Cancer Risk Among Firefighters: A Review and Meta-analysis of 32 Studies

LeMasters, Grace K.; Genaidy, Ash; Succop, Paul; Deddens, James A.; Sobeih, Tarek; Barriera-Viruet, Heriberto; Dunning, Kari; Lockey, James L.

doi:10.1097/01.jom.0000246229.68697.90

Cited by 314 publications

(332 citation statements)

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“…Their episodic intense work, combined with those health risks, contribute to myocardial infarctions being the leading cause of on duty death [9]. Healthy lifestyles are of additional importance because firefighters' risk of cancer is increased [10].…”

Section: Discussionmentioning

confidence: 99%

Worksite wellness program implementation: a model of translational effectiveness

Elliot

MacKinnon

Mabry

et al. 2012

Behav. Med. Pract. Policy Res.

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Occupational health promotion programs with documented efficacy have not penetrated worksites. Establishing an implementation model would allow focusing on mediating aspects to enhance installation and use of evidence-based occupational wellness interventions. The purpose of the study was to implement an established wellness program in fire departments and define predictors of program exposure/dose to outcomes to define a cross-sectional model of translational effectiveness. The study is a prospective observational study among 12 NW fire departments. Data were collected before and following installation, and findings were used to conduct mediation analysis and develop a translational effectiveness model. Worker age was examined for its impact. Leadership, scheduling/competing demands, and tailoring were confirmed as model components, while organizational climate was not a factor. The established model fit data well (χ 2 (9)=25.57, CFI = 0.99, RMSEA = 0.05, SRMR = 0.03). Older firefighters, nearing retirement, appeared to have influences that both enhanced and hindered participation. Findings can inform implementation of worksite wellness in fire departments, and the prioritized influences and translational model can be validated and manipulated in these and other settings to more efficiently move health promotion science to service.

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Section: Discussionmentioning

confidence: 99%

Worksite wellness program implementation: a model of translational effectiveness

Elliot

MacKinnon

Mabry

et al. 2012

Behav. Med. Pract. Policy Res.

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“…These results only show an overall correlation without information on the relationship between the length of work as a firefighter and the degree of risk of prostate cancer. A review by LeMasters et al (2006) supported the positive correlation between firefighting occupations and prostate cancer and reported a summary estimate risk of SRE = 1.28;95% CI:1.15-1.43 following a systematic review and meta-analyses of thirty two studies on cancer risk among firefighters. It is believed that firefighters by virtue of their occupation are susceptible to a number of cancers including multiple myeloma, non-Hodgkin's lymphoma and testicular cancer (LeMasters et al, 2006).…”

Section: Discussionmentioning

confidence: 99%

“…A review by LeMasters et al (2006) supported the positive correlation between firefighting occupations and prostate cancer and reported a summary estimate risk of SRE = 1.28;95% CI:1.15-1.43 following a systematic review and meta-analyses of thirty two studies on cancer risk among firefighters. It is believed that firefighters by virtue of their occupation are susceptible to a number of cancers including multiple myeloma, non-Hodgkin's lymphoma and testicular cancer (LeMasters et al, 2006). PAH (Krstev et al, 1998b) and fire smoke (Demers et al, 1994) are suspected carcinogens but the relationship has not been confirmed although believed to be plausible.…”

Section: Discussionmentioning

confidence: 99%

“…The routes of exposure and delivery to target organs include skin, respiratory system and ingestion. These exposures at the site of contact or target organs produce direct and indirect effects associated with modulation of biochemical or physiologic pathways and other pathways of toxicity (LeMasters et al, 2006). Although firefighters use standard protective equipment which include thermal gear, respirators and face shields the exposures transcend these barriers and impose undue body burden on the firefighters (Coca, Williams, Roberge, & Powell, 2010).…”

Section: Discussionmentioning

confidence: 99%

“…Considering the extent of carcinogenic exposure and the prevalence of prostate cancer among firefighters, there may be a likely correlation between firefighting as an occupation and prostate cancer. The prevalence of prostate cancer among other cancers among firefighters has been reported to be higher (LeMasters et al, 2006;Bates, 2007).This study focuses on the development of prostate cancer among firefighters and its association with occupational exposures in firefighting. We also hope to identify potential chemicals and other burning substances that may be associated with the development of prostate cancer.…”

Section: Introductionmentioning

confidence: 99%

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The Risk of Prostate Cancer from Occupational Exposures in Male Firefighters

