In Indiana, three firefighters were dying. 

They were dying from the very things they used to keep them safe: their protective gear and firefighting foam. Two succumbed to a rare form of brain cancer, and the other passed away from esophageal cancer.

Today cancer is the leading cause of death for firefighters, and many link it to polyfluoroalkyl substances—better known as PFAS—found in a variety of firefighting equipment. PFAS is the name for a class of chemicals known to be carcinogenic and associated with rare cancers, thyroid diseases, decreasing vaccine efficiency and even neurodegenerative diseases like Alzheimer’s.

“That’s a reality that many in this field are facing,” Rep. Maureen Bauer, D-South Bend, said.

The stories of those three firefighters were the reasons she authored a bill in 2023 to enact the PFAS biomonitoring pilot program for Indiana firefighters—the first in the nation.

In an opinion piece in The Courier & Press this May, Bauer expressed her concerns over a loss of funding for this program.

“Despite the overwhelming interest and modest $200,000 price tag, funding for the biomonitoring program was gutted in House Bill 1001, now law, the state budget. The decision is more than disappointing: it’s dangerous. Indiana firefighters will now be left without essential health services, even as their risks remain high and growing,” she said.

But PFAS chemicals aren’t just dangerous to firefighters.

Microwave popcorn, makeup products, shampoo, fertilizers, receipts, fast-food wrappers, drinking water and stain-resistant carpeting are some of the numerous everyday items in which PFAS chemicals have been found.

Studies at Purdue University have also observed PFAS chemicals in the same fish that so many Hoosiers love to catch and eat for dinner.

Hallie Jackson, a senior at Purdue University, doesn’t even want to know if her daily tea contains the chemicals, but she does wonder about those affected by contaminated ponds in the state.

“It’s crazy to think about the amount of people that fish here and don’t even think about it. How much PFAS are they eating? We have no idea,” she said.

Jackson worked in Purdue University’s genetics lab, observing the effects of PFAS on aquatic larval midges—small, non-biting mosquitoes whose red coloration can serve as an indicator of chemical effects. 

The hope is that the experiment’s results will serve as a predictor for the effects of PFAS in humans. What happens in something as simple as a midge could indicate what happens in us. 

Dr. Tyler Hoskins, a research assistant professor in Purdue’s Department of Forestry and Natural Resources and an ecotoxicologist, began his research on the effects of PFAS in 2019, starting with amphibians. Now it has broadened to rural populations in Indiana and their risk of PFAS contamination from fish and game. It’s his “passion project.”

Rural areas can also be exposed to PFAS chemicals through biosolids—human sewage that is then recycled into low-cost fertilizers. In most cases, neither the biosolids companies nor the farmers know they are dealing with PFAS contamination. Without realizing it, farmers expose the soil, their crops and groundwater to the chemicals, which can then be transported via runoff into nearby ponds, livestock and sometimes even people.

Pilot-scale studies done at Purdue have revealed what Hoskins called “concerning levels” of PFAS both in ponds they’ve tested and also in commonly consumed fish like bluegill and bass.

The science of PFAS

Hoskins describes PFAS chemicals as a “big universe of chemicals.” Specific definitions depend on who you ask. 

Among the most studied are PFOA (perfluorooctanoic acid) and PFOS (perfluorooctanesulfonic acid), which have ties to birth defects.

PFAS chemicals have their origins in the 1930s, and their usefulness made them widespread. Teflon nonstick pans are a great example; they contained the extremely toxic PFOA. It wasn’t until the early 2000s that toxicity studies began, and since then, the problem has become more and more recognized.

The usefulness of PFAS chemicals are mainly in their ability to prevent substances from sticking to each other. They’ve been used to create nonstick pans as well as prevent fast-food wrappers from getting greasy and butter from sticking to the insides of microwave popcorn bags.

Beyond being just for convenience, PFAS chemicals are used in lots of medical devices such as catheters, heart valves and prosthetics, making them essential for life-saving interventions. Under some definitions, Prozac—a common antidepressant—is considered under the class of PFAS chemicals.

“It’s a great chemical. It’s great at what it does,” Jackson said.

Currently, there are 5,000 fully recognized PFAS chemicals on the market and even more to be discovered.

“There’s no shortage of questions around PFAS to ask,” Hoskins said. “It’s actually an active area of research, like how many PFAS are out there because we can only detect the ones we know to look for.”

Hoskins said some regulators define PFAS as chemicals containing one carbon molecule whose bonds are completely filled with fluorine atoms. Other definitions require a chemical to contain multiple sets of these fluorinated carbons, and some more specifically require them all to be connected.

The carbon-fluorine bonds in all PFAS chemicals allow them to interact with water while also repelling it at the same time. Those bonds are also incredibly difficult to break, hence their title as a “forever chemical.” Consequently, it makes them long lasting in our bodies.

“Whereas you clear drugs that you take in a matter of hours, it’s more on the scale of years for PFAS once you’re exposed,” Hoskins said. 

Mothers can pass their own PFAS contamination to their children, escalating the problem as generations go by. PFAS can start in the soil, then move to plants, which are eaten by livestock, which are then consumed by us. The concentrations increase as they moves up the food chain.

They also interact with proteins, unlike substances like DDT, which interact with fats.

PFAS’ interaction with proteins is part of their danger since proteins perform a variety of functions in the body from digestion to muscle contractions to nutrient storage. Interacting with them makes PFAS unpredictable and dangerous, especially when combined with other chemicals. 

“It never shows up how you think it will,” Jackson said.

The same goes for PFAS effects in humans.

