AFFF as the Primary Occupational Exposure Source
Firefighters face PFAS exposure through direct skin and respiratory contact with AFFF during training exercises and emergency deployments. Career firefighters at facilities using AFFF regularly — particularly airport crash rescue teams and industrial fire brigades — accumulate PFAS body burdens substantially higher than the general population. Studies of firefighter blood serum consistently show elevated PFAS levels compared to matched general population controls.
Turnout Gear PFAS
Fire-resistant turnout gear — the protective clothing worn by structural firefighters — has historically used PFAS-based durable water repellent (DWR) treatments to shed water and maintain thermal protection. The PFAS compounds in DWR treatments can be absorbed through skin contact and shed PFAS particles that are inhaled. Research at the University of Notre Dame found that new turnout gear contained PFAS at levels comparable to AFFF-containing materials, identifying turnout gear as an additional occupational exposure pathway beyond AFFF.
Cancer Rates in Firefighters
Multiple studies have found elevated cancer rates in career firefighters compared to general population controls, with several cancer types including testicular cancer, non-Hodgkin lymphoma, and mesothelioma showing the strongest associations. While PFAS is not the only occupational carcinogen firefighters face — combustion products, asbestos, and other chemicals contribute — the PFAS-specific evidence base has grown substantially and is increasingly recognized in presumptive cancer coverage legislation for firefighters.
PFAS-Free Alternatives in Transition
The fire service is transitioning away from PFAS-containing AFFF and toward fluorine-free foam (F3) alternatives for non-aviation applications. PFAS-free turnout gear meeting NFPA performance standards has become commercially available, and several fire departments and state agencies have begun transitioning their equipment inventories. These transitions reduce ongoing occupational exposure but do not address the legacy PFAS contamination created by decades of AFFF use at training facilities.