Firefighters are one of the highest risk groups when it comes to PFAS. For decades, it was a key ingredient in aqueous film-forming foams. It is used extensively in their turnout gear thanks to its unique properties. It is also widely released during structural fires and potentially even wildland fires. Studies routinely find that firefighters have far higher levels of PFAS in their blood than the general population. At the same time, they also face increased levels of cancer, cardiovascular disease, and other occupational illnesses linked with PFAS. The upshot is, PFAS is directly costing fire departments through lost man-hours, reduced productivity, and early retirement.
What are PFAS compounds
PFAS compounds, aka “forever chemicals” or per- and polyfluoroalkyl substances, are man-made compounds that have been used for decades. They have some unique chemical properties that make them extremely useful in many applications. Unlike most compounds, they can both attract and repel water and grease. As a result, they are used for applications such as:
- Breathable membranes in modern clothing
- Water- and grease-repellant coatings on fabrics
- Non-stick coatings on cookware
Why are PFAS used in AFFF?
From the 1970s, PFAS were also widely used in the manufacture of aqueous film-forming foams (AFFFs). Their unique surfactant properties made them ideal for creating effective fire-extinguishing foams. Initially, such PFAS-containing foams were used in military contexts, but they soon began to be used globally, especially in aviation. In fact, by the 2000s, the Federal Aviation Administration mandated the use of foams that met the specifications laid down by the Department of Defense. In effect, this made the use of PFAS in AFFF compulsory.
PFAS and turnout gear
Turnout gear has to meet incredibly high standards in order to protect firefighters in the extreme conditions found in live fires. In the US, this means meeting the requirements laid down in NFPA 1971 (soon to be replaced by NFPA 1970). This catchily titled document, “Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting,” defines in exacting detail the performance requirements of turnout gear. This includes the need to be waterproof, heat resistant, and to shed oil and grease. PFAS chemicals are almost the only substances that can meet all these requirements. As a result, virtually all turnout gear tested by NIST has been shown to contain and release significant levels of PFAS.
PFAS in smoke
PFAS compounds are found in a huge variety of household objects including furnishings, carpets, and insulation. They are also widely used in industrial settings. As a result, structural fires have a high risk of releasing PFAS compounds. Recent research also suggests that PFAS may be much more readily absorbed through the skin, so protecting against PFAS in smoke is that much harder. Every fire incident could be a source of PFAS exposure for those responding to the fire. Worryingly, significant numbers of natural water sources are highly polluted with PFAS as well. One study earlier this year showed that the entire Great Lakes Area is polluted, with PFAS even falling in rain. So, water used to fight wildland fires may also be releasing PFAS aerosols.
The impact on firefighters
The result of all this is that firefighters have been exposed to far higher concentrations of PFAS than the general public. Indeed, research shows that firefighters have 53% more PFAS in their bodies on average. PFAS is linked with an increasing range of serious health conditions, many of which are known to be more prevalent among firefighters.
Cancer
It’s well known that firefighters face an increased burden of cancer. They are at 9% increased risk of developing any form of cancer, and for some, the risk is more than doubled. Moreover, they have a 14% increased mortality from cancer, despite increased screening relative to the general population. Many types of PFAS are linked with cancer. For instance, the IARC classifies PFOA (perfluorooctanoic acid) as a Group 1 carcinogen due to evidence of epigenetic alterations and immunosuppression as well as links with kidney and testicular cancer.
Cardiovascular disease
Multiple studies have linked PFAS with cardiovascular disease or CVD. CVD is a collective term for diseases that involve the heart or blood vessels. The two most commonly known types are heart attacks (myocardial infarctions) and strokes (cerebrovascular accidents). PFAS appears to play a complex role in CVD. A 2023 meta-analysis found a quantitative association between PFAS blood levels and cholesterol levels. It is also linked with inflammation and other CVD risk factors. Heart attacks are the number one cause of firefighter deaths linked to active firefighting.
What can fire departments do about PFAS?
It’s hard to quantify the cost, but PFAS is likely to account for many years of lost service time across the fire service. PFAS is also at the center of a growing number of lawsuits. Over time, this is going to start creating unsustainable costs for fire departments. There are three ways fire departments can handle the firefighter PFAS crisis.
Reduce or eliminate PFAS exposure through turnout gear
PFAS-free turnout gear is still in its infancy. However, manufacturers are increasingly aware of the controversy around PFAS. So, expect to see this becoming more readily available. Meanwhile, try to reduce the unnecessary use of turnout gear by your firefighters on jobs that don’t require it. Also, keep following the best practices for excluding turnout gear from living quarters in the firehouse.
Reduce PFAS exposure in the firehouse
One of the most common sources of PFAS exposure for many people is through food and drink. Almost 100M Americans use water supplies that are contaminated with PFAS. PFAS is also used in many unexpected ways, like to provide greaseproof coatings on food wrappers, or to make cardboard takeout and drink containers waterproof. All these risks can be reduced in the firehouse with careful thought and planning,
Provide regular PFAS testing for firefighters
One important thing is to know how bad the problem really is. And that means getting your firefighters tested for PFAS. Almost everyone has some level of PFAS in their blood. However, higher levels indicate increased risk according to a huge report from the National Academies of Science Engineering and Medicine.
Our fire department PFAS testing is designed specifically to address the needs of firefighters and fire departments. It is designed to be taken at home or in the firehouse and only requires a few drops of blood from a finger prick. That makes it far less invasive than most alternative tests. It identifies 18 PFAS compounds that are known to be linked with turnout gear and AFFF, and results are available in just a few days. We provide detailed guidance for firefighters to help reduce exposure. We also provide a longitudinal timeline in our app so that exposure can be checked over time. We also provide fire departments with detailed statistical insights to allow comparisons with other departments and the general public.