By Will Atwater
Firefighting has been shown to be a carcinogenic occupation — depending on the situation, firefighters can encounter toxic fumes and particulate matter during a fire. For years, those within the firefighting community have worked to reduce the health risks associated with their work.
But recently, researchers have shown that fluorinated compounds applied to firefighters’ protective gear to repel liquids can contribute to cancer-related illnesses. 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.
Firefighters’ personal protective equipment is treated with per- and polyfluoroalkyl substances (PFAS), which repel moisture and limit the chances that personal protective gear doused by flammable fluids would ignite during a fire event.
But PFAS are increasingly linked to adverse health outcomes, including cancer, increased cholesterol levels, pre-eclampsia and high blood pressure in pregnant women — something that’s drawn increasing attention in firefighting circles.
“The health and safety of our members is non-negotiable, period,” said Edward Kelly, general president of the International Association of Firefighters at an industry function earlier this year. “If manufacturers or regulatory groups refuse to acknowledge and work to remove these toxic chemicals from the protective gear firefighters wear, our members have no other viable remedies than to challenge these practices in court.
“We will take this battle wherever we need to.”
Now, though, a study suggests that PFAS-free equipment may not be as effective in repelling hazards firefighters may encounter during a fire — such as flammable liquids.
Lab vs. ‘the real world’
“All oil repellents can also repel water, but all water repellents don’t necessarily repel oil,” said Bryan Ormond, assistant professor N.C. State University’s Wilson College of Textiles, a co-author of the study.
Diesel fuel is really difficult to repel, as is hydraulic fluid, Ormond said. “In our tests, turnout gear without PFAS repelled water but not oil or hydraulic fluid.”
Further, oils seem to spread out and soak into the PFAS-free gear, potentially increasing the hazard that these materials could become combustible even as they’re still being worn by firefighters, putting them at risk.
Ormond and his co-authors found no difference, however, in how PFAS-free gear held up to “job-related exposures like weathering, high heat, and repeated laundering, and whether the garments remained durable and withstood tears and rips,” according to a news release from N.C. State.
They found that both sets of gear “performed similarly after exposure to UV rays and various levels of heat and moisture, as well as passes through heating equipment — similar to a pizza oven — and through washing machines.”
“Firefighting as a job is classified as a carcinogen, but it shouldn’t have to be,” Ormond said. “How do we make better gear for them? How do we come up with better finishes and strategies for them?
Ormond said that one of the limitations of this study is that in a lab setting researchers can’t duplicate exactly the conditions faced by firefighters during a fire. For instance, Ormond questions how close lab testing conditions are to what firefighters experience during a live fire.
“[In the lab] we have different pressures that liquids may be splashed and different conditions that [a firefighter] would see in a structure fire, or a car accident,” he said. “It’s that hard thing — translating lab scale testing to the field.”
Switching out gear
Scott Mullins, president of the Professional Firefighters and Paramedics Association of North Carolina, is familiar with Ormond’s study. He said he is not concerned with its findings and said they have protocols to address concerns about repellency issues.
“In the real world, if a firefighter gets into diesel or oil, or whatever they’re doing, [they’re] not going to continue wearing their gear around — that’s why we have two sets of gear,” he said. “[When] they get back to the firehouse, they’re going to take their gear off and wash it. That’s the reality of it.”
Joseph Vindigni, deputy director of the Wake County Fire and Rescue Service, said that firehouses in the county will follow the procedure that Mullins laid out for dealing with firefighting PPE that comes into contact with liquids such as oil or diesel fuel.
“In Wake County, during our budget process last year, we set aside money for second sets of turnout gear for all the members in the not-for-profit departments,” Vindigni said. “A lot of our municipalities are already doing two sets a year, [and] now we’re doing it for all the other departments in Wake County as well.”
The problem is that if firefighters are at an event where they’ve been splashed with oils, they may not have time to change on site.
Vindigni explained that during a fire, if a firefighter’s gear is soiled by oils or diesel fuel, for instance, “they’ll come back to the station, they’ll shower, switch out the gear with a new set and wash the gear that was exposed.”
What’s next?
As PFAS-free gear becomes available, it’s unclear whether the industry will adopt additional safety procedures other than requiring firefighters to replace soiled gear at their stations.
And these days, firefighters are being encouraged to only wear protective gear when necessary to minimize exposure to PFAS. That means taking it off promptly and not wearing the gear during parades and presentations at schools and other events.
In 2024, Mullins said that in select cities such as San Francisco, Ottawa and Denver, fire departments will be testing out PFAS-free gear, so more information on that equipment’s performance will start to come in.
Meanwhile, Ormond expects results from a dermal exposure study he and colleagues are working on. His co-author Andrew Hall, a N.C. State University doctoral student, is conducting research on how readily PFAS gets absorbed through the skin to help identify the level of risk from PFAS-coated gear.
Another question yet to be answered is whether PFAS-free gear will be more expensive. If that’s the case, replacement costs will be an issue for departments.
Ormond stresses that the PFAS-free gear study findings should not be a cause for alarm.
“We can make this transition in the firefighting service to nonfluorinated finishes, but we just need to acknowledge and understand that it’s going to be different, and it’s okay that it’s different,” he said.
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