Essentially, firefighting has always been shrouded in an unspoken expectation: that danger dissipates once the flames are doused. However, for those who move through conflagrated structures, contaminated debris, and smoke-heavy zones day after day, that belief no longer holds. That is because what lingers following an incident—chemical residues, fine particulates, and combustion byproducts—often becomes the more insidious threat quietly jeopardizing the health and safety of first responders. Mounting research has increasingly linked repeated exposure to such toxins to elevated cancer risks, with occupational malignancies accounting for approximately 66% of career firefighter line-of-duty fatalities from 2002 to 2019. And though this is a national trend, its implications are especially visible in regions like Grant County, New Mexico, where firefighters constantly contend with rural structural fires as well as wildland blazes and a wide spectrum of emergency responses shaped by distance, rugged terrain, and limited containment time.
Nor is this risk confined to civilian departments alone, as military personnel also face similarly complex exposure conditions and, in some cases, even more layered hazards due to the legacy materials intrinsic to myriad aging installations as well as specialized equipment and fuel-intensive operations. To better delve into this long-standing crisis, the National Firefighter Registry for Cancer was launched in 2023 to collect and analyze relevant exposure histories and cancer outcomes, thereby bolstering the occupational studies and informing future prevention and policy efforts. Yet it is imperative to learn that the dataset's ability to deliver meaningful insight can only be realized through broad participation from all firefighters across all services—whether or not they have been diagnosed with cancer.
Tracing the Exposure Pathways Behind Firefighter Cancer Risks
The growing concern surrounding cancer risks in the fire service cannot just be attributed to a single incident or exposure source, as the truth is that it certainly stems from the cumulative nature of the profession itself. For instance, in Grant County—where wildfires have become a more familiar challenge—firefighters are often required to spend extended periods operating in settings loaded with toxic smokes while navigating a craggy topography and rapidly changing conditions. However, as these incidents can stretch across days or even weeks—unlike structural blazes and other emergencies—first responders are also more likely to have prolonged contact with generated contaminants such as volatile organic compounds (VOCs), arsenic, nitrate, and disinfection byproducts. Even after suppression efforts conclude, residues may remain embedded in protective equipment and other tools—creating additional opportunities for exposure beyond the fireground. Worse, the peril becomes even more multifaceted for military firefighters, largely because many have historically operated in environments where specialized fuels as well as industrial materials are indispensable and silently integrated in insulation and fireproofing systems.
As such, when a compartment aboard a naval vessel or in any installation flares up, firefighters correspondingly become vulnerable to encountering harmful substances like asbestos fibers, lead, carbon monoxide, liquid hydrocarbons, fire retardants, mercury, and hot gases or vapors. Besides this, training activities can likewise serve as a recurring source of exposure, particularly through the long-standing use of aqueous film-forming foam (AFFF). Because this suppressant contains substantial levels of per- and polyfluoroalkyl substances (PFAS), its widespread application has contributed to contamination concerns at over 700 military bases throughout the country. In New Mexico alone, roughly nine sites—including the White Sands Missile Range, about 155 miles from Grant County—have regrettably been drastically impacted, emphasizing the gravity of the PFAS pollution as well as the alarming carcinogenic risks it poses to deployed crews.
Transforming Individual Experiences Into Actionable Evidence
A meaningful response to the persistent issue of cancer risk within the fire service cannot rely on awareness alone—it fundamentally hinges on whether years of occupational experience can be converted into reliable evidence that can genuinely guide impactful policy change. Acknowledging this imperative, a bipartisan group of lawmakers successfully enacted the Firefighter Cancer Registry Act of 2018 to mandate the Centers for Disease Control & Prevention to create the National Firefighter Registry for Cancer. At its core, this pivotal initiative is designed to connect firefighters' service histories with long-term health outcomes—spanning career, volunteer, retired, and military personnel across the nation—by consolidating disparate data currently held in various departments, jurisdictions, and personal records. In doing so, the registry turns isolated pieces of information into a comprehensive national evidence base to correlate specific firefighting environments and exposure histories with cancer outcomes over time.
At the same time, such insights are essential to enable researchers and policymakers to shape prevention strategies, occupational standards, and future health protections for the fire service. The urgency of this effort becomes even clearer when viewed alongside existing federal protections such as the Honoring Our PACT Act, which has expanded presumptive coverage for more than 20 service-related conditions. Notwithstanding this advancement, many other exposure cases—most notably those involving PFAS contamination—remain outside this apparently beneficial framework. And that very disconnect between emerging evidence and formal acknowledgment underlines a persistent gap in how occupational risks are translated into policy—thus reinforcing the need for stronger and more complete data to guide future determinations. As of June 1, 2026, almost 50,000 firefighters—including over 300 residents in New Mexico—have already enrolled in the registry. But though this figure represents important progress, it still reflects only a small fraction of the more than one million crews serving nationwide.
Virtually, broadening participation will require sustained awareness efforts through department-level briefings as well as onboarding and training integration, veteran transition programs, and routine inclusion in occupational health evaluations so that enrollment becomes a standard part of service rather than an optional step. For Grant County firefighters, stronger engagement is not simply an administrative necessity—it is critical to ensuring that the realities of the region's wildfire-prone terrain, rural response demands, and prolonged operational exposure are fully captured in the dataset that will ultimately drive how firefighter cancer risk is understood, addressed, and acted upon at the national level.
About the Author
Cristina Johnson serves as a veteran advocate at the Asbestos Ships Organization, a nonprofit that raises awareness of veterans' exposure to toxic substances.
