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Li Y, Zhao X, Li X, Zhang Y, Niu Z. The investigation of the enrichment behavior of identified PFAS and unknown PFAA-precursors in water and suspended particulate matter of the surface microlayer: A case study in Tianjin (China). WATER RESEARCH 2024; 260:121944. [PMID: 38909422 DOI: 10.1016/j.watres.2024.121944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2024] [Revised: 05/08/2024] [Accepted: 06/13/2024] [Indexed: 06/25/2024]
Abstract
The surface microlayer (SML) is an important air water interface layer, known as the skin of the ocean, which has chemical enrichment properties. Chemical enrichment in the SML can affect the occurrence of pollutants in the underlying water and air samples. Although the enrichment of per- and polyfluorinated substances (PFAS), a class of persistent organic pollutants of high concern, has been reported in the SML, information on the behavior of unknown PFAA-precursors in SML is lacked, and it is not clear whether there is a similar PFAS enrichment in suspended particulate matter (SPM) in the SML. Therefore, to investigate these questions, we conducted a systematic survey of 24 PFAS in 11 paired water and SPM samples from the SML and underlying water (U50cm and U2m) from the Duliujian River, which flows to the Bohai sea in Tianjin, China. The ∑PFAS mean concentrations in the water and SPM samples were 38.2 ng/L and 64.6 ng/g dw, respectively. The PFAS concentrations of PFAS in the SML were higher than those in the underlying water, and the enrichment factors (EFs) were greater in the SPM than that in the water. The long-chain PFAS EFs were greater than those for short-chain PFAS, indicating that the EFs were positively correlated with the hydrophobicity. Moreover, by applying the total oxidizable precursor (TOP) assay, the unknown PFAA-precursors (C5-C12) in the water and SPM contributed 11.4∼86.4 mol% and 7.1∼88.0 mol% to total PFAS, respectively. The ecological risk of the targeted PFAS in the SML was relatively higher than that in the underlying water, indicating that PFAS in the SML require more attention. Preliminary estimates indicate that the PFAS-enriched SML is an important exposure route that poses a potential risk to wildlife in rivers and oceans.
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Affiliation(s)
- Yuna Li
- School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, China
| | - Xinhai Zhao
- School of Marine Science and Technology, Tianjin University, Tianjin 300072, China
| | - Xiaofeng Li
- School of Marine Science and Technology, Tianjin University, Tianjin 300072, China
| | - Ying Zhang
- School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, China.
| | - Zhiguang Niu
- School of Environmental Science and Engineering, Tianjin University, Tianjin 300072, China; International Joint Institute of Tianjin University, Fuzhou 350205, China
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2
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Glasgow TE, Burch JB, Arcan C, Fuemmeler BF. Cancer Prevention Among Firefighters: Examining Lifestyle, Screening Behavior, and Beliefs. Workplace Health Saf 2024; 72:283-297. [PMID: 38805485 DOI: 10.1177/21650799241254097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
Abstract
BACKGROUND Firefighters are at increased risk of developing cancer due to occupational exposures, but they may also face increased risk due to their lifestyle, such as the quality of their diet and physical activity. Cancer beliefs and screening behavior could also influence their cancer risk. The current study aimed to identify individual differences associated with lifestyle behaviors, cancer screening, and cancer beliefs among firefighters; to describe the strategies firefighters use to adapt to their work schedule; and to describe topics firefighters believe are the most important to address in their workplace. METHODS Career firefighters (N = 171) in a medium-sized U.S. city completed an online survey. FINDINGS Logistic regression analyses identified age, education, racial identity, years of fire service, perceived stress, and rank as predictors of responses to items addressing cancer screening, lifestyle behaviors, and cancer beliefs. Although results varied, age, education, and racial identity were associated with most of the outcomes. Strategies related to sleep such as getting the right amount and napping, exercise, and getting family/roommate support were selected as the top adaptive strategies for work. Sleep, mental health/well-being, and work-life balance were selected most often as the most important topics to address in the fire service, with topics related to reducing occupational exposures receiving less attention. CONCLUSIONS/APPLICATION TO PRACTICE The findings suggest individual differences, such as age, education, and racial identity, should be considered when developing occupational health interventions for firefighters. Interventions related to mental health, work-life balance, and sleep may be desired most by those in the fire service.
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Affiliation(s)
| | - James B Burch
- Department of Family Medicine and Population Health, School of Medicine and School of Population Health, Virginia Commonwealth University
| | - Chrisa Arcan
- Department of Family Medicine and Population Health, School of Medicine and School of Population Health, Virginia Commonwealth University
| | - Bernard F Fuemmeler
- Department of Family Medicine and Population Health, School of Medicine and School of Population Health, Virginia Commonwealth University
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Ahn S, McClure LA, Pinheiro PS, Hernandez D, Boga DJ, Ukani H, Chavez JV, Quintela Fernandez JA, Caban-Martinez AJ, Kobetz E, Lee DJ. Methodological and Practical Challenges in Synthesizing Occupational Cancer Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:742. [PMID: 38928988 PMCID: PMC11203818 DOI: 10.3390/ijerph21060742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/11/2024] [Accepted: 06/02/2024] [Indexed: 06/28/2024]
Abstract
Studies examining occupational exposures and cancer risk frequently report mixed findings; it is thus imperative for researchers to synthesize study results and identify any potential sources that explain such variabilities in study findings. However, when synthesizing study results using meta-analytic techniques, researchers often encounter a number of practical and methodological challenges. These challenges include (1) an incomparability of effect size measures due to large variations in research methodology; (2) a violation of the independence assumption for meta-analysis; (3) a violation of the normality assumption of effect size measures; and (4) a variation in cancer definitions across studies and changes in coding standards over time. In this paper, we first demonstrate these challenges by providing examples from a real dataset collected for a large meta-analysis project that synthesizes cancer mortality and incidence rates among firefighters. We summarize how each of these challenges has been handled in our meta-analysis. We conclude this paper by providing practical guidelines for handling challenges when synthesizing study findings from occupational cancer literature.
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Affiliation(s)
- Soyeon Ahn
- Department of Educational and Psychological Studies, School of Education and Human Development, University of Miami, Coral Gables, FL 33146, USA
| | - Laura A. McClure
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | - Paulo S. Pinheiro
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33101, USA
| | - Diana Hernandez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | - Devina J. Boga
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | - Henna Ukani
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | - Jennifer V. Chavez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
| | | | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33101, USA
| | - Erin Kobetz
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33101, USA
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL 33101, USA
| | - David J. Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL 33101, USA; (L.A.M.); (P.S.P.); (D.H.); (D.J.B.); (H.U.); (J.V.C.); (A.J.C.-M.); (E.K.); (D.J.L.)
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33101, USA
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Rogula-Kozłowska W, Piątek P, Kozielska B, Walczak A. Off-gassing from firefighter suits (nomex) as an indoor source of BTEXS. CHEMOSPHERE 2024; 350:140996. [PMID: 38141684 DOI: 10.1016/j.chemosphere.2023.140996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 11/05/2023] [Accepted: 12/18/2023] [Indexed: 12/25/2023]
Abstract
The clothes and special equipment of firefighters can be a source of indoor air pollution. Nevertheless, it has not been investigated so far what the scale of the release of various compounds from such materials into the indoor air can be. The following study analysed the results of an experiment involving the passive measurement of concentrations of selected compounds, i.a. benzene, toluene, ethylbenzene, m,p-xylene, o-xylene, styrene, isopropylbenzene and n-propylbenzene (BTEXS) in the air of a room where firefighters' special clothing, which had been previously exposed to emissions from simulated fires, was stored. The study included simulations of fires involving three materials: wood, processed wood (OSB/fibreboard) and a mixture of plastics. After being exposed to the simulated fire environment, special clothing (so-called nomex) was placed in a sealed chamber, where passive collection of BTEXS was carried out using tube-type axial passive samplers and a gas chromatograph. Irrespective of which burned material special clothing was exposed to, the compound emitted into the air most intensively was toluene. Its rate of release from a single nomex ranges from 4.4 to 28.6 μg h-1, while the corresponding rates for the sum of BTEXS are between 9.97 and 44.29 μg h-1.
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Affiliation(s)
| | - Piotr Piątek
- Fire University, 52/54 Słowackiego St., 01-629, Warsaw, Poland.
| | - Barbara Kozielska
- Silesian University of Technology, 22B Konarskiego St., 44-100, Gliwice, Poland.
| | - Agata Walczak
- Fire University, 52/54 Słowackiego St., 01-629, Warsaw, Poland.
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Smith CJ, Perfetti TA, Chokshi C, Venugopal C, Ashford JW, Singh SK. Alkylating agents are possible inducers of glioblastoma and other brain tumors. Hum Exp Toxicol 2024; 43:9603271241256598. [PMID: 38758727 DOI: 10.1177/09603271241256598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2024]
Abstract
Epidemiological evidence of an association between exposure to chemical carcinogens and an increased risk for development of glioblastoma (GBM) is limited to weak statistical associations in cohorts of firefighters, farmers, residents exposed to air pollution, and soldiers exposed to toxic chemicals (e.g., military burn pits, oil-well fire smoke). A history of ionizing radiation therapy to the head or neck is associated with an increased risk of GBM. Ionizing radiation induces point mutations, frameshift mutations, double-strand breaks, and chromosomal insertions or deletions. Mutational profiles associated with chemical exposures overlap with the broad mutational patterns seen with ionizing radiation. Data on 16 agents (15 chemicals and radio frequency radiation) that induced tumors in the rodent brain were extracted from 602 Technical Reports on 2-years cancer bioassays found in the National Toxicology Program database. Ten of the 15 chemical agents that induce brain tumors are alkylating agents. Three of the 15 chemical agents have idiosyncratic structures and might be alkylating agents. Only two of the 15 chemical agents are definitively not alkylating agents. The rat model is thought to be of possible relevance to humans suggesting that exposure to alkylating chemicals should be considered in epidemiology studies on GBM and other brain tumors.
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Affiliation(s)
- Carr J Smith
- Society for Brain Mapping and Therapeutics, Pacific Palisades, CA, USA
| | | | - Chirayu Chokshi
- Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
| | - Chitra Venugopal
- Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
- Center for Discovery in Cancer Research (CDCR), McMaster University, Hamilton, ON, Canada
| | - J Wesson Ashford
- Stanford University and VA Palo Alto Health Care System, Palo Alto, CA, USA
| | - Sheila K Singh
- Department of Surgery, McMaster University, Hamilton, ON, Canada
- Department of Biochemistry and Biomedical Sciences, McMaster University, Hamilton, ON, Canada
- Center for Discovery in Cancer Research (CDCR), McMaster University, Hamilton, ON, Canada
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Sritharan J, Demers PA, Eros FR, Berriault C, Dakouo M, Kirkham TL. Cancer Risks among Emergency Medical Services Workers in Ontario, Canada. PREHOSP EMERG CARE 2023; 28:620-625. [PMID: 37967276 DOI: 10.1080/10903127.2023.2283079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Accepted: 10/30/2023] [Indexed: 11/17/2023]
Abstract
OBJECTIVES Emergency medical services workers, such as paramedics, provide important emergency care and may be exposed to potential carcinogens while working. Few studies have examined the risk of cancer among paramedics demonstrating an important knowledge gap in existing literature. This study aimed to investigate cancer risks among paramedics in a large cohort of Ontario workers. METHODS Paramedics were identified in the Occupational Disease Surveillance System (ODSS) from 1996 to 2019. The ODSS was established by linking lost-time worker's compensation claims to administrative health data, including the Ontario Cancer Registry to identify incident cases of cancer. Cox-proportional hazard models were used to calculate age and sex-adjusted hazard ratios and 95% confidence intervals to estimate the risk of cancer among paramedics compared to all other workers in the ODSS. RESULTS A total of 7240 paramedics were identified, with just over half of the paramedics identifying as male similar to the overall ODSS cohort. Paramedics had a statistically significant elevated risk of any cancer (HR 1.19, 95% CI 1.06-1.34), and elevated risks for melanoma (HR 2.18, 95% CI 1.46-3.26) and prostate cancer (HR 1.73, 95% CI 1.34-2.22). Paramedics had a statistically significant reduced risk for lung cancer (HR 0.48, 95% CI 0.28-0.83). Findings were similar to cancer risks identified in firefighters and police in the same cohort. CONCLUSIONS This study contributes valuable findings to understanding cancer risks among paramedics and further supports the existing evidence on the increased risk of cancer among emergency medical services workers. We have observed some similar results for firefighters and police, which may be explained by similar exposures, including vehicle exhaust, shiftwork, and intermittent solar radiation. This can lead to a better understanding of carcinogens and other exposures among paramedics and inform cancer prevention strategies.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Fanni R Eros
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
| | - Colin Berriault
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
| | - Mamadou Dakouo
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
| | - Tracy L Kirkham
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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7
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Furlong MA, Liu T, Snider JM, Tfaily MM, Itson C, Beitel S, Parsawar K, Keck K, Galligan J, Walker DI, Gulotta JJ, Burgess JL. Evaluating changes in firefighter urinary metabolomes after structural fires: an untargeted, high resolution approach. Sci Rep 2023; 13:20872. [PMID: 38012297 PMCID: PMC10682406 DOI: 10.1038/s41598-023-47799-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023] Open
Abstract
Firefighters have elevated rates of urinary tract cancers and other adverse health outcomes, which may be attributable to environmental occupational exposures. Untargeted metabolomics was applied to characterize this suite of environmental exposures and biological changes in response to occupational firefighting. 200 urine samples from 100 firefighters collected at baseline and two to four hours post-fire were analyzed using untargeted liquid-chromatography and high-resolution mass spectrometry. Changes in metabolite abundance after a fire were estimated with fixed effects linear regression, with false discovery rate (FDR) adjustment. Partial least squares discriminant analysis (PLS-DA) was also used, and variable important projection (VIP) scores were extracted. Systemic changes were evaluated using pathway enrichment for highly discriminating metabolites. Metabolome-wide-association-study (MWAS) identified 268 metabolites associated with firefighting activity at FDR q < 0.05. Of these, 20 were annotated with high confidence, including the amino acids taurine, proline, and betaine; the indoles kynurenic acid and indole-3-acetic acid; the known uremic toxins trimethylamine n-oxide and hippuric acid; and the hormone 7a-hydroxytestosterone. Partial least squares discriminant analysis (PLS-DA) additionally implicated choline, cortisol, and other hormones. Significant pathways included metabolism of urea cycle/amino group, alanine and aspartate, aspartate and asparagine, vitamin b3 (nicotinate and nicotinamide), and arginine and proline. Firefighters show a broad metabolic response to fires, including altered excretion of indole compounds and uremic toxins. Implicated pathways and features, particularly uremic toxins, may be important regulators of firefighter's increased risk for urinary tract cancers.
