Why Firefighters Have Greater Cancer Risk — and What Departments Are Doing About It

When we think about the dangers firefighters face in the course of their jobs, we often think about hot flames and collapsing buildings. But there’s growing awareness of another serious job risk: cancer.

Over the years, more data has emerged to back up what some fire chiefs were already suspecting.

In 2013, a Tucson firefighter was diagnosed with blood cancer — but he could not get his treatment covered by the state workers’ compensation plan, says then-Captain John Gulotta. The policy only recognized a handful of cancers as likely job-related. That denial meant the firefighter was left fighting with his health insurance to get medications and treatments covered, and cobbling together sick time and vacation days for his absences.

“The reason why they said they denied that presumptive cancer claim is because there was no research proving firefighters even had [carcinogenic] exposures at fires,” recalls Gulotta, who retired last December after 37 years with the Tucson Fire Department.

Gulotta was shocked to learn about this lack of research and turned to University of Arizona Professor Dr. Jeff Burgess — whom the department had previously worked with on other health research — for answers. But to get enough data on cancer risks, researchers would need to find 250 firefighters willing to participate in a study for three years, Burgess told Gulotta. This proved a far easier task than expected: within three weeks, Gulotta had more than twice that many firefighters signed up to participate.

The results of the three-year study showed that firefighters’ work exposed them to certain toxins that can linger in the body for years and eventually cause cancer. With that research in hand, the department lobbied for change.

Since a new law passed in 2021, firefighters in Arizona qualify more easily for workers’ compensation for cancer. They no longer have to identify the specific date and instance where they were exposed to a carcinogen and no longer have to have first undergone five years of hazardous duty to qualify. The law expanded the state’s Workers’ Compensation for firefighters to automatically cover 20 kinds of cancers.

The victory was too late for the firefighter who’d fallen sick. He died before the study ended, and his family received posthumous compensation.

More and more studies have delved into firefighters’ cancer risks — and ways to better protect them. A 2010-2015 U.S. study found firefighters were 9 percent more likely than the general public to be diagnosed with cancer and 14 percent more likely to die from it. By 2022, the International Agency for Research on Cancer determined that occupational exposure as a firefighter wasn’t just “possibly” carcinogenic but definitely carcinogenic. Cancer reportedly caused 66 percent of career firefighters’ job-related deaths from 2002-2019.

Toxic Fires

Buildings and products today incorporate more plastics than in earlier decades. These materials release toxic chemicals when they burn. Firefighters not only breathe in the chemicals whenever they must take off their respirators but also absorb chemicals through their skin.

Firefighters have greater risks of testicular cancer, mesothelioma, multiple myeloma, non-Hodgkin’s lymphoma and a variety of other cancers. Some research suggests female firefighters have an elevated risk of bladder cancer. While more investigation is needed, one factor could be loose-fitting suits, says Burgess, who now leads the University of Arizona’s Center for Firefighter Health Collaborative Research. Women tend to be given gear designed for male bodies, so it fits worse. In a small pilot study, Burgess’ team found that the more, and larger, the gaps were between skin and suit, the more harmful chemicals women absorbed into their bodies.

Firefighters also need to worry about per- and polyfluoroalkyl substances (PFAS), or forever chemicals, in both inflammable materials and their own protective equipment and fire-extinguishing foam. These hard-to-break down substances are often used in waterproofing and nonstick surfaces and remain in the body without breaking down.

With the new research, some of this is starting to change. Manufacturers of firefighters’ protective suits, known as turnout gear, are starting to remove PFAS. Switching to new, forever chemical-free suits does come with some small trade-offs. The new suits absorb water faster and oils can get in more easily, says Russell Osgood, chief education and outreach research officer for the Firefighter Cancer Support Network’s Health and Wellness Advisory Council.

Plus, switching out equipment is expensive. The small fire department in Ogunquit, Maine, where Osgood is chief paid nearly $100,000 to replace just 11 sets of gear.

For their safety, firefighters are being told to wear their respirators not just when actively putting out fires, but also when checking over the areas for any hot spots that could reignite. Experts now realize there are still contaminants in the air at that point, including asbestos, Burgess says. And it’s not just personnel going into fires who ought to wear respirators, but anyone exposed to the smoke, like fire truck operators.

Keeping Suits Clean

Sooty helmets and gear used to be a badge of honor, Gulotta says. Now, however, he wants his firefighters to see it as a health hazard. Fire departments are starting to treat used gear as contaminated. After a fire ends, firefighters need to give their protective equipment a quick wash with soap and water on the scene, before taking it off. Then they should bag it up to transport it, and keep dirty gear away from the parts of the station where firefighters eat and sleep, Osgood says. And firefighters need to shower as soon as possible to get the soot off, limiting the amount of toxins they absorb through their skin.

But keeping firefighters in clean gear isn’t easy, especially if they get called out again soon after responding to an emergency.

Osgood’s Ogunquit, Maine, department has its own extractors — specialized commercial washing machines designed for firefighter suits — and dryers. When his team returns from a fire, it takes about 6-7 hours to get all the gear clean and dry, and the machines together cost about $35,000. Other departments send their gear to off-site laundry services, but this can mean a 72-hour wait to get the items back.

Smaller communities may supply four to five communal sets of “universally sized” gear that firefighters can use while their own set is being washed, and some departments provide each firefighter with their own second set, Osgood says.

Other departments have also been raising awareness of the importance of clean gear. In 2023, New York state officials announced plans to host in-person sessions around the state demonstrating how firefighters can decontaminate their gear after responding to a fire. Officials also gave attendees kits including detergent, brushes, post-fire wipes and other gear-cleaning supplies.

If firefighters run out of clean gear, chiefs can ask a neighboring department to step in to cover the emergency call rather than expose their personnel to carcinogens, Osgood says.

“We have plenty of mutual aid and other departments that help us out. And we can move engine companies around that aren’t at the fire, to cover while the guys are back at the station changing out their gear, taking a shower, getting new uniforms and things like that, so they’re ready to go again,” he says.

Firefighters also should get cancer screenings younger and pay extra attention to the health factors they can control — such as eating well, exercising, wearing sunscreen and regularly getting doctor visits.

Fighting Wildfires

Firefighters confronting wildfires face many of the same risks, with even less protection. Personnel fighting building fires have facial respirators connected to air tanks and more comprehensive protective suits. But that gear is heavy, and air tanks have to be changed out every 15-20 minutes, Burgess says. The gear also traps heat inside, so firefighters can only wear it for short periods before taking breaks to lower their body temperatures. All that is impractical for firefighters who must carry all their gear on hikes into the wilderness, where they’ll spend hours fighting fires.

But wildfire fighters need something. Their gear tends to consist of normal trousers and a lightweight jacket, offering some protection against skin contamination but leaving many gaps, Burgess says. Traditionally, they haven’t had any breathing protection beyond a bandana to tie around their noses and mouths.

The U.S. Forest Service for decades banned wearing masks, asserting they could cause firefighters to overheat. But the agency eased this stance in September 2025. The service will now issue N95 masks to people responding to large fires and will only ban mask-wearing while firefighters are doing hard physical labor, like digging trenches to contain the flames. Other countries take a different approach: Australia, Canada and Greece provide people battling wildfires with half-face respirators with replaceable filters, which block more particles than N95s do.

Research is still ongoing, but Burgess says fire departments appear to be eagerly making use of the findings that emerge.

“The fire departments have done a great job in responding to this increased information,” he says, noting that a growing number of departments that fight structural fires are now washing dirty gear at the scene of the fire and storing gear away from living quarters. “They’re really paying attention to this.”