Firefighters and Cancer: A Review of the Current State of Cancer Incidences and Recent Trends in Risk Perception and Risk Reduction Efforts
Main Article Content
Abstract
Objective: This paper provides a review of current knowledge and trends in research on firefighters cancer risks and risk reduction efforts and calls for future research focused on European and international firefighters to understand and reduce occupational cancer risk.
Cancer incidence: Firefighters face increased occupational cancer risk. Firefighting has been linked with multiple types of cancer, including bladder, colorectal, brain and central nervous system, non-Hodgkin’s lymphoma, skin melanoma, and prostate and testicular cancer, with several others types of cancer being found at increased rates.
Cancer risks: Increased occupational cancer risk is, in part, related to carcinogenic exposures at fire events and improper use and cleaning of personal protective equipment (PPE), with role and years in service increasing risk.
Risk Perception: Research on efforts to reduce cancer risk are growing, and include examination of firefighter knowledge, attitudes, norms, and behaviors toward decontamination, screening, and healthy eating. Many firefighters report high perceived susceptibility and severity of cancer risk, and identify fire scene exposures, contaminated gear, diet, sleep disruption, chemical exposure from cleaning products, and barriers to medical care as contributing to increased risk.
Risk Reduction: Firefighters have strong desire to reduce cancer risk and report generally favorable attitudes toward decontamination practices and proper gear use, but face barriers to reducing those risks, including lack of knowledge, occupational needs, organizational culture, policy, and lack of resources. Behavioral interventions to reduce cancer risk through decontamination efforts and dietary change have demonstrated positive results, however there is a dearth of research on these efforts, especially with European and international firefighters.
Future Directions: Future research should focus on understanding European and international firefighters’ knowledge, attitudes, and behaviors toward cancer risk reduction, the impact of the built environment on cancer risk (station layout, clean cabs), improved efforts at tracking exposures, use of new technology and virtual reality in training to reduce cancer risk, and improved understanding of firefighter cancer risk by medical professionals.
Keywords:
Firefighters, Cancer, Risk Perception, Risk Reduction, Decontamination
Article Details
How to Cite
HARRISON, Tyler R.; MUHAMAD, Jessica Wendorf; MALOVA, Ekaterina.
Firefighters and Cancer: A Review of the Current State of Cancer Incidences and Recent Trends in Risk Perception and Risk Reduction Efforts.
Medical Research Archives, [S.l.], v. 10, n. 11, nov. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3320>. Date accessed: 21 nov. 2024.
doi: https://doi.org/10.18103/mra.v10i11.3320.
Section
Review Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
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2. Lee DJ, Koru‐Sengul T, Hernandez MN, et al. Cancer risk among career male and female florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981‐2014). Am J Ind Med. 2020;63(4):285-299. Doi:10.1002/ajim.23086
3. Butry DT, Webb D, Gilbert S, Taylor J. The economics of firefighter injuries in the United States. 2019. Doi:10.6028/nist.tn.2078
4. Soteriades ES, Kim J, Christophi CA, Kales SN. Cancer incidence and mortality in firefighters: A state-of-the-art review and meta-َanalysis. Asian Pac J Cancer Prev. 2019;20(11):3221-3231. Doi:10.31557/apjcp.2019.20.11.3221
5. Jalilian H, Ziaei M, Weiderpass E, Rueegg CS, Khosravi Y, Kjaerheim K. Author’s reply to: Cancer incidence and mortality among firefighters. Int J Cancer. 2019. Doi:10.1002/ijc.32300
6. Dolin PJ, Cook-Mozaffari P. Occupation and bladder cancer: A death-certificate study. Br J Cancer. 1992;66(3):568-578. Doi:10.1038/bjc.1992.316
7. Daniels RD, Bertke S, Dahm MM, et al. 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). Occup Envir Med. 2015;72(10):699-706. Doi:10.1136/oemed-2014-102671
8. Walsh JM, Potter MB, Arora M, Gildegorin G, Terdiman J. A workplace colorectal cancer screening program in Firefighters: Lessons Learned. Occup Med. 2014;64(4):255-258. Doi:10.1093/occmed/kqu046
