Format

Send to

Choose Destination
Occup Environ Med. 2020 Feb;77(2):84-93. doi: 10.1136/oemed-2019-105962. Epub 2020 Jan 2.

Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update.

Author information

1
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
2
Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA jyiin@cdc.gov.
3
World Trade Center Health Program, National Institute for Occupational Safety and Health (NIOSH), Washington, District of Columbia, USA.
4
Division of Safety Research, National Institute for Occupational Safety and Health (NIOSH), Denver, Colorado, USA.
5
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
6
Department of Public Health Sciences, University of California Davis, Davis, California, USA.
7
Education and Information Division, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA.

Abstract

OBJECTIVES:

To update the mortality experience of a previously studied cohort of 29 992 US urban career firefighters compared with the US general population and examine exposure-response relationships within the cohort.

METHODS:

Vital status was updated through 2016 adding 7 years of follow-up. Cohort mortality compared with the US population was evaluated via life table analyses. Full risk-sets, matched on attained age, race, birthdate and fire department were created and analysed using the Cox proportional hazards regression to examine exposure-response associations between select mortality outcomes and exposure surrogates (exposed-days, fire-runs and fire-hours). Models were adjusted for a potential bias from healthy worker survivor effects by including a categorical variable for employment duration.

RESULTS:

Compared with the US population, mortality from all cancers, mesothelioma, non-Hodgkin's lymphoma (NHL) and cancers of the oesophagus, intestine, rectum, lung and kidney were modestly elevated. Positive exposure-response relationships were observed for deaths from lung cancer, leukaemia and chronic obstructive pulmonary disease (COPD).

CONCLUSIONS:

This update confirms previous findings of excess mortality from all cancers and several site-specific cancers as well as positive exposure-response relations for lung cancer and leukaemia. New findings include excess NHL mortality compared with the general population and a positive exposure-response relationship for COPD. However, there was no evidence of an association between any quantitative exposure measure and NHL.

KEYWORDS:

cancer; dose-response; epidemiology; firefighters; longitudinal studies; mortality studies

PMID:
31896615
DOI:
10.1136/oemed-2019-105962

Conflict of interest statement

Competing interests: None declared.

Supplemental Content

Full text links

Icon for HighWire
Loading ...
Support Center