Those Who Served: PFAS Exposures in Military Veterans
Military veterans—who sacrificed to serve their country in roles that exposed them to AFFF and PFAS-contaminated environments—face a healthcare system still developing its understanding of PFAS-related health conditions and its processes for establishing service connection. The Department of Veterans Affairs (VA) healthcare and benefits systems are navigating complex questions about which health conditions qualify as service-connected PFAS illnesses, how to document veteran PFAS exposure histories given incomplete military records, and how to provide appropriate healthcare monitoring for veterans with probable PFAS exposures. Veterans and their advocates are pushing for more comprehensive PFAS health protections within the VA framework.
Veterans’ PFAS Exposure Pathways
Military personnel were exposed to PFAS through multiple service-related pathways. Firefighters and crash rescue specialists—the most intensively AFFF-exposed military occupational specialties—participated in regular AFFF training exercises using undiluted foam concentrate and lived in base housing near contaminated training areas. Aircraft maintenance crews worked with PFAS-containing hydraulic fluids, cleaning solvents, and surface treatment chemicals. Ground personnel on flight lines and at fuel storage areas were exposed to AFFF-contaminated soil and water during normal duty activities. Personnel living in on-base housing served by contaminated groundwater consumed PFAS-contaminated water for the duration of their base assignments.
Documenting individual veteran PFAS exposure is complicated by the absence of systematic military PFAS exposure records. Unlike radiation exposure (tracked through dosimetry programs) or Agent Orange (documented through Vietnam deployment records), PFAS exposure during military service was not systematically monitored or recorded. Veterans relying on service connection claims must often reconstruct exposure histories from unit records, duty station assignments, and witness testimony—a process that disadvantages veterans without documentation support and that the VA’s exposure evidence framework is beginning to address through “toxic exposure presumptives” modeled on Agent Orange precedents.
The PACT Act and PFAS
The Sergeant First Class Heath Robinson Honoring our Promise to Address Comprehensive Toxics (PACT) Act of 2022—which significantly expanded VA benefits for veterans exposed to toxic substances including burn pits and Agent Orange—represented a landmark legislative achievement but has limited specific PFAS provisions. The PACT Act required the VA to conduct research into PFAS health effects and to report on establishing PFAS-related presumptive service connections—acknowledging PFAS as a priority toxic exposure requiring further regulatory development rather than immediately establishing service connection for specific PFAS health conditions.
Veterans advocacy organizations including the Military Officers Association of America (MOAA), the Veterans of Foreign Wars (VFW), and PFAS-specific veteran groups are pushing for expanded PFAS provisions in VA benefits—including presumptive service connection for cancers documented to be associated with PFAS exposure in occupational cohort studies. The scientific evidence from firefighter PFAS cancer studies and from the AFFF MDL litigation that established kidney cancer and bladder cancer associations provides the basis for these advocacy efforts, following the model of Agent Orange cancer presumptives that were established through similar advocacy-research-legislation pathways.
VA Healthcare PFAS Response Programs
The VA is developing PFAS health monitoring programs for enrolled veterans with probable PFAS exposures, including baseline PFAS blood testing for veterans who served at documented AFFF-using installations. Several VA Medical Centers have established environmental health clinics that evaluate veterans for PFAS and other toxic exposures, providing individual exposure assessments and health monitoring recommendations. The challenge of reaching the millions of veterans potentially exposed to PFAS during military service—many of whom are not enrolled in VA healthcare or are not aware of their potential exposure—requires proactive outreach through military unit networks, base alumni groups, and primary care providers who serve veteran populations.