Asbestos Exposure in Firefighters

If you served as a firefighter, or someone in your family did, and a diagnosis of mesothelioma, lung cancer, or another asbestos disease has come in, this page explains how the job exposed you and what your options are. Firefighters worked inside older buildings that were full of asbestos, often while those buildings were burning, falling apart, or being torn open after the flames were out.

In 2022 the World Health Organization's cancer agency concluded that working as a firefighter causes mesothelioma, the cancer most closely tied to asbestos, and named asbestos met on the job as a plausible reason. A large U.S. study found mesothelioma at about twice the expected rate, and a Nordic study found it raised in firefighters 70 and older. When the agency pooled seven studies, it found about 58% higher risk in firefighters.

You do not need to know which products were in the buildings you entered. Part of our job is to look at your whole working life, including the buildings, the years, and any other jobs you held, and find where the asbestos came from.

How asbestos reached firefighters

Asbestos was built into American buildings for most of the twentieth century. A firefighter could not choose which buildings to enter, and the older the building, the more likely it held asbestos somewhere.

• Inside a burning building. Heat, water from hose lines, and collapsing ceilings and walls can break apart insulation, fireproofing, and other friable (crumbly) materials. Fibers mix with smoke and settle as dust.
• Overhaul. After the fire is knocked down, crews pull ceilings, open walls, and tear out smoldering material to find hidden fire. This is when much of the dust is raised, and it is also when firefighters have often taken off their breathing masks because the smoke has cleared. A 2001 field study found short-term signs of lung irritation within an hour of overhaul in firefighters who did not wear air-supplied masks, linked to smoke chemicals left in the air.
• Older gear. Asbestos was woven into heat-resistant cloth, gloves, and suits. The industry trade journal Asbestos reported a 1941 order of 10,000 pairs of asbestos gloves for British civilian fire fighters (Asbestos, Mar. 1941) and ran a 1954 item titled "Asbeston Suits for Fire Fighters" (Asbestos, Mar. 1954). In December 1941 the same journal pictured the "Fire Fighting Squad" of the aircraft carrier H.M.S. Furious "clad in asbestos" during a drill at the Philadelphia Navy Yard (Asbestos, Dec. 1941). We do not yet know how widely such gear was used by U.S. fire departments, so we look at each department's history.
• Disaster response. At the World Trade Center, the U.S. Geological Survey found chrysotile asbestos at trace levels (under 1%) in more than two-thirds of the dust and debris samples it collected, and up to 20% chrysotile by volume in coating from a steel beam.

The exposure was repeated. One fire may be a short event. A career is hundreds or thousands of calls over twenty or thirty years.

Who else was exposed

• Other first responders. Police, paramedics, and recovery and cleanup crews worked in the same dust at many scenes, especially at the World Trade Center.
• Families at home. Dust can travel on gear, clothing, hair, and in vehicles. A spouse who handled work clothes, or children who were around them, could breathe it. This is called take-home exposure. Read more on our page about take-home asbestos exposure.
• Building workers. The trades who rebuilt or demolished fire-damaged buildings faced the same materials. See bystander and proximity workers.

The diseases

Asbestos fibers stay in the body for decades. Disease usually shows up many years after the exposure began. That delay is called latency.

• Mesothelioma. A cancer of the lining of the lungs (pleural) or abdomen (peritoneal). Asbestos causes most, but not all, mesothelioma. See mesothelioma.
• Lung cancer. Asbestos raises lung cancer risk, and smoking raises it further. Firefighters also breathe other cancer-causing agents in smoke. See asbestos lung cancer.
• Asbestosis and pleural disease. Scarring of the lung, and pleural plaques or thickening on the lining of the lung. See pleural plaques and thickening.
• Other cancers. IARC found sufficient evidence for bladder cancer and limited evidence for cancers of the colon, prostate, and testis, melanoma, and non-Hodgkin lymphoma in firefighters. Those are linked to firefighting as a whole, which includes smoke, soot, and chemicals, not to asbestos alone.

What the evidence says

The research on firefighters and asbestos has grown over three decades.

