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Goldfarb DG, Prezant DJ, Zeig-Owens R, Hall CB, Schwartz T, Liu Y, Kavouras IG. Association of firefighting exposures with lung function using a novel job exposure matrix (JEM). Occup Environ Med 2024; 81:84-91. [PMID: 38233128 PMCID: PMC11267455 DOI: 10.1136/oemed-2023-109155] [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: 08/10/2023] [Accepted: 12/17/2023] [Indexed: 01/19/2024]
Abstract
OBJECTIVES Characterisation of firefighters' exposures to dangerous chemicals in smoke from non-wildfire incidents, directly through personal monitoring and indirectly from work-related records, is scarce. The aim of this study was to evaluate the association between smoke particle exposures (P) and pulmonary function. METHODS The study period spanned from January 2010 through September 2021. Routine firefighting P were estimated using fire incident characteristics, response data and emission factors from a novel job exposure matrix. Linear mixed effects modelling was employed to estimate changes in pulmonary function as measured by forced expiratory volume in one second (FEV1). Models controlled for age, race/ethnicity, height, smoking and weight. RESULTS Every 1000 kg P was associated with 13 mL lower FEV1 (β=-13.34; 95% CI=-13.98 to -12.70) over the entire 12-year follow-up period. When analysing exposures within 3 months before PFT measurements, 1000 kg P was associated with 27 mL lower FEV1 (β=-26.87; 95% CI=-34.54 to -19.20). When evaluating P estimated within 3 months of a pulmonary function test (PFT), stronger associations were observed among those most highly exposed to the World Trade Center (WTC) disaster (β=-12.90; 95% CI=-22.70 to -2.89); the association of cumulative exposures was similar for both highly and less highly exposed individuals. DISCUSSION Smoke particle exposures were observed to have modest short-term and long-term associations with pulmonary function, particularly in those who, previously, had high levels of WTC exposure. Future work examining the association between P and pulmonary function among non-WTC exposed firefighters will be essential for disentangling the effects of ageing, routine firefighting and WTC exposures.
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Affiliation(s)
- David G Goldfarb
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Environmental and Geospatial Health Sciences, City University of New York Graduate School of Public Health and Health Policy, New York city, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - David J Prezant
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Rachel Zeig-Owens
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Charles B Hall
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Theresa Schwartz
- Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Yang Liu
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Ilias G Kavouras
- Department of Environmental and Geospatial Health Sciences, City University of New York Graduate School of Public Health and Health Policy, New York city, New York, USA
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Goldfarb DG, Prezant DJ, Zeig-Owens R, Schwartz T, Liu Y, Kavouras IG. Development of a job-exposure matrix (JEM) for exposure to smoke particle mass among firefighters of the Fire Department of the City of New York (FDNY). Occup Environ Med 2023; 80:104-110. [PMID: 36635097 DOI: 10.1136/oemed-2022-108549] [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: 06/29/2022] [Accepted: 12/15/2022] [Indexed: 01/14/2023]
Abstract
OBJECTIVES A refined job exposure matrix (JEM) based on incident types and severities and response characteristics was developed for firefighters to estimate quantities of smoke particles emitted during structural and non-structural fire incidents from 2010 to 2021. METHODS The cohort included a subset of 3237 Fire Department of the City of New York firefighters who responded to at least one incident between 2010 and 2021, prior to retirement. Fire incident data included dates, type, severity (alarm level) and location. Response data included dates worked, firehouse, position titles and shift lengths for each firefighter. The quantity of smoke particle mass generated during structural and non-structural fires adjusted by individual firefighter engagement was computed using the United States Environmental Protection Agency AP-42 emissions framework. Correlations between years of employment, fire responses and career total particle mass concentration by firefighter were examined. Linear regression models were fit and corresponding R2 values were calculated. RESULTS Firefighters responded to a median of 424.7 (IQR=202.3-620.0) annual incidents/person; 17.6% were fire incidents (median=77.1; IQR=40.4-114.0). Structural fires were the most common type of fire incident (72.5% of annual incidents/person; median=55.9; IQR=29.6-85.5). Incident severity (alarm level) and firefighter engagement (position title) appeared to differentiate between high and low exposure regimes (R2=0.43). Incident severity explained most of the variability of particle exposures (R2=0.90). CONCLUSIONS Using the JEM, job-related smoke particle concentrations were estimated to vary by incident type, incident severity and firefighter engagement, highlighting the importance of using refined measures, so that future studies can more accurately evaluate associations between firefighting and health outcomes.
