Firefighters Fret Over Health Threats From What Protects Them

Firefighter Paul Cotter faced all manner of risks in his 28 years on the job—collapsing buildings, smoke inhalation, heat exhaustion, mental stress. But there was one threat he never considered: the protective garments he wore when responding to calls.

Firefighters’ “bunker gear” contains significant amounts of chemicals known as PFAS, so-called “forever chemicals” that are linked a host of health problems, including prostate cancer—which Cotter battled.

“No one had ever heard of it before,” Cotter said of PFAS in gear.

Recent lawsuits and legislation have focused primarily on the alleged health risks presented by fire-suppressing foams, some of which also contain PFAS. But now, plaintiffs’ attorneys and lawmakers are increasingly looking at the gear worn by firefighters.

Elizabeth Pritzker of Pritzker Levine LLP is one of those attorneys. She’s representing two dozen firefighters in a California district court case against foam makers and manufacturers of personal protective gear worn by firefighters, including 3M Co., W.L. Gore & Associates, and Johnson Controls Inc.

The plaintiffs were all diagnosed with cancers—nine with prostate cancer like Cotter—and had PFAS in their blood well above national averages, which Pritzker called “a substantial causational link.”

“We think it’s going to bring about change in the industry, and ideally give them compensation for their injuries,” she said of her lawsuit.

The companies have all denied wrongdoing. A spokesperson for 3M said that 3M Scott Fire & Safety “uses limited quantities of certain fluoropolymers in components of firefighter protective equipment.”

“3M’s products have been tested and assessed to help assure their safety for their intended uses,” spokesperson Sean Lynch said.

Firefighters and Cancer

PFAS stands for per- and polyfluoroalkyl substances, a group of human-made chemicals that first hit the market as coatings for Teflon pans in the 1950s, and are now found in products like microwave popcorn bags, pizza boxes, carpets, and cosmetics.

PFAS include thousands of compounds, including PFOA, PFOS, and GenX. They are known for their stability and water and heat resistance, thus making them ideal for firefighter gear.

But they are also linked to increased cholesterol levels, changes in liver enzymes, lower infant birth weights, and increases in the risk of kidney or testicular cancer, according to the Centers for Disease Control and Prevention.

It was that link to cancer that led Massachusetts resident Diane Cotter, Paul’s wife, to ask University of Notre Dame professor and nuclear physicist Graham Peaslee to investigate the gear. The resulting study found firefighter textiles had “high levels of total fluorine,” a critical component of PFAS.

Students collecting garment samples for Peaslee had such alarming levels of potentially toxic fluorochemicals on their hands after handling the gear, they were required to wear gloves and take protective measures.

There’s no question there’s PFAS in the gear, Peaslee said. Now it’s a question of whether it’s getting into firefighters’ bodies and accumulating there.

Paul Cotter was diagnosed with prostate cancer in October 2014. He had no family history of cancer. He also didn’t use the PFAS-containing firefighting foams that are being scrutinized for their role in polluting local water supplies with PFAS.

He underwent surgery to remove the cancer, but the development led to an early retirement, cutting short a promotion to lieutenant that came a week before the diagnosis. It also prompted phone calls from friends and colleagues sharing their own tales of cancer battles, and confusion about the source.

“I keep the list,” Cotter said of those calls. “I have about 35 names on the list right now.”

Next Litigation Trend

Hundreds of lawsuits have already been filed against manufacturers of PFAS-containing firefighting foam.

But Pritzker’s California lawsuit was one of the first to also seek damages from turnout gear manufacturers, alleging that firefighter’s uniforms were leading to clusters of cancer outbreaks.

Also looking at the issue is Rob Bilott, a partner in Taft Stettinius & Hollister LLP’s Cincinnati office who was portrayed in the 2019 film “Dark Waters” for his successful litigation against DuPont on behalf of West Virginia residents.

Bilott is leading a proposed nationwide class action out of Ohio whose lead plaintiff, Kevin Hardwick, is a firefighter alleging he’s been exposed to high levels of PFAS through his job.

Notably, the case mentions Hardwick’s exposure to gear “treated and/or coated with materials containing and/or contaminated with one or more PFAS materials.”

Lawyers bringing the proposed class action, which has survived several motions to dismiss, want a court to force the companies to study the effects of PFAS on the human body. They also want to compel the creation of an independent PFAS science panel funded by the manufacturers.

New Research Coming

Manufacturers caution that some substances found in firefighter gear are “polymers of low concern” that shouldn’t be looped in with other PFAS.

These fluoropolymers, which include PTFE, have high molecular weights incapable of crossing cell membranes, don’t bioaccumulate, and are insoluble in water, according to Amy Calhoun, a spokesperson for W.L. Gore & Associates. The company manufactures components that go into turnout gear.

“Our commitment is clearly to the health and safety of the firefighters,” Calhoun said, and making sure their product meets required standards.

