Chemicals in Firefighters’ Gear Could Lead to Illness

“Every firefighter knows there is a link between the job and occupational illnesses, including cancer. The studies prove it,” said Edward Kelly, president of the International Association of Firefighters.

Firefighters are routinely exposed to carcinogens in fumes from burning buildings and vehicles. It’s an occupational hazard, and they know this from the start. While people who perform certain occupations understand the associated risks, there’s a risk that firefighters might not have anticipated: the risk of carcinogens in their turnout gear.

“Turnout gear” is the personal protective equipment a firefighter wears to stay safe from high heat, direct flame, sharp objects, and more. It consists of a thermal liner, moisture barrier, and outer shell. It must be tough and durable, but still allow for comfort and breathability to reduce fatigue and heat stress while fighting a fire.

A series of articles in North Carolina Health News is bringing awareness to risks specifically facing firefighters.

Controversy has erupted over cancer-causing chemicals within turnout gear. The outermost layer and inner moisture barrier are typically coated with Per- and Polyfluorinated Substances (PFAS) to repel liquid like oil and water. PFAS are included in a category called “forever chemicals”, which are highly persistent chemicals that don’t occur in nature.

Exposure to forever chemicals can be dangerous and is linked to cancers, weakened immune systems, weight gain, and a variety of other health risks. The CDC considers PFAS a public health concern.

Workers’ compensation implications for firefighters’ PFAS exposure

It’s been traditionally difficult for firefighters to receive cancer-related claims for workers’ compensation benefits.

One difference between workers’ compensation claims (in any industry or occupation) and a personal injury lawsuit is that when you claim workers’ comp, you don’t need to prove negligence. In other words, the injury or illness doesn’t have to be caused by anyone’s fault. Instead, you need to prove that it happened while you were at work or engaged in duties related to your job.

Firefighters facing the burden of proof that their cancer was caused by conditions at their job were rarely successful. They would have to prove which carcinogen they were exposed to and when the exposure occurred.

Are firefighters exposed to PFAS in ways other than from their turnout gear?

Yes, and that is part of the problem with the burden of proof.

There are so many PFAS used in everyday items—electronics, makeup and personal care products, carpets and upholstery, waxy food wrappers, sweat-resistant workout clothes, raincoats and umbrellas, dental floss, nonstick cookware, and numerous other common goods. When a structure catches fire, smoke from the burning materials could contain PFAS or toxic compounds. It can settle on turnout gear because of airborne particle accumulation while fighting the fire. In addition, there are individuals on scene at a fire like incident commanders, EMTs, and people who operate engines and pumps, who are not wearing respiratory protection. These individuals can also be exposed to carcinogens on the job.

Even outside of an active scene, when dust settles on the turnout gear that’s returned to the fire station, it’s not always cleaned thoroughly. PFAS have been detected in dust in and around firehouses, and it’s impossible to know whether it’s from the fabric of the turnout gear or was picked up at a fire scene.

The National Institute of Occupational Safety and Health reported in 2019 that firefighters develop cancer at a rate that is 9% higher than the general population and their risk of dying from cancer is 14% higher.

Congress acts to reduce the burden of proof for firefighters’ workers’ compensation claims

Finally, Congress acknowledged this risk. The National Defense Authorization Act now includes a provision that federal firefighters may file for presumptive benefits, which means that if a firefighter is diagnosed with certain cancers, the cause is presumed to be from their occupation. This would allow a firefighter to receive workers’ compensation benefits for a cancer claim.

This is good news for firefighters as it will hopefully lead the way for state workers’ compensation laws to change, too.

Can we make firefighting safer?

Researchers and other experts are asking this question, and working hard to find an answer. It is possible to create turnout gear without PFAS in the fabric, but then it could increase risks of short-term injuries because the firefighters’ gear is less protective.

It’s not just water that PFAS repels; it also can repel liquids like oil or fuel, which could prevent a firefighter from being burned in a hot environment. It also allows moisture vapors to escape.

However, if we can determine that the turnout gear is only a small portion of a firefighter’s cancer risk, then it’s a mixed outcome. On one hand, firefighters might not need to sacrifice important and potentially life-saving PPE. On the other hand, chemicals in coal, crude oil, and gasoline could also result in long-term health problems like cancers. So, it would then be back in the hands of legislators to determine whether or not any cancer in a firefighter could be attributed to working conditions.

North Carolina laws for workers’ compensation and occupational disease

North Carolina General Statute § 97-53 sets forth a list of conditions that qualify for workers’ compensation benefits; your illness is not required to be included in the list to qualify for workers’ compensation, however. The worker must prove that their employment caused or substantially contributed to their condition.

If the employee has been exposed to the same health risk while employed by more than one employer (i.e. if you worked for one fire company for a number of years and then a different one), the workers’ compensation claim would be attributed to the most recent employer.

North Carolina General Statute § 97-53 (13) specifies that a worker can seek compensation for any disease “which is proven to be due to causes and conditions which are characteristic of and peculiar to a particular trade, occupation or employment, but excluding all ordinary diseases of life to which the general public is equally exposed outside of the employment.”

The worker must show that:

1. Their employment put them at increased risk as compared to the general public for developing their specific occupational disease; and
2. The employment substantially contributed to their occupational disease.

This would be proven through medical evidence and a doctor’s testimony.

It’s important to note that there are specific deadlines for filing an occupational disease workers’ compensation claim. Unlike an immediate injury at work (burn injury, head injury, etc.), an occupational disease could take years or decades to have symptoms.

The worker must file a claim with the North Carolina Industrial Commission within two years of either the date of diagnosis of the disease or the date the employee first becomes disabled from the disease, whichever is later.

What if you’re a firefighter with a disease linked to PFAS or other toxins?

If you were diagnosed with a disease that’s linked to PFAS or other toxins, and if you’ve been a firefighter, you could be eligible for workers’ compensation.

Each state has its own workers’ compensation laws, but most offer these benefits:

• Medical treatment related to the work injury or occupational disease
• Lost wages
• Survivor benefits if the employee dies from the work-related injury or illness

Long-term occupational diseases are complicated when it comes to workers’ compensation—for anyone, not just firefighters—and it’s important to seek the guidance of a qualified workers’ compensation attorney.