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Affiliation(s)
- David G Goldfarb
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA .,Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA
| | - David J Prezant
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Rachel Zeig-Owens
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA.,Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Theresa Schwartz
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA.,Department of Medicine, Montefiore Medical Center, Brooklyn, New York, USA
| | - Yang Liu
- Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
| | - Ilias G Kavouras
- Department of Environmental, Occupational, and Geospatial Health Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
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Pinkerton LE, Bertke S, Dahm MM, Kubale TL, Siegel MR, Hales TR, Yiin JH, Purdue MP, Beaumont JJ, Daniels RD. End-stage renal disease incidence in a cohort of US firefighters from San Francisco, Chicago, and Philadelphia. Am J Ind Med 2022; 65:975-984. [PMID: 36268894 PMCID: PMC9828160 DOI: 10.1002/ajim.23435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 09/29/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Firefighters perform strenuous work in hot environments, which may increase their risk of chronic kidney disease. The purpose of this study was to evaluate the risk of end-stage renal disease (ESRD) and types of ESRD among a cohort of US firefighters compared to the US general population, and to examine exposure-response relationships. METHODS ESRD from 1977 through 2014 was identified through linkage with Medicare data. ESRD incidence in the cohort compared to the US population was evaluated using life table analyses. Associations of all ESRD, systemic ESRD, hypertensive ESRD, and diabetic ESRD with exposure surrogates (exposed days, fire runs, and fire hours) were examined in Cox proportional hazards models adjusted for attained age (the time scale), race, birth date, fire department, and employment duration. RESULTS The incidence of all ESRD was less than expected (standardized incidence ratio (SIR) = 0.79; 95% confidence interval = 0.69-0.89, observed = 247). SIRs for ESRD types were not significantly increased. Positive associations of all ESRD, systemic ESRD, and hypertensive ESRD with exposed days were observed: however, 95% confidence intervals included one. CONCLUSIONS We found little evidence of increased risk of ESRD among this cohort of firefighters. Limitations included the inability to evaluate exposure-response relationships for some ESRD types due to small observed numbers, the limitations of the surrogates of exposure, and the lack of information on more sensitive outcome measures for potential kidney effects.
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Affiliation(s)
- Lynne E. Pinkerton
- MaximusMcLeanVirginiaUSA
- Division of Field Studies and EngineeringNational Institute for Occupational Safety and HealthCincinnatiOhioUSA
| | - Stephen Bertke
- Division of Field Studies and EngineeringNational Institute for Occupational Safety and HealthCincinnatiOhioUSA
| | - Matthew M. Dahm
- Division of Field Studies and EngineeringNational Institute for Occupational Safety and HealthCincinnatiOhioUSA
| | - Travis L. Kubale
- World Trade Center Health ProgramNational Institute for Occupational Safety and HealthWashingtonDistrict of ColumbiaUSA
| | - Miriam R. Siegel
- Division of Field Studies and EngineeringNational Institute for Occupational Safety and HealthCincinnatiOhioUSA
| | - Thomas R. Hales
- Division of Safety ResearchNational Institute for Occupational Safety and HealthDenverColoradoUSA
| | - James H. Yiin
- Office of Extramural ProgramsNational Institute for Occupational Safety and HealthAtlantaGeorgiaUSA
| | - Mark P. Purdue
- Division of Cancer Epidemiology and GeneticsNational Cancer InstituteRockvilleMarylandUSA
| | - James J. Beaumont
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
| | - Robert D. Daniels
- World Trade Center Health ProgramNational Institute for Occupational Safety and HealthWashingtonDistrict of ColumbiaUSA
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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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5
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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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Hwang J, Xu C, Agnew RJ, Clifton S, Malone TR. Health Risks of Structural Firefighters from Exposure to Polycyclic Aromatic Hydrocarbons: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4209. [PMID: 33921138 PMCID: PMC8071552 DOI: 10.3390/ijerph18084209] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 01/03/2023]
Abstract
Firefighters have an elevated risk of cancer, which is suspected to be caused by occupational and environmental exposure to fire smoke. Among many substances from fire smoke contaminants, one potential source of toxic exposure is polycyclic aromatic hydrocarbons (PAH). The goal of this paper is to identify the association between PAH exposure levels and contributing risk factors to derive best estimates of the effects of exposure on structural firefighters' working environment in fire. We surveyed four databases (Embase, Medline, Scopus, and Web of Science) for this systematic literature review. Generic inverse variance method for random effects meta-analysis was applied for two exposure routes-dermal and inhalation. In dermal, the neck showed the highest dermal exposure increased after the fire activity. In inhalation, the meta-regression confirmed statistically significant increases in PAH concentrations for longer durations. We also summarized the scientific knowledge on occupational exposures to PAH in fire suppression activities. More research into uncontrolled emergency fires is needed with regard to newer chemical classes of fire smoke retardant and occupational exposure pathways. Evidence-based PAH exposure assessments are critical for determining exposure-dose relationships in large epidemiological studies of occupational risk factors.
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Affiliation(s)
- Jooyeon Hwang
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Chao Xu
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Robert J. Agnew
- Fire Protection & Safety Engineering Technology Program, College of Engineering, Architecture and Technology, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Shari Clifton
- Department of Health Sciences Library and Information Management, Graduate College, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.C.); (T.R.M.)
| | - Tara R. Malone
- Department of Health Sciences Library and Information Management, Graduate College, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.C.); (T.R.M.)
