Women, volunteers left behind in Washington firefighter protections
This time corresponds to an increased awareness of toxic exposure among firefighters, as well as limited legislation on presumptive coverage for conditions caused by hazardous chemical exposure. Notably, although some developments have been achieved in legislation, several gaps remain. To date, volunteer firefighters are not covered by presumptive laws, while women firefighters, a growing demographic in this profession, still face exclusions in coverage for reproductive cancers.
Today, over 90,000 firefighters in the U.S. are women, totaling 9% of the entire workforce. More than 72,000 of them work as volunteers, and thus do not benefit from presumptive coverage for any conditions. In 2025, the Federal Employees' Compensation Act was updated to include automatic access to healthcare and financial compensation for breast, ovarian, cervica, and uterine cancers. Yet state-level legislation has yet to adopt this model, although recruitment and retention strategies recognize the importance of coverage.
Firefighters and toxic exposure on the job
Some risks in the firefighting profession are more obvious than others. With each intervention, these professionals risk injuries from collapsing structures, burns, smoke inhalation and acute trauma. Toxic exposure in firefighters is nonetheless an invisible and considerable risk, which includes elements far beyond smoke inhalation.
Until 2000, not much was known about the toxicity of per- and polyfluoroalkyl substances (PFAS), also known as the so-called 'forever chemicals', despite these compounds having been part of firefighter turnout gear and firefighting foams for decades. With legal action against manufacturers, data and research on these substances now reveal that PFAS can cause several severe conditions, including various types of cancer. Action against these substances has only recently been implemented, while since 2023, firefighters from several states have sued manufacturers for failing to properly warn users of these risks.
Subsequent investigations into PFAS and firefighters' risks have shown that turnout gear contains staggering amounts of these chemicals. Analysis of blood samples from career and volunteer firefighters reveals an elevated level of PFAS, significantly exceeding the levels found in the general population contaminated through environmental exposure.
Concomitantly, as volunteer firefighting departments are funded from local budgets, turnout gear is often overworn and used, leading to an increased release of PFAS that can be absorbed through the skin, especially in hot and humid conditions. Currently, a large-scale cohort study is recruiting female firefighters to gather more accurate data on cancer risk in this population. Notably, research available thus far suggests that there is an increased risk of breast cancer among women firefighters, with an age of onset far lower than that of the general population.
Washington state omits key cancers in coverage
Several states across the U.S. exclude women's reproductive cancers altogether, even for career firefighters. In this case, compensation may be achieved only following a laborious process whereby the firefighter affected by cancer needs to demonstrate exposure and causality. These processes can take months to develop, often requiring extensive medical documentation, expert testimony and navigating complex legal matters.
While the Washington State Revised Code acknowledges breast and cervical cancers as occupational hazards for female firefighters, it omits ovarian and uterine cancers from the list, two diseases with well-established links to the toxic exposure common in firefighting environments. Moreover, where compensation is provided, these benefits are available only to career firefighters who have served more than ten years as full-time employees.
There is no recent data available on the number of women firefighters in Washington state; however, according to the latest statistics, 204 women were serving in 30 fire departments.
However, an archived report mentions that in 2008, 93 of the 1,038 firefighters in Seattle were women, which is approximately 9%, reflecting the national average and establishing a link to what became a trend for women in the firefighting profession.
Washington state relies heavily on volunteer firefighters, recruiting approximately 3,900 new volunteers each year. While women remain underrepresented in the field, they are gradually joining the ranks in growing numbers. Under these circumstances, the bill's omission of the volunteer firefighters, as well as the ovarian and uterine cancers from the list of occupational hazards, is simply unacceptable and morally wrong. It's time for the state to align with federal standards and recognize the full scope of risks all firefighters face.
By expanding presumptive coverage to include all reproductive cancers and extending protections to volunteer firefighters, Washington state can secure not only a fair work environment and compensation for these professionals but also its entire future firefighting force.
Jordan Cade is a practicing attorney at Environmental Litigation Group, P.C., where he provides comprehensive legal representation and case assessments for individuals affected by environmental and occupational toxic exposures.
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