An epidemiologic study of cancer and other causes of mortality in San Francisco firefighters

Abstract

To test the hypothesis that firefighter exposures may increase cancer risk, mortality rates were calculated for 3,066 San Francisco Fire Department firefighters employed between 1940 and 1970. Vital status was ascertained through 1982, and observed and expected rates, rate ratios (RR), and 95% confidence intervals (CI) were computed using United States death rates for comparison. The total number deceased (1,186) was less than expected and there were fewer cancer deaths than expected. However, there were significant excess numbers of deaths from esophageal cancer (12 observed, 6 expected), cirrhosis and other liver diseases (59 observed, 26 expected), and accidental falls (21 observed, 11 expected). There were 24 line-of-duty deaths, which were primarily due to vehicular injury, falls, and asphyxiation. Heart disease and respiratory disease deaths occurred significantly less often than expected. It was concluded that the increased risks of death from esophageal cancer and cirrhosis and other liver diseases may have been due to firefighter exposures, alcohol consumption, or interaction between alcohol and exposures. Because this was an older cohort and firefighter exposures have changed due to the increasing use of synthetic materials, it is recommended that the effects of modern-day exposures be further studied.

Mortality in Florida professional firefighters, 1972 to 1999

“…Consistent with the results from other cohort studies [Beaumont et al, 1991;Demers et al, 1992;Guidotti, 1993;Tornling et al, 1994;Baris et al, 2001], we found significant decreases in mortality from infectious, allergic/endocrine, circulatory system, respiratory, digestive, and genitourinary diseases, and from external causes. We did not find an increased mortality from cardiovascular or respiratory disease.…”

Physiological Determinants of the Candidate Physical Ability Test in Firefighters

“…In addition to potentially elevated risk of cardiovascular disease-related death, many studies have reported an elevated risk of several types of cancer among the firefighting population (7,21,38,40,41,54). The most common forms of cancer identified include thyroid cancer, breast, brain, prostate, esophageal, and lung cancer.…”

Occupational Health Concerns of Firefighting

“…One study from Denmark (46), in which the comparison population is unusual, reported a standardized mortality ratio of 317 for older firefighters, whereas studies on cohorts from San Francisco and Buffalo showed no excess (13,122). The possibility that an association is obscured, in comparison to the general population by the healthy worker effect, is probably less likely for this cause of death than for other chronic diseases; over the long periods of observation typical for these studies, the mortality experience of initially selected workers can be expected to approach that of the general population more closely, especially for noncar diovascular causes of death.…”

“…Recent studies suggest that mortality is about that expected (13,27,44,46,96,122), although some studies have suggested elevations of 50% (99). There is ergonomic evidence that some firefighters may be stressed to the limit during the exertions of their work.…”