• New York City, 1991. Researchers examined 212 long-serving New York City firefighters who had worked in ladder companies in the 1960s. Of the 152 who reported no asbestos exposure before firefighting, 13% had X-ray changes consistent with asbestos, including 9% with pleural thickening. The authors concluded that firefighters are at risk of asbestos-related lung and pleural scarring from the job itself, and recommended respiratory protection through all phases of a fire (Markowitz et al., 1991).
• U.S. career firefighters, 2014. A NIOSH study of 29,993 career firefighters in San Francisco, Chicago, and Philadelphia, tracked deaths from 1950 to 2009 and cancer diagnoses from 1985 to 2009. Mesothelioma was diagnosed at 2.29 times the expected rate (35 cases) and caused twice the expected number of deaths (12). The authors called it the first report of excess mesothelioma in U.S. firefighters and noted that asbestos is a known hazard of firefighting. A 2020 update of the same group again found mesothelioma deaths above the expected rate.
• Nordic countries, 2014. A study of 16,422 male firefighters in five Nordic countries found 17 mesotheliomas, about 1.5 times the expected number, a difference that could have been chance. In men 70 and older the rate was 2.59 times expected (10 cases) (Pukkala et al., 2014). The authors pointed to asbestos as one possible explanation.
• IARC Monograph 132, 2022. An international panel of 25 experts met in Lyon in June 2022 and classified occupational exposure as a firefighter as IARC Group 1, carcinogenic to humans. It found sufficient evidence that the work causes mesothelioma and bladder cancer. The panel's published summary named asbestos in firefighting as a plausible cause of the mesothelioma finding. Firefighting had been rated "possibly carcinogenic" (Group 2B) before.

What the studies do not show. They show higher risk across groups of firefighters. They do not prove what caused any one person's illness. Each case is built on its own work history and medical evidence.

Protection today

• Breathing air through overhaul. NIOSH research supports keeping self-contained breathing apparatus (SCBA) on during overhaul. In a 2021 study that simulated overhaul, SCBA prevented almost all exposure to smoke contaminants, while canister masks let some through in heavy conditions.
• Medical checks. The New York City researchers in 1991 recommended medical surveillance for firefighters, and that advice still holds for anyone with a long career.
• Tracking cancer. In 2018 Congress passed the Firefighter Cancer Registry Act, which directed NIOSH to build a voluntary national registry of firefighters. Enrollment opened in 2023.

Asbestos that is still in place in older buildings can be disturbed whenever one of those buildings burns, so the hazard has not gone away.

Presumption laws are not the same as asbestos claims

Many states have firefighter cancer presumption laws. Under these laws, certain cancers in firefighters are presumed to be caused by the job, so the employer or its insurer must prove otherwise. The International Association of Fire Fighters describes these laws as a way to make it easier for firefighters with cancer to receive workers' compensation, disability, health, or death benefits. Read more about how an asbestos presumption law works.

The rules vary a great deal from state to state. Many laws list which cancers are covered, require a minimum number of years of service, or let the employer rebut the presumption, for example by pointing to smoking.

A presumption claim is against your employer's benefits system. An asbestos claim is against the companies that made the asbestos products. They are different systems, and a firefighter may be able to pursue both. Ask about how the two interact in your state before you settle either one.

How firefighter asbestos claims work

Who may have a claim:

• A current or retired firefighter diagnosed with mesothelioma, asbestos lung cancer, or another asbestos disease.
• A family member who was exposed through the firefighter's clothing or gear.
• The family of a firefighter who has died from an asbestos disease, through a wrongful death claim where state law allows.

Where compensation may come from:

• Asbestos trusts. Dozens of asbestos product makers went through bankruptcy and set up a bankruptcy trust to pay people they harmed. Trust claims are paperwork claims, not trials. See how asbestos trust claims work.
• Lawsuits. Companies still in business that made or sold asbestos products may be sued. See mesothelioma lawsuits.
• Workers' compensation and presumption benefits, through your department's system, described above.
• The World Trade Center Health Program, for responders with a certified condition.

We reconstruct the product exposure. A firefighter rarely knows what brand of insulation was in a burning warehouse. We work from the department's run history, the buildings and years, published records of where products were used, and your other jobs. Some firefighters also worked a second trade, served in the Navy, or worked in shipyards, plants, or construction before or during their fire service. Those jobs often have clearer product records, and we look at all of them. This is called product identification, and it is often where a firefighter's case is won or lost. We will tell you honestly what we find.

If you have not been diagnosed but are worried, our free screening uses a chest X-ray read by a B-reader. It looks for asbestos changes in the lungs. It is not a test for mesothelioma. See our free asbestos health test.