Understanding PFAS Exposure Risks for US Firefighters

Per- and polyfluoroalkyl substances, commonly known as PFAS or "forever chemicals," are a group of synthetic compounds prized for their resistance to water, grease, and stains. These persistent chemicals do not break down easily in the environment or the human body, accumulating over time and raising serious health concerns. In the United States, career firefighters face disproportionately high exposure to PFAS due to their occupational environment, primarily through contaminated personal protective equipment and legacy firefighting foams.

Firefighters routinely encounter these chemicals during fire suppression activities. Aqueous film-forming foam (AFFF), historically used to extinguish fuel-based fires, contains high concentrations of PFAS. Even as many departments phase out legacy AFFF, residues linger in training grounds, equipment, and wastewater. Turnout gear, the multi-layered protective suits worn by firefighters, incorporates PFAS for water and oil repellency, leading to dermal absorption and inhalation of off-gassed vapors during use and storage.

Studies consistently show that US firefighters exhibit elevated serum PFAS levels compared to the general population. For instance, concentrations of PFHxS (perfluorohexane sulfonate), PFOS (perfluorooctane sulfonate), and related compounds are often significantly higher, with geometric means exceeding those in the National Health and Nutrition Examination Survey (NHANES) benchmarks by factors of 2 to 10 times in some cohorts. This chronic exposure contributes to broader occupational health challenges, including a 9% increased cancer diagnosis rate and 14% higher cancer mortality compared to the general public.

University of Arizona's Landmark Study on PFAS Predictors

Researchers at the University of Arizona's Mel and Enid Zuckerman College of Public Health have led a pivotal investigation into the drivers of PFAS accumulation in firefighters' blood. Published on January 19, 2026, in the Journal of Occupational and Environmental Medicine, the study draws from the Fire Fighter Cancer Cohort Study (FFCCS), analyzing serum from 2,056 structural firefighters across six states between July 2023 and October 2024.

Lead author Reagan Conner, a public health doctoral student, collaborated with co-lead Melissa Furlong, PhD, an assistant professor of environmental health sciences, and a multidisciplinary team including Jeff Burgess, MD, MS, MPH, professor in community, environment, and policy. Fire service partners like Captain Orion Godfrey from Goodyear Fire Department contributed practical insights. The work stems from the Center for Firefighter Health Collaborative Research, a hub dedicated to mitigating occupational risks through data-driven interventions.

"These study findings underscore the importance of occupational practices in shaping PFAS exposure among firefighters," Conner noted. The research identifies actionable predictors, empowering departments to implement targeted reductions.

Methodology: A Robust Cohort Approach

The study employed comprehensive surveys from individual firefighters and their agencies, capturing demographics, lifestyle factors, occupational exposures, and departmental policies. Serum PFAS concentrations were quantified using advanced laboratory techniques, evaluating associations via statistical models with significance at p ≤ 0.05. This large-scale, multi-state design ensures generalizability across US career fire services.

By integrating self-reported data with biomarker measurements, the researchers isolated both personal and systemic contributors, providing a holistic view absent in smaller studies.

Key Predictors Identified: Occupational and Personal Factors

The analysis pinpointed eight significant predictors spanning individual habits and departmental protocols. Here's a breakdown:

• Post-fire on-scene decontamination: Inadequate cleaning routines after fires correlate with higher PFAS uptake from soot and residues.
• Turnout gear storage and transportation: Storing contaminated gear in station living areas or personal vehicles facilitates off-gassing and secondary exposure.
• Using aqueous film-forming foam (AFFF): Direct handling of legacy foams during operations elevates serum levels.
• Carpet in fire station living quarters: Porous materials trap and release PFAS particulates over time.
• Drinking water source: Contaminated municipal supplies amplify body burdens.
• Military service: Prior exposures from military AFFF training contribute cumulatively.
• Rank and years of service: Senior roles with more fires link to prolonged accumulation.
• Plasma or blood donation: Regular donations lower circulating PFAS, acting as a natural detox.

These factors explain variations in specific PFAS like PFOS and PFHxS, guiding precise interventions.

Health Implications: Linking PFAS to Firefighter Outcomes

Accumulated PFAS in firefighters heighten risks for immune suppression, thyroid disruption, elevated cholesterol, and cancers including prostate, testicular, and kidney. Epigenetic studies from UArizona reveal PFAS-induced gene changes accelerating biological aging and chronic disease. Cardiovascular strain and reproductive issues further compound the toll, underscoring the urgency of mitigation.

For those pursuing careers in public health or research jobs, understanding these links highlights opportunities in occupational epidemiology.

Broader Context: AFFF, Gear, and Regulatory Shifts

AFFF remains a primary exposure vector despite federal phase-outs; the EPA mandates fluorine-free alternatives by 2024, but legacy stocks persist. Turnout gear PFAS content varies, with states like California and New York banning new purchases post-2027. Ongoing lawsuits against manufacturers seek accountability for health harms.

University of Arizona study page details practical steps. For PFAS-free gear innovation, explore higher ed research assistant positions.

Prior UArizona Contributions to Firefighter Health

The Center has produced seminal work, including elevated PFAS in healthcare workers and epigenetic cancer links. Interventions like blood donation show promise in lowering levels, as piloted in the Firefighter Collaborative Research Project.

This body of research positions UArizona as a leader, attracting funding and collaborations.

Pathways to Reduction: Actionable Insights

• Implement gross decontamination at scenes with wipes and water.
• Store gear in dedicated ventilated spaces.
• Transition to PFAS-free foams and gear.
• Encourage regular blood donations.
• Test station water and upgrade carpets to hard surfaces.

"Our fire service partners are already using this information," Furlong shared. Aspiring academics can contribute via academic CV tips.

Policy and Future Directions

Federal grants from FEMA and state initiatives fund ongoing trials. Future research targets wildland firefighters and women-specific risks. Higher education plays a crucial role, training experts for these challenges—consider faculty positions in public health.

As PFAS regulations evolve, UArizona's predictors study offers a blueprint for safer practices nationwide.

Photo by Walter Martin on Unsplash

Conclusion: Empowering Firefighters Through Research

This UArizona-led breakthrough illuminates modifiable risks, fostering healthier careers. Explore opportunities at Rate My Professor, higher ed jobs, career advice, university jobs, or post a job.