PFAS firefighter health risk is no longer a future concern. I attended the FIERO PPE Symposium in Greenville, South Carolina earlier this year, and for three days I sat in rooms where the researchers studying turnout gear, the manufacturers building it, and the firefighters wearing it were all part of the same conversation. What I heard confirmed what the science has been pointing toward for years. It also gave me reason to believe the fire service is finally moving in the right direction, though perhaps not fast enough.

Dr. Bryan Ormond’s keynote at FIERO, “Following the Science: Navigating the Shift to Non-PFAS PPE,” set the tone immediately. The conversation was technical, honest, and frank about trade-offs. More of these conversations are needed, especially around the trade-offs firefighters must face in order to have non-PFAS PPE.

What PFAS Firefighter Health Risk Actually Looks Like Today

Turnout gear is built in three layers: an outer shell, a moisture barrier, and a thermal liner closest to the skin. For years, per- and polyfluoroalkyl substances (PFAS) were present across all three. These synthetic chemicals provide water and oil repellency, but studies have linked PFAS exposure to an increased risk of certain cancers, elevated cholesterol, and immune system dysfunction. Cancer is one of the leading causes of Long-Term and Total Line-of-Duty Deaths among firefighters in this country, and PFAS firefighter health risk is central to that conversation. Accepting that as inevitable is not a leadership position. It is a failure of one.

The current picture is more nuanced than the headlines suggest, and the nuance matters for purchasing decisions. Research from the National Institute of Standards and Technology established that switching to a non-PFAS coating on the outer shell essentially eliminates PFAS from that layer, and the thermal liner has relatively little PFAS to begin with. Non-PFAS outer shells are widely available now. The thermal liner was never the primary concern.

The moisture barrier is the remaining challenge. It has to block pathogens on medical calls and liquids on extrications while maintaining breathability to prevent heat stress at a working fire. Those are competing demands. The fluorochemical technology used historically manages both well. Finding a PFAS-free replacement that does the same, clears NFPA certification, and scales to production is not a simple swap.

At FIERO, manufacturers and researchers were direct about this. Removing fluorinated chemistry from the moisture barrier can cause the layer to behave like a sponge, absorbing rather than repelling liquids. That is a real-world performance risk that departments need to understand before purchasing.

A solution does exist and has been deployed in the field. In June 2025, the East Providence Fire Department became the first in the United States to outfit all of its firefighters with fully non-PFAS gear across all three layers, including the moisture barrier, through a collaboration between manufacturer Fire-Dex and textile company Milliken and Company. Independent testing confirmed performance met or exceeded NFPA requirements for heat protection and breathability. Manufacturers across the industry are now in final development or approaching market readiness with their own versions.

One more finding deserves direct attention. A December 2025 study led by Dr. Heather Stapleton at Duke University found that newer gear marketed as PFAS-free often contained elevated levels of brominated flame retardants, chemicals linked to potential hormone and thyroid disruption. The highest concentrations were in the moisture barriers. One chemical appeared at levels suggesting it was intentionally added after PFAS were removed. “PFAS-free” on a label is not the same as chemically safe. The transition requires scrutiny, not just momentum.

A Warning from FIERO Every Officer Should Hear

Dr. Dan Madrzykowski, Senior Director of Research at UL FSRI, presented data at FIERO that every officer in the fire service should understand. Modern turnout gear is so effective at insulating firefighters from their environment that by the time a firefighter feels the heat through the gear, they may be only seconds from second-degree burns or gear degradation.

When I started in the 1980s, I had a cotton-duck outer shell, 3/4 boots, and a first-generation Nomex hood. The heat environment gave you feedback in real time. Today’s gear is so capable that it has removed those instinctual cues. That is a remarkable safety advancement. It is also a leadership training gap that many departments have not addressed.

The Leadership Obligation Behind the Science

When PFAS first surfaced as a serious concern, the response across the fire service was fragmented. The IAFF pursued litigation. Manufacturers cited technical constraints and supply timelines. Standards bodies navigated competing interests from within their own membership. Departments purchased whatever was certified. And throughout all of it, the people absorbing the exposure were the firefighters wearing the gear.

