High Alert Institute



Bioaccumulation and the One Nature/One Health Impacts of Occupational PFAS

by | Dec 26, 2022

Bioaccumulation and the One Nature/One Health Impacts of Occupational PFAS

Coauthors: Mark Goldfeder, MS, NRP, and Maurice A. Ramirez, DO, PhD


Occupational PFAS (per- or poly-fluoroalkyl substances) chemicals pose a significant exposure threat to workers in many industries. The use of PFAS in building materials, cleaning supplies, protective equipment, uniforms, and personal items make occupational PFAS exposure inevitable in nearly every workplace. Our previous article in this series identified the One Nature/One Health impacts of PFAS and how these risks are magnified by bioaccumulation. Today we will discuss occupational PFAS exposure using the story of PFAS and firefighters as a cautionary tale.

Firefighters accept the known risks associated with their job. They understand the dangers of running into a burning building, working motor vehicle collisions on busy highways, and performing other dangerous tasks as part of their daily duties. Some make the ultimate sacrifice, giving their life to save others. To minimize risk, firefighters hone their skills to the best of their ability.  

PFAS is a component of firefighting foam, and PFAS is in all three layers of protective clothing worn when fighting fires. The use of PFAS in firefighting foam and so many other products will have lasting detrimental effects on the current population and future generations. A lifelong dedication to saving lives and the property of others should never be tainted with products and materials on the job, which can increase the risk of cancer and other health concerns.  

PFAS exposure is linked to multiple diseases and health issues, including cancer, thyroid disease, birth defects, endocrine disruption, miscarriage, preeclampsia, asthma, diabetes, and high cholesterol. Studies conducted by the Centers for Disease Control (CDC) identified firefighters to have a 9% higher risk of being diagnosed with cancer and a 14% higher risk of dying from cancer than the general U.S. population. Additionally, the International Association of Firefighters (IAFF) identified cancer as the cause of 66% of career firefighter line-of-duty deaths (LODD) from 2002-2019, with 70% of all LODDs in 2016 being due to cancer.

Unfortunately, active firefighters are not the only individuals at risk for PFAS-related cancers. PFAS exposure is linked to increased cancer risk in their children as well. A study of the children of county firefighters in the state of Washington found they were 27 times more likely to develop cancer than a child in the general population. No longer can we pass the issue of PFAS remediation down the line. We must break the cycle before it is too late for not only our children but our grandchildren as well. 

Firefighters are not the only ones exposed to PFAS at work. Many work-related products cause occupational PFAS exposures. One example is fabrics treated with PFAS-containing flame/stain retardants. These fabrics leech PFAS into the wearer’s sweat, and multiple studies have shown that PFAS is absorbed through the skin, thus elevating blood PFAS levels. In one study, employees and their work uniforms were tested for PFAS. The same PFAS chemicals found in the uniforms were also found in similar concentrations in the workers’ sweat and even higher levels in their blood. Another series of studies found that face masks and N95 respirators (masks) contained PFAS chemicals. Like the uniform study, wearers of PFAS-containing masks had elevated PFAS blood levels. Other studies have shown PFAS absorption from workplace sources as varied as carpets, cleaning agents, and dust.

The scientific evidence documenting the risks and impacts of occupational PFAS is unquestionable. Everyone in the workplace, owners, management, and employees alike, is at risk. While some regulation exists for PFAS levels in workplaces manufacturing PFAS chemicals, regulatory agencies, including EPA and OSHA, have yet to issue exposure limits or safe workplace levels for all workplaces. Business owners and employees can reduce their occupational PFAS exposure through careful product selection, which avoids PFAS-containing products. The health risks related to occupational PFAS exposures will not be solved until regulatory agencies issue exposure limits and testing requirements for PFAS in all workplaces. Individuals and businesses have the power to influence change through their professional societies, their labor unions, and by supporting environmental organizations calling for PFAS regulation and PFAS-free alternatives.  


