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Why Firefighters Face a Higher Cancer Risk
When firefighters rush into burning buildings, there are immediate and obvious dangers: collapsing structures, intense heat and suffocating smoke. However, for many firefighters, the most serious threat may not manifest until years after they extinguish the flames.
Increasingly, research shows that firefighters face a significantly higher risk of developing cancer compared with the general population, raising concerns about occupational safety and long-term health.
A growing body of scientific evidence has documented this risk. One of the most widely cited studies, conducted by the National Institute for Occupational Safety and Health (NIOSH), examined nearly 30,000 firefighters from Chicago, Philadelphia and San Francisco. Researchers found firefighters had a 9% higher rate of cancer diagnoses and a 14% higher rate of cancer-related deaths compared with the general population.
More recent research has reinforced those findings. A large American Cancer Society study tracking hundreds of thousands of men over several decades found firefighters had elevated mortality from several cancers, including skin and kidney cancer. In 2022, the International Agency for Research on Cancer, part of the World Health Organization, classified occupational exposure as a firefighter as “carcinogenic to humans,” placing it in the agency’s highest risk category.
What Hazards Firefighters Are Exposed To
The elevated risk stems largely from the hazardous chemicals released during fires. Burning homes, offices and industrial buildings produce a complex mix of toxins, including benzene, formaldehyde, asbestos and polycyclic aromatic hydrocarbons — many of which are known carcinogens.
Modern fires may be even more dangerous than those in the past. As synthetic materials — such as plastics, foams and treated fabrics — have become common in furniture, electronics and construction materials, the smoke produced during fires now contains a broader and more toxic chemical mixture.
Firefighters can be exposed in several ways. While breathing apparatus helps protect lungs during active firefighting, toxins may still be inhaled during other stages of response. Carcinogens can also be absorbed through the skin, especially through the neck, jaw and other areas where protective gear may not seal completely.
Another risk comes during the overhaul phase, when firefighters return to a burned structure to search for hidden hot spots and remove debris. Respiratory protection is not always used during this stage, even though hazardous chemicals may still be present.
Lingering Contamination
Even after firefighters leave a scene, the danger may follow them back to the station. Protective gear, helmets and hoses can carry toxic particles from the fireground. Without proper cleaning and decontamination procedures, those contaminants can spread throughout fire stations and vehicles.
Firefighting foam has also raised concerns. Many types historically contained PFAS — per- and polyfluoroalkyl substances sometimes known as “forever chemicals.” These compounds resist breaking down in the environment and can accumulate in the human body. Some studies have linked PFAS exposure to increased risk of kidney, bladder and testicular cancers.
Over time, repeated exposure to these hazards can add up. Researchers have found that the risk of several cancers — including prostate, colorectal and lung cancer — increases with the length of a firefighter’s career.
A Growing Focus on Occupational Cancer Prevention
As awareness of the problem has grown, fire departments across the United States have begun implementing new procedures designed to reduce exposure. Many departments now emphasize on-scene decontamination, including rinsing gear and equipment before leaving a fire scene. Firefighters are also encouraged to shower and change clothes as soon as possible after returning to the station.
The federal government created the National Firefighter Registry for Cancer, a nationwide effort that collects information about firefighters’ health histories and occupational exposures. The registry aims to help scientists identify patterns and develop strategies to prevent cancer within the fire service.
Designing Fire Stations to Reduce Risk
Reducing exposure is not limited to the fireground. Increasingly, architects and fire departments are rethinking how fire stations themselves are designed to prevent contaminants from spreading into living spaces.
One approach gaining attention is known as Red/Yellow/Green, a design strategy that separates contaminated and clean areas inside the building.
Turnout Gear Storage and Drying: Proper storage and ventilation of turnout gear play a critical role in limiting ongoing exposure.
The concept uses color-coded zones similar to a traffic signal. The red zone includes apparatus bays and other areas where trucks and equipment return from fires carrying potentially toxic residue. The yellow zone serves as a transition space where firefighters wash equipment and gear and shower after calls. The green zone contains clean areas, such as kitchens, offices, training rooms and sleeping quarters where firefighters live and work during shifts.
Decontamination Showers + Transition Zone: A clear transition from apparatus bay to clean space helps reduce the spread of contaminants. Dedicated decontamination areas, including showers placed along the path of travel, support daily routines that protect long-term health.
By physically separating these areas — and using dedicated ventilation systems, gear-cleaning rooms and decontamination procedures — the design helps limit the spread of carcinogens that may be carried on clothing, equipment or skin.
Gear Cleaning and Extraction Room: Purpose-built cleaning spaces allow crews to address contaminants immediately after a call. By separating gear washing and equipment maintenance from living areas, stations create a safer, more controlled environment.
For firefighters who routinely face life-threatening situations to protect their communities, these changes represent an effort to confront a danger that is less visible — but just as serious.
About the Author
Crystal Henry is a senior associate with FGMA based in Reston, Virginia. She brings nearly 20 years of experience in public safety design, with a focus on fire stations that support firefighter health and safety. Crystal has dedicated her work to researching scientific studies and data that inform how the built environment can reduce cancer risks and support mental and behavioral health. She advocates for evidence-based design strategies that promote long-term wellness for firefighters and EMS personnel, supporting them throughout their careers and into retirement.
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