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Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009).

Authors
Daniels-RD; Kubale-TL; Yiin-JH; Dahm-MM; Hales-TR; Baris-D; Zahm-SH; Beaumont-JJ; Waters-KM; Pinkerton-LE
Source
Occup Environ Med 2014 Jun; 71(6):388-397
NIOSHTIC No.
20043263
Abstract
OBJECTIVES: To examine mortality patterns and cancer incidence in a pooled cohort of 29,993 US career firefighters employed since 1950 and followed through 2009. METHODS: Mortality and cancer incidence were evaluated by life table methods with the US population referent. Standardised mortality (SMR) and incidence (SIR) ratios were determined for 92 causes of death and 41 cancer incidence groupings. Analyses focused on 15 outcomes of a priori interest. Sensitivity analyses were conducted to examine the potential for significant bias. RESULTS: Person-years at risk totalled 858,938 and 403,152 for mortality and incidence analyses, respectively. All-cause mortality was at expectation (SMR=0.99, 95% CI 0.97 to 1.01, n=12,028). There was excess cancer mortality (SMR=1.14, 95% CI 1.10 to 1.18, n=3285) and incidence (SIR=1.09, 95% CI 1.06 to 1.12, n=4461) comprised mainly of digestive (SMR=1.26, 95% CI 1.18 to 1.34, n=928; SIR=1.17, 95% CI 1.10 to 1.25, n=930) and respiratory (SMR=1.10, 95% CI 1.04 to 1.17, n=1096; SIR=1.16, 95% CI 1.08 to 1.24, n=813) cancers. Consistent with previous reports, modest elevations were observed in several solid cancers; however, evidence of excess lymphatic or haematopoietic cancers was lacking. This study is the first to report excess malignant mesothelioma (SMR=2.00, 95% CI 1.03 to 3.49, n=12; SIR=2.29, 95% CI 1.60 to 3.19, n=35) among US firefighters. Results appeared robust under differing assumptions and analytic techniques. CONCLUSIONS: Our results provide evidence of a relation between firefighting and cancer. The new finding of excess malignant mesothelioma is noteworthy, given that asbestos exposure is a known hazard of firefighting.
Keywords
Fire-fighters; Cancer; Cancer-rates; Mortality-data; Mortality-rates; Employee-exposure; Worker-health; Fire-fighting; Long-term-study; Mathematical-models; Statistical-analysis; Lifespan; Analytical-processes; Risk-analysis; Digestive-system; Respiratory-system-disorders; Malignant-neoplasms; Mesothelial-cells; Asbestos-fibers
Contact
Dr Robert D Daniels, Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, 4676 Columbia Parkway, Mailstop R-13, Cincinnati, OH 45226, USA
CODEN
OEMEEM
Publication Date
20140601
Document Type
Journal Article
Email Address
rtd2@cdc.gov
Fiscal Year
2014
NTIS Accession No.
NTIS Price
Identifying No.
M102013
Issue of Publication
6
ISSN
1351-0711
NIOSH Division
DSHEFS
Priority Area
Public Safety
Source Name
Occupational and Environmental Medicine
State
OH; MD; CA
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