Background: United States Preventative Task Force recommends annual lung cancer screening with low dose computed tomography (CT) in adults ages 55-80, who have a thirty pack year history of smoking and are currently smoking or quit within the past 15 years. Thirty percent of all lung cancers diagnosed in United States are due to occupational exposure, with a vast majority diagnosed in first responders. No occupational specific guidelines exist for lung cancer screening with low dose CT for first responders. Method: November 1, 2018-March 21, 2019 low dose lung CTs were performed on a 144 first responders. Age ranges from 40-76, Gender: 116 Males and 28 Females. The average years of exposure was 23 yrs. Patients were screened at various Simon Med Radiology locations in Arizona with various CT scanners. The CT dose index ranged (CTDI vol) ranged from 1.6-2.6mGy. No contrast was used. Result: 40 lung nodules identified: 1 anterior mediastinal mass, 2.1x1.5cm which was removed in a 42 yearold and found to be an epithelioid thymoma. Lung-RADS screening follow-up was used even though a lot of the patients did not meet age criteria. The remainder of the lung lesions classified as follows: Lung-