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Affiliation(s)
- Melissa A Furlong
- Environmental Health Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA.
| | - Tuo Liu
- Environmental Health Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Justin M Snider
- School of Nutritional Sciences and Wellness, University of Arizona, Tucson, USA
- University of Arizona Cancer Center, Tucson, USA
| | - Malak M Tfaily
- Department of Environmental Science, University of Arizona, Tucson, USA
| | - Christian Itson
- Department of Environmental Science, University of Arizona, Tucson, USA
| | - Shawn Beitel
- Environmental Health Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Krishna Parsawar
- Analytical and Biological Mass Spectrometry Core, University of Arizona, Tucson, USA
| | - Kristen Keck
- Analytical and Biological Mass Spectrometry Core, University of Arizona, Tucson, USA
| | | | - Douglas I Walker
- Gangarosa Department of Environmental Health, Emory University Rollins School of Public Health, Atlanta, GA, USA
| | | | - Jefferey L Burgess
- Environmental Health Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
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Ohayon JL, Rasanayagam S, Rudel RA, Patton S, Buren H, Stefani T, Trowbridge J, Clarity C, Brody JG, Morello-Frosch R. Translating community-based participatory research into broadscale sociopolitical change: insights from a coalition of women firefighters, scientists, and environmental health advocates. Environ Health 2023; 22:60. [PMID: 37649086 PMCID: PMC10466827 DOI: 10.1186/s12940-023-01005-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/17/2023] [Indexed: 09/01/2023]
Abstract
BACKGROUND We report on community-based participatory research (CBPR) initiated by women firefighters in order to share successful elements that can be instructive for other community-engaged research. This CBPR initiative, known as the Women Worker Biomonitoring Collaborative (WWBC) is the first we are aware of to investigate links between occupational exposures and health outcomes, including breast cancer, for a cohort of exclusively women firefighters. METHODS In order to be reflective of the experiences and knowledge of those most intimately involved, this article is co-authored by leaders of the research initiative. We collected leaders' input via recorded meeting sessions, emails, and a shared online document. We also conducted interviews (N = 10) with key research participants and community leaders to include additional perspectives. RESULTS Factors contributing to the initiative's success in enacting broadscale social change and advancing scientific knowledge include (1) forming a diverse coalition of impacted community leaders, labor unions, scientists, and advocacy organizations, (2) focusing on impacts at multiple scales of action and nurturing different, yet mutually supportive, goals among partners, (3) adopting innovative communication strategies for study participants, research partners, and the broader community, (4) cultivating a prevention-based ethos in the scientific research, including taking early action to reduce community exposures based on existing evidence of harm, and (5) emphasizing co-learning through all the study stages. Furthermore, we discuss external factors that contribute to success, including funding programs that elevate scientist-community-advocacy partnerships and allow flexibility to respond to emerging science-policy opportunities, as well as institutional structures responsive to worker concerns. CONCLUSIONS While WWBC shares characteristics with other successful CBPR partnerships, it also advances approaches that increase the ability for CBPR to translate into change at multiple levels. This includes incorporating partners with particular skills and resources beyond the traditional researcher-community partnerships that are the focus of much CBPR practice and scholarly attention, and designing studies so they support community action in the initial stages of research. Moreover, we emphasize external structural factors that can be critical for CBPR success. This demonstrates the importance of critically examining and advocating for institutional factors that better support this research.
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Affiliation(s)
| | - Sharima Rasanayagam
- California Breast Cancer Research Program, University of California, Office of the President, Oakland, CA, USA
| | - Ruthann A Rudel
- Silent Spring Institute, 320 Nevada Street, Suite 302, Newton, MA, 02460, USA
| | - Sharyle Patton
- Commonweal Biomonitoring Resource Center, Bolinas, CA, USA
| | | | - Tony Stefani
- San Francisco Firefighters Cancer Prevention Foundation, San Francisco, CA, USA
| | - Jessica Trowbridge
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Cassidy Clarity
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA
| | - Julia Green Brody
- Silent Spring Institute, 320 Nevada Street, Suite 302, Newton, MA, 02460, USA
| | - Rachel Morello-Frosch
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, Berkeley, CA, USA.
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9
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Ledda C, Bracci M, Spadafora A, Motta G, Smecca G, Catelan D, Rapisarda V. Unmasking the Hidden Danger: A Decade-Long Systematic Review of Case-Control Studies on Single Occupational Risks and Prostate Cancer. Life (Basel) 2023; 13:1820. [PMID: 37763224 PMCID: PMC10532927 DOI: 10.3390/life13091820] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 08/21/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
The present systematic review addresses the influence of occupational exposures on prostate cancer risk. Eleven studies were analyzed for a range of occupational exposures, including but not limited to firefighting, physical activity, night shift work, chemical exposure, and solar ultraviolet radiation. The results of the review reveal that firefighters exposed to harmful substances, individuals engaged in physically strenuous work, and workers with chronic night shift routines showed an increased likelihood of developing prostate cancer. Moreover, the review identified an increased risk associated with exposure to certain chemicals, including alkylphenolic compounds and benzene-related substances. The evidence underscores the importance of considering the cumulative effect of multiple risk factors in a comprehensive risk assessment. However, the conclusions indicate the necessity for further research to deepen these relationships and develop more effective strategies for the prevention of prostate cancer.
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Affiliation(s)
- Caterina Ledda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy;
| | - Massimo Bracci
- Occupational Medicine, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, 60121 Ancona, Italy;
| | - Alba Spadafora
- Occupational Health and Safety Unit, Provincial Health Agency of Siracusa, 96100 Siracusa, Italy;
| | - Giuseppe Motta
- Occupational Medicine Unit, “Garibaldi” Hospital of Catania, 95123 Catania, Italy;
| | - Giuseppe Smecca
- Prevention and Protection Unit, Provincial Health Agency of Ragusa, 97100 Ragusa, Italy;
| | - Dolores Catelan
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, 35131 Padova, Italy;
| | - Venerando Rapisarda
- Occupational Medicine, Department of Clinical and Experimental Medicine, University of Catania, 95124 Catania, Italy;
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10
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Kling HE, Koru-Sengul T, Solle NS, Louzado-Feliciano P, Lee DJ, Kobetz EN, Caban-Martinez AJ. Weight Status and Binge Drinking Among Male and Female Florida Firefighters. J Occup Environ Med 2023; 65:e565-e570. [PMID: 37253243 PMCID: PMC10524551 DOI: 10.1097/jom.0000000000002894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
OBJECTIVE The aim of the study is to examine the association between weight status and binge drinking among Florida firefighters. METHODS Health survey data collected between 2015 and 2019 among Florida firefighters participating in the Annual Cancer Survey were analyzed for weight class (healthy, overweight, obese) and binge-drinking behaviors. Binary logistic regression models were fit and stratified by sex while controlling for sociodemographic and health characteristics. RESULTS Among 4002 firefighter participants, 45.1% binge drink, 50.9% are overweight, and 31.3% are obese. Among male firefighters, being overweight (adjusted odds ratio = 1.34; 95% confidence interval = 1.10-1.64) or obese (1.29; 1.04-1.61) was significantly associated with binge drinking compared with healthy weight counterparts. In female firefighters, being obese (2.25; 1.21-4.22) was significantly associated with binge drinking but being overweight was not. CONCLUSIONS Being overweight or obese is selectively associated with binge drinking among male and female firefighters.
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Affiliation(s)
- Hannah E. Kling
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Tulay Koru-Sengul
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Natasha Schaefer Solle
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Medicine and University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Paola Louzado-Feliciano
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - David J. Lee
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Erin N. Kobetz
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Medicine and University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Alberto J. Caban-Martinez
- Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
- Department of Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, FL, USA
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11
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Everaert S, Schoeters G, Claes K, Raquez JM, Buffel B, Vanhaecke T, Moens J, Laitinen J, Van Larebeke N, Godderis L. Balancing Acute and Chronic Occupational Risks: The Use of Nitrile Butadiene Rubber Undergloves by Firefighters to Reduce Exposure to Toxic Contaminants. TOXICS 2023; 11:534. [PMID: 37368634 DOI: 10.3390/toxics11060534] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 06/01/2023] [Accepted: 06/14/2023] [Indexed: 06/29/2023]
Abstract
Firefighters are exposed via multi-route exposure to a multitude of chemicals (PAHs, VOCs, flame retardants, dioxins, etc.) that may cause acute and long-term health effects. The dermal absorption of contaminants is a major contributor to the overall exposure and can be reduced by wearing appropriate personal protective equipment. As leather firefighters' gloves cannot be decontaminated regularly by wet cleaning, many Belgian firefighters wear supplementary undergloves made of nitrile butadiene rubber (NBR) to protect against the accumulation of toxicants. However, the safety of this practice has been questioned. In this commentary, the current practice and risks are outlined for the first time, assessed by an interdisciplinary working group of the Belgian Superior Health Council. As NBR sticks to the skin more at high temperatures, the contact time on removal will be prolonged, posing an additional risk for deeper burns. However, based on the physicochemical properties of NBR and the existing experience of firefighters and burn centers, it is estimated that such incidents occur relatively rarely in practice. On the other hand, the risk of repeated exposure to contaminated gloves if no undergloves are worn is unacceptable. Despite the slightly increased risk for deeper burns, it is concluded that wearing disposable NBR gloves under regular firefighters' gloves is an appropriate and effective preventive measure against toxic contamination. The nitrile butadiene rubber must always be fully covered to avoid any contact with the heat.
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Affiliation(s)
- Stijn Everaert
- Chemical Environmental Factors Group, Superior Health Council, 1060 Brussels, Belgium
| | - Greet Schoeters
- Department of Biomedical Sciences, University of Antwerp, 2650 Antwerp, Belgium
| | - Karel Claes
- Burn Center & Department of Plastic Surgery, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jean-Marie Raquez
- Polymer and Composite Materials Department, University of Mons, 7000 Mons, Belgium
| | - Bart Buffel
- Department of Materials Engineering, KU Leuven, 8200 Bruges, Belgium
| | - Tamara Vanhaecke
- Department of In Vitro Toxicology and Dermato-Cosmetology, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Jonas Moens
- Belgian Poison Centre, 1120 Brussels, Belgium
| | - Juha Laitinen
- Pelastusopisto, Emergency Services Academy Finland, 70821 Kuopio, Finland
| | - Nicolas Van Larebeke
- Department of Radiotherapy and Experimental Cancerology, Ghent University, 9000 Ghent, Belgium
- Department of Analytical, Environmental and Geo-Chemistry, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Lode Godderis
- Center for Environment and Health, Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
- IDEWE, External Service for Prevention and Protection at Work, 3001 Heverlee, Belgium
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12
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DeBono NL, Daniels RD, Beane Freeman LE, Graber JM, Hansen J, Teras LR, Driscoll T, Kjaerheim K, Demers PA, Glass DC, Kriebel D, Kirkham TL, Wedekind R, Filho AM, Stayner L, Schubauer-Berigan MK. Firefighting and Cancer: A Meta-analysis of Cohort Studies in the Context of Cancer Hazard Identification. Saf Health Work 2023; 14:141-152. [PMID: 37389311 PMCID: PMC10300491 DOI: 10.1016/j.shaw.2023.02.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 02/22/2023] [Accepted: 02/27/2023] [Indexed: 03/08/2023] Open
Abstract
Objective We performed a meta-analysis of epidemiological results for the association between occupational exposure as a firefighter and cancer as part of the broader evidence synthesis work of the IARCMonographs program. Methods A systematic literature search was conducted to identify cohort studies of firefighters followed for cancer incidence and mortality. Studies were evaluated for the influence of key biases on results. Random-effects meta-analysis models were used to estimate the association between ever-employment and duration of employment as a firefighter and risk of 12 selected cancers. The impact of bias was explored in sensitivity analyses. Results Among the 16 included cancer incidence studies, the estimated meta-rate ratio, 95% confidence interval (CI), and heterogeneity statistic (I2) for ever-employment as a career firefighter compared mostly to general populations were 1.58 (1.14-2.20, 8%) for mesothelioma, 1.16 (1.08-1.26, 0%) for bladder cancer, 1.21 (1.12-1.32, 81%) for prostate cancer, 1.37 (1.03-1.82, 56%) for testicular cancer, 1.19 (1.07-1.32, 37%) for colon cancer, 1.36 (1.15-1.62, 83%) for melanoma, 1.12 (1.01-1.25, 0%) for non-Hodgkin lymphoma, 1.28 (1.02-1.61, 40%) for thyroid cancer, and 1.09 (0.92-1.29, 55%) for kidney cancer. Ever-employment as a firefighter was not positively associated with lung, nervous system, or stomach cancer. Results for mesothelioma and bladder cancer exhibited low heterogeneity and were largely robust across sensitivity analyses. Conclusions There is epidemiological evidence to support a causal relationship between occupational exposure as a firefighter and certain cancers. Challenges persist in the body of evidence related to the quality of exposure assessment, confounding, and medical surveillance bias.
