WHY IT MATTERS
The Case for Better Decontamination, in Six Parts
What the research shows about firefighter cancer, where exposure continues after the fire, and why access to advanced decontamination is still uneven.
THE OCCUPATIONAL REALITY
Firefighting Is a Recognized Occupational Cancer Risk
A National Institute for Occupational Safety and Health (NIOSH) study of nearly 30,000 career firefighters found 9% more cancer diagnoses and 14% more cancer-related deaths than expected based on U.S. population rates.
At the 2025 International Association of Fire Fighters (IAFF) Fallen Fire Fighter Memorial, 247 of the 311 members honored died from occupational cancer. In 2022, the International Agency for Research on Cancer (IARC) classified occupational exposure as a firefighter as carcinogenic to humans.
14%
More cancer-related deaths than expected
NIOSH
9%
More cancer diagnoses than expected
NIOSH
79.4%
Of 2025 memorial honorees died from occupational cancer
IAFF
AFTER THE INCIDENT
Exposure Doesn't Stop When the Incident Does
Contaminants picked up on scene travel with the firefighter and their gear. Each stop is another chance for residue to reach skin or air.
THE RIDE BACK
Contaminated gear shares an enclosed apparatus cab with the crew.
AT THE STATION
Gear hangs near living and sleeping areas between calls.
THE NEXT CALL
The same gear goes back on, often before it has been thoroughly cleaned.
BEYOND THE STATION
Volunteers and members without a second set often carry gear in personal vehicles.
THE GEAR ITSELF
Protective Equipment Can Carry Contamination
Turnout gear is built in layers: an outer shell, a moisture barrier and a thermal liner. Combustion residues can settle on and within those layers during an incident.
The gear's own materials are part of the picture too. National Institute of Standards and Technology (NIST) researchers identified 26 different per- and polyfluoroalkyl substances (PFAS) across 20 new turnout gear textiles. Levels in the moisture barrier and treated outer shell were up to 400 times higher than in the thermal liner. Follow-up NIST work found that wear and tear can increase how much PFAS gear textiles release.
NIST · 2023
26 PFAS identified across 20 new turnout gear textiles, highest in treated outer shells and moisture barriers.
This research concerns the gear's materials, separate from fire residue. Both are reasons gear care deserves attention.
NIST · Researchers Pin Down PFAS Prevalence in Firefighter Gear
CLEANING MATTERS
Routine Cleaning, Advanced Cleaning and Inspection Each Have a Job
ROUTINE CLEANING
After Use
Brushing, rinsing and spot cleaning to remove surface soiling before it spreads.
ADVANCED CLEANING
On Schedule and After Heavy Exposure
Thorough machine cleaning of the full garment by trained technicians using validated processes.
ADVANCED INSPECTION
At Least Annually
A trained check of seams, barriers and components, so damage is found and addressed.
This isn't a debate between water and liquid carbon dioxide (CO2). Water-based advanced cleaning is an established, essential method. Liquid CO2 is another. The right process depends on the gear, the contamination and the manufacturer's instructions.
WHAT'S AVAILABLE
Better Decontamination Is Available
Liquid CO2 decontamination uses pressurized carbon dioxide as the cleaning solvent. The National Fire Protection Association (NFPA) 1850 standard recognizes it when the gear manufacturer approves and the risk of damage is minimal.
Testing has measured contaminant removal for specific contaminants under specific processes. In a 2022 peer-reviewed laboratory study, liquid CO2 removed an average of 95.4% of targeted contaminants, compared with 68.8% for conventional washing under the same conditions.
READ RESULTS FOR WHAT THEY ARE
- Results apply to the contaminants tested and the processes tested.
- The 2022 study used liquid contaminants applied in a lab, not real smoke and soot particles, and didn't measure gear durability.
- No decontamination method can promise to prevent cancer. It reduces one exposure pathway.
THE ACCESS GAP
Access Remains Uneven
Advanced decontamination adds cost for departments already balancing personnel, equipment and training. Specialized services aren't available in every community. Volunteer, rural and smaller departments often have the least room in their budgets.
That's the Gap Afterburn Exists to Close.
EVIDENCE LIBRARY
Sources Behind This Page
Federal research, the U.S. Fire Administration (USFA), national standards, peer-reviewed studies and provider testing from Emergency Technical Decon (ETD). Each source is labeled by type, so independent research and provider-reported data are never confused.
NIOSH
IAFF
NIST
NFPA
USFA
LAB
ETD
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