Details:

Alternative Title:
Occup Environ Med
Publisher's site:
http://dx.doi.org/10.1136/oemed-2014-102671
Personal Author:
Daniels, Robert D. ; Bertke, Stephen ; Dahm, Matthew M. ; Yiin, James H. ; Kubale, Travis L. ; ... More +
Daniels, Robert D. ; Bertke, Stephen ; Dahm, Matthew M. ; Yiin, James H. ; Kubale, Travis L. ; Hales, Thomas R. ; Baris, Dalsu ; Zahm, Shelia H. ; Beaumont, James J. ; Waters, Kathleen M. ; Pinkerton, Lynne E. ; Less -
Description:
Objectives To examine exposure–response relationships between surrogates of firefighting exposure and select outcomes among previously studied US career firefighters. Methods Eight cancer and four non-cancer outcomes were examined using conditional logistic regression. Incidence density sampling was used to match each case to 200 controls on attained age. Days accrued in firefighting assignments (exposed-days), run totals (fire-runs) and run times (fire-hours) were used as exposure surrogates. HRs comparing 75th and 25th centiles of lagged cumulative exposures were calculated using loglinear, linear, log-quadratic, power and restricted cubic spline general relative risk models. Piecewise constant models were used to examine risk differences by time since exposure, age at exposure and calendar period. Results Among 19 309 male firefighters eligible for the study, there were 1333 cancer deaths and 2609 cancer incidence cases. Significant positive associations between fire-hours and lung cancer mortality and incidence were evident. A similar relation between leukaemia mortality and fire-runs was also found. The lung cancer associations were nearly linear in cumulative exposure, while the association with leukaemia mortality was attenuated at higher exposure levels and greater for recent exposures. Significant negative associations were evident for the exposure surrogates and colorectal and prostate cancers, suggesting a healthy worker survivor effect possibly enhanced by medical screening. Conclusions Lung cancer and leukaemia mortality risks were modestly increasing with firefighter exposures. These findings add to evidence of a causal association between firefighting and cancer. Nevertheless, small effects merit cautious interpretation. We plan to continue to follow the occurrence of disease and injury in this cohort.
Subject:
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Adult
Aged
Age Distribution
Cause Of Death
Cohort Studies
Firefighters
Humans
Incidence
Leukemia
Lung Neoplasms
Male
Middle Aged
Occupational Diseases
Occupational Exposure
Prognosis
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Survival Analysis

Source:
Occup Environ Med. 72(10):699-706.
Pubmed ID:
25673342
Pubmed Central ID:
PMC4558385
Document Type:
Journal Article ;
Funding:
CC999999/Intramural CDC HHS/United States ; N01-PC-35136/PC/NCI NIH HHS/United States ; N01-PC-35139/PC/NCI NIH HHS/United States ; N02-PC-15105/PC/NCI NIH HHS/United States ; U55/CCR921930-02/PHS HHS/United States ;
CC999999/Intramural CDC HHS/United States ; N01-PC-35136/PC/NCI NIH HHS/United States ; N01-PC-35139/PC/NCI NIH HHS/United States ; N02-PC-15105/PC/NCI NIH HHS/United States ; U55/CCR921930-02/PHS HHS/United States ; Less -
Place as Subject:
Chicago, IL ; Philadelphia, PA ; San Francisco, CA ;
Chicago, IL ; Philadelphia, PA ; San Francisco, CA ; Less -
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:208c3a0fab528bab765ec93d75d2f4d3fee61d4b9b8d27cf6e32579d87a8fdd5
File Type:

Supporting Files

• 	NIHMS719201-supplement-online_tables.pdf	pdf
  	nihms719201.nxml	bin
  	nihms719201f1.gif	gif
  	nihms719201f1.jpg	jpeg

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