About the Authors:

Mark Goldfeder, MS, NRP, is the Founder and President of Five Bugles Institute, a provider of safety, leadership, and technical education nationally for over a decade. A 30-year veteran firefighter and paramedic, he is the coauthor of Five Bugles Institute’s PFAS remediation and replacement educational program. Learn more about Five Bugles Institute’s research at www.fivebuglesinstitute.com/pfas


Maurice A. Ramirez, D.O., Ph.D. is the recipient of the Lifetime Achievement Award in Disaster Medicine and Co-Founder of the High Alert Institute, a 501c3 not-for-profit educational public charity dedicated to providing disaster readiness education and resources to unserved and underserved communities, industries, and charitable organizations in an All Hazards, One Health/One Nature, One Framework paradigm. Learn more about the High Alert Institute at www.HighAlertInstitute.org

Griffin Works offers Pawsitive Interactions with Service Dogs During Response Operations©, an audience-customized training that breaks down barriers by offering hands-on handling training and demonstrations with working service dogs for fire departments, EMS agencies, and public safety organizations.

Part of the National Domestic Preparedness Consortium and home to the National Emergency Response and Recovery Training Center, TEEX has been leading homeland security training since 1998. The major TEEX programs include fire and rescue, infrastructure and safety, law enforcement, economic and workforce development, and homeland security. As a member of The Texas A&M University System, TEEX is unique in its ability to access a broad range of emerging research and technical expertise. Beginning with course design and development all the way through hands-on instruction and national certification testing, TEEX delivers comprehensive training through both classroom and hands-on instruction and as online courses.

The National Child Traumatic Stress Network (NCTSN) was created by Congress in 2000 as part of the Children’s Health Act to raise the standard of care and increase access to services for children and families who experience or witness traumatic events. This unique network of child-serving professionals, caregivers and young adults, researchers, and national partners is committed to changing the course of children’s lives by improving their care and moving scientific gains quickly into practice across the U.S. The NCTSN is administered by the Substance Abuse and Mental Health Services Administration (SAMHSA) and coordinated by the UCLA-Duke University National Center for Child Traumatic Stress (NCCTS). 

The Emergency Management Institute (EMI) is part of the Department of Homeland Security’s Federal Emergency Management Agency (FEMA). The EMI provides national leadership in developing and delivering training to ensure that individuals and groups having key emergency management responsibilities possess the requisite skills to effectively perform their jobs.

The High Alert Institute maintains a list of reviewed courses provided by governments, universities and professional organizations. This list is geared towards the non-emergency management person who participates in disaster planning, preparedness, response, recovery or mitigation as part of their job responsibilities.

The High Alert Institute has partnered with Shutterstock to distribute stock images from the nature images donated by our supporters. For eligible stock images, Shutterstock will donate a portion of the royalty to the High Alert Institute. There is no cost to charitable organizations or to Shutterstock customers.

For eligible purchases through AmazonSmile, the AmazonSmile Foundation will donate 0.5% of the purchase price to the High Alert Institute. There is no cost to charitable organizations or to AmazonSmile customers. All you need to do is push the SMILE NOW button and select to support THE HIGH ALERT INSTITUTE on AmazonSmile.

Koi need forever homes, too! For pond enthusiasts, freshwater exotic and ornamental fish may not be available through pet stores or rescues in their area. The High Alert Institute Aquatic Pet Shelter Rehoming Program will be happy to assist you in stocking your new pond or adding a new finned friend to your school. Coming soon – when you adopt a Koi from the High Alert Institute Aquatic Pet Shelter Rehoming Program, we can arrange for delivery to your door anywhere in the continental United States.

Have you always wanted a Koi pond but don’t have the space one? Sponsor a Koi in our community shelter pond and we send you photos of your sponsored animal. Coming soon are live Koi Cameras above and below the water to enjoy your sponsored Koi anytime.

Dumping of freshwater non-native species and exotic aquatic pets into wild habitats is a man-made disaster that is truly preventable. The Institute’s Aquatic Pet Welfare Partnership works to raise awareness and reduce the impact on healthy ecosystems through education, as well as rescue and rehoming. Joined by champions of animal welfare and environmental stewardship, this  association of aquatic pet rescue operations and aquatic pet shelters across the United States aims to save our finned friends and preserve our waterways together.

Want to share our cause with family, friends, and colleagues? Looking for a non-traditional way to celebrate a birthday or honor someone special? Support the Institute by starting your own Peer-to-Peer fundraising challenge! Let your contacts know why our mission is important to you and what they can do to support your cause. START YOUR OWN FUNDRAISER for the High Alert Institute.

