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State of the Science on Wildland Firefighter Health and Wellbeing

Summary: This webinar highlights findings from 40 years of research into Wildland Firefighter Health, including data scarcity and imbalance, disease prevalence, and a new needs assessment to prioritize future research into this topic. Recorded on: February 11, 2026 Description: What does 40 years of research tell us about wildland firefighter health—and where are the gaps? This webinar highlights findings from the Wildland Firefighter Health Scoping Review, which analyzed more than 250 studies published between 1985–2025. The review shows that while some groups—like Interagency Hotshot Crews—are frequently studied, others, including support personnel, receive far less attention. Research on cancer, cardiovascular disease, and other chronic disease risks is growing, but long-term health studies remain scarce. Although many strategies have been proposed to reduce health risks, few have been formally evaluated. This webinar also introduces the Wildland Firefighters’ Science Needs Assessment, a new effort to identify priority research areas and strengthen collaboration between practitioners and researchers to better support firefighter health and wellbeing. Presenters: Arielle Milkman, Postdoctoral Fellow, Environmental and Radiological Health Sciences – Colorado State University Webpage: https://www.swfireconsortium.org/2026... Additional resources: Federal Health and Wellbeing Program: https://health.nifc.gov/ Medical and Public Health Advisory Team Research Requests process: https://www.nwcg.gov/partners/fire-ma... Webpage for the project (Wildland Firefighter Needs Assessment): https://www.themontroselab.com/wlff-n... NIOSH FF Registry for Cancer: https://nfr.cdc.gov/ Quantitative analysis of environmental health hazards and wildland firefighting: https://link.springer.com/article/10.... Nonprofit with resources for firefighter wellbeing: https://www.hotshotwellness.org/ Pilot project to create science communication content for wildland firefighters: https://www.themontroselab.com/scienc... Chapters: 0:00 Introduction of project 5:41 Approach and background of project 12:05 What area is most and least researched 13:35 Where this research is being conducted 14:02 Who are we talking about in the US? Who is the wildland firefighting workforce? 17:15 Data gathered from this project 33:17 Wrap up: Challenges going forward 34:51 Needs assessment 36:06 End presentation 38:08 Q & A The "I don't have time to watch the full webinar" summary: Researchers reviewed studies published between 1985-2025, screening more than 6,800 records and analyzing 268 relevant health studies. Studies were grouped into five categories: environmental exposures, intermediate health impacts, clinical health outcomes, well-being, and health systems/information practices. The largest body of research focuses on intermediate health impacts—particularly respiratory function, performance, metabolic demands, and physiological adaptation. Wildfire smoke is the most studied exposure, especially particulate matter (PM2.5), carbon monoxide, and polycyclic aromatic hydrocarbons (PAHs). There is significantly less research on long-term clinical outcomes such as cancer, cardiovascular disease, PTSD, reproductive health, and musculoskeletal disorders. Some modeling studies suggest elevated cancer and cardiovascular risks based on years of service, but longitudinal data are scarce. Notable exceptions include long-term mental health cohort studies following the Ash Wednesday and Fort McMurray fires, which identified elevated PTSD risk and highlighted the benefits of peer support. Well-being research—covering morale, burnout, leadership, retention, and identity—is the smallest but growing area. Studies also show workforce gaps: research disproportionately reflects younger, male, operational hotshot crews, with limited representation of contract crews, volunteers, tribal firefighters, former firefighters, and specialized roles. A major finding is the lack of evidence on effective mitigation strategies. While administrative controls (e.g., deployment length adjustments, hygiene practices) and respiratory protection have been proposed, few rigorous evaluations exist. The next phase—the needs assessment—aims to “ground truth” these findings by engaging firefighters, leadership, and researchers to identify priority gaps and cultural barriers to change. Key future challenges include representing workforce diversity, expanding longitudinal research, clarifying dose-response relationships, evaluating mitigation strategies, and translating research into accessible formats (including social media partnerships). The webinar concluded by emphasizing collaboration, cultural change, and applied research as essential to improving long-term health and well-being for wildland firefighters.