Cancer Incidence in World Trade Center-Exposed and Non-Exposed Male Firefighters, as Compared with the US Adult Male Population: 2001–2016

Details

• Personal Author:
  Daniels, Robert D. ; Goldfarb DG ; Hall CB ; Jaber N ; Prezant DJ ; Salako J ; Singh A ; Skerker M ; Webber MP ; Zeig-Owens R
• 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 standardized 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 localized 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. [Description provided by NIOSH]
• Subjects:
  Demography Firefighters Neoplasms Occupational Health Safety September 11 Terrorist Attacks Smokers
• Keywords:
  Cancer Demographic Characteristics Disaster Recovery Disaster Response Disaster Sites Fire Fighters Smoking Surveillance World Trade Center WTC
• ISSN:
  1351-0711
• Document Type:
  Text
• Funding:
  Cooperative Agreement ; Contract
• Genre:
  Journal Article
• Place as Subject:
  New York ; Ohio ; OSHA Region 2 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  WTCHP - World Trade Center Health Program
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  78
• Issue:
  10
• NIOSHTIC Number:
  nn:20063478
• Citation:
  Occup Environ Med 2021 Oct; 78(10):707-714
• Contact Point Address:
  Dr. Mayris P. Webber, Bureau of Health Services, Fire Department of the City of New York, Brooklyn, NY 11201, USA
• Email:
  mayris.webber@fdny.nyc.gov
• Federal Fiscal Year:
  2022
• Performing Organization:
  Albert Einstein College of Medicine, Bronx, New York
• Peer Reviewed:
  True
• Start Date:
  20160901
• Source Full Name:
  Occupational and Environmental Medicine
• End Date:
  20210831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:05ac7d0ecc3ad46e43e342b80655a113b9e74fe5e7c7fdaae120d0a825a445dea01e51b63cba98ab2987ac54c07c040c788069fd9519e185f2b84a55ef4d6d77
• Download URL:
  https://stacks.cdc.gov/view/cdc/226538/cdc_226538_DS1.pdf
• File Type:
  [PDF - 744.97 KB ]