More than two in three firemen are diagnosed with cancer during their lifetimes, according to data from the International Association of Fire Fighters.

For decades, Diane Cotter and other “fire wives” were told their husband’s cancer was caused by smoke from burning buildings. In the mid-2010s, Diane’s husband, Paul Cotter, began his battle with prostate cancer, and it led the woman who described herself as “just a housewife… [who] barely graduated high school” on a Davidian journey to take on all of the institutional Goliaths of her small Massachusetts community and to investigate what may have actually caused her husband’s condition.

Diane’s husband was diagnosed with aggressive prostate cancer in 2014, and for years, she watched helplessly as he wasted away.

“He spent weeks and weeks in a reclining chair, just staring at the walls,” she told The Dallas Express. “The light in his eyes was gone… the end of the career did not come the way he’d always envisioned. He had just a month before been promoted to lieutenant.”

Determined to find answers, she started looking into the potential causes of her husband’s condition. Countless hours of painstaking research helped her build a wide social network and learn of cases of firemen in other states who had been injured by their protective gear.

Diane was eventually approached by Erin Brockovich, the famous consumer advocate played by Julia Roberts in the eponymous 2000 motion picture. Brockovich told Diane she knew of a fire department where all 13 of their firemen had cancer.

This is when Diane says the “rabbit hole opened.” Diane found out that Europe was banning chemicals known as PFAS or PFOAs from their gear because of concerns they were causing cancer in firemen. These chemicals had initially been added to protective equipment because, as a derivative of Teflon, they repel water and contaminants.

Diane said she contacted the fire departments, unions, and even the gear manufacturers to ask whether PFOAs were in American turnout gear and whether there was cause for concern.

“They couldn’t or wouldn’t provide answers,” she said before adding that the manufacturers told her the gear was safe and PFOAs were only present in harmless “trace amounts.”

Diane was suspicious of this claim, so she decided to run her own tests of the gear. With the help of social media, she found and purchased unused gear from a seller in North Carolina. Then she got ahold of Graham Peaslee, a professor of chemistry and biochemistry at Notre Dame University. He told her how to cut samples from the gear, and he ran the initial tests.

“Oh, you’re going to need a bigger test because there is so much more here than trace amounts,” Diane said Peaslee had told her. “[Then] we saw the fallout in the pushback from all sides, from the union who contacted the manufacturers who told them … there’s nothing to be concerned of.”

“DuPont said [that] in their own material to the International Association of Fire Fighters (IAFF) in both 2017 and 2018… The IAFF published a statement saying there was nothing wrong. We contacted the manufacturers, and they told us, ‘Don’t worry,'” Diane said.

She attributes the IAFF’s willingness to believe the manufacturers resulted from a close advertising relationship between the industry and the union. She alleged the cozy relationship between union leadership and manufacturers was partly defined by a salesmen program that exists for firemen.

“When you’re a salesperson for these [manufacturers], DuPont, 3M, Lion Gear, they all have sales incentive programs,” Diane said.

She believes the major fireman magazines were silent because much of their advertising came from the same manufacturers.

However, she broke through some of the silence with a 2017 article in Station Pride titled “The REAL Cancer In Your Gear.” There, she laid out her concerns about the prevalence of cancer at fire departments and the influence of the National Fire Protection Association, which she noted was controlled by the manufacturers who are represented on nine of the 16 seats on its leadership committee.

The Station Pride article was like a burning beacon calling reinforcements to a one-woman battle. Suddenly, firemen and specialists nationwide were calling to tell Diane their stories and offer help. They compiled 30 sets of gear spanning decades of use and varying degrees of wear and sent them off to Peaslee.

But then there was the money issue.

“Dr. Peasley has always worked pro bono, but the tests are very expensive. These are commercial tests,” Diane explained to DX, noting that the costs of running the 30 or so required tests cost upwards of $120,000. The Last Call Foundation, led by Kathy Crosby-Bell, volunteered to cover the costs.

Diane credits Crosby-Bell with helping her overcome a social lockout from the unions at that time. Diane said that she and Paul were under a “shunning order.” Many of their fire department friends would not talk to them anymore “because [they] were rocking the status quo.” She said that Kathy “fought alongside” her and was her “mediator [with the unions] and mentor.”

Then, the war of the studies began.

Lion, a manufacturer of protective gear, published a 2019 study that was endorsed by the IAFF. However, it would not share the study with Jeff Knobbe, a personal protective equipment (PPE) specialist who had been working with Diane, unless they could watch him read it. So, the Lion Gear team flew from Dayton, Ohio, to Alameda County, California, to Knobbe’s PPE laboratory to keep watch while he read. During the meeting, Knobbe was told by experts that the newer short-chain PFAS were “too big to go through the skin.”

Diane and the others, who had been researching PFAS for years at this point, were aghast. Diane said that Knobbe called “B.S.”

The third-party expert who made this claim, Paul Chrostowski, has a publicly available PowerPoint presentation that assures readers of the safety of PFOAS and Lion’s gear. He claims that PFOAs have been widely used for years and do not break down in Lion’s PPE. In a slide with a picture of different-sized balls, he states that not all PFOAs are the same and, therefore, are not all equally dangerous.

Shortly after Chrostowski’s statement, Peaslee’s study was released. The June 2020 study “found that PFOA was in every garment tested, new and used. It also found that PFOA was migrating from the outer shell to the thermal liner. It also found that the replacement chemicals, C6 and PFBS, were there in staggering amounts,” Diane told DX. “So much so that, to me, I thought it looked like a typo.”