At least three other studies—including two federally funded projects—are ongoing to determine the presence of PFAS in turnout gear, how easily it may shed from the gear, and its ability to enter firefighters’ bodies.

“There’s a lot of PFAS chemicals out there, and there are many that we really don’t know what effects they have,” said University of Arizona researcher Jefferey Burgess, who is leading one of the two federally funded studies.

The International Association of Fire Fighters—the country’s largest firefighting union—is also working on gathering research on the safety risks of PFAS, said spokesperson Doug Stern. The union is involved in three studies looking at PFAS levels in firefighters’ blood, PFAS levels in the dust of fire houses, and PFAS levels in turnout gear.

“It’s definitely something that’s a high priority for the IAFF—to look into this and determine whether or not PFAS levels in firefighting gear have a direct correlation to firefighters’ occupational cancer,” Stern said.

‘Burn to Death’

The chemical industry has resisted efforts to ban PFAS in firefighting gear, said Bill Allayaud, the Environmental Working Group’s director of California government affairs, who worked on a recent California law that bans the toxic fluorinated chemicals in firefighting foams.

Tom Flanagin, a spokesman for the American Chemistry Council, said “we do have concerns that restricting PFAS in firefighter turnout gear could put the lives of our first responders in jeopardy.”

Improper turnout gear “can mean the difference between life and death, not just for the firefighter but also for potential fire victims. Despite years of research into potential alternatives, which is ongoing, use of PFAS-based materials remains the only viable option,” he said.

Several states, including California, Minnesota, Kentucky, and Virginia, have begun to regulate PFAS in firefighting foam—but efforts to regulate turnout gear are just beginning. Without good alternatives to PFAS-free turnout gear, lawmakers are crafting and passing legislation that at least mandates gear makers disclose the dangers of exposure to PFAS.

California state Sen. Ben Allen (D) successfully pushed legislation that bans the toxic chemicals from firefighting foams, which Gov. Gavin Newsom (D) signed in September.

There is also a notification requirement of the hazards of chemicals in turnout gear—similar to provisions in recently passed laws in New York, Washington, Colorado, and New Hampshire—that “makes firefighters aware of the chemicals and the risks of them. We want people to be more cognizant of that,” Allen told Bloomberg Law.

“No state has actually banned it in the PPE because at least up until now there hasn’t been a viable alternative,” he said, referring to personal protective equipment. “As much as a firefighter doesn’t want to get cancer 20 years from now, they don’t want to burn to death five seconds from now.”

PFAS or Nothing

But getting PFAS out of gear is next to impossible, said fire prevention officer Sean Mitchell of the Nantucket, Mass., Fire Department.

Mitchell went on the hunt for PFAS-free gear earlier this year after his department received funding to replace older uniforms. He called manufacturing representatives and read research. Several months later, he still hasn’t made a purchase. “There’s nothing out there,” Mitchell said.

The problem is twofold. PFAS presents itself in the water-resistant outer layer of uniforms, as well as the inner moisture barrier that improves garment breathability and provides an additional barrier against fluids.

PFAS-free outer layers are in development and scheduled for sale next year, including a product called PF Zero by manufacturer Safety Components.

But the inner moisture barrier presents complications. Only moisture barriers made with PFAS can meet minimum safety certifications established by the National Fire Protection Association, or NFPA. At issue is a provision—Section 8.62 of NFPA 1971—added in 2007 to the NFPA’s standards for structural firefighting gear. It requires moisture barriers to be able to withstand “40 hours of continuous light exposure.”

The only products on the market that can meet that UV exposure requirement contain Teflon, which uses PFAS in the production process, according to Peaslee. He said the UV test requirement “makes absolutely no sense.”

“I could imagine it being a test on the outside,” Peaslee said. But “they only do it on the inside liner, on the part that never sees sunlight.”

Blowback From Firefighters

Cotter, the long-time Massachusetts firefighter, is now cancer-free. But insisting firefighting gear could be dangerous led to clashes between the Cotters and the IAFF, as well as its affiliated Professional Fire Fighters of Massachusetts. Diane Cotter said many in union leadership won’t talk to them, a development Paul called “devastating.”

Stern, the IAFF spokesperson, denied any efforts to shun the couple, and said the union shares the same goals as the pair but “two different paths to get there,” with the union awaiting further research results.

Professional Fire Fighters of Massachusetts President Richard MacKinnon said his association is also committed to awaiting further studies linking PFAS in gear to cancer, and using the legislative process to enact change.

“I think they’re well-intentioned,” MacKinnon said of the Cotters. “But again, some of their efforts have been contradictory to us.”

Despite disagreements in process, Paul Cotter said he’s encouraged by departments changing how they handle protective clothing as they await PFAS-free alternatives.

“We just need more people to know about it and to demand change,” Cotter said. “We can change it. We can make the fire service a little bit safer.”