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By David Santos, Colton FD
As someone who has spent more than two decades in the fire service, I’ve read a lot of research about firefighter cancer risk. Some studies raise concerns. Others confirm what we already suspect. But every once in a while, a study comes out that moves the conversation forward in a practical way.
A recent peer-reviewed study published in January 2026 in the Journal of Occupational and Environmental Medicine did exactly that. Researchers from the University of Arizona analyzed blood samples from more than 2,000 career firefighters across seven states, including California. Their goal was simple but important: identify what factors are associated with higher or lower levels of PFAS in firefighters’ blood. The results matter to every one of us.
Why PFAS Is a Firefighter Issue
PFAS—per- and polyfluoroalkyl substances are synthetic chemicals used in aqueous film-forming foam (AFFF), certain protective gear components, and many industrial and consumer products. They are persistent in the environment and in the human body. Once they enter the bloodstream, they remain for years.
Multiple health agencies have linked specific PFAS compounds to cancer and other chronic health conditions. For firefighters, exposure pathways are well known: foam, fire-ground smoke, contaminated dust, station environments, and in some cases drinking water.
In this study, every firefighter tested had detectable PFAS in their blood. That finding alone underscores the occupational nature of this issue.
But the most important takeaway wasn’t just that PFAS is present it was that levels varied significantly depending on behavior and department policy.
What Was Associated with Higher Levels
The researchers identified several factors linked to elevated PFAS levels. Some were predictable, others less so.
Firefighters who relied on well water as their primary drinking source tended to have higher concentrations. Unlike municipal systems, private wells are not regulated in the same way and may go untested for contaminants.
Active use of legacy firefighting foam products was also associated with increased levels of certain PFAS compounds. Additionally, individuals with prior military service showed higher concentrations likely reflecting historical exposure patterns.
Environmental factors within stations also appeared relevant. Carpeted living areas were associated with higher levels of certain PFAS markers. And, as expected, more years on the job and increasing age correlated with greater accumulation.
In short, exposure builds over time. But that’s only half the story.
What Was Associated with Lower Levels
The more encouraging findings centered on actions that correlated with reduced PFAS levels.
One of the strongest associations was with blood and plasma donation. Firefighters who donated plasma showed substantially lower levels of certain PFAS compounds, with whole blood donation also demonstrating measurable reductions. The science behind this is straightforward: PFAS binds to proteins in the blood. Removing blood or plasma removes some of the chemical burden along with it.
Drinking water source mattered as well. Firefighters who used bottled water or reverse osmosis filtration systems tended to have lower PFAS concentrations compared to those drinking untreated well water.
Operational practices made a difference too. Firefighters who performed structured on-scene decontamination specifically a soap, scrub, and rinse process on turnout gear had lower levels of certain PFAS compounds. Departments that required gear cleaning before storage saw similar trends.
Even station housekeeping practices appeared relevant. Regular dust removal in living quarters and structured hood cleaning programs were associated with lower PFAS measurements.
What stood out to me his this: policy matters. Culture matters. Routine matters.
Beyond Minimum Compliance
Interestingly, simply meeting baseline gear maintenance standards did not appear to be enough to influence PFAS levels. What seemed to make a difference were clear, enforced expectations washing gear before it goes back into service, keeping contaminated equipment out of living areas, and maintaining clean station environments.
This reinforces something I often say about safety programs: writing a policy is not the same as operationalizing it. Consistency and accountability are what drive results.
What This Means for Us
As firefighters, we accept that risk is part of the profession. But unnecessary exposure should not be.
This research does not suggest panic. It does suggest opportunity.
At the individual level, we can:
- Consider regular blood or plasma donation if medically eligible.
- Evaluate our home water source, especially if relying on a private well.
- Commit to thorough on-scene decontamination every time not just at large incidents.
At the department level, leaders should be asking:
- Has station water been tested recently?
- Are we enforcing gear cleaning before storage?
- Do we support hood rotation or cleaning programs?
- Are our living quarters designed to minimize contamination transfer?
None of these steps eliminate PFAS exposure entirely. But this study suggests they can reduce measurable levels in the bloodstream, That matters.
A Long Game, Not a Quick Fix
PFAS compounds remain in the body for years. No single intervention erases decades of exposure. But incremental reductions over time may translate into meaningful long-term health benefits.
For those who have been on the job 20 or 25 years, this is not a message of “too late.” It is a reminder that what we do today still has value. Reducing ongoing exposure is still progress.
Firefighter cancer prevention is not solved by one study. But this research adds clarity. It connects policy decisions to biological outcomes. It gives us data to support funding requests, operational changes, and cultural expectations.
As leaders and professionals, we owe it to our people to stay informed and to adapt based on credible evidence.
We cannot control every hazard in this profession. But when research shows that specific actions correlate with lower exposure, ignoring it is not leadership.
The fire service has always evolved based on lessons learned. This is one more lesson grounded in data, measured in blood samples, and directly relevant to every station in this country.
The question now isn’t whether PFAS is present. It is whether we are willing to act on what we know.
View Journal of Occupational and Environmental Medicine Study by University of Arizona Predictors of serum per- and polyfluoroalkyl substances (PFAS) levels among U.S. career firefighters (PDF 2.3mb)
About the Author
David Santos
Colton FD
[email protected]