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Affiliation(s)
- Nathan L. DeBono
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
| | - Robert D. Daniels
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, USA
| | - Laura E. Beane Freeman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA
| | - Judith M. Graber
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Piscataway, USA
| | - Johnni Hansen
- Danish Cancer Society Research Centre, Copenhagen, Denmark
| | | | - Tim Driscoll
- Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | | | - Paul A. Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
| | - Deborah C. Glass
- School of Epidemiology and Preventative Medicine, Monash University, Melbourne, Australia
| | - David Kriebel
- Lowell Center for Sustainable Production, University of Massachusetts Lowell, Lowell, USA
| | - Tracy L. Kirkham
- Occupational Cancer Research Centre, Ontario Health, Toronto, Canada
| | - Roland Wedekind
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
| | - Adalberto M. Filho
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
| | - Leslie Stayner
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
- University of Illinois at Chicago, School of Public Health, Division of Epidemiology and Biostatistics
| | - Mary K. Schubauer-Berigan
- Evidence Synthesis and Classification Branch, International Agency for Research on Cancer, Lyon, France
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13
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Sidossis A, Lan FY, Hershey MS, Hadkhale K, Kales SN. Cancer and Potential Prevention with Lifestyle among Career Firefighters: A Narrative Review. Cancers (Basel) 2023; 15:cancers15092442. [PMID: 37173909 PMCID: PMC10177420 DOI: 10.3390/cancers15092442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/13/2023] [Accepted: 04/19/2023] [Indexed: 05/15/2023] Open
Abstract
Career firefighters are at considerable risk for chronic diseases, including an increased risk of various cancers, compared to the general population. Over the last two decades, several systematic reviews and large cohort studies have demonstrated that firefighters have statistically significant increases in overall and site-specific cancer incidence and site-specific cancer mortality compared to the general population. Exposure assessment and other studies have documented exposures to a variety of carcinogens in fire smoke and within the fire station. Other occupational factors such as shift work, sedentary behavior, and the fire service food culture may also contribute to this working population's increased cancer risk. Furthermore, obesity and other lifestyle behaviors such as tobacco use, excessive alcohol consumption, poor diet, inadequate physical activity, and short sleep duration have also been associated with an increased risk of certain firefighting-associated cancers. Putative prevention strategies are proposed based on suspected occupational and lifestyle risk factors.
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Affiliation(s)
- Amalia Sidossis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
| | - Fan-Yun Lan
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University, Taipei 112, Taiwan
- Occupational Medicine, Department of Family Medicine, National Yang Ming Chiao Tung University Hospital, Yilan 260, Taiwan
| | - Maria S Hershey
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
| | - Kishor Hadkhale
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
- Faculty of Social Sciences Health Sciences (Epidemiology), Tampere University, 33100 Tampere, Finland
| | - Stefanos N Kales
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02138, USA
- Division of Occupational Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA 02139, USA
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14
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Grothe J, Tucker S, Blake A, Achutan C, Medcalf S, Suwondo T, Fruhling A, Yoder A. Exploring First Responders' Use and Perceptions on Continuous Health and Environmental Monitoring. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4787. [PMID: 36981694 PMCID: PMC10048923 DOI: 10.3390/ijerph20064787] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
First responders lose their lives in the line of duty each year, and many of these deaths result from strenuous physical exertion and exposure to harmful environmental agents. Continuous health monitoring may detect diseases and alert the first responder when vital signs are reaching critical levels. However, continuous monitoring must be acceptable to first responders. The purpose of this study was to discover first responders' current use of wearable technology, their perceptions of what health and environmental indicators should be monitored, and who should be permitted to monitor them. The survey was sent to 645 first responders employed by 24 local fire department stations. A total of 115 (17.8%) first responders answered the survey and 112 were used for analysis. Results found first responders perceived a need for health and environmental monitoring. The health and environmental indicators that respondents perceived as most important for monitoring in the field were heart rate (98.2%) and carbon monoxide (100%), respectively. Overall, using and wearing monitoring devices was not age-dependent and health and environmental concerns were important for first responders at any stage of their career. However, current wearable technology does not seem to be a viable solution for first responders due to device expense and durability issues.
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Affiliation(s)
- Jacob Grothe
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Sarah Tucker
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Anthony Blake
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Chandran Achutan
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Sharon Medcalf
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Troy Suwondo
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
| | - Ann Fruhling
- College of Information Science & Technology, University of Nebraska-Omaha, Omaha, NE 68182, USA
| | - Aaron Yoder
- College of Public Health, University of Nebraska Medical Center, Omaha, NE 68198, USA
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15
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Rosenfeld PE, Spaeth KR, Remy LL, Byers V, Muerth SA, Hallman RC, Summers-Evans J, Barker S. Perfluoroalkyl substances exposure in firefighters: Sources and implications. ENVIRONMENTAL RESEARCH 2023; 220:115164. [PMID: 36584840 DOI: 10.1016/j.envres.2022.115164] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 12/23/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
Firefighters are at risk of occupational exposure to long-chain per- and poly-fluoroalkyl substances (PFASs), most notably from PFASs present in Class B aqueous film-forming foam (AFFF). Firefighters have been found to have elevated serum levels of long-chain PFASs. Due to the persistence of PFAS chemicals in the human body and their ability to bioaccumulate, firefighters experience the latent and cumulative effects of PFAS-containing AFFF exposure that occurs throughout their careers. This article summarizes the history of AFFF use by firefighters and current AFFF use practices. In addition, this paper describes PFAS levels in firefighter serum, PFAS serum removal pathways, PFAS exposure pathways, and occupational factors affecting PFAS levels in firefighters. International, national, and state agencies have concluded that PFOA, a long-chain PFAS, is potentially carcinogenic and that carcinogens have an additive effect. From the cancer types that may be associated with PFAS exposure, studies on cancer risk among firefighters have shown an elevated risk for thyroid, kidney, bladder, testicular, prostate, and colon cancer. Thus, exposure to PFAS-containing AFFF may contribute to firefighter cancer risk and warrants further research.
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Affiliation(s)
- Paul E Rosenfeld
- Soil Water Air Protection Enterprise (SWAPE), 2656 29th Street, Suite 201, Santa Monica, CA, 90405, USA.
| | - Kenneth R Spaeth
- Division of Occupational and Environmental Medicine, Zucker School of Medicine at Hofstra/Northwell, NY, USA.
| | - Linda L Remy
- Family Health Outcomes Project, Family and Community Medicine, School of Medicine, University of California San Francisco, 500 Parnassus Ave. Room MU-337, San Francisco, CA, 94143-0900, USA.
| | - Vera Byers
- Immunology Inc. PO Box 4703, Incline Village, NV, 89450, USA.
| | - Stuart A Muerth
- Soil Water Air Protection Enterprise (SWAPE), 2656 29th Street, Suite 201, Santa Monica, CA, 90405, USA.
| | - Ryan C Hallman
- Soil Water Air Protection Enterprise (SWAPE), 2656 29th Street, Suite 201, Santa Monica, CA, 90405, USA.
| | - Jasmine Summers-Evans
- University of California, Los Angeles, Institute of the Environment and Sustainability. LaKretz Hall, 619 Charles E Young Dr E #300, Los Angeles, CA, 90024, USA.
| | - Sofia Barker
- Soil Water Air Protection Enterprise (SWAPE), 2656 29th Street, Suite 201, Santa Monica, CA, 90405, USA.
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16
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Horn GP, Stakes K, Neumann DL, Madrzykowski D, Fent KW. Exposure Risks and Potential Control Measures for a Fire Behavior Lab Training Structure: Part B. Chemical Gas Concentrations. FIRE TECHNOLOGY 2023; 59:3255-3282. [PMID: 38650825 PMCID: PMC11034741 DOI: 10.1007/s10694-023-01447-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/09/2023] [Indexed: 04/25/2024]
Abstract
Firefighters' or instructors' exposure to airborne chemicals during live-fire training may depend on fuels being burned, fuel orientation and participants' location within the structure. This study was designed to evaluate the impact of different control measures on exposure risk to combustion byproducts during fire dynamics training where fuel packages are mounted at or near the ceiling. These measures included substitution of training fuels (low density wood fiberboard, oriented strand board (OSB), pallets, particle board, plywood) and adoption of engineering controls such as changing the location of the instructor and students using the structure. Experiments were conducted for two different training durations: the typical six ventilation cycle (6-cycle) and a shorter three ventilation cycle (3-cycle) with a subset of training fuels. In Part A of this series, we characterized the fire dynamics within the structure, including the ability of each fuel to provide an environment that achieves the training objectives. Here, in Part B, airborne chemical concentrations are reported at the location where fire instructors would typically be operating. We hypothesized that utilizing a training fuel package with solid wood pallets would result in lower concentrations of airborne contaminants at the rear instructor location than wood-based sheet products containing additional resins and/or waxes. In the 6-cycle experiments (at the rear instructor location), OSB-fueled fires produced the highest median concentrations of benzene and 1,3 butadiene, plywood-fueled fires produced the highest total polycyclic aromatic hydrocarbon (PAH) concentrations, particle board-fueled fires produced the highest methyl isocyanate concentrations, and pallet-fueled fires produced the highest hydrogen chloride concentrations. All fuels other than particle board produced similarly high levels of formaldehyde at the rear instructor location. The OSB fuel package created the most consistent fire dynamics over 6-cycles, while fiberboard resulted in consistent fire dynamics only for the first three cycles. In the follow-on 3-cycle experiment, PAH, benzene, and aldehyde concentrations were similar for the OSB and fiberboard-fueled fires. Air sampling did not identify any clear differences between training fires from burning solid wood pallets and those that incorporate wood-based sheet products for this commonly employed fuel arrangement with fuels mounted high in the compartment. However, it was found that exposure can be reduced by moving firefighters and instructors lower in the compartment and/or by moving the instructor in charge of ventilation from the rear of the structure (where highest concentrations were consistently measured) to an outside position.
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Affiliation(s)
- Gavin P Horn
- Fire Safety Research Institute, UL Research Institutes, 6200 Old Dobbin Lane, Suite 150, Columbia, MD, 21045, USA
| | - Keith Stakes
- Fire Safety Research Institute, UL Research Institutes, 6200 Old Dobbin Lane, Suite 150, Columbia, MD, 21045, USA
| | - Danielle L Neumann
- Asset and Sustainability Performance, UL Solutions, Lake Forest, CA, USA
| | - Daniel Madrzykowski
- Fire Safety Research Institute, UL Research Institutes, 6200 Old Dobbin Lane, Suite 150, Columbia, MD, 21045, USA
| | - Kenneth W Fent
- National Institute for Occupational Safety & Health, Cincinnati, OH, USA
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17
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Goodrich JM, Jung AM, Furlong MA, Beitel S, Littau S, Gulotta J, Wallentine D, Burgess JL. Repeat measures of DNA methylation in an inception cohort of firefighters. Occup Environ Med 2022; 79:656-663. [PMID: 35332072 PMCID: PMC9484361 DOI: 10.1136/oemed-2021-108153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 03/11/2022] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Firefighters face exposures associated with adverse health outcomes including risk for multiple cancers. DNA methylation, one type of epigenetic regulation, provides a potential mechanism linking occupational hazards to adverse health outcomes. We hypothesised that DNA methylation profiles would change in firefighters after starting their service and that these patterns would be associated with occupational exposures (cumulative fire-hours and fire-runs). METHODS We profiled DNA methylation with the Infinium MethylationEPIC in blood leucocytes at two time points in non-smoking new recruits: prior to live fire training and 20-37 months later. Linear mixed effects models adjusted for potential confounders were used to identify differentially methylated CpG sites over time using data from 50 individuals passing all quality control. RESULTS We report 680 CpG sites with altered methylation (q value <0.05) including 60 with at least a 5% methylation difference at follow-up. Genes with differentially methylated CpG sites were enriched in biological pathways related to cancers, neurological function, cell signalling and transcription regulation. Next, linear mixed effects models were used to determine associations between occupational exposures with methylation at the 680 loci. Of these, more CpG sites were associated with fire-runs (108 for all and 78 for structure-fires only, q<0.05) than with fire-hours (27 for all fires and 1 for structure fires). These associations were independent of time since most recent fire, suggesting an impact of cumulative exposures. CONCLUSIONS Overall, this study provides evidence that DNA methylation may be altered by fireground exposures, and the impact of this change on disease development should be evaluated.
