Duke-Led Study Aims to Better Understand Cancer Risk for Firefighters

A research study led by members of the Duke University Nicholas School of the Environment (NSOE) and the Duke Cancer Institute (DCI) aims to tackle the issue of cancer risk among firefighters based on their exposure to certain harmful chemicals.The North Carolina Firefighter Cancer Cohort Study (NC FFCCS), led by Heather Stapleton, PhD, the Ronie-Richele Garcia-Johnson Distinguished Professor of Environmental Health in the NSOE and a member of the DCI, launched in 2024 as part of the National Firefighter Cancer Cohort Study, which has partnered with fire service members across the country to recruit and track their exposure to hazardous chemicals over a 30-year period.The NC FFCCS has 305 participants currently enrolled and aims to recruit 1,000 firefighters across North Carolina by July 2026. Participants are contacted every two years for health updates.Firefighters are often exposed to combustion byproducts, per- and polyfluoroalkyl substances (PFAS), flame retardants, and trace metals in the line of duty. NC FFCCS study team members work with participants to collect blood and urine samples, which are analyzed for contaminants and biological markers of cancer pathways. This analysis allows study team members to assess the impact these chemicals have on their cancer risk.“Firefighters often experience higher exposure to chemical carcinogens compared to people in other lines of work,” Stapleton said. “Our preliminary results indicate elevated exposures may contribute to multiple forms of cancer.”In addition to chemical exposures from fires themselves, firefighters could also be exposed to chemicals through their turnout gear and poor air quality in fire stations. The NC FFCCS team is examining this, as well as comparing participants’ blood PFAS levels to samples from communities with contaminated drinking water to see how their exposures compare.The North Carolina Collaboratory is sponsoring the study as it partners with academic institutions and government agencies to turn research into practical solutions for communities.“PFAS are a problem in many areas of North Carolina due to contaminated drinking water, particularly in areas that draw their water from the Cape Fear River,” Stapleton said. “Firefighters working and living in these areas receive exposure similar to the general population but could have additional exposures from the use of firefighting foams and personal protective equipment (PPE), which has historically been treated with PFAS. Our study hopes to understand if firefighter exposures are similar or different than the general public.”In the future, the study team plans to expand the use of wearable exposure devices to firefighters in North Carolina, along with wildland firefighters. They are also partnering with the New York Fire Department to study e-bike fire exposures. The North Carolina site continues to host recruitment events at fire departments, with several scheduled in High Point in March.“This study can provide firefighters better information about their individual risk for cancer,” Stapleton said. “These findings could lead to more comprehensive recommendations for reducing exposures, and thus cancer risks, in the fire service profession.”Visit the study website to learn more.(Photo courtesy of Mike Legeros)

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