Firefighters put on their protective gear to do a dangerous job. But what happens to that gear after a fire matters, too.
Smoke, combustion byproducts, and other hazardous substances can contaminate protective clothing during emergency responses. Some contamination may remain after the incident, creating opportunities for continued exposure or transfer to other surfaces.
That raises an important question for fire departments: what does the research actually tell us about firefighter gear and cancer risk?
The evidence supports taking occupational cancer seriously and managing exposure wherever practical. It does not support claiming that contaminated gear is the sole cause of firefighter cancer, that one cleaning method prevents cancer, or that advanced decontamination eliminates every occupational hazard.
For fire chiefs, health and safety officers, and personal protective equipment (PPE) officers, understanding that distinction is essential to making informed decisions about equipment care.
What does research say about firefighter cancer risk?
Firefighters encounter a wide range of exposures during their careers. Depending on the incident, these may include combustion products, particulates, chemicals from burning materials, and other hazardous substances.
Large-scale research has documented elevated cancer rates in firefighter populations.
A study by the National Institute for Occupational Safety and Health (NIOSH) examined nearly 30,000 career firefighters from Chicago, Philadelphia, and San Francisco. Researchers found 9% more cancer diagnoses and 14% more cancer-related deaths than expected based on U.S. population rates.
These findings are important because they document an occupational health concern across a substantial firefighter population.
They do not, however, establish that every firefighter faces the same level of risk or that a particular source of exposure explains the entire difference. Firefighter cancer risk involves multiple exposures and circumstances, and population-level findings cannot predict an individual’s outcome.
The practical conclusion is clear: departments should take exposure management seriously and use evidence to guide the steps they can control.
How does contaminated gear fit into the picture?
Protective equipment is intended to help firefighters perform their work safely. During an incident, however, that equipment can become contaminated by substances encountered on the fireground.
Contamination may remain on protective clothing after the incident. Handling and transporting the gear can also transfer material to skin, vehicles, equipment, and station areas.
These pathways are part of the reason PPE care matters.
NIOSH guidance emphasizes appropriate handling, bagging, laundering, and storage of contaminated firefighter gear as components of reducing opportunities for exposure after an incident.
Exposure can continue after the fire is out
The fireground is not the only place where exposure management matters.
Contaminated clothing can come into contact with other surfaces during removal, transport, and storage. Depending on the substances involved, material may also move from the gear into the surrounding environment.
This does not mean every contact creates a meaningful health risk. It means departments should avoid treating the end of the incident as the end of all exposure-related responsibilities.
Consistent post-incident procedures help address these practical pathways.
Gear is one part of a larger exposure picture
Firefighters encounter occupational hazards through multiple routes and under different conditions. Protective equipment can be one source or carrier of contamination, but it is not the only potential contributor to exposure.
That distinction matters because a department cannot address the full cancer problem through gear cleaning alone. Equipment care should sit alongside other occupational health and safety practices appropriate to the department’s operations.
What do we know about chemicals in firefighter gear?
Researchers have studied different categories of contaminants associated with firefighting, including combustion-related chemicals and substances present in protective textiles.
Two areas are particularly relevant to departments evaluating PPE care.
Combustion-related contaminants
Smoke and burning materials can produce complex mixtures of chemicals and particles. Some substances can deposit on protective clothing during an incident and may be difficult to remove completely through a particular cleaning process.
The specific contaminants depend on the materials involved and the conditions of the fire. No single list describes every firefighter’s exposure.
Research into cleaning performance helps determine how effectively different processes reduce particular contaminants. Such findings should be interpreted according to the specific substances and conditions tested.
PFAS in protective textiles
Per- and polyfluoroalkyl substances (PFAS) are a large group of synthetic chemicals used in various industrial and consumer applications.
The National Institute of Standards and Technology (NIST) has identified PFAS in structural turnout gear textiles, gloves, hoods, and wildland firefighting textiles.
These findings show that certain PFAS can be present in protective materials themselves, not only as contamination deposited during a fire.
However, NIST’s textile studies do not establish the health risks attributable specifically to PFAS in firefighter gear. The presence of a chemical in a material is an important finding, but it is not the same as quantifying a person’s exposure or determining the resulting health risk.
Departments should follow credible research as it develops and avoid drawing conclusions that the evidence does not support.
Can cleaning or decontamination reduce cancer risk?
This is where careful wording matters.
Appropriate cleaning can remove soil and reduce contamination on protective equipment. Specialized decontamination processes may provide an additional option for reducing particular contaminants, depending on the equipment and process used.
But demonstrating contaminant removal is not the same as demonstrating cancer prevention.
A laboratory test may show that a cleaning process reduced a particular substance under specified conditions. That result does not, by itself, establish how much a firefighter’s total exposure changes, how that change affects long-term health, or whether the process prevents cancer.