“It’s exploding. It’s actually hard to keep up with the human health-related studies,” Hoskins said. “We sometimes joke that PFAS are general messer-uppers because they seem to influence so many things.”

The issues with regulations

Despite the multitude of health effects that some PFAS chemicals can have, they have proven incredibly useful in medical devices and life-saving interventions—which makes it difficult for regulators to simply ban PFAS chemicals entirely.

“I think most of us would argue that the small PFAS exposure and release that’s gonna result from a small amount of PFAS being used on a heart valve is not as big of a hazard as a massive coronary heart attack that would kill a person if they didn’t have that valve,” Hoskins said.

Although completely eradicating the world of PFAS chemicals isn’t feasible today, it’s an intention for the future.

The Environmental Protection Agency has listed the maximum contamination level for PFOS and PFOA at four parts per trillion—listed as the enforceable level. However, it listed the maximum contamination level goal at zero parts per trillion. Last year, the EPA set standards for six PFAS chemicals in drinking water, and starting in 2027, public water systems will be required to publish PFAS levels in drinking water to the public. By 2029, public water systems exceeding EPA standards must have implemented methods to reduce PFAS levels.

However, reaching the goal of zero parts per trillion PFAS chemicals in water systems is not as easy as it sounds. 

Entities like municipal water utilities or biosolids companies have found themselves caught in the middle of PFAS regulations, funded by taxpayers to comply with standards. Despite not realizing that their services were tinged with PFAS, they are often tasked with fixing it.

“Taxpayers did not knowingly create the problem. We all benefited from the chemistries,” Hoskins said. “We didn’t know this problem was being created. Ultimately, the liability lies with the chemical industry that created this problem.” 

DuPont, Corteva and Chemours are all chemical companies that, in 2023, settled for billions of dollars on claims of contaminating public water systems with PFAS chemicals.

The future

Hoskins suggests the essential-use concept, where rather than regulating PFAS, you regulate their uses, as a solution.

For example, if a life-saving drug is considered a PFAS chemical, producers can apply for an exemption for its continued use. The government would also invest in research for safer replacement chemicals. This could effectively regulate PFAS chemicals while also reducing the world’s dependence on them.

This method was largely successful in decreasing the use of chlorofluorocarbons (CFCs) in the Montreal Protocol, and Hoskins cites it as one of the biggest environmental success stories of the century.

“It’s really easy to become kind of like hopeless that this is just too big of a problem for us to tackle, and that’s not the case,” Hoskins said. “We can fix this problem if we pay attention to it.”

He points to PFOS and PFOA, which were attacked by regulations and have mostly been fazed out in the United States.

Chemical companies like DuPont have already begun to reduce their PFAS chemical use either due to increasing regulations or on their own. Hoskins also said that “consumers voting with their wallets” as information becomes more widely spread is another method of decreasing PFAS usage.

PFAS is a problem requiring input from consumers, industries, regulators, academia and everyone else.

But will regulation and research receive adequate funding and support?

In the Indiana Statehouse, several bills were authored in the past session, but none made it to the governor’s desk. House Bill 1286, for example, would have required the Indiana Department of Environmental Management to publish a list of companies that release PFAS into state waters. 

“We saw great pushback in the Indiana General Assembly from industry who use these chemicals and want to continue using them,” Bauer said. 

Senate Bill 538 received support from some companies because it attempted to establish a narrow definition of PFAS chemicals, but others were especially opposed to Bauer’s House Bill 1553, which aimed to set a maximum PFAS level in biosolid fertilizers and educate users on the PFAS content.

Bauer said that many opponents of PFAS legislation believe that legislators are attempting to fully ban PFAS chemicals in the state. Rather, she said the goal is to educate Hoosiers on what is in the products they consume.

“When it comes to risk and reward, I would argue that we look at the economic reward over the health risk on this issue,” Bauer said. “I believe that, as legislators, we should help educate consumers and give them information to make educated decisions about what they ingest and what products they use in their home.”

State funding for the biomonitoring program for firefighters didn’t come through this year—a disappointment for Bauer.

She continues to remain optimistic, however, saying that Gov. Mike Braun and other elected officials have pushed towards removing toxic chemicals in food to create a healthier state. PFAS chemicals are a great starting point. 

Indiana Attorney General Todd Rokita is in the middle of a lawsuithe filed against 22 companies that illegally manufactured dangerous PFAS chemicals.

On the other hand, Jackson remains concerned.

“I think that the lawmakers in general are uninformed when it comes to PFAS and PFAS regulations. … I don’t know if the right people are necessarily making laws,” Jackson said. “It’s hard to introduce a law that would effectively regulate PFAS when you don’t have a background in PFAS research or ecotoxicology.”

She is worried that lawmakers are taking an overly conservative approach to regulating PFAS; her concerns expand to an overtrust in chemical companies and skepticism in science.

“There’s no reason to not trust science. Scientists aren’t trying to dupe you,” she said. “I don’t get paid enough to trick you that PFAS is bad.”

Today it’s hard for Jackson to not think about what she’s eating, drinking or using on a daily basis. 

“It is my life, and water is not something that you can just choose to not have,” Jackson said.

When the PFAS biomonitoring pilot program for firefighters was enacted, Bauer said her goal was to keep people healthy and ensure that the things they use in their everyday life are safe.

“I think if we continue to keep the conversation which has always been when it comes to firefighters, their health and their safety, if we continue that narrative, who else can we protect?” Bauer said.

Protecting first responders has been the first step, but she hopes it won’t be the last.