Read the full article by David Ferry (Men’s Health)

It was winter of 2015, and Diane Cotter was in the cellar, tearing through boxes. Upstairs, the inside of the tidy southern New Hampshire home she shares with her husband, Paul, is something of a shrine to firefighting—Paul’s commendations on the armoire, photos, boxes of swag and mementos accumulated from a lifetime on the rescue truck in Worcester, Massachusetts. But Paul’s firefighting gear was packed away in the cellar. It was too hard to look at.

Even at 55, Paul was in top physical shape. Thick and barrel shaped, with close-cropped hair, he is a bear of a man. At his peak, he could deadlift 495 pounds, and he liked to boast, in his heavy Worcester accent, that he was one of only two guys in the firehouse who could climb up the three-story fire pole. His diagnosis—prostate cancer, aggressive—on November 20, 2014, was shattering. Overnight, his life became medicalized. The tumor scored a seven out of ten on the Gleason scale, whatever the hell that was. Bad, but could be worse, the oncologist explained. They could excise the tumor, the hotshot surgeon in Boston said to them. Nobody mentioned the eventual side effects—the incontinence, the impotence, the weakness—but none of that matters when you start measuring your life expectancy in five-year chunks. The rhythms of Paul’s life changed from shifts and calls to regular blood draws, post-op meetings, and fears of relapse.

In the cellar, Diane muscled Paul’s fire-resistant trousers out of the box. She was no firefighter, but Diane knew her way around what the squad called ‘turnout gear.’ For almost 40 years, since he had first flashed a smile at her from his baby-blue Cadillac during her junior year of high school, Diane had been by Paul’s side. Although she raised two kids and worked half a dozen jobs over the years, her home was always open to hundreds of firefighters from Local 1009 and their families whenever somebody made captain or didn’t come home from a shift. She was terrified for Paul’s safety, but she knew he lived for the job. Plus, she couldn’t deny she loved the smell of smoke that clung to him when he walked in the door.

The diagnosis had forced Paul into a retirement he wasn’t ready for and sunk him into depression, but it had thrust Diane toward a new obsession: finding the culprit, the reason why Paul was the only man in his large family to be diagnosed with a cancer known to run in families. Why was it that cancer had torn a hole in nearly every firefighting family they knew, all across America?

Late one night on the Internet, she discovered that the lining that was part of all firefighting gear might be a cause. It wasn’t until two years later that she found out more: that it contained man-made chemicals called perfluoroalkyl and polyfluoroalkyl substances, or PFASs. This is a ubiquitous class of chemicals, the stuff that makes Teflon slick and Scotchgard stain-resistant—but, she would soon learn, it also includes widespread environmental toxicants and substances that interfere with the body’s hormonal functions. It’s linked to various adverse health effects, including cancer. She stopped the Googling and picked up Paul’s gear. She shined his old field flashlight at the high-tech lining, and light poured through several holes near the groin. The chemical-laden lining was degrading. She wondered if that was the trouble. If so, Paul had been vulnerable, day after day, week after week, for a decade.

It was the beginning of a six-year odyssey, a quest to protect firefighters from the gear that was supposed to save them, an undertaking that would, to the Cotters’ devastating surprise, alienate friends and pit them against their union and some of the most powerful corporations on earth. Given that PFASs are also in all kinds of common household products, was it possible that firefighters were the canaries in the coal mine?

Diane felt ill.

PAUL READS NAMES FROM a list in the Cotters’ makeshift war room—a former crafting room with a listless Internet connection, no cell service, and a lot of yarn—while Diane practices a speech for a conference on toxic chemicals and activism. It’s a late-May morning earlier this year, and Paul has just gotten over the mild symptoms of his second Covid shot. His list, stored on an aging yellow notepad, is up to 32 neatly written names. Each is a firefighter who has reached out to him, and beside each entry is a letter—P for prostate, T for testicular, B for brain, and so on. ‘When I came home after my surgery, I started getting calls,’ he says. ‘I was getting one a month. I still get calls.’

There are many ways to die in the fire service, and firefighters train to avoid the most gruesome. But today, most active-duty firefighters do not die from falling beams or back drafts—they die from cancer. Cancer is now the number-one killer in the fire service. Firefighters have a 9 percent higher risk of cancer, and a 14 percent higher risk of dying from cancer, than the rest of the population. ‘Every firehouse is a cancer cluster,’ Diane likes to say, and she’s right. A firefighter is twice as likely as a civilian to get testicular cancer, 53 percent more likely to contract non-Hodgkin’s lymphoma, and 28 percent more likely to develop prostate cancer, like Paul.

Paul doesn’t like to talk about what cancer took from him, but he talks to all the firefighters who call, for as long as they want, about treatments, disability, the things nobody tells you—the anxiety, the depression that comes from having a job you loved, a purpose, torn from you too soon. Paul says he’s one of the lucky ones. Doctors say he’s cancer-free now, though treatment left its scars, both physical and mental.

Most firefighters assume their cancers come solely from carcinogens in the smoke they inhale. But for the better part of a decade, Paul and Diane have been out to prove that not all cancer in the fire service is directly related to the fires they fight. Some of firefighting’s most common cancers, like testicular and prostate, may not be tied to breathing in smoke at all and instead could be more closely related to four letters that have come to dominate the Cotters’ lives: PFAS. ‘These people don’t know they’re being poisoned,’ Paul says.”…