Perspectives on Environmental and Occupational Exposures and Cancer Risk From Florida's Wildland Firefighters: A Forestry and Wildland Risk Discussions (FORWRD) Qualitative Study.

BACKGROUND

Firefighters responding to wildland and wildland-urban interface (WUI) fires increasingly navigate a hazardous landscape of environmental pollutants and occupational risks that may influence their health risk perceptions, yet their firsthand experiences and work-related safety concerns are insufficiently understood.

METHODS

Between December 2024 and February 2025, we conducted seven focus groups and four key informant interviews with 51 Florida Forest Service personnel, whose service averaged 11.5 years. Qualitative analysis of interview data employed a coding reliability thematic approach informed by a postpositivist paradigm.

RESULTS

Four primary themes emerged: (1) Safety risks associated with heavy equipment operations and inadequate immersive training; (2) environmental hazards from complex smoke mixtures, invasive species, anthropogenic contaminants, and expanding WUI conditions; (3) systemic deficiencies in personal protective equipment availability, decontamination infrastructure, and cultural norms that valorize soiled gear; and (4) acute and chronic health burdens, including respiratory irritation, cardiovascular strain, mental health stressors, and perceived elevated cancer risk. Preinterview survey data documented that 72.5% of respondents self-reported wearing no respiratory protection during fireground activities. Health conditions reported included hypertension (24.0%), arthritis (11.8%), and asthma (9.8%). Approximately 8.0% reported having depressive disorder, and 7.8% reported having kidney disease. Among all participants, 46.9% were obese.

CONCLUSION

Findings highlight critical gaps in occupational health practices, resource allocation, and cultural attitudes within the wildland firefighting workforce. Integration of technical interventions, such as enhanced respiratory protection, realistic equipment training, and station-based laundering facilities with culturally informed strategies to shift perceptions of risk and of gear cleanliness should be validated in population-based studies.