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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
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. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Authors: J Mustajbegovic; E Zuskin; E N Schachter; J Kern; M Vrcic-Keglevic; S Heimer; K Vitale; T Nada Journal: Am J Ind Med Date: 2001-07 Impact factor: 2.214
Authors: N S Shilnikova; D L Preston; E Ron; E S Gilbert; E K Vassilenko; S A Romanov; I S Kuznetsova; M E Sokolnikov; P V Okatenko; V V Kreslov; N A Koshurnikova Journal: Radiat Res Date: 2003-06 Impact factor: 2.841
Authors: Jessica Trowbridge; Roy R Gerona; Thomas Lin; Ruthann A Rudel; Vincent Bessonneau; Heather Buren; Rachel Morello-Frosch Journal: Environ Sci Technol Date: 2020-02-26 Impact factor: 9.028
Authors: Paola Louzado-Feliciano; Katerina M Santiago; Laura Paule; Geovanny Rivera; Natasha Schaefer Solle; Marija Miric; Eddy Perez-Then; Alberto J Caban-Martinez Journal: J Occup Environ Med Date: 2022-03-01 Impact factor: 2.162
Authors: Carolina Bigert; Per Gustavsson; Kurt Straif; Dirk Taeger; Beate Pesch; Benjamin Kendzia; Joachim Schüz; Isabelle Stücker; Florence Guida; Irene Brüske; Heinz-Erich Wichmann; Angela C Pesatori; Maria Teresa Landi; Neil Caporaso; Lap Ah Tse; Ignatius Tak-Sun Yu; Jack Siemiatycki; Jérôme Lavoué; Lorenzo Richiardi; Dario Mirabelli; Lorenzo Simonato; Karl-Heinz Jöckel; Wolfgang Ahrens; Hermann Pohlabeln; Adonina Tardón; David Zaridze; John K Field; Andrea 't Mannetje; Neil Pearce; John McLaughlin; Paul Demers; Neonila Szeszenia-Dabrowska; Jolanta Lissowska; Peter Rudnai; Eleonora Fabianova; Rodica Stanescu Dumitru; Vladimir Bencko; Lenka Foretova; Vladimir Janout; Paolo Boffetta; Susan Peters; Roel Vermeulen; Hans Kromhout; Thomas Brüning; Ann C Olsson Journal: J Occup Environ Med Date: 2016-11 Impact factor: 2.162
Authors: Emily H Sparer; Daniel P Prendergast; Jennifer N Apell; Madeleine R Bartzak; Gregory R Wagner; Gary Adamkiewicz; Jaime E Hart; Glorian Sorensen Journal: J Occup Environ Med Date: 2017-10 Impact factor: 2.162
Authors: Rebecca J Tsai; Sara E Luckhaupt; Pam Schumacher; Rosemary D Cress; Dennis M Deapen; Geoffrey M Calvert Journal: Am J Ind Med Date: 2015-05-06 Impact factor: 3.079
Authors: Kyoung Sook Jeong; Jin Zhou; Stephanie C Griffin; Elizabeth T Jacobs; Devi Dearmon-Moore; Jing Zhai; Sally R Littau; John Gulotta; Paul Moore; Wayne F Peate; Crystal M Richt; Jefferey L Burgess Journal: J Occup Environ Med Date: 2018-05 Impact factor: 2.162
Authors: Jeavana Sritharan; Manisha Pahwa; Paul A Demers; Shelley A Harris; Donald C Cole; Marie-Elise Parent Journal: Environ Health Date: 2017-11-17 Impact factor: 5.984
Authors: Jin Zhou; Timothy G Jenkins; Alesia M Jung; Kyoung Sook Jeong; Jing Zhai; Elizabeth T Jacobs; Stephanie C Griffin; Devi Dearmon-Moore; Sally R Littau; Wayne F Peate; Nathan A Ellis; Peter Lance; Yin Chen; Jefferey L Burgess Journal: PLoS One Date: 2019-03-26 Impact factor: 3.240
Authors: Anna A Stec; Kathryn E Dickens; Marielle Salden; Fiona E Hewitt; Damian P Watts; Philip E Houldsworth; Francis L Martin Journal: Sci Rep Date: 2018-02-06 Impact factor: 4.379