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Affiliation(s)
- Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
| | - Alesia M Jung
- Department of Community, Environment, and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Melissa A Furlong
- Department of Community, Environment, and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Shawn Beitel
- Department of Community, Environment, and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | - Sally Littau
- Department of Community, Environment, and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
| | | | | | - Jefferey L Burgess
- Department of Community, Environment, and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, Arizona, USA
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18
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Hardy T. Firefighter Occupational Cancer Risk: Starting the Conversation. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2022; 37:1019-1025. [PMID: 33196950 DOI: 10.1007/s13187-020-01914-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 06/11/2023]
Abstract
This study was conducted to determine if an educational session would increase the firefighter's knowledge of their occupational cancer risk and increase their motivation and confidence to have a conversation with their primary care provider (PCP) in regard to their occupational cancer risk. This study was an exploratory descriptive interventional pilot study. Firefighters self-reported using a pre-/post-educational intervention survey. Results were analyzed using a paired t test in IBM SPSS Version 23 to compare the pre-/post-test mean scores. There were statistically significant differences noted in the mean scores of the pre-/post-interventional survey tool. It seems an educational intervention can motivate and increase the firefighter's confidence to have a conversation with their PCP in regard to their occupational cancer risk. Firefighter perceptions of their "lived" care experience at the PCP level shared during study sessions also contributed to some key conclusions. These conclusions lead to the development of an informational wallet card for the firefighter to use as a conversational tool during a visit with their PCP. Motivating firefighters to have a conversation with their PCP in regard to their occupational cancer risk could potentially increase firefighter occupational cancer awareness at the PCP level and result in earlier detection of cancers in firefighters leading to decreased firefighter cancer mortality rates. Increasing informed firefighter conversations at the PCP level in regard to their occupational cancer risk could potentially increase appropriate cancer prevention guidance and earlier cancer screenings at the primary care level.
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Affiliation(s)
- Tracy Hardy
- Graduate Family Nurse Practitioner Program, Rivier University, 420 South Main Street, Nashua, NH, 03060, USA
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19
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Fent KW, Mayer AC, Toennis C, Sammons D, Robertson S, Chen IC, Bhandari D, Blount BC, Kerber S, Smith DL, Horn GP. Firefighters' urinary concentrations of VOC metabolites after controlled-residential and training fire responses. Int J Hyg Environ Health 2022; 242:113969. [PMID: 35421664 PMCID: PMC9969558 DOI: 10.1016/j.ijheh.2022.113969] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/16/2022] [Accepted: 04/02/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Firefighters are exposed to volatile organic compounds (VOCs) during structural fire responses and training fires, several of which (e.g., benzene, acrolein, styrene) are known or probable carcinogens. Exposure studies have found that firefighters can absorb chemicals like benzene even when self-contained breathing apparatus (SCBA) are worn, suggesting that dermal absorption contributes to potentially harmful exposures. However, few studies have characterized VOC metabolites in urine from firefighters. OBJECTIVES We quantified VOC metabolites in firefighters' urine following live firefighting activity across two field studies. METHODS In two separate controlled field studies, spot urine was collected before and 3 h after firefighters and firefighter students responded to simulated residential and training fires. Urine was also collected from instructors from the training fire study before the first and 3 h after the last training scenario for each day (instructors led three training scenarios per day). Samples were analyzed for metabolites of VOCs to which firefighters may be exposed. RESULTS In the residential fire study, urinary metabolites of xylenes (2MHA), toluene (BzMA), and styrene (MADA) increased significantly (at 0.05 level) from pre- to post-fire. In the training fire study, MADA concentrations increased significantly from pre- to post-fire for both firefighter students and instructors. Urinary concentrations of benzene metabolites (MUCA and PhMA) increased significantly from pre- to post-fire for instructors, while metabolites of xylenes (3MHA+4MHA) and acrolein (3HPMA) increased significantly for firefighter students. The two highest MUCA concentrations measured post-shift from instructors exceeded the BEI of 500 μg/g creatinine. CONCLUSIONS Some of the metabolites that were significantly elevated post-fire are known or probable human carcinogens (benzene, styrene, acrolein); thus, exposure to these compounds should be eliminated or reduced as much as possible through the hierarchy of controls. Given stringent use of SCBA, it appears that dermal exposure contributes in part to the levels measured here.
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Affiliation(s)
- Kenneth W. Fent
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA
| | - Alexander C. Mayer
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA
| | | | - Deborah Sammons
- Health Effects Laboratory Division, NIOSH, CDC, Cincinnati, OH, USA
| | | | - I-Chen Chen
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA
| | - Deepak Bhandari
- Division of Laboratory Sciences, National Center for Environmental Health, CDC, Atlanta, GA, USA
| | - Benjamin C. Blount
- Division of Laboratory Sciences, National Center for Environmental Health, CDC, Atlanta, GA, USA
| | - Steve Kerber
- Fire Safety Research Institute, Underwriters Laboratories Inc, Columbia, MD, USA
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA, Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, IL, USA
| | - Gavin P. Horn
- Fire Safety Research Institute, Underwriters Laboratories Inc, Columbia, MD, USA, Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, IL, USA
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20
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Pohl H, Mumtaz M. Evaluation of interactions in chemical mixtures containing cyanides. Regul Toxicol Pharmacol 2022; 132:105187. [DOI: 10.1016/j.yrtph.2022.105187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/26/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
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Krzemińska SM, Szewczyńska M. Hazard of chemical substances contamination of protective clothing for firefighters - a survey on use and maintenance. Int J Occup Med Environ Health 2022; 35:235-248. [PMID: 34897292 PMCID: PMC10464726 DOI: 10.13075/ijomeh.1896.01868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 09/15/2021] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVES The objective of the work was to analyze the impact of selected factors concerning the use and maintenance of firefighters' protective clothing worn during rescue operations on the hazard of contamination by chemical substances. MATERIAL AND METHODS The participants were firefighters (N = 688) from rescue and firefighting units of the State Fire Service in Poland, aged <30, 31-40, 41-50 or >60 years, with different seniority: up to >21 years of service. The survey questionnaire developed by the authors was used. The questionnaire was available online. The Statistica 10.0 statistical package using the χ2 test was applied in the analysis of the significance of the results. RESULTS As reported by the vast majority (>60%) of the firefighters, the maintenance was carried out after recording an average or a high level of contamination. It was pointed out that removal of the contaminants from protective clothing was difficult (83%). The surfaces of the legs and sleeves of protective clothing were the most contaminated areas. A feeling of discomfort was observed (90%) after returning from firefighting operations due to fire, smoke, or combustion residues. CONCLUSIONS It is necessary to conduct training and information actions concerning the use and maintenance of protective clothing and the harmfulness of chemicals contaminating the garments used by firefighters. Int J Occup Med Environ Health. 2022;35(2):235-48.
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Affiliation(s)
- Sylwia Maria Krzemińska
- Central Institute for Labour Protection – National Research Institute, Department of Personal Equipment, Łódź, Poland
| | - Małgorzata Szewczyńska
- Central Institute for Labour Protection – National Research Institute, Department of Chemical, Biological and Aerosol Hazards, Warsaw, Poland
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22
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Sritharan J, Kirkham TL, MacLeod J, Marjerrison N, Lau A, Dakouo M, Logar-Henderson C, Norzin T, DeBono NL, Demers PA. Cancer risk among firefighters and police in the Ontario workforce. Occup Environ Med 2022; 79:533-539. [PMID: 35354650 PMCID: PMC9304109 DOI: 10.1136/oemed-2021-108146] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 03/05/2022] [Indexed: 11/23/2022]
Abstract
Objective Firefighters and police often work in high-stress, complex environments with known and suspected carcinogenic exposures. We aimed to characterise cancer incidence among firefighters and police. Methods The Occupational Disease Surveillance System (ODSS) was used to identify workers employed as firefighters or police in Ontario. A cohort of workers were identified using lost-time workers’ compensation claims data and followed for cancer in the Ontario Cancer Registry (1983–2020). Cox proportional hazard models were used to estimate HRs and 95% CIs for primary site-specific cancer diagnoses adjusted for age at start of follow-up, birth year and sex. Results A total of 13 642 firefighters and 22 595 police were identified in the cohort. Compared with all other workers in the ODSS, firefighters and police had increased risk of prostate cancer (firefighters: HR=1.43, 95% CI 1.31 to 1.57; police: HR=1.47, 95% CI 1.35 to 1.59), colon cancer (firefighters: HR=1.39, 95% CI 1.19 to 1.63; police: HR=1.39, 95% CI 1.21 to 1.60) and skin melanoma (firefighters: HR=2.38, 95% CI 1.99 to 2.84; police: HR=2.27, 95% CI 1.96 to 2.62). Firefighters also had increased risk of cancer of the pancreas, testis and kidney, as well as non-Hodgkin’s lymphoma and leukaemia. Police had increased risk of thyroid, bladder and female breast cancer. When compared directly with the police, firefighters had an elevated risk of mesothelioma and testicular cancer. Conclusions Firefighters and police demonstrated some similar as well as some unique cancer risks. Findings from this larger worker population may have important implications for workplace and policy-level changes to improve preventative measures and reduce potential exposures to known carcinogenic hazards.
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Affiliation(s)
- Jeavana Sritharan
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Tracy L Kirkham
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jill MacLeod
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Niki Marjerrison
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Department of Research, Cancer Registry of Norway, Oslo, Norway
| | - Ashley Lau
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Mamadou Dakouo
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | | | - Tenzin Norzin
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
| | - Nathan L DeBono
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Mayer AC, Fent KW, Wilkinson A, Chen IC, Kerber S, Smith DL, Kesler RM, Horn GP. Characterizing exposure to benzene, toluene, and naphthalene in firefighters wearing different types of new or laundered PPE. Int J Hyg Environ Health 2022; 240:113900. [PMID: 34902715 PMCID: PMC9903203 DOI: 10.1016/j.ijheh.2021.113900] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/22/2021] [Accepted: 12/03/2021] [Indexed: 01/25/2023]
Abstract
The fire service has become more aware of the potential for adverse health outcomes due to occupational exposure to hazardous combustion byproducts. Because of these concerns, personal protective equipment (PPE) manufacturers have developed new protection concepts like particulate-blocking hoods to reduce firefighters' exposures. Additionally, fire departments have implemented exposure reduction interventions like routine laundering of PPE after fire responses. This study utilized a fireground exposure simulator (FES) with 24 firefighters performing firefighting activities on three consecutive days wearing one of three PPE ensembles (stratified by hood design and treatment of PPE): 1) new knit hood, new turnout jacket and new turnout pants 2) new particulate-blocking hood, new turnout jacket and new turnout pants or 3) laundered particulate-blocking hood, laundered turnout jacket and laundered turnout pants. As firefighters performed the firefighting activities, personal air sampling on the outside and inside the turnout jacket was conducted to quantify exposures to volatile organic compounds (VOCs) and naphthalene. Pre- and immediately post-fire exhaled breath samples were collected to characterize the absorption of VOCs. Benzene, toluene, and naphthalene were found to diffuse through and/or around the turnout jacket, as inside jacket benzene concentrations were often near levels reported outside the turnout jacket (9.7-11.7% median benzene reduction from outside the jacket to inside the jacket). The PPE ensemble did not appear to affect the level of contamination found inside the jacket for the compounds evaluated here. Benzene concentrations in exhaled breath increased significantly from pre to post-fire for all three groups (p-values < 0.05). The difference of pre-to post-fire benzene exhaled breath concentrations were positively associated with inside jacket and outside jacket benzene concentrations, even though self-contained breathing apparatus (SCBA) were worn during each response. This suggests the firefighters can absorb these compounds via the dermal route.
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Affiliation(s)
- Alexander C. Mayer
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA
| | - Kenneth W. Fent
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA
| | - Andrea Wilkinson
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA
| | - I-Chen Chen
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA
| | - Steve Kerber
- Fire Safety Research Institute, Underwriters Laboratories, Columbia, MD, USA
| | - Denise L. Smith
- Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY, USA,Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, IL, USA
| | - Richard M. Kesler
- Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, IL, USA
| | - Gavin P. Horn
- Fire Safety Research Institute, Underwriters Laboratories, Columbia, MD, USA
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24
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Examination of Factors Influencing SCBA Washing Behavior among Firefighters in Metropolitan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042240. [PMID: 35206426 PMCID: PMC8872399 DOI: 10.3390/ijerph19042240] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/04/2022] [Accepted: 02/13/2022] [Indexed: 02/05/2023]
Abstract
Field-washing decontamination of equipment is an effective way for firefighters to reduce their risk of secondary contamination. No study has yet clarified the factors influencing effective field decontamination of equipment such as self-contained breathing apparatuses (SCBAs). This study sought to examine factors that influence the SCBA washing and decontamination behavior of firefighters. We conducted a questionnaire using the web-based Seoul Metropolitan Electronic Questionnaire System. As of May 2021, the survey had been sent to 3626 of 7198 Seoul career firefighters, and 1940 subjects were selected to participate in the study. Binomial logistic regression and χ2-test analyses were performed. We confirmed that previous training in SCBA washing was an important factor in effective field decontamination of SCBAs. Firefighters should be trained to perform field decontamination procedures systematically and regulations to perform field decontamination before leaving the scene of a fire should be introduced.
