Per‐and polyfluoroalkyl substances (PFAS) exposure profiles and their predictors in a study of us volunteer firefighters
By Katherine A Lubina, Zorimar Rivera-Núñez, Miriam M Calkins, Robert Laumbach, Shou-En Lu, Jefferey L Burgess, Elena Austin, Derrick L Edwards, Maria D H Koeppel, Jaclyn M Goodrich, Zhihua Tina Fan, Chang Ho Yu, Kaleigh M Hinton, Casey C Grant, Brian Kubiel, Daniel Roy, and Judith M Graber
Am J Ind Med
June 14, 2026
DOI: 10.1002/ajim.70104
Introduction
Firefighters may experience occupational exposure to per- and polyfluoroalkyl substances (PFAS). Volunteer firefighters make up 65% of the US fire service, but their serum PFAS profiles have not been well characterized. This study aims to (1) describe PFAS serum profiles among US volunteer firefighters from 9 states enrolled in the Firefighter Cancer Assessment and Prevention Study (CAPS), and (2) identify predictors of their serum PFAS concentrations.
Methods
Twelve PFAS were quantified in serum of 550 active volunteer firefighters collected at enrollment into CAPS between 2020 and 2023. Fire service, occupational, sociodemographic, and health predictors of interest were captured in the CAPS enrollment survey. PFAS detection frequencies, average concentrations, and distributions were characterized overall and by regional groups. Associations between serum PFAS and predictors of interest were assessed using multivariable generalized estimating equation models for all participants and by sex in those < 50 years old.
Results
CAPS participants' serum PFAS profiles varied by geography, age, and sex. Firefighting, occupational, sociodemographic, and health factors were associated with serum PFAS in the full cohort. In sex-stratified models, some associations differed between males and females and from the full cohort.
Conclusion
Stronger associations between sociodemographic and health factors with serum PFAS, with less strong associations between serum PFAS and occupational and fire service factors highlight the likely multifaceted exposure experience of volunteer firefighters and the relative importance of community factors. Sex and age differences in serum profiles and associations with predictors may imply different exposure and elimination pathways among male and female volunteer firefighters.
Location:
Topics: