What We Know, What We’re Learning, and Why Tracking Matters
When firefighters think about occupational cancer, breast cancer usually isn't first on the list. But researchers are taking a closer look at the chemicals firefighters encounter on the job, and what those exposures may do to the body.
Fire, smoke, and hazardous exposures don’t discriminate, nor does breast cancer. While scientists have established that firefighting is a cancer-causing occupation, researchers are still working to understand the connection between occupational exposures and breast cancer in both women and men. What we already know about these exposures gives us plenty of reason to take them seriously, even as the research continues. That’s exactly why the record you keep today matters.
What the Research Tells Us
In 2022, the International Agency for Research on Cancer (IARC) classified occupational exposure as a firefighter as carcinogenic to humans (Group 1). The strongest evidence linked firefighting to bladder cancer and mesothelioma. But what about breast cancer?
Researchers have been examining breast cancer rates among firefighters, along with the chemicals they encounter on the job. While studies have not established a direct link between firefighting and breast cancer, they have identified many chemicals found in soot, smoke and other firefighting environments that have been associated with breast cancer in studies of workers in other populations and in experimental research.
Twelve Chemicals Worth Understanding
A 2024 study by Cardona et al. examined occupational exposure to 12 chemicals or chemical groups associated with breast cancer risk. Researchers identified nine with strong evidence of elevated exposure among firefighters:
- Benzene: A combustion and diesel exhaust product measured above short-term exposure limits on structure fires and training burns.
- Polycyclic aromatic hydrocarbons (PAHs): Found in combustion products and identified by the researchers as having particularly concerning evidence related to breast cancer.
- Acetaldehyde: Released in structure fires, training burns, and overhaul.
- Styrene: Released from burning plastics; elevated in firefighters after live-fire training, even with SCBA on.
- Dioxins and dioxin-like compounds: Combustion byproducts measured in firefighters' blood after structural fires.
- PFAS: A group of persistent chemicals associated with certain firefighting foams and other sources. Breast cancer-specific evidence remains limited and inconsistent.
- PBDE flame retardants: Chemicals present in some building materials, furnishings, and other products encountered during firefighting.
- Replacement flame retardants: Organophosphate and other newer flame retardants used in place of PBDEs.
- Polychlorinated biphenyls (PCBs): Legacy industrial chemicals found in station dust, burning buildings, and soiled gear.
Benzene and PAHs carried the strongest evidence suggesting an increased breast cancer risk following adult exposure. Acetaldehyde, styrene, and replacement flame retardants also raised concerns.
The bottom line: firefighters are exposed to chemicals associated with breast cancer. That does not prove those chemicals cause breast cancer in firefighters. More research is needed, and that research depends on knowing who was exposed to what.
Source: Cardona et al. (2024), Breast Cancer-Related Chemical Exposures in Firefighters.
What About Women Firefighters?
Women have been underrepresented in firefighter cancer research for decades. That leaves real gaps in what we know about occupational breast cancer risk.
Some studies have found higher breast cancer rates among women firefighters, but the increases have not consistently been statistically significant (Cardona et al., 2024). For example, an Ontario occupational cohort study published in 2022 identified only seven breast cancer cases among female firefighters and did not find a statistically significant increase compared with other workers. Numbers that small can’t tell us much.
Other factors complicate the research, including differences in years of service, job assignments, exposure intensity, protective equipment, shift work, and individual cancer risk factors.
Male Breast Cancer: An Overlooked Conversation
Breast cancer in men is rare, accounting for less than 1% of breast cancer cases in the United States. Because it is uncommon, male breast cancer has received relatively little attention in firefighter occupational cancer studies.
A 2021 overview of firefighter cancer research found no statistically significant increase in male breast cancer incidence. It did report an elevated mortality estimate, but on limited data with wide confidence intervals. Other meta-analyses are similarly inconclusive.
This does not establish that firefighting increases male breast cancer risk. It does, however, highlight how difficult it is to study a rare disease without sufficient cases and detailed exposure histories.
Men should be aware of potential warning signs, including a breast lump, nipple changes, or unexplained discharge.
Recognized risk factors include increasing age, certain inherited genetic mutations, and family history.
Breast health belongs in occupational health education for all firefighters.
The Record Problem
Every gap in this research comes back to one question: What was this firefighter exposed to, and when? The effect of occupational exposures may not become apparent for years or even decades (CDC, 2026). Certain PAHs can cause DNA damage (ATSDR, 2009), while some PFAS can remain in the body for years (NASEM, 2022). These findings reinforce the importance of documenting exposures throughout a firefighter's service.
A missing record affects:
- Healthcare: Without a documented exposure history, you may have less information to share with your healthcare provider when discussing occupational risks.
- Research: Studies such as the Fire Fighter Cancer Cohort Study (FFCCS) rely on accurate exposure data to better understand potential connections between firefighting exposures and cancer.
Where Exposure Tracker Fits
The IPSDI Exposure Tracker™ is built for exactly this. Log incidents and occupational exposures as they happen, and go back and document past exposures that were never recorded.
Use it to:
- Capture incident details, assignments, and potential hazards while they're fresh.
- Build your exposure history one call at a time.
- Bring a real record to your occupational health provider.
- Keep records that may matter in future health evaluations or research.
Tracking won't prevent cancer. It won't prove exposure caused a specific cancer. What it does is keep information that's hard, or impossible, to rebuild later. Log it now or lose it.
What Firefighters Can Do Now
- Know your personal risk.