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25
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Horn GP, Madrzykowski D, Neumann DL, Mayer AC, Fent KW. Airborne contamination during post-fire investigations: Hot, warm and cold scenes. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2022; 19:35-49. [PMID: 34762010 PMCID: PMC10074475 DOI: 10.1080/15459624.2021.2002343] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Fire investigators may be occupationally exposed to many of the same compounds as the more widely studied fire suppression members of the fire service but are often tasked with working in a given exposure for longer periods ranging from hours to multiple days and may do so with limited personal protective equipment. In this study, we characterize the area air concentrations of contaminants during post-fire investigation of controlled residential fires with furnishings common to current bedroom, kitchen and living room fires in the United States. Area air sampling was conducted during different investigation phases including when investigations might be conducted immediately after fire suppression and extended out to 5 days after the fire. Airborne particulate over a wide range of dimensions, including sub-micron particles, were elevated to potentially unhealthy levels (based on air quality index) when averaged over a 60 min investigation period shortly after fire suppression with median PM2.5 levels over 100 µg/m3 (range 16-498 µg/m3) and median peak transient concentrations of 1,090 µg/m3 (range 200-23,700 µg/m3) during drywall removal or shoveling activities. Additionally, airborne aldehyde concentrations were elevated compared to volatile organic compounds with peak values of formaldehyde exceeding NIOSH ceiling limits during the earliest investigation periods (median 356 µg/m3, range: 140-775 µg/m3) and occasionally 1 day post-fire when the structure was boarded up before subsequent investigation activities. These results highlight the need to protect investigators' airways from particulates when fire investigation activities are conducted as well as during post-fire reconstruction activities. Additionally, vapor protection from formaldehyde should be strongly considered at least through investigations occurring 3 days after the fire and personal formaldehyde air monitoring is recommended during investigations.
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Affiliation(s)
- Gavin P. Horn
- Fire Safety Research Institute, Underwriters Laboratories Inc.; Columbia, MD
| | - Daniel Madrzykowski
- Fire Safety Research Institute, Underwriters Laboratories Inc.; Columbia, MD
| | | | | | - Kenneth W. Fent
- National Institute for Occupational Safety & Health; Cincinnati, OH
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26
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Abstract
Firefighters are the professional force at high risk of suffering potential health consequences due to their chronic exposure to numerous hazardous pollutants during firefighting activities. Unfortunately, determination of fire emission exposure is very challenging. As such, the identification and development of appropriate biomarkers is critical in meeting this need. This chapter presents a critical review of current information related with the use of different urinary biomarkers of effect and exposure in occupationally exposed firefighters over the last 25 years. Evidence suggests that urinary isoprostanes and mutagenicity testing are promising biomarkers of early oxidative stress. Data indicate that firefighters participating in firefighting activities present with increased urinary biomarkers of exposure. These include polycyclic aromatic hydrocarbons, heavy metals and metalloids, organo-chlorine and -phosphorus compounds, environmental phenols, phthalates, benzene and toluene. More studies are urgently needed to better evaluate firefighter occupational safety and health and to support the implementation of preventive measures and mitigation strategies to promote the protection of this chronically exposed group of workers.
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27
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Webber MP, Singh A, Zeig-Owens R, Salako J, Skerker M, Hall CB, Goldfarb DG, Jaber N, Daniels RD, Prezant DJ. Cancer incidence in World Trade Center-exposed and non-exposed male firefighters, as compared with the US adult male population: 2001-2016. Occup Environ Med 2021; 78:707-714. [PMID: 34507965 PMCID: PMC8458058 DOI: 10.1136/oemed-2021-107570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/29/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To compare cancer incidence in Fire Department of the City of New York (FDNY) firefighters who worked at the World Trade Center (WTC) site to incidence in a population of non-WTC-exposed firefighters, the Career Firefighter Health Study (CFHS) cohort, and to compare rates from each firefighter cohort to rates in demographically similar US males. METHODS FDNY (N=10 786) and CFHS (N=8813) cohorts included male firefighters who were active on 11 September 2001 (9/11) and were followed until death or 31 December 2016. Cases were identified from 15 state cancer registries. Poisson regression models assessed cancers in each group (FDNY and CFHS) versus US males, and associations between group and cancer rates; these models estimated standardised incidence ratios (SIRs) and adjusted relative rates (RRs), respectively. Secondary analyses assessed surveillance bias and smoking history. RESULTS We identified 915 cancer cases in 841 FDNY firefighters and 1002 cases in 909 CFHS firefighters. FDNY had: higher rates for all cancers (RR=1.13; 95% CI 1.02 to 1.25), prostate (RR=1.39; 95% CI 1.19 to 1.63) and thyroid cancer (RR=2.53; 95% CI 1.37 to 4.70); younger median ages at diagnosis (55.6 vs 59.4; p<0.001, all cancers); and more cases with localised disease when compared with CFHS. Compared with US males, both firefighter cohorts had elevated SIRs for prostate cancer and melanoma. Control for surveillance bias in FDNY reduced most differences. CONCLUSIONS Excess cancers occurred in WTC-exposed firefighters relative to each comparison group, which may partially be explained by heightened surveillance. Two decades post-9/11, clearer understanding of WTC-related risk requires extended follow-up and modelling studies (laboratory or animal based) to identify workplace exposures in all firefighters.
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Affiliation(s)
- Mayris P Webber
- Division of Epidemiology, Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Ankura Singh
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Rachel Zeig-Owens
- Division of Epidemiology, Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Joke Salako
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Molly Skerker
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Charles B Hall
- Division of Biostatistics, Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - David G Goldfarb
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
| | - Nadia Jaber
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Robert D Daniels
- World Trade Center Health Program, Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA
| | - David J Prezant
- Division of Epidemiology, Department of Epidemiology and Population Health, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York, USA
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28
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Jung AM, Zhou J, Beitel SC, Littau SR, Gulotta JJ, Wallentine DD, Moore PK, Burgess JL. Longitudinal evaluation of whole blood miRNA expression in firefighters. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:900-912. [PMID: 33603099 PMCID: PMC8445815 DOI: 10.1038/s41370-021-00306-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/18/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Dysregulated microRNA (miRNA) expression could provide a mechanism linking firefighter exposure to increased cancer risk. OBJECTIVE To determine if changes in longitudinal miRNA expression in firefighters are associated with occupational exposures. METHODS Whole blood MiRNA was evaluated in 52 new recruits prior to live-fire training and 20-37 months later. Linear mixed effects models adjusted for age, ethnicity, BMI, and batch effects were used to determine associations separately for all fires and structure fires only between employment duration, cumulative fire-hours and fire-runs, and time since most recent fire with (1) nine a priori and (2) the full array of 799 miRNAs. RESULTS For multivariable models including all fires, two a priori miRNAs were associated with employment duration and four with time since most recent fire. For multivariable models restricted to structure fires, three a priori miRNAs were associated with employment duration and one with fire-runs. Additional miRNAs from the full array were associated with employment duration for all fires and/or structure fires. In general, tumor suppressive miRNAs decreased and oncogenic miRNAs increased with exposure. SIGNIFICANCE Changes in miRNAs may serve as biomarkers of exposure effects and a mechanism for increased cancer risk in firefighters.
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Affiliation(s)
- Alesia M Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Jin Zhou
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Shawn C Beitel
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sally R Littau
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | | | | | - Jefferey L Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
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Bader M, Bäcker S, Jäger T, Webendörfer S, Van Bortel G, Van Mieghem F, Van Weyenbergh T. Preparedness as a key factor for human biomonitoring programs after chemical incidents. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:867-875. [PMID: 33774650 DOI: 10.1038/s41370-021-00320-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/11/2021] [Accepted: 03/12/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Human biomonitoring (HBM) has been repeatedly recommended for and applied to post-incident chemical exposure assessment. The applicability of HBM and the validity of its results, however, closely depend on the existence and quality of preparatory measures such as information and instruction materials, sampling procedures, transport and storage facilities, and on the selection of appropriate biomarkers, sampling time, transport and storage conditions. OBJECTIVE To establish a standardized HBM program for emergency responders of a large chemical production site, considering the aforementioned aspects. METHODS An HBM program based on a comprehensive questionnaire, information and training of emergency responders, and availability of sampling material was established. The quantitative determination of metabolites of hazardous substances was carried out based on quality-controlled analytical methods. RESULTS The use of HBM after emergency operations was significantly increased immediately after the implementation of the program. Only in single cases, however, established HBM assessment values were exceeded. After one major incident, an increased exposure to benzene exceeding the internal action value was observed after firefighting and safeguarding. SIGNIFICANCE The experience with several minor and one major incident at a chemical production site suggests that the implementation of easily accessible and applicable routines is one paramount prerequisite for the success of HBM programs after chemical incidents.
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Affiliation(s)
- Michael Bader
- Corporate Health Management, BASF SE, Ludwigshafen, Germany.
| | - Sandra Bäcker
- Corporate Health Management, BASF SE, Ludwigshafen, Germany
| | - Thomas Jäger
- Corporate Health Management, BASF SE, Ludwigshafen, Germany
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30
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Clarity C, Trowbridge J, Gerona R, Ona K, McMaster M, Bessonneau V, Rudel R, Buren H, Morello-Frosch R. Associations between polyfluoroalkyl substance and organophosphate flame retardant exposures and telomere length in a cohort of women firefighters and office workers in San Francisco. Environ Health 2021; 20:97. [PMID: 34454526 PMCID: PMC8403436 DOI: 10.1186/s12940-021-00778-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 07/29/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Environmental chemical exposures can affect telomere length, which in turn has been associated with adverse health outcomes including cancer. Firefighters are occupationally exposed to many hazardous chemicals and have higher rates of certain cancers. As a potential biomarker of effect, we assessed associations between chemical exposures and telomere length in women firefighters and office workers from San Francisco, CA. METHODS We measured serum concentrations of polyfluoroalkyl substances (PFAS), urinary metabolites of flame retardants, including organophosphate flame retardants (OPFRs), and telomere length in peripheral blood leukocytes in women firefighters (N = 84) and office workers (N = 79) who participated in the 2014-15 Women Workers Biomonitoring Collaborative. Multiple linear regression models were used to assess associations between chemical exposures and telomere length. RESULTS Regression results revealed significant positive associations between perfluorooctanoic acid (PFOA) and telomere length and perfluorooctanesulfonic acid (PFOS) and telomere length among the whole cohort. Models stratified by occupation showed stronger and more significant associations among firefighters as compared to office workers. Among firefighters in models adjusted for age, we found positive associations between telomere length and log-transformed PFOA (β (95%CI) = 0.57(0.12, 1.02)), PFOS (0.44 (0.05, 0.83)), and perfluorodecanoic acid (PFDA) (0.43 (0.02, 0.84)). Modeling PFAS as categories of exposure showed significant associations between perfluorononanoic acid (PFNA) and telomere length among firefighters. Significant associations between OPFR metabolites and telomere length were seen for bis (1,3-dichloro-2-propyl) phosphate (BDCPP) and telomere length among office workers (0.21(0.03, 0.40)) and bis (2-chloroethyl) phosphate (BCEP) and telomere length among firefighters (- 0.14(- 0.28, - 0.01)). For OPFRs, the difference in the direction of effect by occupational group may be due to the disparate detection frequencies and concentrations of exposure between the two groups and/or potential unmeasured confounding. CONCLUSION Our findings suggest positive associations between PFAS and telomere length in women workers, with larger effects seen among firefighters as compared to office workers. The OPFR metabolites BDCPP and BCEP are also associated with telomere length in firefighters and office workers. Associations between chemical exposures and telomere length reported here and by others suggest mechanisms by which these chemicals may affect carcinogenesis and other adverse health outcomes.
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Affiliation(s)
- Cassidy Clarity
- Department of Environmental Science, Policy and Management University of California, 130 Mulford Hall, 94720, Berkeley, CA, USA
| | - Jessica Trowbridge
- Department of Environmental Science, Policy and Management University of California, 130 Mulford Hall, 94720, Berkeley, CA, USA
- School of Public Health, University of California, Berkeley, CA, USA
| | - Roy Gerona
- Department of Obstetrics, Clinical Toxicology and Environmental Biomonitoring Lab, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Katherine Ona
- Department of Cell and Tissue Biology, University of California, San Francisco, CA, USA
- Department of Obstetrics, Center for Reproductive Sciences, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Michael McMaster
- Department of Cell and Tissue Biology, University of California, San Francisco, CA, USA
- Department of Obstetrics, Center for Reproductive Sciences, Gynecology and Reproductive Sciences, University of California, San Francisco, CA, USA
| | - Vincent Bessonneau
- Silent Spring Institute, Newton, MA, USA
- Univ. Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé, Environnement et Travail) - UMR_S 1085, F-35000, Rennes, France
| | | | | | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management University of California, 130 Mulford Hall, 94720, Berkeley, CA, USA.
- School of Public Health, University of California, Berkeley, CA, USA.
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31
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Urwin DJ, Alexandrova AN. Regularization of least squares problems in CHARMM parameter optimization by truncated singular value decompositions. J Chem Phys 2021; 154:184101. [PMID: 34241037 DOI: 10.1063/5.0045982] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
We examine the use of the truncated singular value decomposition and Tikhonov regularization in standard form to address ill-posed least squares problems Ax = b that frequently arise in molecular mechanics force field parameter optimization. We illustrate these approaches by applying them to dihedral parameter optimization of genotoxic polycyclic aromatic hydrocarbon-DNA adducts that are of interest in the study of chemical carcinogenesis. Utilizing the discrete Picard condition and/or a well-defined gap in the singular value spectrum when A has a well-determined numerical rank, we are able to systematically determine truncation and in turn regularization parameters that are correspondingly used to produce truncated and regularized solutions to the ill-posed least squares problem at hand. These solutions in turn result in optimized force field dihedral terms that accurately parameterize the torsional energy landscape. As the solutions produced by this approach are unique, it has the advantage of avoiding the multiple iterations and guess and check work often required to optimize molecular mechanics force field parameters.
