
Gary Flook served within the Air Force for 37 years, as a firefighter on the now-closed Chanute Air Force Base in Illinois and the previous Grissom Air Force Base in Indiana, where he frequently trained with aqueous film forming foam, or AFFF — a frothy white fire retardant that is extremely effective but now known to be toxic.
Flook volunteered at his local fire department, where he also used the froth, unaware of the health risks it posed. In 2000, at age 45, he received devastating news: He had testicular cancer, which might require an orchiectomy followed by chemotherapy.
A whole bunch of lawsuits, including one by Flook, have been filed against corporations that make firefighting products and the chemicals utilized in them.
And multiple studies show that firefighters, each military and civilian, have been diagnosed with testicular cancer at higher rates than people in most other occupations, often pointing to the presence of perfluoroalkyl and polyfluoroalkyl substances, or PFAS, in the froth.
However the link between PFAS and testicular cancer amongst service members was never directly proven — until now.
A brand new federal study for the primary time shows a direct association between PFOS, a PFAS chemical, present in the blood of hundreds of military personnel and testicular cancer.
Using banked blood drawn from Air Force servicemen, researchers on the National Cancer Institute and Uniformed Services University of the Health Sciences found strong evidence that airmen who were firefighters had elevated levels of PFAS of their bloodstreams and weaker evidence for individuals who lived on installations with high levels of PFAS within the drinking water. And the airmen with testicular cancer had higher serum levels of PFOS than those that had not been diagnosed with cancer, said study co-author Mark Purdue, a senior investigator at NCI.
“To my knowledge,” Purdue said, “that is the primary study to measure PFAS levels within the U.S. military population and to research associations with a cancer endpoint on this population, in order that brings latest evidence to the table.”
In a commentary within the journal Environmental Health Perspectives, Kyle Steenland, a professor at Emory University’s Rollins School of Public Health, said the research “provides a invaluable contribution to the literature,” which he described as “fairly sparse” in demonstrating a link between PFAS and testicular cancer.
More studies are needed, he said, “as is all the time the case for environmental chemicals.”
Not ‘just soap and water’
Old stocks of AFFF that contained PFOS were replaced prior to now few many years by foam that incorporates newer-generation PFAS, which now are also known to be toxic. By congressional order, the Department of Defense must stop using all PFAS-containing foams by October 2024, though it may well keep buying them until this October. That is many years after the military first documented the chemicals’ potential health concerns.
A DoD study in 1974 found that PFAS was fatal to fish. By 1983, an Air Force technical report showed its deadly effects on mice.
But given its effectiveness in fighting extremely hot fires, like aircraft crashes and shipboard blazes, the Defense Department still uses it in operations. Rarely, if ever, had the military warned of its dangers, in keeping with Kevin Ferrara, a retired Air Force firefighter, in addition to several military firefighters who contacted KFF Health News.
“We were told that it was just soap and water, completely harmless,” Ferrara said. “We were completely slathered in the froth — hands, mouth, eyes. It looked similar to when you were going to replenish your sink with dish soap.”
Photos released by the Defense Visual Information Distribution Service in 2013 show personnel working in the froth without protective gear. The outline calls the “small sea of fireplace retardant foam” at Travis Air Force Base in California “non-hazardous” and “just like soap.”
“No people or aircraft were harmed within the incident,” it reads.
There are millions of PFAS chemicals, invented within the Nineteen Forties to ward off stains and stop sticking in industrial and household goods. Together with foam used for many years by firefighters and the military, the chemicals are in makeup, nonstick cookware, water-repellent clothing, rugs, food wrappers, and a myriad of other consumer goods.
Often called “eternally chemicals,” they don’t break down within the environment and do accumulate within the human body. Researchers estimate that just about all Americans have PFAS of their blood, exposed primarily by groundwater, drinking water, soil, and foods. A recent U.S. Geological Survey study estimated that no less than 45% of U.S. tap water has no less than one style of eternally chemical from each private wells and public water supplies.
Health and environmental concerns related to the chemicals have spurred a cascade of lawsuits, plus state and federal laws that targets the manufacturers and sellers of PFAS-laden products. Gary Flook is suing 3M and associated corporations that manufactured PFAS and the firefighting foam, including DuPont and Kidde-Fenwal.
Congress has prodded the Department of Defense to wash up military sites and take related health concerns more seriously, funding site inspections for PFAS and mandating blood testing for military firefighters. Advocates argue those actions usually are not enough.
“How long has [DoD] spent on this issue with none real results aside from putting some filters on drinking water?” said Jared Hayes, a senior policy analyst on the Environmental Working Group. “In the case of cleansing up the issue, we’re in the identical place we were years ago.”
On a mission to get screening
The Department of Veterans Affairs doesn’t recommend blood testing for PFAS, stating on its website that “blood tests can’t be linked to current or future health conditions or guide medical treatment decisions.”
But that would change soon. Rep. Dan Kildee (D-Mich.), co-chair of the congressional PFAS Task Force, in June introduced the Veterans Exposed to Toxic PFAS Act, which might require the VA to treat conditions linked to exposure and supply disability advantages for those affected, including for testicular cancer.
“The last item [veterans] and their families must undergo is to fight with VA to get access to advantages we promised them after they put that uniform on,” Kildee said.
