Young firefighters are dying of cancer: Is enough being done to protect them?

January is Firefighter Cancer Awareness Month. The World Health Organization recently designated the job of firefighting as a carcinogen, putting it in the same category of risk as cigarettes. With young firefighters facing devastating diagnoses, we discovered failing protections, both in the gear they wear and in the insurance coverage for life-saving early screening.

Diane Cotter’s husband Paul, a firefighter, was in perfect health until 2015 when he received a diagnosis she calls ‘shattering.’ At 55 years old, Paul had an aggressive form of cancer.

When the doctor said those words, ‘it’s cancer,’ I screamed,” said Diane Cotter. “My husband just broke out into a white sweat and sunk down into a chair.

Diane Cotter made a stunning discovery about cancer among firefighters like her husband (Photo: Diane Cotter)Cotter, who had no history of cancer in his family, endured a surgery to remove his prostate that came with complications: It ended his 27-year career in firefighting. That outcome was devastating.

“As the realization set in for Paul that he wasn’t going back to the love of his life, his job, he began to fall into a depression,” said his wife further explained. “His depression is what spurred me on to research firefighter cancer.”

Paul was just 55 when he was diagnosed with an aggressive form of cancer.

Her research would change the game for firefighters nationwide, shedding light on a risk that at the time was unknown.


Diane Cotter transformed her knitting room into a war room, asking questions about why young firefighters were getting cancer at such a high rate. She estimates she sent 25,000 emails to leading politicians, scientists and advocates who would help her unravel the mystery.

Diane Cotter showed Spotlight on America her ‘war room,’ where lifesaving research began (Photo: Larry Deal)

Cotter ultimately discovered that embedded in firefighters’ turnout gear were fluorinated chemicals known as PFAS (per- and poly-fluoroalkyl substances), a class of waterproof materials long suspected to be carcinogens. These materials are perhaps more widely and infamously known as “forever chemicals” and have been found in everything from drinking water to food packaging and dental floss, posing varying degrees of risk to human health.

Cotter remembers the moment it came together in her mind.

“I ran into our basement and unpacked his gear and saw after pulling apart the layers of his turnout gear, that there were coin size pieces of fabric missing,” she said. “That horrified me.”

She said that her research revealed that firefighters are wearing the most highly fluorinated textile known to man.

The numbers of these chemicals in our report, they look like a typo, they’re so high,” Cotter explained. “I had one physician let me know that she was so shocked by these numbers that she wept for a family member who’s also a firefighter.

One of the chemicals, PFOA, was just placed into the most dangerous class of carcinogens by the World Health Organization.

New studies are revealing more about the risk of PFAS chemicals (Photo: SBG)

“An undetectable amount of PFOA will grow a pancreatic tumor in a lab animal,” Cotter elaborated.

Studies show that firefighters are exposed to these PFAS chemicals every day, as it flakes off their gear, getting on their hands, and spreading carcinogens into their trucks and firehouses.

Those chemicals are now suspected of contributing to firefighters’ risk of developing cancer at a rate significantly higher than the general population.


Raising awareness is a high priority for Ed Kelly, general president of the International Association of Firefighters.

Our number one exposure we get to carcinogens is simply putting on our bunker gear, our PPE, our personal protective equipment, and taking it off every day,” Kelly told Spotlight on America.

Spotlight on America obtained a running list of job-related cancer deaths among firefighters since 2018. Among the more than 500 names were victims as young as 25, with many others only in their 30s.

More than 500 firefighters have died from what’s considered job related cancer since 2018 (Photo: SBG)

“Cancer’s been plaguing the fire service for generations, but it’s at an epidemic level now, and we need to do everything in our power to change that,” Kelly went on to say.

At the 2023 IAFF Fallen Fire Fighter Memorial Ceremony, names were added to a wall in memory of those who had died. Staggeringly, the majority of lives lost were not because of flames, smoke inhalation or collapsing buildings. 63% of the fire fighters whose names were added to the memorial wall died from occupational cancer.


One way to help protect America’s first responders is to allow them access to early screening and advanced monitoring for cancer, something Kelly calls “critically important.” But, according to Kelly, some health insurance companies will not cover screenings at younger ages.

Spotlight on America followed up on his comments and reached out to eight of the largest health insurance companies in the U.S. and asked them if they cover screening for early detection, and at what age a firefighter is eligible.

United, Centene, Kaiser Permanente, HCSC, Elevance Health, CVS (Aetna), Cigna, and Humana did not answer SOA’s question.

“We need to do better,” saidKelly. “We’ll go from Main Street to Wall Street and from the boardroom to the courtroom and take this fight wherever we need to go.”

Ed Kelly called cancer among firefighters an epidemic (Photo: Larry Deal)


The pressure is mounting.

More than 20,000 firefighters, including Paul Cotter, have joined a federal lawsuit against PFAS manufacturers.

“They’ve poisoned America’s bravest,” said Diane Cotter. With hundreds of families who have lost a beloved firefighter to cancer, there is a message she wants them to hear: “I want them to know we’re seeking justice for them. We truly are.”

Diane says PFAS in turnout gear has “poisoned America’s bravest.” (Photo: Larry Deal)

Meanwhile, individual states have taken some action to protect firefighters, but nothing has been passed at the federal level.

Members of Congress introduced bipartisan legislation that would ban PFAS in firefighter gear and require insurers to cover cancer screenings for firefighters. Whether it will become law remains to be seen.

In the meantime, Spotlight on America’s in-depth reporting will continue. Up next: the team is asking what, if any, funding is being set aside to research PFAS and cancer in firefighters. They will sit down with a key member of Congress to find out what it’s going to take to pass legislation that better protects our first responders.

For now, firefighters are urged to join the National Firefighter Cancer Registry, which will track diagnoses and inform research about exposure.