Presumptive laws provide a safety net for individuals working in hazardous conditions, ensuring health coverage and compensation in the event of disease.
In America, more than 65% of the entire firefighting workforce does not benefit from presumptive coverage, as many of these individuals work as volunteers.
Of these firefighters, more than 72,000 are women, comprising 11% of all female fire personnel in the United States.
Prior to 2025, women firefighters working on employment contracts across fire departments in the country did not benefit from presumptive coverage for breast, ovarian, cervical and uterine cancer, despite federal legislation including various malignancies for compensation. Female-specific cancers are now included in the Federal Employees’ Compensation Act (FECA), yet on a state level, presumptive legislation still fails to cover volunteers and women’s specific cancers.
This is a major legislative gap, given that cancer development in firefighters is a known consequence of toxic exposure during service.
Washington state law fails to protect women firefighters
Currently, several states exclude women’s reproductive cancers as service-related conditions for firefighters altogether, while some of them fail to address all the associated illnesses. This is also the case in Washington state.
The state’s Revised Code acknowledges cervical and breast cancers as occupational hazards, but it stops short when it comes to ovarian and uterine cancers, although these lethal conditions have well-established links to the toxic exposure women firefighters face in daily operations.
Moreover, where available, the compensation is only provided for career firefighters with over 10 years of employment in the force.
Recent data about the number of women firefighters in Washington state is scarce. However, the latest statistics point out that 204 women were serving in the state’s 30 fire departments. The tradition of women firefighters in Washington is also highlighted in a Seattle archived report, which mentions that in 2008, 93 of the 1,038 firefighters were women.
Washington state relies heavily on volunteer firefighters, who are clearly excluded from any such compensation.
The state is recruiting approximately 3,900 new volunteers each year, and women are gradually joining the ranks in growing numbers.
Considering these circumstances, the bill’s omission of the volunteer firefighters, as well as the ovarian and uterine cancers from the list of occupational hazards, is simply unacceptable.
Although the women firefighters’ exposure to toxic chemicals is linked to their conditions, they are forced to go through lengthy processes just to prove an already acknowledged fact. Aligning the state’s law with federal standards should thus be a priority for lawmakers who must urgently recognize the full scope of risks for all firefighters.
Cancer risk and PFAS exposure in women firefighters
One of the main health concerns in the firefighting profession is exposure to PFAS, or per- and polyfluoroalkyl substances, now linked with a variety of cancers, including uterine and ovarian malignancies.
These chemicals are highly resistant to heat and fire, making them a preferred choice for personal protective equipment among firefighters. Nonetheless, data show that the PFAS content of turnout gear is exceptionally high, while these chemicals can be absorbed through the skin and directly into the blood, especially under firefighting conditions characterized by moisture and heat.
Volunteers are presumed to work fewer hours and, therefore, may be less exposed to PFAS in their gear compared to career firefighters.
However, volunteer fire departments also benefit from less funding and are thus more likely to use old equipment, including turnout gear. Additional investigations have shown that, with wear and tear, PFAS release from turnout gear is significantly higher, thereby increasing the risk of disease development for volunteers.
As a result, research on the PFAS content in the blood of career and volunteer firefighters reveals similar levels of contamination.
Women who work as volunteers in this profession may thus face a substantial cancer risk. Presently, the Fire Fighter Cancer Cohort Study (FFCCS) is recruiting women firefighters to analyze the incidence of malignant cases in this population. Available data on smaller samples of female firefighters show an increased risk of ovarian cancer with an earlier age of onset, pointing to a potential causal link with repeated toxic exposure.
Women firefighter populations thus display an increased likelihood for cancer development, which in some cases can affect female-specific anatomy.
Although in Washington state, breast cancer and cervical cancers are covered by presumptive laws, disregard for uterine and ovarian cancers leaves many women to navigate a difficult, time-consuming claims process while battling a life-threatening disease.
This gap in legislation is not just a legal oversight but a public and occupational health failure. To ensure true justice for all who serve, Washington must update its presumptive laws to reflect the full scope of cancer risks women firefighters face.
Jordan Cade is an attorney with the Environmental Litigation Group P.C., specializing in toxic exposure litigation, with a focus on occupational hazards torts involving PFAS and other harmful chemicals.
