In today’s firefighting world, it’s no longer a surprise that our structural firefighting gear contains per- and polyfluoroalkyl substances (PFAS), commonly known as “forever chemicals.” These substances are virtually unavoidable; they pervade our environment, appearing everywhere we turn in both our personal and work environments. However, as firefighters, we face a unique and heightened risk from these chemicals.
- Understanding the Impact of PFAS in the Fire Service
- Researcher Responds to Claims About PFAS, Firefighter PPE
- It’s Time for Firefighters to Demand PFAS-Free PPE
- Your Gear, Your Life: Firefighter PPE Toxins and What to Do About Them
A Sobering Reality
Firefighters have a significantly higher chance of being diagnosed with and dying from cancer. Many of us entered this profession without fully understanding the extent of this risk. For those who were informed, the weight of this knowledge is a heavy burden. The statistics are clear that firefighters have a 9% increased risk from the general population of being diagnosed with cancer. Additionally, firefighters have a 14% higher risk of dying from cancer than the general population does.
At the 2023 International Association of Firefighters (IAFF) Fallen Fire Fighter Memorial, almost 66% of the names added to the wall were members who had died from occupational cancer. In 2023, 72% of the line-of-duty deaths (LODDs) of IAFF members were from occupational cancer. In Canada, where most provinces and territories have robust presumptive laws, close to 94% of LODDs among professional firefighters are the result of occupational cancers.
Reflecting on my own career, I cringe at the memory of thinking that a dirty helmet and structural firefighting gear was a badge of honor. I was wrong, and I wish I had known better.
Although we cannot eliminate PFAO exposure, we can take steps to minimize the risk to ourselves and our family. During my tenure as a battalion chief and deputy chief, I mandated that my shift and department members wore their gear to every call, without exception. Today, if I were in that position, I would implement a different approach: I would establish a policy to wear structural firefighting gear strictly for structural fire-related calls. I am fully aware that we must always be ready to act to save someone in our community. I fully understand that seconds matter. I also remember sleeping in the firehouse with my structural firefighting pants on the floor in the bunk room next to my bed. When we were ordered to no longer bring our gear into the bunk room, I was not happy and felt I would be delayed in getting out the door. Over the following years, I learned the value of not having that gear in the bunk room, and there was no increased delay to serve the citizens. This was a cultural change that took a long time to get accustomed to. Today, I am positively optimistic there is not a firehouse in the country that allows structural firefighting gear in the bunk room area.
To Wear Turnout Gear or Not to Wear Turnout Gear
One significant measure to reducing your risk to PFAOs is not wearing your structural firefighting gear for training sessions—unless live fire or protection from cuts and abrasions necessitates it. Gear should not be worn for non-structural calls such as public service, motor vehicle accidents, EMS, outdoor fire emergencies, or any other routine activities like getting meals or heading out for a “ride.”
Let’s talk about the pump operator’s role. Many pump operators wear their structural gear in this role (I certainly did). In addition to wearing my structural pants I would also always were my structural firefighting jacket. I can argue that driving while wearing the jacket, pants, and boots can contribute to decreased mobility and increased pedal issues while driving. In a department with minimal staffing, I can fully understand the mentality that you must be ready with structural firefighting gear on for an unanticipated emergency requiring your role to change. However, it is a personal choice and a department’s standard operating guideline (SOGs) should be looked at, since each department operates differently and has different expectations for each riding position.
Moreover, I would enforce a strict policy against having family, friends, or children pose for pictures in our gear. This includes fire prevention activities. This gear is not a costume; it’s a tool that carries serious risks, and those risks should not be extended to our loved ones.
Leadership of departments who have not yet begun to understand this thought process should start by researching and understanding per- and polyfluoroalkyl substances (PFAS) and their impact on firefighters. Do you know that the children of firefighters have an increased cancer rate? Yes, the risks that firefighters accept are also passed down to their families.
Some research suggests that children of firefighters may have an increased risk of cancer. For example, one study found that children of career firefighters in Kitsap County, Washington, have a 27.4 times higher chance of developing cancer than the general population.
As a policy maker, can you completely eliminate the cancer risk? No, of course not. However, there are many actions you can and should take to reduce the risk to your membership and their family.
A Cultural Change
Here are some measures to policies and best practices to consider for your department:
- Limiting PPE usage
- Consider using non-structural gear for non-structural calls (technical rescue, motor vehicle accidents, wildland urban interface, public service calls)
- Smoking cessation assistance
- No tobacco use policy
- Exhaust capture systems
- Gear exchange or provision of a second set of gear
- Gross decontamination procedures, including on-scene wipes and mandating a shower within the hour
- Self-contained breathing apparatus mask mandates during overhaul until the building is cleared by meters
- Ensuring clean equipment in the cab
For some agencies, these steps may be simple to implement; others may find it more difficult. Consider, however that the on scene use of wipes decreases the cancer risk by 54% and proper gross decon of gear decreases the risk by 85%. Fire service leaders must realize the importance of reducing the risk where and when we can.
By implementing these strategies, you can significantly reduce the cancer risks for your firefighters and, by extension, their families. While you may not be able to eliminate the risks entirely, taking proactive steps to minimize them is crucial for the health and safety of your team.
To truly protect ourselves and future generations of firefighters, we need a cultural shift. It is imperative that we learn to reduce our risk by changing how and when we wear our gear. By making these adjustments, we can continue to serve our communities while safeguarding our health and well-being.
Let’s make a commitment to this change—starting today.
P.J. NORWOOD is the director of training for the Connecticut Fire Academy. He is a retired deputy chief from the East Haven (CT) Fire Department. He is on the Fire Engineering/FDIC Advisory Board and serves as UL-FSRI Technical Panel member, Fire Dynamics instructor, and Training Advisory Committee member.