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Affiliation(s)
- Derek J Urwin
- Department of Chemistry and Biochemistry, University of California Los Angeles, Los Angeles, California 90095, USA
| | - Anastassia N Alexandrova
- Department of Chemistry and Biochemistry, University of California Los Angeles, Los Angeles, California 90095, USA
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Abstract
OBJECTIVE Evaluate the effectiveness of firefighter exposure reduction interventions. METHODS Fireground interventions included use of self-contained breathing apparatus by engineers, entry team wash down, contaminated equipment isolation, and personnel showering and washing of gear upon return to station. Urinary polycyclic aromatic hydrocarbon metabolites (PAH-OHs) were measured after structural fire responses before and after intervention implementation. Separately, infrared sauna use following live-fire training was compared to standard postfire care in a randomized trial. RESULTS The fireground interventions significantly reduced mean total urinary postfire PAH-OHs in engineers (-40.4%, 95%CI -63.9%, -2.3%) and firefighters (-36.2%, 95%CI -56.7%, -6.0%) but not captains (-11.3% 95%CI -39.4%, 29.9%). Sauna treatment non-significantly reduced total mean PAH-OHs by -43.5% (95%CI -68.8%, 2.2%). CONCLUSIONS The selected fireground interventions reduced urinary PAH-OHs in engineers and firefighters. Further evaluation of infrared sauna treatment is needed.
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Goodrich JM, Furlong MA, Caban-Martinez AJ, Jung AM, Batai K, Jenkins T, Beitel S, Littau S, Gulotta J, Wallentine D, Hughes J, Popp C, Calkins MM, Burgess JL. Differential DNA Methylation by Hispanic Ethnicity Among Firefighters in the United States. Epigenet Insights 2021; 14:25168657211006159. [PMID: 35036834 PMCID: PMC8756104 DOI: 10.1177/25168657211006159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/02/2021] [Indexed: 01/04/2023] Open
Abstract
Firefighters are exposed to a variety of environmental hazards and are at increased risk for multiple cancers. There is evidence that risks differ by ethnicity, yet the biological or environmental differences underlying these differences are not known. DNA methylation is one type of epigenetic regulation that is altered in cancers. In this pilot study, we profiled DNA methylation with the Infinium MethylationEPIC in blood leukocytes from 31 Hispanic white and 163 non-Hispanic white firefighters. We compared DNA methylation (1) at 12 xenobiotic metabolizing genes and (2) at all loci on the array (>740 000), adjusting for confounders. Five of the xenobiotic metabolizing genes were differentially methylated at a raw P-value <.05 when comparing the 2 ethnic groups, yet were not statistically significant at a 5% false discovery rate (q-value <.05). In the epigenome-wide analysis, 76 loci exhibited DNA methylation differences at q < .05. Among these, 3 CpG sites in the promoter region of the biotransformation gene SULT1C2 had lower methylation in Hispanic compared to non-Hispanic firefighters. Other differentially methylated loci included genes that have been implicated in carcinogenesis in published studies (FOXK2, GYLTL1B, ZBTB16, ARHGEF10, and more). In this pilot study, we report differential DNA methylation between Hispanic and non-Hispanic firefighters in xenobiotic metabolism genes and other genes with functions related to cancer. Epigenetic susceptibility by ethnicity merits further study as this may alter risk for cancers linked to toxic exposures.
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Affiliation(s)
- Jaclyn M Goodrich
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, USA,Jaclyn M Goodrich, Department of Environmental Health Sciences, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, USA.
| | - Melissa A Furlong
- Department of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Alberto J Caban-Martinez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alesia M Jung
- Department of Epidemiology and Biostatistics, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Ken Batai
- Department of Urology, University of Arizona, Tucson, AZ, USA
| | - Timothy Jenkins
- Department of Physiology and Developmental Biology, Brigham Young University, Provo, UT, USA
| | - Shawn Beitel
- Department of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | - Sally Littau
- Department of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
| | | | | | - Jeff Hughes
- Orange County Fire Authority, Irvine, CA, USA
| | | | - Miriam M Calkins
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, Tucson, AZ, USA
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Laroche E, L’Espérance S. Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2519. [PMID: 33802629 PMCID: PMC7967542 DOI: 10.3390/ijerph18052519] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 02/25/2021] [Accepted: 02/25/2021] [Indexed: 12/26/2022]
Abstract
Firefighters are exposed to carcinogens that may increase their risk of developing many types of occupational cancer. Many systematic reviews (SRs) have been produced with sometimes conflicting conclusions. In this overview of reviews, we aim to assess the conclusion consistency across the available systematic reviews on the cancer risk in firefighters. Literature searches were conducted in several indexed databases and grey literature to retrieve systematic reviews aiming to evaluate cancer incidence or cancer mortality in firefighters. Results from included SRs were analyzed according to the tumour site. Out of 1054 records identified by the search in the databases, a total of 11 SRs were ultimately included. The original studies (n = 104) analyzed in the SRs were published between 1959 and 2018. The results consistently reported a significant increase in the incidence of rectal, prostate, bladder and testicular cancers as well as mesothelioma and malignant melanoma in firefighters compared to the general population. The SRs also indicate that death rates from rectal cancer and non-Hodgkin's lymphoma are higher among firefighters. Consistent SR results suggest that several types of cancer may be more frequent in firefighters than in the general population.
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Affiliation(s)
- Elena Laroche
- School of Administration Sciences, Université TELUQ, Quebec, QC G1K 9H6, Canada;
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Baum JLR, Bakali U, Killawala C, Santiago KM, Dikici E, Kobetz EN, Solle NS, Deo S, Bachas L, Daunert S. Evaluation of silicone-based wristbands as passive sampling systems using PAHs as an exposure proxy for carcinogen monitoring in firefighters: Evidence from the firefighter cancer initiative. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 205:111100. [PMID: 32911453 DOI: 10.1016/j.ecoenv.2020.111100] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 05/23/2023]
Abstract
Compared to the general population, firefighters are known to sustain greater levels of exposure to hazardous compounds, despite their personal protective equipment, also known as turnout gear. Among the most significant toxins that firefighters are chronically exposed to are polycyclic aromatic hydrocarbons (PAHs). Additionally, firefighters have also been noted to exhibit an increased incidence of certain types of cancer. Considering a probable link between exposure to PAHs and increased rates of cancer in the fire service, we aim to document ambient chemical concentrations in the firefighter work environment. Our strategy involves the use of silicone-based wristbands that have the capacity to passively sorb PAHs. To determine if wristbands can serve as an effective chemical monitoring device for the fire service, silicone wristbands were pilot-tested as personal sampling devices for work environment risk monitoring in active-duty firefighters. Recovered wristbands underwent multiple extraction steps, followed by GC-MS analysis to demonstrate their efficacy in monitoring PAHs in the firefighter environment. Initial findings from all wristband samples taken from firefighters showed multiple exposures to various PAHs of concern for the health of the firefighters when in a fire environment. In addition to PAH monitoring, we examined known and potential sources of PAH contamination in their work environment. To that end, profiles of elevated PAH concentrations were documented at various fire stations throughout South Florida, for individual firefighters both during station duties and active fire response.
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Affiliation(s)
- Jeramy L R Baum
- Chemistry, University of Miami, Coral Gables, FL, USA; Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Umer Bakali
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Chitvan Killawala
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA; Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Katerina M Santiago
- Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Emre Dikici
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Erin N Kobetz
- Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA; Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Natasha Schaefer Solle
- Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Sapna Deo
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | | | - Sylvia Daunert
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, Miami, FL, USA.
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Clarity C, Trowbridge J, Gerona R, Ona K, McMaster M, Bessonneau V, Rudel R, Buren H, Morello-Frosch R. Associations between polyfluoroalkyl substance and organophosphate flame retardant exposures and telomere length in a cohort of women firefighters and office workers in San Francisco. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.11.05.20226183. [PMID: 33173912 PMCID: PMC7654908 DOI: 10.1101/2020.11.05.20226183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Environmental chemical exposures can affect telomere length, which in turn has been associated with adverse health outcomes including cancer. Firefighters are occupationally exposed to many hazardous chemicals and have higher rates of certain cancers. As a potential marker of effect, we assessed associations between chemical exposures and telomere length in women firefighters and office workers from San Francisco, CA. METHODS We measured serum levels of polyfluoroalkyl substances (PFAS), urinary metabolites of flame retardants, including organophosphate flame retardants (OPFRs), and telomere length in peripheral blood leukocytes in women firefighters and office workers who participated in the 2014-15 Women Workers Biomonitoring Collaborative. Multiple linear regression models were used to assess associations between chemical exposures and telomere length. RESULTS Regression results revealed significant positive associations between perfluorooctanoic acid (PFOA) and telomere length and perfluorooctanesulfonic acid (PFOS) and telomere length among the whole cohort. Models stratified by occupation showed stronger and more significant associations among firefighters as compared to office workers. Among firefighters in models adjusted for age, we found positive associations between telomere length and log-transformed PFOA ( β (95%CI) = 0.57(0.12, 1.02)), PFOS (0.44 (0.05, 0.83)), and perfluorodecanoic acid (PFDA) (0.43 (0.02, 0.84)). Modeling PFAS as categories of exposure showed significant associations between perfluorononanoic acid (PFNA) and telomere length among firefighters. Significant associations between OPFR metabolites and telomere length were seen for bis(1,3-dichloro-2-propyl) phosphate (BDCPP) and telomere length among office workers (0.21(0.03, 0.40)) and bis(2-chloroethyl) phosphate (BCEP) and telomere length among firefighters (-0.14(-0.28, -0.01)). For OPFRs, the difference in the direction of effect by occupational group may be due to the disparate detection frequencies and levels of exposure between the two groups and/or potential unmeasured confounding. CONCLUSION Our findings suggest positive associations between PFAS and telomere length in women workers, with larger effects seen among firefighters as compared to office workers. The OPFR metabolites BDCPP and BCEP are also associated with telomere length in firefighters and office workers. Associations between chemical exposures and telomere length reported here and by others suggest mechanisms by which these chemicals may affect carcinogenesis and other adverse health outcomes.
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Mayer A, Horn GP, Fent KW, Bertke S, Kerber S, Kesler RM, Newman H, Smith DL. Impact of select PPE design elements and repeated laundering in firefighter protection from smoke exposure. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2020; 17:505-514. [PMID: 32990508 PMCID: PMC8609407 DOI: 10.1080/15459624.2020.1811869] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
As the Fire Service becomes more aware of the potential health effects from occupational exposure to hazardous contaminants, personal protective equipment (PPE) manufacturers, and fire departments have responded by developing and implementing improved means of firefighter protection, including more frequent laundering of PPE after exposures. While laboratory testing of new PPE designs and the effect of laundering on PPE fabric provides a useful way to evaluate these approaches, laboratory scale testing does not necessarily translate to full garment protection. Utilizing a fireground smoke exposure simulator, along with air and/or filter-substrate sampling for polycyclic aromatic hydrocarbons (PAHs) and benzene, this pilot study tested the chemical-protective capabilities of firefighting PPE of different designs (knit hood vs. particulate-blocking hood, turnout jacket with zipper closure vs. hook & dee closure), including the impact of repeatedly exposing and cleaning (through laundering or decontamination on-scene) PPE 40 times. Overall, PAH contamination on filters under hoods in the neck region were higher (median PAHs = 14.7 µg) than samples taken under jackets in the chest region (median PAHs = 7.05 µg). PAH levels measured under particulate-blocking hoods were lower than levels found under knit hoods. Similarly, zippered closures were found to provide a greater reduction in PAHs compared to hook & dee closures. However, neither design element completely eliminated contaminant ingress. Measurements for benzene under turnout jackets were similar to ambient chamber air concentrations, indicating little to no attenuation from the PPE. The effect of laundering or on-scene decontamination on contaminant breakthrough appeared to depend on the type of contaminant. Benzene breakthrough was negatively associated with laundering, while PAH breakthrough was positively associated. More research is needed to identify PPE features that reduce breakthrough, how targeted changes impact exposures, and how fireground exposures relate to biological absorption of contaminants.
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Affiliation(s)
- Alexander Mayer
- National Institute for Occupational Safety & Health; Cincinnati, OH
| | - Gavin P. Horn
- University of Illinois, Fire Service Institute; Urbana-Champaign, IL
- UL Firefighter Safety Research Institute; Columbia, MD
| | - Kenneth W. Fent
- National Institute for Occupational Safety & Health; Cincinnati, OH
| | - Steve Bertke
- National Institute for Occupational Safety & Health; Cincinnati, OH
| | - Steve Kerber
- UL Firefighter Safety Research Institute; Columbia, MD
| | - Richard M. Kesler
- University of Illinois, Fire Service Institute; Urbana-Champaign, IL
| | - Hannah Newman
- University of Illinois, Fire Service Institute; Urbana-Champaign, IL
| | - Denise L. Smith
- University of Illinois, Fire Service Institute; Urbana-Champaign, IL
- Skidmore College, Health and Human Physiological Sciences Department; Saratoga Springs, NY
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Internal exposure of firefighting instructors to polycyclic aromatic hydrocarbons (PAH) during live fire training. Toxicol Lett 2020; 331:102-111. [DOI: 10.1016/j.toxlet.2020.05.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2019] [Revised: 05/14/2020] [Accepted: 05/20/2020] [Indexed: 01/07/2023]
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Korn GP, Alvarenga EHDL, Dall'Oglio GP, Azevedo RR, Chamun W, Cordeiro TG, Boggi AC, Pezato R. The Effects in the Upper Airway of Heat and Exposure to Combustion Byproducts of Burning Materials on Larynx of Firefighters. J Voice 2020; 36:737.e11-737.e16. [PMID: 32917461 DOI: 10.1016/j.jvoice.2020.08.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 11/25/2022]
Abstract
INTRODUCTION High exposure to heat and combustion byproducts is associated with health problems and an increased risk of cancer. OBJECTIVE To study the effects of heat and smoke derived from burning on the upper airway of firefighters. METHODS Thirteen firefighters underwent a 4-week training program in Compartment Fire Behavior Training simulators while working with live fire, heat, and smoke from pallets and oriented-strand board sheet burns. The firefighters were evaluated before exposure and at the end of the first and fourth weeks of training. The larynx was assessed by the Voice Handicap Index GRBASI scale, laryngoscopy, and peak expiratory flow. RESULTS There was no change in Voice Handicap Index and GRBASI (only one in three speech therapists judged tension as worse by one point). Laryngoscopy showed alterations in one-third of the firefighters, with the most frequent being increased viscous mucus. Peak expiratory flow decreased significantly from 685 to 552 and 550 L/min in the first and fourth weeks, respectively. CONCLUSIONS Although participants were protected from gases and smoke during the exercises, which proved to be very effective, the airway was slightly impacted by heat and combustion-derived byproducts.
