Firefighter advocates say occupational cancer remains the profession’s most persistent and deadly threat as departments mark Firefighter Cancer Awareness Month in January.
Leaders across the United States told The Dallas Express that while progress has been made in screenings and safer gear, gaps in accountability, coverage, and chemical oversight remain.
“We do know that cancer has been on the rise in the fire service for several years,” Brian Becker, president of the Irving Professional Fire Fighters Association, told The Dallas Express.
Becker said modern fire environments — filled with plastics and synthetic materials in furniture, vehicles, and building components — release “deadly, cancer-causing chemicals” when burned.
In Texas, 11 cancers are currently recognized as presumptive under state law, meaning firefighters diagnosed with those illnesses are generally eligible for workers’ compensation coverage. However, Becker said many claims are initially denied by third-party administrators hired by municipalities, forcing firefighter associations to fight for benefits.
At the same time, departments have stepped up efforts to reduce exposure.
Many cities have purchased second sets of turnout gear to limit prolonged contact with contaminants, expanded on-scene decontamination procedures, and increased annual cancer screenings.
Texas lawmakers passed House Bill 198 in May 2025, known as the Wade Cannon Act, which will require political subdivisions to provide no-cost occupational cancer screenings beginning in a firefighter’s fifth year of service. The law is scheduled to take effect on June 1, 2026.
At the time, Tim Mackling, president of the Flower Mound Professional Fire Fighters Association, who worked alongside Cannon, told The Dallas Express that the bill’s passage was a victory for firefighters. However, he noted there are still holes in the state code.
“Anything not listed in the presumptive cancer list will still require the employee to show causation between their type of cancer and their job,” Mackling explained. “But this bill allows members who are being denied these tests under our medical insurance to obtain them because of their risk as a firefighter.”
Others agreed that there was still more to do.
“Catching certain cancers early significantly improves outcomes, and testing is far less expensive than late-stage cancer treatment,” Becker previously told DX.
Beyond screenings, attention has increasingly focused on PFAS — per- and polyfluoroalkyl substances — historically used in some firefighting gear. Diane Cotter, a nationally recognized anti-PFAS activist, said fire departments across the country are beginning to roll out PFAS-free gear.
“In the greater US, we see rollouts of PFAS-free gear to departments across the nation weekly. It’s remarkable to witness really,” Cotter said told DX this month, pointing to field testing in Worcester, Massachusetts, where her husband once served in the fire department before being diagnosed with cancer.
Still, Cotter argues that accountability for past chemical exposure is lacking. “Accountability. Justice. Acknowledgment. There is none,” she said, contending that industry influence and legal settlements have hindered full transparency.
Cotter has emphasized concerns about PFOA, a chemical within the broader PFAS family that has been designated a carcinogen by international health authorities. “PFOA was the carcinogen we were told by industry and institutions was not in our gear, but in fact was there in staggering amounts,” she said.
A 2020 study by Dr. Graham F. Peaslee of Notre Dame University found that “The majority of PFAS identified in the extraction from textiles [from certain gear] are found in the short and long-chain fluoroalkyl acids including PFOA.”
Becker said awareness remains the most immediate defense. He encourages firefighters to clean gear promptly after fires, wipe down high-absorption areas such as the neck and groin, and shower as soon as possible after leaving a fire scene.
For January, the Irving association circulated weekly materials to members focused on understanding exposures, early detection, lifestyle health, and behavioral support following a diagnosis.
“To mitigate the risk, we first need to know and understand the risk,” Becker said.