The Arbinger Institute describes this pattern as an inward mindset: institutions so focused on their own objectives, metrics, and risk exposure that they lose genuine awareness of how their decisions affect the people they exist to serve. Most of the people involved in this issue have good intentions. The inward mindset is not about character. It is about where attention goes when the problem gets hard.

The outward mindset works the other way. It is not simply about doing your job well. It is about doing right by the people your job exists to serve. When that standard is held collectively across every institution in the fire service, the entire system shifts. Manufacturers disclose chemical data voluntarily rather than waiting for litigation to force it. Unions approach manufacturers as partners in a hard technical problem rather than solely as adversaries. Departments ask what the gear does to the person wearing it for thirty years, not just whether it passes the current standard. No single institution can move this fast alone. But when all of them are asking the same questions, the answers come faster.

That shift in orientation is exactly what the FIERO Symposium produced. Scientists and manufacturers worked through trade-off data together in real time. Union representatives and gear engineers sat in the same sessions and pushed toward the same outcome. A fire officer from a department evaluating new gear could put a direct question to the researcher who studied it. The conversation that has happened in separate rooms for years was finally happening in the same room. Everyone agreed on the same goal: solve the PFAS issue without creating the same problem with its replacement in twenty years. Transparency in process and solutions is what makes that possible. Much work is still to be done by our industry leaders.

The East Providence deployment is the proof of what that collective orientation produces. It did not happen through litigation. It happened because a fire chief, a manufacturer, and a textile company decided to work toward a shared outcome and invested the resources to do it right. That is what the outward mindset looks like when it moves from conversation to action.

Reducing PFAS Firefighter Health Risk: What Leaders Can Do Right Now

You may not sit on standards committees. But you lead people wearing this gear on every shift, and your posture on this issue has direct consequences for their long-term health.

Start with exposure reduction today. The IAFF and Metro Chiefs have recommended keeping turnout gear out of firehouse living areas, cleaning apparatus cabs regularly and after every fire, and washing hands after handling gear. These steps require no purchase order. They require a leader who takes them seriously and holds the standard.

Know what you are actually buying, and conduct wear trials before committing. Understand the difference between a non-PFAS outer shell, widely available and the minimum acceptable standard, and a fully non-PFAS composite that addresses the moisture barrier. Understand the performance dynamics of each in fire suppression operations. Ask about the moisture barrier specifically. Ask about seam tape chemistry. Require full chemical disclosure on every layer as a condition of purchase. As more manufacturers advertise ‘PFAS-free’ gear, understanding the real PFAS firefighter health risk means departments need reliable information to separate marketing claims from verified safety.

Pay attention to what is replacing PFAS. The brominated flame retardant data is a warning, not a verdict, but it is exactly the scrutiny that should have been applied to PFAS decades ago. The question is not just whether the gear meets the standard. It is what that gear does to the person wearing it for thirty years.

The Bottom Line

PFAS firefighter health risk is further along toward resolution than most people realize, and less resolved than the marketing would suggest. The outer shell is largely addressed. The thermal liner was never the primary risk. The moisture barrier now has a certified, field-tested solution. And a separate chemical concern is emerging that demands the same scrutiny PFAS never received early enough.

The technical path forward exists. What needs to catch up is the leadership: whether the institutions involved will operate with enough transparency and shared accountability to close the gap between what is now possible and what is actually in firehouses across the country.

I have watched this profession make enormous progress before. We have come a very long way from cotton-duck shells and 3/4 boots. Events like FIERO leave me genuinely optimistic, because the right people are finally in the same room, asking the same questions, and taking the answers seriously. Get involved. Understand where we are. Be part of where we can go.

This post is part of the Under Pressure: Leadership Lessons from the Fire Service series at EMPOWER2Evolve. Read the series anchor post: First Responder Leadership: What 30 Years in Emergency Services Teaches You About Leading People. For Scott’s published work on incident command leadership, see his March 2026 article in Firehouse Magazine.

Scott Richardson is a Division Chief with South Metro Fire Rescue, co-founder of EMPOWER2Evolve, and co-author of Technical Rescue: Trench Levels I and II (Cengage Learning, 2009). He coaches emergency services leaders on conscious leadership and collaborative culture.

Photo courtesy of South Metro Fire Rescue.