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Affiliation(s)
| | | | | | | | - Walter Chamun
- Federal University of São Paulo, São Paulo, São Paulo, Brazil
| | | | | | - Rogerio Pezato
- Federal University of São Paulo, São Paulo, São Paulo, Brazil
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Poutasse CM, Poston WSC, Jahnke SA, Haddock CK, Tidwell LG, Hoffman PD, Anderson KA. Discovery of firefighter chemical exposures using military-style silicone dog tags. ENVIRONMENT INTERNATIONAL 2020; 142:105818. [PMID: 32521346 PMCID: PMC9985454 DOI: 10.1016/j.envint.2020.105818] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 05/07/2023]
Abstract
Occupational chemical hazards in the fire service are hypothesized to play a role in increased cancer risk, and reliable sampling technologies are necessary for conducting firefighter chemical exposure assessments. This study presents the military-style dog tag as a new configuration of silicone passive sampling device to sample individual firefighters' exposures at one high and one low fire call volume department in the Kansas City, Missouri metropolitan area. The recruited firefighters (n = 56) wore separate dog tags to assess on- and off-duty exposures (ndogtags = 110), for a total of 30 24 h shifts. Using a 63 PAH method (GC-MS/MS), the tags detected 45 unique PAHs, of which 18 have not been previously reported as firefighting exposures. PAH concentrations were higher for on- compared to off-duty tags (0.25 < Cohen's d ≤ 0.80) and for the high compared to the low fire call volume department (0.25 ≤ d < 0.70). Using a 1530 analyte screening method (GC-MS), di-n-butyl phthalate, diisobutyl phthalate, guaiacol, and DEET were commonly detected analytes. The number of fire attacks a firefighter participated in was more strongly correlated with PAH concentrations than firefighter rank or years in the fire service. This suggested that quantitative data should be employed for firefighter exposure assessments, rather than surrogate measures. Because several detected analytes are listed as possible carcinogens, future firefighter exposure studies should consider evaluating complex mixtures to assess individual health risks.
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Affiliation(s)
- Carolyn M Poutasse
- Department of Toxicology, Oregon State University, Corvallis, OR 97331, USA
| | - Walker S C Poston
- Center for Fire, Rescue, and EMS Health Research, NDRI-USA, Leawood, KS 66224, USA
| | - Sara A Jahnke
- Center for Fire, Rescue, and EMS Health Research, NDRI-USA, Leawood, KS 66224, USA
| | | | - Lane G Tidwell
- Department of Toxicology, Oregon State University, Corvallis, OR 97331, USA
| | - Peter D Hoffman
- Department of Toxicology, Oregon State University, Corvallis, OR 97331, USA
| | - Kim A Anderson
- Department of Toxicology, Oregon State University, Corvallis, OR 97331, USA.
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Geiger KW, Wright TJ, Deters L. Renal Cell Carcinoma as an Incidental Finding in Firefighters: A Case Series. Cureus 2020; 12:e9259. [PMID: 32821605 PMCID: PMC7431987 DOI: 10.7759/cureus.9259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
The link between cancer, including cancers of the kidney, and occupational exposure in firefighters has been well established. Renal cell carcinoma has a tendency to present incidentally on imaging rather than with the classic symptoms of flank pain and hematuria. In this case series, we identify four firefighter patients, all of whom initially presented with a kidney tumor as an incidental finding. We examine the absence of other risk factors in these patients along with current screening guidelines. This report aims to detail how these tumors present incidentally as well as evaluate the current screening guidelines in an effort to build awareness within this population. Patient demographics, risk factors, length of firefighting career, final pathology, and postoperative recurrence were evaluated. Four males underwent successful partial or total nephrectomy. All who have had follow-up have been tumor free with renal function intact. None are dialysis dependent. The role of routine renal imaging of this population is explored.
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Affiliation(s)
- Kyle W Geiger
- Medicine, Elson S. Floyd College of Medicine, Washington State University, Spokane, USA
| | - Tanner J Wright
- Medicine, Elson S. Floyd College of Medicine, Washington State University, Spokane, USA
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Fent KW, LaGuardia M, Luellen D, McCormick S, Mayer A, Chen IC, Kerber S, Smith D, Horn GP. Flame retardants, dioxins, and furans in air and on firefighters' protective ensembles during controlled residential firefighting. ENVIRONMENT INTERNATIONAL 2020; 140:105756. [PMID: 32388249 PMCID: PMC9989945 DOI: 10.1016/j.envint.2020.105756] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 04/01/2020] [Accepted: 04/20/2020] [Indexed: 05/20/2023]
Abstract
INTRODUCTION Structure fires that involve modern furnishings may emit brominated flame retardants (BFRs) and organophosphate flame retardants (OPFRs), as well as brominated and chlorinated dioxins and furans, into the environment. OBJECTIVES The goal of this study was to quantify the airborne and personal protective equipment (PPE) contamination levels of these compounds during controlled residential fires in the U.S., and to evaluate gross-decontamination measures. METHODS Bulk-sampling was done to confirm the presence of flame retardants (FRs) in the furnishings used in 12 controlled residential structure fires. Area air samples were collected during the fires and PPE wipe samples were collected from the firefighters' turnout jackets and gloves after firefighting. For each fire, half of the jackets were decontaminated and the other half were not. RESULTS Of the BFRs and OPFRs measured in air during the fire period, decabromodiphenyl ether (BDE-209) and triphenyl phosphate (TPP) were the most abundant, with medians of 15.6 and 408 µg/m3, respectively, and were also detected during overhaul. These and several other BFRs and OPFRs were measured on PPE. Some gloves had contaminant levels exceeding 100 ng/cm2 and were generally more contaminated than jackets. Air and surface levels of the brominated furans appeared to be higher than the chlorinated dioxins and furans. Routine gross decontamination appeared to reduce many of the BFR contaminants, but results for the OPFRs were mixed. CONCLUSIONS Structure fires are likely to result in a variety of FRs, dioxins, and furans into the environment, leading to PPE contamination for those working on the fireground. Firefighters should wear self-contained breathing apparatus during all phases of the response and launder or decontaminate their PPE (including gloves) after fire events.
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Affiliation(s)
- Kenneth W Fent
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Cincinnati, OH, USA.
| | - Mark LaGuardia
- Department of Aquatic Health Sciences, Virginia Institute of Marine Science, William & Mary, Gloucester Point, VA, USA
| | - Drew Luellen
- Department of Aquatic Health Sciences, Virginia Institute of Marine Science, William & Mary, Gloucester Point, VA, USA
| | - Seth McCormick
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Alexander Mayer
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - I-Chen Chen
- Division of Field Studies and Engineering, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention, Cincinnati, OH, USA
| | - Steve Kerber
- Firefighter Safety Research Institute, Underwriters Laboratories, Columbia, MD, USA
| | - Denise Smith
- Health and Human Physiological Sciences Department, Skidmore College, Saratoga Springs, NY, USA; Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, IL, USA
| | - Gavin P Horn
- Firefighter Safety Research Institute, Underwriters Laboratories, Columbia, MD, USA; Illinois Fire Service Institute, University of Illinois at Urbana-Champaign, IL, USA
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Abstract
The aim of this study was to evaluate benzene, toluene, ethylbenzene, xylene, and styrene (BTEXS) concentrations in the changing room and garage in a fire station located in the Upper Silesian agglomeration (Poland), to compare them with the concentrations of the same compounds in the atmospheric air (outdoor background) and to assess the health exposure to BTEXS among firefighters and office workers in this unit. BTEXS samples were collected during the winter of 2018 in parallel in the garage, in the changing room, and outside, using sorption tubes filled with activated carbon. The average total BTEXS concentrations in the changing room and garage were over six times higher than those in the atmospheric air in the vicinity of the fire station. At each sampling site, toluene and benzene had the highest concentrations. According to the diagnostic indicators, the combustion of various materials and fuels was the source of BTEXS inside, while outside, the sources were the combustion of fuels and industrial activity. The carcinogenic risk related to benzene inhalation by the firefighters and office employees in the monitored unit exceeded the acceptable risk level value of 7.8 × 10−6 per 1 μg/m3 by more than 20 times.
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Michalek IM, Kinnunen TI, Kjaerheim K, Lynge E, Martinsen JI, Sparen P, Tryggvadottir L, Weiderpass E, Pukkala E. Smoking-adjusted risk of kidney cancer by occupation: a population-based cohort study of Nordic men. Acta Oncol 2020; 59:582-587. [PMID: 32009517 DOI: 10.1080/0284186x.2020.1714722] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 01/08/2020] [Indexed: 12/28/2022]
Abstract
Background: Evidence suggests that among some occupational groups, there is an elevated risk of kidney cancer. This might, however, derive from a difference in smoking habits across occupational groups. The objective of this study was to determine smoking-adjusted occupational variation in the incidence of kidney cancer in Nordic males.Material and Methods: The source population for this study consisted of 7.4 million men from Denmark, Iceland, Finland, Norway, and Sweden. Data on occupation were obtained from national censuses conducted in the years 1960-1990. Data on cancer cases came from national cancer registries. A proxy for the occupation-specific smoking prevalence among all Nordic men was calculated based on the occupation-specific smoking prevalence and lung cancer incidence data for Finnish men. Smoking-adjusted standardized incidence ratio (SIRadj) with 95% confidence intervals (95%CI) were calculated for each occupational group.Results: The highest SIRadj estimates were observed in dentists (1.32, 95%CI 1.06-1.62), journalists (1.20, 95%CI 1.00-1.42), physicians (1.19, 95%CI 1.03-1.36), public safety workers (1.18, 95%CI 1.10-1.26), administrators (1.17, 95%CI 1.13-1.22), military personnel (1.16, 95%CI 1.05-1.28), and religious workers (1.17, 95%CI 1.09-1.26). The lowest SIRadj was observed among forestry workers (0.82, 95%CI 0.76-0.88).Conclusions: Tobacco smoking plays an important role in the occupational variation in the risk of kidney cancer. The smoking-adjusted incidence of kidney cancer was increased in dentists, physicians, journalists, administrators, and public safety workers.
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Affiliation(s)
- Irmina Maria Michalek
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Women-Mother-Child Department, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Tarja I Kinnunen
- Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Kristina Kjaerheim
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Elsebeth Lynge
- Nykøbing Falster Hospital, University of Copenhagen, Denmark
| | - Jan Ivar Martinsen
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Pär Sparen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Laufey Tryggvadottir
- Icelandic Cancer Registry, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Elisabete Weiderpass
- International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Eero Pukkala
- Faculty of Social Sciences, Tampere University, Tampere, Finland
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
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Zhao G, Erazo B, Ronda E, Brocal F, Regidor E. Mortality Among Firefighters in Spain: 10 Years of Follow-up. Ann Work Expo Health 2020; 64:614-621. [DOI: 10.1093/annweh/wxaa036] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 03/12/2020] [Accepted: 03/20/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
The objective of this study was to compare mortality rates for the main causes of death and the most frequent sites of cancer in firefighters and all other occupations.
Methods
Mortality was calculated from a longitudinal study conducted between 2001 and 2011 following a total of 9.5 million men aged 20–64 years old who were in employment in 2001. The age-standardized mortality rate for firefighters was calculated for cancer and other causes of death and compared with that for all other occupations using the mortality rate ratio (MRR).
Results
No differences were observed between firefighters and all other occupations for overall mortality [MRR = 0.99, 95% confidence interval (CI): 0.91–1.07] or for mortality from cancer in general (MRR = 1.00, 95% CI: 0.89–1.12). No significant differences were observed in mortality by site of cancer, except for mortality from cancer of larynx (MRR = 1.77, 95% CI: 1.01–3.09) and hypopharynx (MRR = 2.96, 95% CI: 1.31–6.69), which presented a higher magnitude in firefighters. Neither was any significant differences observed between the two groups in mortality due to cardiovascular, respiratory, or digestive diseases or in mortality due to external causes.
Conclusions
Exposure to carcinogens combined with a possible failure to use respiratory protection when fighting fires may be responsible for excess mortality from laryngeal and hypopharyngeal cancer in firefighters. In the future, more research is needed on the health of firefighters and strengthening preventive policies for these workers.
