This dwarfed the second leading cause of death — heart disease — which accounted for only 18 percent of line-of-duty deaths during the same period. Lawsuits now pending, along with evolving scientific evidence, seek to lay the blame for at least part of the surge in cancer deaths at the feet of the manufacturers of AFFF.
The Science Connecting AFFF and Cancer
AFFFs have been used throughout the firefighting world for decades. Environmental concerns pertaining to their use, however, came to light when dangerously high levels of carcinogens were detected in groundwater near areas where AFFFs were commonly used. Sites such as military bases, airports, and fire stations have become environmental cleanup zones as communities attempt to remedy the contamination and avoid a potential health crisis caused by ingestion of carcinogen-tainted water.
The specific chemicals within AFFF that give rise to these concerns are known as per- and polyfluoroalkyl substances (“PFAS”). Exposure to PFAS has been linked to an increased risk of contracting many different types of cancer, including testicular cancer, mesothelioma, non-Hodgkin’s lymphoma and prostate cancer. PFAS has also been linked to non-cancerous illnesses such as thyroid disease and liver disease. Obviously drinking water contaminated with PFAS is a bad idea. However, beyond concerns of water contamination, in 2015 a study first confirmed elevated levels of PFAS in the blood of firefighters who had been exposed to AFFFs for an extended period of time. This study did not analyze, however, the potential ways in which the carcinogens migrated into the body. More analysis needed to be done.
In 2019, a study conducted by the National Institute or Occupational Safety and Health suggested that skin exposure to AFFF and the chemicals it contains is sufficient to transfer carcinogens into the body. Within this study, mice were topically treated with AFFF carcinogens. After only four days of skin exposure, AFFF carcinogens were detected within the mouse blood. Though the authors of the study emphasized that its results need to be analyzed and confirmed by additional scientific research, this individual study did reveal a connection between skin exposure to AFFF carcinogens and deleterious health effects.
Lawsuits Arising from AFFF
The lawsuits stemming from AFFF carcinogens include both communities seeking funding for environmental clean-up and individuals asserting damages related to cancer and other health defects they believe were caused by their exposure to AFFF. As of August 17, 2020, 739 cases have been filed throughout United States federal courts. These cases have been centralized in what is known as “multidistrict litigation” where one judge presides over all cases. Judge Richard Gergel in Charleston, South Carolina has been appointed to oversee the litigation.
Though the scientific connection between AFFF exposure and cancer and other illnesses appears to be strengthening, proving a specific claim is not easy. Some cancers and illnesses have a stronger relationship to the carcinogens found within AFFF than others. Other illnesses have known risk factors that could make it difficult to establish that your illness was caused by exposure to AFFF. For example, it is well-established that smoking causes lung cancer. Thus, if an individual had a history of smoking tobacco, it would be very difficult to prove that his or her lung cancer was caused by AFFF.
For this reason, proving an AFFF exposure claim requires a good deal of preparation. Sufficient personal and health history must be gathered to provide medical experts with the evidence to testify that an individual’s illness most likely was caused by AFFF carcinogens. This includes ordering medical records, speaking with witnesses familiar with the individual’s exposure to AFFF, establishing what brand of AFFF was used, and many other steps necessary to build a strong case.
Compounding the difficulty of establishing a claim is the fact that a three-year statute of limitations applies to all such claims within the state of South Carolina. (Other states, such as Georgia and North Carolina, have a shorter two-year statute of limitations.) This time limitation begins to run when the individual knew or should have known that he or she might have a claim. As a result, it is always wise to move quickly if you believe you might be entitled to relief.
What’s on the Horizon for AFFF
While the effectiveness of AFFF as a firefighting tool is well-established, many departments are beginning to explore alternative substances that do not contain the carcinogens referenced above. The combination of the very real threat of dermal exposure and the large volume of AFFF that is often utilized is pushing the industry to develop a safer foam product that retains the firefighting qualities of traditional AFFF
Lurking in the distance, however, is another potential threat to the safety of the firefighting community involving the same carcinogens in a different product. A recently published 2020 study conducted by the University of Notre Dame hypothesizes that firefighter “turnout gear” could be a source of carcinogens independent of AFFF. As it turns out, manufacturers of turnout gear often blend within these textiles many of the same PFAS chemicals found in AFFF because of their fire-resistant qualities. The study sampled both new and used gear that was donated by 30 departments from across the United States. The study “revealed very high total fluorine levels in both the moisture barrier and outside shell layers of every textile sample tested.” While the authors were careful to refer to their results as a “hypothesis” and not a conclusion, the specter of personal protective equipment posing a cancer risk is of obvious concern.
The Notre Dame study suggested two ways in which turnout gear could pass carcinogens into the body: first, degradation of the textiles and subsequent ingestion or inhalation; or second, direct contact with the skin and dermal absorption. The authors suggested several ways to minimize the potential threat posed by turnout gear while further studies are conducted:
- Segregate PFAS-treated turnout gear from other textiles and living quarters
- Washing thermal liners before first use
- Wearing PFAS-free clothing under turnout gear
- Washing hands after touching turnout gear
With hope, these cancer threats to the firefighting community can be further clarified and eventually eliminated.