9. Maloney SR, Udasin IG, Black TM, et al. Perceived health risks among firefighters; the New Jersey Firefighter Health Survey. J Occup Envir Med. 2020;63(4):317-321. Doi:10.1097/jom.0000000000002125
10. Oh HE, Kim SJ, Woo H, Ham S. Associations between awareness of the risk of exposure to pollutants occurring at fire scenes and health beliefs among metropolitan firefighters in the Republic of Korea. Int J Environ Res Public Health. 2022;19(14):8860. Doi:10.3390/ijerph19148860
11. Laroche E, L’Espérance S. Cancer incidence and mortality among firefighters: An overview of Epidemiologic Systematic Reviews. Int J Environ Res Public Health. 2021;18(5):2519. doi:10.3390/ijerph18052519
12. Harris MA, Kirkham TL, MacLeod JS, Tjepkema M, Peters PA, Demers PA. Surveillance of cancer risks for firefighters, police, and armed forces among men in a Canadian census cohort. Am J Ind Med. 2018;61(10):815-823. doi:10.1002/ajim.22891
13. Casjens S, Brüning T, Taeger D. Cancer risks of firefighters: A systematic review and meta-analysis of secular trends and region-specific differences. Int Arch Occup Environ Health. 2020;93(7):839-852. doi:10.1007/s00420-020-01539-0
14. Lee DJ, Koru‐Sengul T, Hernandez MN, et al. Cancer risk among career male and female florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981‐2014). Am J Ind Med. 2020;63(4):285-299. doi:10.1002/ajim.23086
15. Jung AM, Zhou J, Beitel SC, et al. Longitudinal evaluation of whole blood MIRNA expression in firefighters. J Expos Sci Environ Epi. 2021;31(5):900-912. doi:10.1038/s41370-021-00306-8
16. Muegge CM, Zollinger TW, Song Y, Wessel J, Monahan PO, Moffatt SM. Excess mortality among Indiana Firefighters, 1985-2013. Am J Ind Med. 2018;61(12):961-967. doi:10.1002/ajim.22918
17. Landgren O, Zeig-Owens R, Giricz O, et al. Multiple myeloma and its precursor disease among firefighters exposed to the World Trade Center disaster. JAMA Oncology. 2018;4(6):821. doi:10.1001/jamaoncol.2018.0509
18. Georgakopoulou R, Fiste O, Sergentanis TN, et al. Occupational exposure and multiple myeloma risk: An updated review of Meta-Analyses. J Clin Med. 2021;10(18):4179. doi:10.3390/jcm10184179
19. Gallagher A. Potential toxic mechanisms for increased cancer risks in firefighters. Oncol Times. 2022;44(18):17-18. doi:10.1097/01.cot.0000884692.76827.a1
20. Hwang J, Xu C, Agnew RJ, Clifton S, Malone TR. Health risks of structural firefighters from exposure to polycyclic aromatic hydrocarbons: A systematic review and meta-analysis. Int J Environ Res Public Health. 2021;18(8):4209. doi:10.3390/ijerph18084209
21. Barros B, Oliveira M, Morais S. Firefighters’ occupational exposure: Contribution from biomarkers of effect to assess health risks. Environ Int. 2021;156:106704. doi:10.1016/j.envint.2021.106704
22. Korn GP, Alvarenga EH, Dall'Oglio GP, et al. The effects in the upper airway of heat and exposure to combustion byproducts of burning materials on larynx of firefighters. J Voice. 2022;36(5). doi:10.1016/j.jvoice.2020.08.020
23. Andersen MH, Saber AT, Clausen PA, et al. Association between polycyclic aromatic hydrocarbon exposure and peripheral blood mononuclear cell DNA damage in human volunteers during fire extinction exercises. Mutagenesis. 2017;33(1):105-115. doi:10.1093/mutage/gex021
24. Goodrich JM, Furlong MA, Caban-Martinez AJ, et al. Differential DNA methylation by Hispanic ethnicity among firefighters in the United States. Epigenet Insights. 2021;14:251686572110061. doi:10.1177/25168657211006159
25. Smith DL, Friedman NMG, Bloom SI, et al. Firefighting induces acute inflammatory responses that are not relieved by aspirin in older firefighters. J Occup Environ Med. 2019;61(7):617-622. doi:10.1097/jom.0000000000001626
26. McAllister MJ, Gonzalez AE, Waldman HS. Time restricted feeding reduces inflammation and cortisol response to a firegrounds test in professional firefighters. J Occup Environ Med. 2021;63(5):441-447. doi:10.1097/jom.0000000000002169
27. Gaughan DM, Cox-Ganser JM, Enright PL, et al. Acute upper and lower respiratory effects in wildland firefighters. J Occup Environ Med. 2008;50(9):1019-1028. doi:10.1097/jom.0b013e3181754161
28. Brinchmann BC, Bugge MD, Nordby K-C, Alfonso JH. Firefighting and melanoma, epidemiological and toxicological associations: A case report. Occup Med. 2022;72(2):142-144. doi:10.1093/occmed/kqab183
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