Firefighting and Cancer: A Meta-Analysis of Cohort Studies in the Context of Cancer Hazard Identification

Details

• Personal Author:
  Beane Freeman, Laura E. ; Daniels, Robert D. ; DeBono, Nathan L. ; Demers, Paul A. ; Driscoll, Tim ; Filho, Adalberto M. ; Glass, Deborah C. ; Graber, Judith M. ; Hansen, Johnni ; Kirkham, Tracy L. ; Kjaerheim, Kristina ; Kriebel, David ; Schubauer-Berigan, Mary K. ; Stayner, Leslie T. ; Teras, Lauren R. ; Wedekind, Roland
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Cohort Studies Epidemiology Fires Mortality Neoplasms Occupational Exposure Occupational Health Safety
• Keywords:
  Author Keywords: Cancer Cancer Rates Cohort Studies Firefighter Fire Fighting Hazard Mortality Rates Occupational Exposure Systematic Reviews
• ISSN:
  2093-7911
• Document Type:
  Text
• Genre:
  Journal Article
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  WTCHP - World Trade Center Health Program
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  12 pdf pages
• Volume:
  14
• NIOSHTIC Number:
  nn:20067348
• Citation:
  Saf Health Work 2023 Jun; 14(2):141-152
• Contact Point Address:
  Mary Schubauer-Berigan, International Agency for Research on Cancer, 25 Av. Tony Garnier, 69007, Lyon, France
• Email:
  beriganm@iarc.who.int
• Federal Fiscal Year:
  2023
• Peer Reviewed:
  True
• Source Full Name:
  Safety and Health at Work
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c8f510c28fcf428fb728da298bfa4e140e2ada034d14bea6c7894c01b6c61dd277690265663a388e5078a2154dd64bc54dd30a9983d8f531bc8ff12b30c2df9a
• Download URL:
  https://stacks.cdc.gov/view/cdc/230850/cdc_230850_DS1.pdf
• File Type:
  [PDF - 1.00 MB ]