Firefighters and cancer: the epidemiological evidence

It is recognised that firefighters can be exposed to many different harmful substances. In 2007 the International Agency for Research on Cancer convened a working group to assess the carcinogenicity of a variety of occupations, increased rates of testicular, prostate and non-Hodgkin's lymphoma were identified for firefighting. This report examines the research published since an IOM review for the UK Industrial Injuries Advisory Council, by carrying out a systematic review and meta-analyses of the epidemiological evidence for specific cancers in firefighters. In total 304 publications were screened against the inclusion criteria, 261 publications were excluded based on their title/abstract and a further 20 were excluded once the full publication had been examined. The remaining 23 papers were included in the review. Meta-analyses were carried out for 23 specific cancer sites. Cancers identified as having a positive association with firefighting included colon (meta-RR=1.18, 95% CI 1.08-1.29), rectal (meta-RR=1.16, 95% CI 1.05-1.29), lymphatic and haematopoietic (meta-RR=1.20, 95% CI 1.07-1.35), non-Hodgkin's lymphoma (meta-RR=1.14, 95% CI 1.05-1.23), melanoma (meta-RR=1.41, 95% CI 1.21-1.65), prostate (meta-RR=1.13, 95% CI 1.03-1.24), bladder (meta-RR=1.12, 95% CI 1.01-1.26) and kidney cancer (meta-RR=1.16, 95% CI 1.00-1.23). The report highlights that a number of cancers were identified as having a raised risk among firefighters, but there was no evidence in this literature of the association found previously with testicular cancer.


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