From the staffing pool to the shelter ponds, from the boardroom to the classroom, and from reading the science to writing the analyses, High Alert Institute programs and services benefit from the experience, expertise, and generosity of our volunteers. Put your talents to use for good and to good use – VOLUNTEER TODAY.

Make your donation twice as nice by rehoming aquatic pets and providing a rehabilitation companion pet to a deserving person, family, or facility. Sponsor part or all of a Joy of Koi Program pond installation – complete with rehomed koi – and give the gifts of love and recovery.

Professional photographers, amateurs, and legal copywrite holders are all welcome to participate in the High Alert Institute Nature Photo Donation Program. Sales of the images benefit the Institute and donors are eligible for tax deductions equivalent to the fair market value of their photos. Landscapes, seascapes, animals, flowers – all may be accepted – whether new or vintage  images. People may be included in the photo but only if unidentifiable (i.e., blurred figures at a distance).

Did you know that unused patents and copyrights can be donated to charity? Intellectual Property (IP) just sitting on a shelf will lose value as it becomes obsolete. The High Alert Institute IP Donation Program seeks to rescue stranded, technology-related IP with the potential for development into marketable products. Once accepted by the program, the owner/inventor is eligible for a tax deduction equivalent to the fair market value of the IP. The Institute receives the patent licensing fees or revenue from the sale of the IP to businesses, helping us to fund our mission. In turn, businesses are able to advance their markets and create jobs for less money than starting a project from scratch.

Disasters are defined as situations in which needs exceed or overwhelm available resources. Some disasters affect an entire community, while other disasters impact individuals and families. Crises of physical or psychological health can be very personal disasters.
The therapeutic value of pets during illness, trauma, and recovery is well established. And Koi fish may be well suited for people who are not able to provide verbal pet commands or physically care for pets like dogs and cats. Koi ponds are also a source of beauty and peace, providing an ideal setting for quiet reflection or meditation.
We are working to partner with pond installers and aquatic pet rescues/shelters to offer free or reduced-cost ponds with rehomed Koi fish to people seeking this type of pet therapy.

Disasters disrupt life and impact our sense of personal, family, and community safety. Survivors and responders alike often are not aware of the emotional, psychological or spiritual challenges that they may face from disaster onset through recovery. With two decades of experience training responders and communities to prepare for the behavioral health aspects of disasters, we will continue to provide education and a curated list of resources to groups or individuals.

Non-medical factors that impact overall health are termed Social Determinants of Health or SDoH. Noise pollution, poor air quality, and poor water quality are three environmental factors known to have a strong link to overall health. And the same environmental factors that impact humans impact their pets and other animals in their care. We continue to assist in advocacy, education, and technology development to mitigate the impact of SDoH on humans and animals alike.

Our efforts in shelter and rescue are the main focus of our environmental stewardship, reducing the environmental impact of non-native aquatic animals being dumped into public waterways. The High Alert Institute also assists innovators with the design, development, and evaluation of green and renewable energy technologies. Reducing the carbon footprint associated with disaster preparedness, response, and recovery furthers our continued mission to mitigate risk and improve resilience.

We partner with public and private organizations, sharing resources and fostering partnerships to improve disaster preparedness, response, and recovery, and mitigation.

The High Alert Institute team has over a century of combined research experience in medical, nursing, behavioral health, and disaster sciences. Our team provides support to researchers and technology developers through comprehensive literature searches and reviews, as well as failure mode database searches and adjudicated reviews.

When disaster strikes, most aquatic pet owners have limited options to secure the safety of their pets. Sheltering in place may not be possible if there is no power to provide aeration and “pet-friendly” shelters do not include ponds or aquariums. Our goal is to provide an option for aquatic pet owners in need of rescue and shelter for their finned friends.

Our goal is to share our two decades of disaster readiness experience with animal welfare organizations, shelters, caretakers, and pet owners, as they implement contingency  plans for natural and manmade disasters.

Join the Institute
Stay informed and get updates.

*We do NOT share your information with any other sites or organizations.

High Alert Institute

4800 Ben Hill Trail
Lake Wales, FL 33898
Office: 863.696.8090
FAX: 407.434.0804


Privacy Policy

Cookie Policy

Terms of Use


Get Your Data

Shipping Policy

Message Us



Do Not Sell Info

Return Policy