Assessing carcinogenic and mutagenic hazards in firefighting: a comprehensive review

This review aims to critically assess the carcinogenic and mutagenic risks associated with firefighting, with a focus on cancer incidence, cancer mortality and other chronic health outcomes. Firefighting is widely recognized as a high-risk occupation due to repeated exposure to hazardous substances, including polycyclic aromatic hydrocarbons (PAHs) and other combustion by-products. An extensive review of empirical studies, meta-analyses, and institutional reports was conducted, considering not only direct fireground exposure but also risks arising from contaminated personal protective equipment (PPE) and indoor air pollution within fire stations. The findings establish a consistent link between firefighting and elevated risks of multiple cancers and chronic diseases. The complexity of modern -firefighting -environments, amplified by evolving materials, under--ventilated fires, and inadequate decontamination practices, further intensifies these risks. The review highlights the urgent need for advanced protective gear, standardized decontamination protocols, routine health surveillance, and policy reforms. It underscores the importance of multidisciplinary collaboration in developing effective strategies to safeguard the health of firefighters, who play a vital role in ensuring public safety.