The EPA has since found exposure to these chemicals to be unsafe at any level. New EPA regulations restrict PFOAs and PFAS to the parts per trillion level. Some chemicals, according to Peaslee’s study, were found at the parts per million level.

But that was not the only shocking discovery. Peaslee found that PFOAs formed from precursor chemicals the very moment they were added to the gear. This breakdown process likely allowed the manufacturers to truthfully say there was no PFOA in the gear, but Diane called this “slick language.”

“They could say there is no PFOA on the gear, or if it was there … it was there in trace amounts. What they didn’t say was, ‘But it’s forming,’” Diane said.

She explained that the national union leadership and corporations were actively trying to squash discussions about potential risks to firemen.

“What was surprising was the amount of effort that went into obstruct[ing] the information [from] get[ting] to the front line, to get to the firefighters themselves,” Diane told DX.

Seeing this intransigence, the local union chapters began to take action and investigate. Contemporaneously but on an unrelated matter, much of the national union leadership Diane had locked horns with was removed, and a new union chief, Ed Kelly, was put in power.

Diane and others give Kelly tremendous credit for steering the IAFF toward action on the carcinogenic gear.

A subsequent study in 2021, ordered by Kelly, broadened Peaslee’s findings. The study confirmed the existence of toxic chemicals in staggering amounts and rang more alarm bells. “New turnout gear should be examined as a potential source of firefighter occupational exposure to nonvolatile and volatile PFASs in future assessments,” the study’s abstract reads.

Last Call Foundation’s president wrote at the time of the study’s publication, “In response to the certain knowledge that PFAS and PFOA are playing a significant role in the cancer rates in the fire service, and with the full support of the rank-and-file IAFF General President Ed Kelly filed Tentative Interim Amendment 1594, in 2021, regarding NFPA 1971, the Standard on Protective Ensembles for Structural Fire Fighting and Proximity Fire Fighting, 2018 Edition. The NFPA technical committee, quickly followed by the standards council, closed ranks and voted to deny the TIA regarding NFPA 1971.”

“This research confirms and expands on Dr. Peaslee’s research. Perhaps it is time for the fire service to write its own spec’s regarding turnout gear? Firefighters’ health indeed their lives are not, cannot and as the NFPA rejection of TIA 1594 clearly shows should never have been at the mercy of the self-interests of the NFPA. Sadly I’ve come to understand why so many firefighters consider the NFPA ‘the manufacturers’ publishing company,’” Crosby-Bell wrote.

Crosby-Bell called for immediate action from the firemen themselves, if necessary. “Fight like hell until you get new turnout gear, manufactured without chemical carcinogen treatment,” she added, before turning to the woman who started it all. “And by the way thank Diane Cotter!”

Diane said this sent shockwaves through communities of firemen across the country.

“I think what was hard for the fire service to absorb was everybody had let them down. Their own institutions had let them down. The people they trusted, the manufacturers,” she told DX. “You’ve got to remember, when you open up a fire engineering magazine, you’ve got DuPont staring you in the face with their ad that says, ‘It’s what’s inside that counts.’”

Leaked internal emails from Lion and other manufacturers show panic after the publication of Diane’s article in Station Pride. In some communications, company executives recognize that there had been a PFOA powder recently put into firemen’s gear –– but they tell each other that the practice had stopped and there were no longer any PFOAs in turnout gear. In one exchange, an executive asks for “ammo” to beat back the concerns arising from Diane’s allegations.

A consumer notice was put out regarding turnout gear. Firemen, including Paul, are suing the major manufacturers, including Lion, 3M, BASF, DuPont, and others. Some attorneys general may join the lawsuits as well, and the Cotters are hopeful the first will be Andrea Campbell in Massachusetts.

The political wheels are starting to move at both the state and federal levels. Legislators in Massachusetts and the U.S. Senate have introduced bills to require a transition away from PFAS-contaminated gear and compensation for injured firemen. However, the legislation is currently caught in gridlock at every level. The U.S. Senate bill, for example, has no co-sponsors, while the Massachusetts legislation is stuck in committee.

Even if the legislation passes or the lawsuits are successful, the contracts to produce the new gear will further enrich the same manufacturers being sued because only so many companies can produce fire gear.

“We’re rewarding industry by purchasing new gear that’s PFAS free. So I’m hoping that Attorney General Campbell and every other attorney general will investigate what they can do to not reward [the manufacturers],” Diane lamented.

Even if legislation is passed or plaintiffs win their lawsuits, this may not help small, rural fire departments in the Texas hill country or other places across the United States who likely do not have the resources to replace their gear.

In a sign of progress, new PFOA-free fire gear that meets NFPA standards is now on the market. In February, StedAIR, a Canadian company, released a product called Clear, which offers a non-fluorinated moisture barrier option for turnout gear.

DX contacted Campbell, Att. Gen. Ken Paxton, Gov. Greg Abbott, and Sens. John Cornyn (R-Texas) and Ted Cruz (R-Texas) for comment and asked when they intend to take action on this matter, but no responses were received by the time of publication.

Diane was asked about her husband’s condition toward the end of a recent appearance on the Cowtown Caller podcast, where her story can be heard in long-form and unedited. “I never know how to answer that because you see that the cancer is gone. He goes every six months for blood work because they didn’t get the clear margins when they did the surgery that they were hoping for. But it’s been going on 10 years, and He misses [the fire department] every day.”

Since beginning her campaign against PFOAs, presidential candidate Robert F. Kennedy Jr. has supported Diane. Recently, he called her “one of his heroes.”

A documentary, Burned: Protecting The Protectors, about Diane’s story is in the works.