships with these [manufacturers], all sponsorships—we don’t want a dime from them—as long as they’re creating a product that is contributing to the death of our firefighters,’” Burns said.  He noted that nearly three-quarters of firefighter deaths are cancer related.

There is speculation that new regulations regarding moisture barrier requirements have been drafted by the National Fire Protection Association (NFPA) and will eliminate PFAS from turnout gear. The updated regulations are expected to be published soon.

This could be the moment that researchers, firefighters and activists have spent years working toward.

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Will Atwater

Will Atwater has spent the past decade working with educators, artists and community-based organizations as a short-form documentary and promotional video producer. A native North Carolinian, Will grew...

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