Departments should view PPE care as one component of exposure reduction, not as a guarantee of a particular health outcome.
What should departments look for in cleaning evidence?
When evaluating a cleaning or decontamination service, ask:
- Which contaminants have been tested?
- What equipment and process were used?
- What reduction was measured?
- Were the findings specific to the gear and conditions relevant to your department?
- Who conducted the testing, and was it independently verified?
- What limitations apply to the results?
These questions help departments distinguish demonstrated performance from broader claims that may not be supported by the evidence.
For more information, see What Contaminants Can Remain in Firefighter Turnout Gear? and Liquid CO₂ Firefighter PPE Decontamination: How It Works.
What can fire departments do to manage exposure?
Departments do not need to solve every scientific uncertainty before taking practical steps to manage contamination.
Establish consistent post-incident procedures
Firefighters should know how to handle contaminated equipment after an incident. Procedures should address initial decontamination where appropriate, removal, transportation, cleaning, and storage.
Consistency matters. A policy that exists on paper but is not followed reliably will not provide the same benefit as a process personnel understand and can carry out.
Maintain appropriate cleaning schedules
Follow the applicable National Fire Protection Association (NFPA) requirements, manufacturer instructions, and department procedures. Address contamination as needed rather than relying solely on a calendar.
Routine washing remains essential. Additional cleaning or specialized decontamination should be evaluated according to the equipment, exposure, and available evidence.
Track equipment care
Maintain records of cleaning, inspections, repairs, and other required maintenance. These records help PPE officers understand equipment history, identify gaps, and plan future service.
Evaluate advanced decontamination when appropriate
Liquid carbon dioxide (CO₂) decontamination is one specialized option departments may consider when evaluating how to address particular contaminants.
The relevant questions are whether the process is suitable for the equipment, what its testing demonstrates, and how it fits into the department’s broader care program.
The decision should be based on evidence and actual needs, not on a promise that any one technology eliminates cancer risk.
The access problem: when cost limits better gear care
Knowing that contamination management matters does not guarantee that a department can access every service it considers appropriate.
Advanced decontamination may involve treatment fees, transportation, and coordination. Those costs can be difficult to accommodate alongside equipment replacement, staffing, training, and other operational needs.
The burden can look different for a large career department than for a small rural or volunteer agency. What matters is the department’s actual financial and logistical situation, not an assumption based on its classification.
The Afterburn Foundation helps qualifying fire departments access advanced PPE decontamination when cost stands in the way.
Afterburn is an access and funding organization, not a manufacturer or cleaning facility. It connects documented department need with philanthropic funding and qualified independent service providers.
Its annual sponsorship model is built around a simple commitment:
$500. One firefighter. One year.
A $500 sponsorship provides one firefighter with one year of funded access to qualifying advanced PPE decontamination services. The standard annual model is designed around two advanced CO₂ decontamination cycles and one annual advanced inspection, with flexibility to fund services according to actual need.
Sponsorship funds are pooled so services can vary according to equipment, exposure, geography, and logistics. The model funds access to qualifying services; it does not promise identical treatment for every firefighter or guarantee a health outcome.
For departments that want to evaluate advanced decontamination but face a financial barrier, Afterburn offers a way to seek assistance.
Frequently asked questions
Does contaminated firefighter gear cause cancer?
Research establishes that firefighters face occupational cancer risks and that protective gear can carry hazardous substances. However, the presence of contamination on gear does not, by itself, establish that a particular garment caused cancer. Risk depends on multiple factors, including the substances involved and the nature of exposure.
What does NIOSH research say about firefighter cancer?
A NIOSH study of nearly 30,000 career firefighters from three U.S. cities found 9% more cancer diagnoses and 14% more cancer-related deaths than expected based on U.S. population rates. These are population-level findings, not predictions for individual firefighters or proof that one exposure source explains the results.
Can cleaning turnout gear prevent firefighter cancer?
Cleaning can remove soil and reduce contamination, and appropriate gear care is part of exposure management. However, evidence of contaminant reduction does not establish that a cleaning method prevents cancer. No such guarantee should be made.
Does PFAS in turnout gear mean the gear is unsafe?
NIST has identified PFAS in several types of firefighter protective textiles. The presence of PFAS is a legitimate subject for research, but those findings do not establish the specific health risk attributable to PFAS in a particular garment. Departments should follow current research, manufacturer guidance, and applicable requirements.
Can Afterburn help departments access advanced decontamination?
Yes. The Afterburn Foundation helps qualifying departments access advanced PPE decontamination when cost stands in the way. Departments can apply for funding to have their needs evaluated.
Better decontamination shouldn’t depend on your department’s budget.
Afterburn helps qualifying fire departments access advanced PPE decontamination when cost stands in the way.
Help another department get access: Sponsor a Firefighter
