Aqueous film-forming foam (AFFF) is a firefighting foam that has been widely used by the military, airports, and industrial facilities since the 1970s to quickly extinguish fuel and solvent fires. AFFF contains per- and poly-fluoroalkyl substances (PFAS), which are emerging contaminants of concern as they do not degrade in the environment easily.
Certain individuals may suffer from prolonged or repeated exposure to AFFF, such as firefighters, airport firefighters, and military personnel who regularly train with or respond to fires. There is growing evidence that AFFF exposure is associated with a number of adverse health effects. Understanding these health risks is important for those regularly working with AFFF as well as communities impacted by AFFF contamination.
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AFFF Exposure Pathways
AFFF contains PFAS, which are synthetic chemicals that repel oil, grease, and water. During firefighting activities, AFFF containing PFAS can contaminate soil, surface water, and groundwater. PFAS have also been detected in drinking water sources near military bases, airports, and fire training facilities where AFFF was regularly used.
The most common exposure pathways for AFFF are through drinking contaminated water, direct contact with foam during firefighting activities, or contact with PFAS-contaminated soil. PFAS accumulate in the body over time and do not easily break down, which is why even short, low exposures can lead to a harmful build-up in the body.
Firefighting Foam Lawsuit
In recent years, an increasing number of lawsuits have been filed by individuals who developed medical conditions after prolonged exposure to AFFF-containing PFAS chemicals. A firefighting foam lawsuit alleges that manufacturers of AFFF knew or should have known the potential health hazards associated with these chemicals but failed to provide sufficient warning. Most lawsuits have been filed by current or former firefighters and others with high occupational exposure to AFFF, such as military personnel.
Plaintiffs in these lawsuits argue that their cancers, liver or kidney disease, thyroid problems, or other conditions are a direct result of AFFF exposure. They seek financial compensation for medical costs, lost wages, and mental distress. Defendants, including major chemical manufacturers, have denied claims that AFFF is responsible for health effects in these lawsuits. Litigation is ongoing.
As the scientific evidence linking AFFF and conditions like cancer continues to emerge, more lawsuits will likely emerge. These legal cases represent efforts to hold manufacturers financially accountable for the health consequences of PFAS and obtain justice for those harmed by AFFF exposure. They also aim to spur companies to develop safer firefighting alternatives without PFAS.
Health Effects of AFFF Exposure
The health effects potentially associated with exposure to PFAS-containing AFFF are still being investigated. However, based on current research, here are some of the possible health risks:
1. Cardiovascular Effects
Some research indicates that PFAS exposure can lead to increased cholesterol levels and risk of high blood pressure. Elevated cholesterol and hypertension are major risk factors for cardiovascular disease.
For firefighters and others with high occupational exposure to AFFF, it will be important to regularly monitor cardiovascular health markers. Early detection of any cardiovascular changes can allow for better management through medications or lifestyle adjustments to minimize the risks.
Ongoing research will continue to clarify the cardiovascular risks of AFFF and ways to mitigate itspotential effects.
2. Gastrointestinal Effects
There is some emerging evidence that AFFF exposure may be associated with certain gastrointestinal issues. A few recent studies have found connections between PFAS exposure and liver damage or ulcerative colitis, an inflammatory bowel disease.
One study of firefighters found that higher PFAS blood levels were associated with increased biomarkers of liver injury. Elevated liver enzymes can indicate liver cell damage and inflammation. Over time, chronic AFFF exposure could potentially lead to serious liver disease.
Another study found higher rates of ulcerative colitis among Air Force personnel exposed to AFFF compared to the general population. Ulcerative colitis is a chronic digestive condition that causes inflammation and ulcers in the colon. While more research is still needed, these early studies suggest AFFF exposure may have gastrointestinal effects.
For those regularly working with or exposed to AFFF, it will be important to be aware of any symptoms like abdominal pain, digestive issues, or unexplained weight loss. These could indicate possible liver or gastrointestinal problems, warranting medical evaluation.
3. Neurological Effects
Hard evidence has been found concerning neurological effects linked to AFFF exposure. PFAS have been found to accumulate in the brain and potentially alter neurophysiology.
Some studies in animals have found that PFAS exposure can cause neurobehavioral effects and changes in brain cell development and neurotransmitters. While animal studies do not always predict human effects, these results suggest neurotoxic potential.
Other research has found associations between elevated PFAS levels and headaches, impaired cognitive function, and lower IQ scores in children. A recent study of firefighters found higher PFAS exposure was associated with poorer performance on tests of motor function.
While more research is still needed, these early findings suggest PFAS exposure through AFFF has the potential to impact the neurological system. Those regularly working with AFFF should be aware of any unexplained neurological symptoms and report them to a doctor. Monitoring children’s neurological development is also recommended if there is parental AFFF exposure.
4. Respiratory Effects
Because AFFF is applied as a foam, inhalation exposure is a potential concern. Firefighters and others who work directly with AFFF can inhale foam droplets or vapors. Studies have found firefighters exposed to AFFF have higher rates of respiratory symptoms compared to the general population.
One study of Air Force firefighters found connections between AFFF exposure and chronic bronchitis, sinusitis, pneumonia, and other respiratory diagnoses. Firefighters with the highest AFFF contact had nearly double the rate of respiratory diseases.
Another study showed Australian firefighters had an increased risk of lung function decline and respiratory symptoms like wheezing with AFFF exposure. The pulmonary effects were most pronounced in those with the highest contact.
While respiratory protection is commonly used during firefighting, it may not fully eliminate inhalation exposure, especially when working in close contact with AFFF foam over many years. The inhalation pathway represents a significant exposure risk.
Those who work with AFFF should undergo regular lung function and respiratory symptom screening to identify any effects early.
AFFF is an important firefighting tool that has been used for decades, but emerging research indicates exposure may be associated with a number of adverse health effects.
More research is critically needed to firmly establish the dose-response effects of AFFF exposure through different pathways. However, it is prudent to minimize exposure whenever possible as a precautionary measure.
While AFFF provides critical fire protection, it is vital to balance these benefits with potential health hazards. Understanding the emerging research on AFFF toxicity can help guide policies and practices to better protect both firefighters on the front lines as well as the communities they serve.