Evidence is powerful that exposure to PFAS is related to health effects akin to decreased response to vaccines, kidney cancer, and low birth weight, in keeping with an expansive, federally funded report published last 12 months by the National Academies of Sciences, Engineering, and Medicine. The nonprofit institution beneficial blood testing for communities with high exposure to PFAS, followed by health screenings for those above certain levels.
It also said that, based on limited evidence, there’s “moderate confidence” of an association between exposure and thyroid dysfunction, preeclampsia in pregnant women, and breast and testicular cancers.
The brand new study of Air Force servicemen published July 17 goes further, linking PFAS exposure on to testicular germ cell tumors, which make up roughly 95% of testicular cancer cases.
Testicular cancer is probably the most commonly diagnosed cancer amongst young adult men. Additionally it is the style of cancer diagnosed at the very best rate amongst energetic military personnel, most of whom are male, ages 18 to 40, and in peak physical condition.
That age distribution and knowing AFFF was a source of PFAS contamination drove Purdue and USUHS researcher Jennifer Rusiecki to research a possible connection.
Using samples from the Department of Defense Serum Repository, a biobank of greater than 62 million blood serum specimens from service members, the researchers examined samples from 530 troops who later developed testicular cancer and people of 530 members of a control group. The blood had been collected between 1988 and 2017.
A second sampling collected 4 years after the primary samples were taken showed the upper PFOS concentrations positively related to testicular cancer.
Ferrara doesn’t have testicular cancer, though he does produce other health concerns he attributes to PFAS, and he worries for himself and his fellow firefighters. He recalled working at Air Combat Command headquarters at Joint Base Langley-Eustis in Virginia within the early 2010s and seeing emails mentioning two forms of PFAS chemicals: PFOS and perfluorooctanoic acid, or PFOA.
But employees on the bottom remained largely unfamiliar with the jumble of acronyms, Ferrara said.
At the same time as the evidence grew that the chemicals in AFFF were toxic, “we were still led to imagine that it’s perfectly secure,” Ferrara said. “They kept putting out vague and cryptic messages, citing environmental concerns.”
When Ferrara was working a desk job at Air Combat Command and not fighting fires, his exposure likely continued: Joint Base Langley-Eustis is among the many top five most PFAS-contaminated military sites, in keeping with the EWG, with groundwater at the previous Langley Air Force Base registering 2.2 million parts per trillion for PFOS and PFOA.
In accordance with the EPA, just 40 parts per trillion would “warrant further attention,” akin to testing and amelioration.
The Defense Department didn’t provide comment on the brand new study.
Air Force officials told KFF Health News that the service has swapped products and not allows uncontrolled discharges of firefighting foam for maintenance, testing, or training.
“The Department of the Air Force has replaced Aqueous Film Forming Foam, which contained PFAS, with a foam that meets Environmental Protection Agency recommendations in any respect installations,” the Air Force said in an announcement provided to KFF Health News.
Each older-generation eternally chemicals aren’t any longer made within the U.S. 3M, the important manufacturer of PFOS, agreed to begin phasing it out in 2000. In June, the economic giant announced it might pay no less than $10.3 billion to settle a class-action suit.
Alarmed over what it perceived because the Defense Department’s unwillingness to handle PFAS contamination or stop using AFFF, Congress in 2019 ordered DoD to supply annual testing for all active-duty military firefighters and banned the usage of PFAS foam by 2024.
In accordance with data provided by DoD, amongst greater than 9,000 firefighters who requested the tests in fiscal 12 months 2021, 96% had no less than one among two forms of PFAS of their blood serum, with PFOS being probably the most commonly detected at a median level of three.1 nanograms per milliliter.
Readings between 2 and 20 ng/mL carry concern for opposed effects, in keeping with the national academies. In that range, it recommends people limit additional exposure and screen for prime cholesterol, breast cancer, and, if pregnant, hypertension.
In accordance with DoD, 707 energetic and former defense sites are contaminated with PFAS or have had suspected PFAS discharges. The department is within the early stages of a decades-long testing and cleansing process.
Greater than 3,300 lawsuits have been filed over AFFF and PFAS contamination; beyond 3M’s massive settlement, DuPont and other manufacturers reached a $1.185 billion agreement with water utility corporations in June.
Attorneys general from 22 states have urged the court to reject the 3M settlement, saying in a filing July 26 it might not adequately cover the damage caused.
For now, many firefighters, like Ferrara, live with anxiety that their blood PFAS levels may result in cancer. Flook declined to talk to KFF Health News because he is an element of the 3M class-action lawsuit. The cancer wreaked havoc on his marriage, robbing him and his wife, Linda, of “affection, assistance, and conjugal fellowship,” in keeping with the lawsuit.
Congress is again attempting to push the Pentagon. This 12 months, Sen. Jeanne Shaheen (D-N.H.) reintroduced the PFAS Exposure Assessment and Documentation Act, which might require DoD to check all service members — not only firefighters — stationed at installations with known or suspected contamination as a part of their annual health checkups in addition to members of the family and veterans.
The tests, which are not covered by the military health program or most insurers, typically cost from $400 to $600.
In June, Kildee said veterans have been stymied in getting assistance with exposure-related illnesses that include PFAS.
“For too long, the federal government has been too slow to act to cope with the threat posed by PFAS exposure,” Kildee said. “This case is totally unacceptable.”
This text was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente. |