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Affiliation(s)
- Guanlan Zhao
- Preventive Medicine and Public Health Area, University of Alicante, Alicante, Spain
| | - Boris Erazo
- Preventive Medicine and Public Health Area, University of Alicante, Alicante, Spain
| | - Elena Ronda
- Preventive Medicine and Public Health Area, University of Alicante, Alicante, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Planta, Madrid, Spain
| | - Francisco Brocal
- Department of Physics, Systems Engineering and Signal Theory, University of Alicante, Alicante, Spain
| | - Enrique Regidor
- CIBER Epidemiología y Salud Pública (CIBERESP), Planta, Madrid, Spain
- Department of Public Health and Maternal and Child Health, Complutense University of Madrid, Madrid, Spain
- Instituto de Investigación Sanitaria de Hospital Clínico San Carlos (IdISSC), Madrid, Spain
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Grashow R, Bessonneau V, Gerona RR, Wang A, Trowbridge J, Lin T, Buren H, Rudel RA, Morello-Frosch R. Integrating Exposure Knowledge and Serum Suspect Screening as a New Approach to Biomonitoring: An Application in Firefighters and Office Workers. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:4344-4355. [PMID: 31971370 PMCID: PMC7182169 DOI: 10.1021/acs.est.9b04579] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/15/2020] [Accepted: 01/23/2020] [Indexed: 05/18/2023]
Abstract
Firefighters (FF) are exposed to recognized and probable carcinogens, yet there are few studies of chemical exposures and associated health concerns in women FFs, such as breast cancer. Biomonitoring often requires a priori selection of compounds to be measured, and so, it may not detect relevant, lesser known, exposures. The Women FFs Biomonitoring Collaborative (WFBC) created a biological sample archive and conducted a general suspect screen (GSS) to address this data gap. Using liquid chromatography-quadrupole time-of-flight tandem mass spectrometry, we sought to identify candidate chemicals of interest in serum samples from 83 women FFs and 79 women office workers (OW) in San Francisco. We identified chemical peaks by matching accurate mass from serum samples against a custom chemical database of 722 slightly polar phenolic and acidic compounds, including many of relevance to firefighting or breast cancer etiology. We then selected tentatively identified chemicals for confirmation based on the following criteria: (1) detection frequency or peak area differences between OW and FF; (2) evidence of mammary carcinogenicity, estrogenicity, or genotoxicity; and (3) not currently measured in large biomonitoring studies. We detected 620 chemicals that matched 300 molecular formulas in the WFBC database, including phthalate metabolites, phosphate flame-retardant metabolites, phenols, pesticides, nitro and nitroso compounds, and per- and polyfluoroalkyl substances. Of the 20 suspect chemicals selected for validation, 8 were confirmed-including two alkylphenols, ethyl paraben, BPF, PFOSAA, benzophenone-3, benzyl p-hydroxybenzoate, and triphenyl phosphate-by running a matrix spike of the reference standards and using m/z, retention time, and the confirmation of at least two fragment ions as criteria for matching. GSS provides a powerful high-throughput approach to identify and prioritize novel chemicals for biomonitoring and health studies.
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Affiliation(s)
- Rachel Grashow
- Silent
Spring Institute, Newton, Massachusetts 02460, United States
| | | | - Roy R. Gerona
- Clinical
Toxicology and Environmental Biomonitoring Lab, Department of Obstetrics,
Gynecology and Reproductive Sciences, University
of California San Francisco, San
Francisco, California 94143, United States
| | - Aolin Wang
- Program
on Reproductive Health and the Environment, Department of Obstetrics,
Gynecology and Reproductive Sciences & Bakar Computational Health
Sciences Institute, University of California
San Francisco, San Francisco, California 94143, United States
| | - Jessica Trowbridge
- School
of Public Health, University of California
Berkeley, Berkeley, California 94720, United States
| | - Thomas Lin
- Clinical
Toxicology and Environmental Biomonitoring Lab, Department of Obstetrics,
Gynecology and Reproductive Sciences, University
of California San Francisco, San
Francisco, California 94143, United States
| | - Heather Buren
- United Fire
Service Women, San Francisco, California 94143, United States
| | - Ruthann A. Rudel
- Silent
Spring Institute, Newton, Massachusetts 02460, United States
- E-mail: . Phone: 617-332-4288 (R.A.R.)
| | - Rachel Morello-Frosch
- School
of Public Health, University of California
Berkeley, Berkeley, California 94720, United States
- Department
of Environmental Science, Policy and Management
University of California Berkeley, Berkeley, California 94720, United States
- E-mail: , Phone: 510-643-6358 (R.M.-F.)
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47
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Lee DJ, Koru‐Sengul T, Hernandez MN, Caban‐Martinez AJ, McClure LA, Mackinnon JA, Kobetz EN. Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014). Am J Ind Med 2020; 63:285-299. [PMID: 31930542 DOI: 10.1002/ajim.23086] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/22/2019] [Accepted: 12/17/2019] [Indexed: 12/14/2022]
Abstract
BACKGROUND Firefighters are at increased risk for select cancers. However, many studies are limited by relatively small samples, with virtually no data on the cancer experience of female firefighters. This study examines cancer risk in over 100,000 career Florida firefighters including 5000 + females assessed over a 34-year period. METHODS Florida firefighter employment records (n = 109 009) were linked with Florida Cancer Data System registry data (1981-2014; ~3.3 million records), identifying 3760 male and 168 female-linked primary cancers. Gender-specific age and calendar year-adjusted odds ratios (aOR) and 95% confidence intervals for firefighters vs non-firefighters were calculated. RESULTS Male firefighters were at increased risk of melanoma (aOR = 1.56; 1.39-1.76), prostate (1.36; 1.27-1.46), testicular (1.66; 1.34-2.06), thyroid (2.17; 1.78-2.66) and late-stage colon cancer (1.19;1.00-1.41). Female firefighters showed significantly elevated risk of brain (2.54; 1.19-5.42) and thyroid (2.42; 1.56-3.74) cancers and an elevated risk of melanoma that approached statistical significance (1.68; 0.97-2.90). Among male firefighters there was additional evidence of increased cancer risk younger than the age of 50 vs 50 years and older for thyroid (2.55; 1.96-3.31 vs 1.69; 1.22-2.34), prostate (1.88; 1.49-2.36 vs 1.36; 1.26-1.47), testicular (1.60; 1.28-2.01 vs 1.47; 0.73-2.94), and melanoma (1.87; 1.55-2.26 vs 1.42; 1.22-1.66) cancers. CONCLUSION Male career firefighters in Florida are at increased risk for five cancers with typically stronger associations in those diagnosed younger than the age of 50, while there was evidence for increased thyroid and brain cancer, and possibly melanoma risk in female firefighters. Larger cohorts with adequate female representation, along with the collection of well-characterized exposure histories, are needed to more precisely examine cancer risk in this occupational group.
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Affiliation(s)
- David J. Lee
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Miami Florida
- Florida Cancer Data System, Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiami Florida
| | - Tulay Koru‐Sengul
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Miami Florida
| | - Monique N. Hernandez
- Florida Cancer Data System, Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiami Florida
| | - Alberto J. Caban‐Martinez
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Miami Florida
| | - Laura A. McClure
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Miami Florida
| | - Jill A. Mackinnon
- Florida Cancer Data System, Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of MedicineMiami Florida
| | - Erin N. Kobetz
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Miami Florida
- Department of MedicineUniversity of Miami Miller School of Medicine Miami Florida
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48
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Trowbridge J, Gerona RR, Lin T, Rudel RA, Bessonneau V, Buren H, Morello-Frosch R. Exposure to Perfluoroalkyl Substances in a Cohort of Women Firefighters and Office Workers in San Francisco. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2020; 54:3363-3374. [PMID: 32100527 PMCID: PMC7244264 DOI: 10.1021/acs.est.9b05490] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
Studies of firefighters have shown increased exposures to carcinogenic compounds and elevated rates of certain cancers compared to the general population, yet this research has focused almost exclusively on men. To address this gap, the Women Firefighters Biomonitoring Collaborative created a biological sample archive and analyzed levels of perfluoroalkyl substances (PFAS) among women firefighters (N = 86) and office workers (N = 84) in San Francisco. Serum samples were collected and analyzed using liquid chromatography-tandem mass spectrometry (LC-MS/MS) to measure and compare PFAS levels between firefighters and office workers. 7 of 12 PFAS congeners were detected in the least 70% of the study population, and 4 congeners were detected in 100% of participants. In regression models comparing PFAS levels by occupation and adjusting for potential confounders, firefighters had higher geometric mean concentrations of PFAS compared to office workers PFHxS (2.22 (95% CI = 1.55, 3.18)), PFUnDA (1.83 (95% CI = 0.97, 3.45)), and PFNA (1.26 (95% CI = 1.01, 1.58)). Among firefighters, occupational position predicted exposure-firefighters and officers had higher PFNA, PFOA, PFDA, and PFUnDA levels compared to drivers. Women firefighters are exposed to higher levels of some PFAS compared to office workers, suggesting that some of these exposures may be occupationally related.
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Affiliation(s)
- Jessica Trowbridge
- Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, CA
- School of Public Health, University of California, Berkeley, Berkeley, CA
| | - Roy R. Gerona
- Clinical Toxicology and Environmental Biomonitoring Lab, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
| | - Thomas Lin
- Clinical Toxicology and Environmental Biomonitoring Lab, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA
| | | | | | | | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management, University of California, Berkeley, Berkeley, CA
- School of Public Health, University of California, Berkeley, Berkeley, CA
- Corresponding author: Rachel Morello-Frosch, , 510-643-6358, Department of Environmental Science, Policy and Management, 130 Mulford, Hall #3144, University of California, Berkeley, Berkeley CA, 94720
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Fent KW, Toennis C, Sammons D, Robertson S, Bertke S, Calafat AM, Pleil JD, Wallace MAG, Kerber S, Smith D, Horn GP. Firefighters' absorption of PAHs and VOCs during controlled residential fires by job assignment and fire attack tactic. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2020; 30:338-349. [PMID: 31175324 PMCID: PMC7323473 DOI: 10.1038/s41370-019-0145-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 04/11/2019] [Accepted: 04/17/2019] [Indexed: 05/07/2023]
Abstract
To better understand the absorption of combustion byproducts during firefighting, we performed biological monitoring (breath and urine) on firefighters who responded to controlled residential fires and examined the results by job assignment and fire attack tactic. Urine was analyzed for metabolites of polycyclic aromatic hydrocarbons (PAHs) and breath was analyzed for volatile organic compounds (VOCs) including benzene. Median concentrations of PAH metabolites in urine increased from pre-firefighting to 3-h post firefighting for all job assignments. This change was greatest for firefighters assigned to attack and search with 2.3, 5.6, 3.9, and 1.4-fold median increases in pyrene, phenanthrene, naphthalene, and fluorene metabolites. Median exhaled breath concentrations of benzene increased 2-fold for attack and search firefighters (p < 0.01) and 1.4-fold for outside vent firefighters (p = 0.02). Compared to interior attack, transitional attack resulted in 50% less uptake of pyrene (p = 0.09), 36% less uptake phenanthrene (p = 0.052), and 20% less uptake of fluorene (p < 0.01). Dermal absorption likely contributed to firefighters' exposures in this study. Firefighters' exposures will vary by job assignment and can be reduced by employing a transitional fire attack when feasible.
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Affiliation(s)
- Kenneth W Fent
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA.
| | - Christine Toennis
- Division of Applied Research and Technology, NIOSH, CDC, Cincinnati, OH, USA
| | - Deborah Sammons
- Division of Applied Research and Technology, NIOSH, CDC, Cincinnati, OH, USA
| | - Shirley Robertson
- Division of Applied Research and Technology, NIOSH, CDC, Cincinnati, OH, USA
| | - Stephen Bertke
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC), Cincinnati, OH, USA
| | - Antonia M Calafat
- Division of Laboratory Services, National Center for Environmental Health, CDC, Atlanta, GA, USA
| | - Joachim D Pleil
- National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - M Ariel Geer Wallace
- National Exposure Research Laboratory, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, NC, USA
| | - Steve Kerber
- Firefighter Safety Research Institute, Underwriters Laboratories, Columbia, MD, USA
| | - Denise Smith
- Skidmore College, Saratoga Springs, New York, NY, USA
- Illinois Fire Service Institute, University of Illinois at Urbana-, Champaign, IL, USA
| | - Gavin P Horn
- Illinois Fire Service Institute, University of Illinois at Urbana-, Champaign, IL, USA
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50
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Pinkerton L, Bertke SJ, Yiin J, Dahm M, Kubale T, Hales T, Purdue M, Beaumont JJ, Daniels R. Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update. Occup Environ Med 2020; 77:84-93. [PMID: 31896615 PMCID: PMC10165610 DOI: 10.1136/oemed-2019-105962] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Revised: 11/13/2019] [Accepted: 12/08/2019] [Indexed: 11/04/2022]
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.
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Affiliation(s)
- Lynne Pinkerton
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Stephen J Bertke
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - James Yiin
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Matthew Dahm
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Travis Kubale
- World Trade Center Health Program, National Institute for Occupational Safety and Health (NIOSH), Washington, District of Columbia, USA
| | - Thomas Hales
- Division of Safety Research, National Institute for Occupational Safety and Health (NIOSH), Denver, Colorado, USA
| | - Mark Purdue
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
| | - James J Beaumont
- Department of Public Health Sciences, University of California Davis, Davis, California, USA
| | - Robert Daniels
- Education and Information Division, National Institute for Occupational Safety and Health (NIOSH), Cincinnati, Ohio, USA
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