Exposure–response relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009)

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.

doi:10.1136/oemed-2014-102671

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Exposure–response relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009)

Published Date:

Feb 11 2015

Publisher's site:

http://dx.doi.org/10.1136/oemed-2014-102671 New Site Icon

Source:

Occup Environ Med. 72(10):699-706.

[PDF-442.30 KB]

Details:

Personal Authors:

Daniels, Robert D. ; Bertke, Stephen ; Dahm, Matthew M. ; Yiin, James H. ; Kubale, Travis L. ; ... More ▼

Keywords:

[+]

Pubmed ID:

25673342

Pubmed Central ID:

PMC4558385

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.

Document Type:

Journal Article

Collection(s):

CDC Public Access

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

Supporting Files:

NIHMS719201-supplement-online_tables.pdf	application/pdf
nihms719201.nxml	application/octet-stream
nihms719201f1.gif	image/gif
nihms719201f1.jpg	image/jpeg

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