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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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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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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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Neitzel RL, Andersson M, Eriksson H, Torén K, Andersson E. Development of a Job Exposure Matrix for Noise in the Swedish Soft Tissue Paper Industry. Ann Work Expo Health 2017; 62:195-209. [DOI: 10.1093/annweh/wxx095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 10/24/2017] [Indexed: 12/20/2022] Open
Abstract
Abstract
Objectives
Noise exposure is a common occupational hazard, but has not been sufficiently characterized in paper mills. We developed a job-exposure matrix (JEM) for noise exposure for use in estimating exposures among Swedish soft tissue paper mill workers.
Methods
We used a combination of area and personal dosimetry noise exposure measurements made at four soft tissue paper mills by industry and research staff between 1977 and 2013 to estimate noise exposures by department, location, and job title. We then utilized these estimates, in conjunction with information on process and facility changes and use of hearing protection collected via focus groups, to create a seven-category, semi-quantitative JEM for all departments, locations, and job titles spanning the years 1940–2010.
Results
The results of the 1157 area and personal dosimetry noise measurements indicated that noise levels have generally declined in Swedish paper mills over time, though these changes have been neither uniform nor monotonic within or across the four mills. Focus group results indicated that use of hearing protection has generally increased over time. The noise JEM totals 1917 cells, with each cell representing a unique combination of operation, job title, and single year. We estimated that ~50% of workers at the four mills assessed were exposed at or above the Swedish 8-h average noise exposure limit of an 85 dBA at the conclusion of the study period in 2010.
Conclusions
Our results highlight the continuing need for hearing loss prevention and noise control efforts at these and similar mills, and the completed JEM now represents a tool for use in epidemiological studies of noise-related health outcomes.
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Affiliation(s)
- Richard Lee Neitzel
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Marianne Andersson
- Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Helena Eriksson
- Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Kjell Torén
- Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Eva Andersson
- Section of Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden
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Sparer EH, Prendergast DP, Apell JN, Bartzak MR, Wagner GR, Adamkiewicz G, Hart JE, Sorensen G. Assessment of Ambient Exposures Firefighters Encounter While at the Fire Station: An Exploratory Study. J Occup Environ Med 2017; 59:1017-1023. [PMID: 28991807 PMCID: PMC5641976 DOI: 10.1097/jom.0000000000001114] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Firefighters are at an increased risk for many types of cancer. Although most studies on this topic focus on exposures encountered while fighting fires, exposures at the fire station are also cause for concern. This pilot study aimed to describe air quality within a few fire stations in and around Boston, Massachusetts, and to investigate physical and organizational factors that may influence levels of contaminants in stations. METHODS Air sampling of particulate matter less than 2.5 μm in diameter (PM2.5) and particle-bound polycyclic aromatic hydrocarbons (PAHs) was completed at four fire stations in Spring, 2016. Sampling occurred in the kitchen, truck bay, and just outside the station. Data were analyzed to assess differences between and within stations. Interviews (n =7) were conducted with officers at each station to explore health and safety-related organizational policies and practices. Interviews were transcribed and analyzed for thematic content. RESULTS At each station, levels of contaminants were higher in the truck bays than either the outdoors or kitchen, and varied the most throughout the day. The station with the highest exposures in the truck bay had the lowest levels in the kitchen, which was possibly explained by new building materials and effective separation between building zones. The age and layout of the stations appeared to determine the extent to which policies favoring exhaust capture were implemented. CONCLUSION Levels of PM2.5 and PAH inside fire stations may contribute to firefighter cancer risk. Through understanding contaminant variability, we can begin to design and test interventions that improve cancer prevention.
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Affiliation(s)
- Emily H Sparer
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Drs Sparer, Sorensen); Center for Community-Based Research, Dana-Farber Cancer Institute, Boston, Massachusetts (Drs Sparer, Sorensen); Department of Civil and Environmental Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts (Mr Prendergast, Mr Apell); MetroWest Medical Center, Framingham, Massacusetts (Bartzak); Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts (Bartzak, Drs Wagner, Adamkiewicz, Hart); Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts (Dr Hart)
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Glass DC, Del Monaco A, Pircher S, Vander Hoorn S, Sim MR. Mortality and cancer incidence among male volunteer Australian firefighters. Occup Environ Med 2017; 74:628-638. [DOI: 10.1136/oemed-2016-104088] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 01/19/2017] [Accepted: 01/30/2017] [Indexed: 11/04/2022]
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Glass DC, Pircher S, Del Monaco A, Hoorn SV, Sim MR. Mortality and cancer incidence in a cohort of male paid Australian firefighters. Occup Environ Med 2016; 73:761-771. [DOI: 10.1136/oemed-2015-103467] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 07/01/2016] [Indexed: 12/27/2022]
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