Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001–2016

Details

• Alternative Title:
  Occup Environ Med
• Personal Author:
  Webber, Mayris P ; Singh, Ankura ; Zeig-Owens, Rachel ; Salako, Joke ; Skerker, Molly ; Hall, Charles B ; Goldfarb, David G ; Jaber, Nadia ; Daniels, Robert D ; Prezant, David J
• Description:
  Objective
  
  To compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of non-WTC-exposed firefighters, the Career Firefighter Health Study (CFHS) cohort, and to compare rates from each firefighter cohort to rates in demographically similar US males.
  
  Methods
  
  FDNY (N=10 786) and CFHS (N=8813) cohorts included male firefighters who were active on 11 September 2001 (9/11) and were followed until death or 31 December 2016. Cases were identified from 15 state cancer registries. Poisson regression models assessed cancers in each group (FDNY and CFHS) versus US males, and associations between group and cancer rates; these models estimated standardised incidence ratios (SIRs) and adjusted relative rates (RRs), respectively. Secondary analyses assessed surveillance bias and smoking history.
  
  Results
  
  We identified 915 cancer cases in 841 FDNY firefighters and 1002 cases in 909 CFHS firefighters. FDNY had: higher rates for all cancers (RR=1.13; 95% CI 1.02 to 1.25), prostate (RR=1.39; 95% CI 1.19 to 1.63) and thyroid cancer (RR=2.53; 95% CI 1.37 to 4.70); younger median ages at diagnosis (55.6 vs 59.4; p<0.001, all cancers); and more cases with localised disease when compared with CFHS. Compared with US males, both firefighter cohorts had elevated SIRs for prostate cancer and melanoma. Control for surveillance bias in FDNY reduced most differences.
  
  Conclusions
  
  Excess cancers occurred in WTC-exposed firefighters relative to each comparison group, which may partially be explained by heightened surveillance. Two decades post-9/11, clearer understanding of WTC-related risk requires extended follow-up and modelling studies (laboratory or animal based) to identify workplace exposures in all firefighters.
  
  
• Subjects:
  Adult Case-Control Studies Firefighters Humans Male Middle Aged Neoplasms Occupational Diseases Occupational Exposure Registries September 11 Terrorist Attacks

  More +
• Source:
  Occup Environ Med. 2021; 78(10):707-714
• Pubmed ID:
  34507965
• Pubmed Central ID:
  PMC8458058
• Document Type:
  Journal Article
• Funding:
  U01 OH011309/OH/NIOSH CDC HHSUnited States/ ; HHSN261201800032C/CA/NCI NIH HHSUnited States/ ; HHSN261201800009C/CA/NCI NIH HHSUnited States/ ; NU58DP006344/DP/NCCDPHP CDC HHSUnited States/ ; HHSN261201800015I/CA/NCI NIH HHSUnited States/ ; U01 OH011934/OH/NIOSH CDC HHSUnited States/ ; HHSN261201800032I/CA/NCI NIH HHSUnited States/ ; HHSN261201800015C/CA/NCI NIH HHSUnited States/ ; P30 CA013330/CA/NCI NIH HHSUnited States/ ; HHSN261201800009I/CA/NCI NIH HHSUnited States/
• Place as Subject:
  New York City, NY ; United States
• Volume:
  78
• Issue:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:7a9b0aa24db4ef4eb635ed5f88c61bcfc94819b1c8d009822548f6791132526b
• Download URL:
  https://stacks.cdc.gov/view/cdc/118759/cdc_118759_DS1.pdf
• File Type:
  [PDF - 731.61 KB ]