Occupational mortality among firefighters: assessing the association

Area of Science:

• Occupational Health
• Epidemiology
• Toxicology

Background:

• Firefighters are exposed to numerous toxic agents during their work.
• This occupational exposure may increase their risk for various diseases.
• Assessing disease risk requires comparing findings and inferring the magnitude of risk.

Purpose of the Study:

• To review existing literature on disease risks among firefighters.
• To compare findings and determine the magnitude of occupational risk.
• To establish criteria for the presumption of occupational risk.

Main Methods:

• Literature review of studies on disease risk in firefighters.
• Analysis of Standardized Mortality Ratios (SMRs) and equivalent risk estimates.
• Focus on risks approaching or exceeding an SMR of 200 for presumption.

Main Results:

• Strong evidence supports a general presumption of risk for genitourinary tract cancers (kidney, ureter, bladder).
• Incomplete evidence suggests a possible association for brain cancer, consistent with presumption.
• Evidence for lung cancer, cardiovascular disease, and colorectal cancer did not meet criteria for general presumption.
• Aortic aneurysm risk is uncertain but potentially compatible with presumption if an association exists.

Conclusions:

• Firefighters have a presumed occupational risk for genitourinary cancers and possibly brain cancer.
• Further research is needed for aortic aneurysms, while lung, cardiovascular, and colorectal cancers do not warrant general presumption.
• Acute lung disease from specific exposures can cause severe toxicity but doesn't increase chronic disease risk.