Family history, inherited genetic mutations, age, and other health factors all play a role. Talk through your personal and occupational history with a provider who understands the job. - Recognize changes.
Possible symptoms of breast cancer include:
A new lump or thickening in the breast or underarm
Changes in breast shape or skin texture
Nipple inversion or unexplained discharge
Persistent changes in the breast or nipple area
Any unexplained change should be evaluated by a healthcare professional. - Follow screening guidance.
For women at average risk, the U.S. Preventive Services Task Force recommends mammography every two years between ages 40 and 74. People at higher risk may need earlier or additional screening based on individualized medical guidance. Routine mammography is not generally recommended for all men, but men with significant risk factors should discuss appropriate evaluation and screening with their healthcare providers. - Reduce occupational exposure.
Wear your SCBA through overhaul. Do on-scene decon. Clean your gear and equipment. Keep contaminants out of the rig, the station, and your personal vehicle. - Log it.
Open Exposure Tracker after the call, not next month. Then start working backwards throughout your years of service.
What Can Fire Departments Do?
Every department can widen the cancer conversation beyond old assumptions about who’s at risk.
- Build breast health into existing occupational health programs, with education for women and men.
- Reinforce exposure reduction on every call, not just big ones.
- Support appropriate medical screening.
- Make exposure documentation standard practice. Give crews time after calls to log exposures, and time to add past ones.
- Encourage participation in firefighter health research like Fire Fighter Cancer Cohort Study (FFCCS) and the National Firefighter Registry for Cancer (NFR).
Awareness Today. Better Evidence Tomorrow.
We know firefighters encounter chemicals associated with breast cancer in other populations and in experimental research. We also know the research hasn't established whether firefighting raises breast cancer risk in women or men.
What's still unknown: which exposures matter most, how cumulative exposure drives risk, and whether certain roles or assignments contribute. Answering those questions takes stronger research, more women in the data, real attention to male breast cancer, and complete exposure histories.
The researchers can't build that last piece. You can, by tracking your exposures. And make breast health part of the conversation for every firefighter.
Cancer Resources for Firefighters
Fire Fighter Cancer Cohort Study (FFCCS): Long-term research tracking firefighter exposures and cancer outcomes. Ask your department about enrolling.
National Firefighter Registry for Cancer (NFR): NIOSH's voluntary registry for U.S. firefighters, active, retired, career, and volunteer. Joining adds your service to the data.
Firefighter Cancer Support Network (FCSN): Peer mentoring and support for firefighters and families facing cancer.
Dana-Farber Direct Connect for Firefighters: Fast access to specialized cancer care, plus help navigating diagnosis and treatment.
American Cancer Society: Plain-language breast cancer guidance for women and men, including detection and screening.
DetecTogether: Early cancer detection education for firefighters, including downloadable breast self-exam cards.
Know the risks. Recognize the signs. Reduce exposure. Track what matters.
References
1. Cardona, B., Rodgers, K. M., Trowbridge, J., Buren, H., & Rudel, R. A. (2024). Breast cancer-related chemical exposures in firefighters. Toxics, 12(10), 707. https://doi.org/10.3390/toxics12100707
2. International Agency for Research on Cancer. (2023). Occupational exposure as a firefighter. IARC Monographs, Volume 132. https://www.iarc.who.int/news-events/iarc-monographs-volume-132-occupational-exposure-as-a-firefighter/
3. Burgess et al. (2025). The Fire Fighter Cancer Cohort Study: Protocol for a longitudinal occupational cohort study. JMIR Research Protocols. https://www.researchprotocols.org/2025/1/e70522
4. Sritharan et al. (2022). Ontario occupational cancer cohort study of firefighters and police. Occupational and Environmental Medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC9304109/
5. Laroche, E., & L’Espérance, S. (2021). Cancer incidence and mortality among firefighters: An overview of epidemiologic systematic reviews. International Journal of Environmental Research and Public Health, 18(5), 2519. https://doi.org/10.3390/ijerph18052519
6. Casjens, S., Brüning, T., & Taeger, D. (2020). Cancer risks of firefighters: A systematic review and meta-analysis of secular trends and region-specific differences. International Archives of Occupational and Environmental Health. https://pmc.ncbi.nlm.nih.gov/articles/PMC7452930/
7. Jahnke et al. (2024). Meta-analysis of incidence and mortality of firefighter cancer: An update on emerging science. Asian Pacific Journal of Cancer Prevention. https://pmc.ncbi.nlm.nih.gov/articles/PMC11152373/
8. U.S. Preventive Services Task Force. (2024). Breast cancer: Screening. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening
9. American Cancer Society. Breast cancer in men: Detection and diagnosis. https://www.cancer.org/cancer/types/breast-cancer-in-men/detection-diagnosis-staging.html
10. Centers for Disease Control and Prevention. (2026). Guidelines for examining unusual patterns of cancer and environmental concerns. https://www.cdc.gov/cancer-environment/php/guidelines/phase-3.html
11. Agency for Toxic Substances and Disease Registry. (2009). Polycyclic aromatic hydrocarbons (PAHs): How do PAHs induce pathogenic changes? Centers for Disease Control and Prevention. https://archive.cdc.gov/www_atsdr_cdc_gov/csem/polycyclic-aromatic-hydrocarbons/pathogenic_changes.html
12. National Academies of Sciences, Engineering, and Medicine. (2022). Guidance on PFAS exposure, testing, and clinical follow-up. The National Academies Press. https://doi.org/10.17226/26156