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Cancer incidence among male Massachusetts firefighters, 1987–2003
Kang, Dongmug,Davis, Letitia K.,Hunt, Phillip,Kriebel, David Wiley Subscription Services, Inc., A Wiley Company 2008 AMERICAN JOURNAL OF INDUSTRIAL MEDICINE - Vol.51 No.5
<B>Background</B><P>Firefighters are known to be exposed to recognized or probable carcinogens. Previous studies have found elevated risks of several types of cancers in firefighters.</P><B>Methods</B><P>Standardized morbidity odds ratio (SMORs) were used to evaluate the cancer risk in white, male firefighters compared to police and all other occupations in the Massachusetts Cancer Registry from 1986 to 2003. Firefighters and police were identified by text search of the usual occupation field. All other occupations included cases with identifiable usual occupations not police or firefighter. Control cancers were those not associated with firefighters in previous studies.</P><B>Results</B><P>Risks were moderately elevated among firefighters for colon cancer (SMOR = 1.36, 95% CI: 1.04–1.79), and brain cancer (SMOR = 1.90, 95% CI: 1.10–3.26). Weaker evidence of increased risk was observed for bladder cancer (SMOR = 1.22, 95% CI: 0.89–1.69), kidney cancer (SMOR = 1.34, 95% CI: 0.90–2.01), and Hodgkin's lymphoma (SMOR = 1.81, 95% CI: 0.72–4.53).</P><B>Conclusions</B><P>These findings are compatible with previous reports, adding to the evidence that firefighters are at increased risk of a number of types of cancer. Am. J. Ind. Med. 51:329–335, 2008. © 2008 Wiley-Liss, Inc.</P>
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DeBono Nathan L.,Daniels Robert D.,Beane Freeman Laura E.,Graber Judith M.,Hansen Johnni,Teras Lauren R.,Driscoll Tim,Kjaerheim Kristina,Demers Paul A.,Glass Deborah C.,Kriebel David,Kirkham Tracy L. 한국산업안전보건공단 산업안전보건연구원 2023 Safety and health at work Vol.14 No.2
Objective: We performed a meta-analysis of epidemiological results for the association between occupational exposure as a firefighter and cancer as part of the broader evidence synthesis work of the IARC Monographs program. Methods: A systematic literature search was conducted to identify cohort studies of firefighters followed for cancer incidence and mortality. Studies were evaluated for the influence of key biases on results. Random-effects meta-analysis models were used to estimate the association between ever-employment and duration of employment as a firefighter and risk of 12 selected cancers. The impact of bias was explored in sensitivity analyses. Results: Among the 16 included cancer incidence studies, the estimated meta-rate ratio, 95% confidence interval (CI), and heterogeneity statistic (I2) for ever-employment as a career firefighter compared mostly to general populations were 1.58 (1.14–2.20, 8%) for mesothelioma, 1.16 (1.08–1.26, 0%) for bladder cancer, 1.21 (1.12–1.32, 81%) for prostate cancer, 1.37 (1.03–1.82, 56%) for testicular cancer, 1.19 (1.07–1.32, 37%) for colon cancer, 1.36 (1.15–1.62, 83%) for melanoma, 1.12 (1.01–1.25, 0%) for non-Hodgkin lymphoma, 1.28 (1.02–1.61, 40%) for thyroid cancer, and 1.09 (0.92–1.29, 55%) for kidney cancer. Ever-employment as a firefighter was not positively associated with lung, nervous system, or stomach cancer. Results for mesothelioma and bladder cancer exhibited low heterogeneity and were largely robust across sensitivity analyses. Conclusions: There is epidemiological evidence to support a causal relationship between occupational exposure as a firefighter and certain cancers. Challenges persist in the body of evidence related to the quality of exposure assessment, confounding, and medical surveillance bias.
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