Wong¹,

Gomes²

2011

RISS-IJHS

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Le cancer de la prostate est le cancer le plus fréquemment diagnostiqué chez les hommes. Étant donné qu'il se développe lentement, on peut prévenir la mortalité si on détecte et traite la tumeur alors qu'elle n'en est encore qu'à ses premiers stades de développement. On a démontré que des facteurs environnementaux pouvaient augmenter le risque de cancer de la prostate. Quelques recherches ont été effectuées sur les niveaux de cancer de la prostate chez les pompiers, mais peu d'articles ont été publiés à ce sujet. Cette étude vise à trouver une corrélation entre le métier de pompier et le niveau de cancer de la prostate. L'article indique des agents cancérigènes potentiels liés au métier de pompier. Cette étude analyse cinq articles ayant utilisé différentes méthodes d'obtention des cas et des cohortes étudiés, ainsi que diverses méthodes de comparaison. Néanmoins, les articles étudiés ont conclu à une corrélation positive entre le niveau d'exposition des pompiers dans le cadre de leur métier et le niveau de cancer de la prostate. Les produits chimiques suspectés d'être des agents cancérigènes par ces études sont les hydrocarbures aromatiques polycycliques (HAP) et la fumée d'incendie. Cependant, les études ultérieures devront être plus rigoureuses dans le calcul des niveaux de cancer de la prostate, en tenant compte de facteurs liés au style de vie, et d'autres variables confondantes comme le tabac et la durée estimée de l'exposition. Mots-clés :Pompier, exposition professionnelle, néoplasme de la prostate Abstract:Prostate cancer is the most commonly diagnosed cancer among men. Since prostate cancer is a slow developing cancer, mortality can be prevented if the tumour is detected and treated in its early stages. There is proof that environmental exposures can increase the risk of prostate cancer. Many papers have performed data analyses on prostate cancer levels in firefighters. There has been some research on firefighter prostate cancer levels but few reviews on the topic. This paper focuses on finding whether there is a correlation between firefighting occupation and levels of prostate cancer. As well, this paper notes potential carcinogens within the firefighting occupation. Five papers were included in this review; these papers used different methods to obtain the cases and cohorts for the study. The papers also used different controls for comparison. Nevertheless, the papers found in the search supported a positive correlation between exposures in firefighting occupations and the level of prostate cancer. The two chemicals that were suspected carcinogens in these studies were Polyaromatic hydrocarbons (PAH) and fire smoke. However, future research can be more rigorous in calculations of prostate cancer levels by including lifestyle factors, other confounders such as smoking, and estimated length of exposure.

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Diagnosis and Management of Multiple Myeloma

Cowan

Green

Kwok

et al. 2022

JAMA

514

272

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ultiple myeloma is a hematologic malignancy characterized by abnormal clonal plasma cells in the bone marrow, with potential for uncontrolled growth causing destructive osseous bone lesions, acute kidney injury, anemia, and hypercalcemia. The median age at onset of multiple myeloma is 69 years, and approximately 63% of patients diagnosed with multiple myeloma are older than 65 years. 1 In 2021, an estimated 34 290 new diagnoses of multiple myeloma and 12 410 deaths occurred in the US. In 2019, more than 155 688 people were diagnosed with multiple myeloma worldwide. 2 Approximately 100 000 deaths from multiple myeloma occur each year worldwide. 1 This review summarizes current evidence regarding the epidemiology, clinical presentation, diagnosis, and management of multiple myeloma. MethodsA literature search of the PubMed database was performed between January 1, 2000, through October 6, 2021, for Englishlanguage studies of the epidemiology, diagnosis, clinical presentation, and treatment of multiple myeloma. Additional papers were identified from review of the references from identified relevant articles. A total of 111 reports were identified and reviewed. IMPORTANCE Multiple myeloma is a hematologic malignancy characterized by presence of abnormal clonal plasma cells in the bone marrow, with potential for uncontrolled growth causing destructive bone lesions, kidney injury, anemia, and hypercalcemia. Multiple myeloma is diagnosed in an estimated 34 920 people in the US and in approximately 588 161 people worldwide each year. OBSERVATIONS Among patients with multiple myeloma, approximately 73% have anemia, 79% have osteolytic bone disease, and 19% have acute kidney injury at the time of presentation. Evaluation of patients with possible multiple myeloma includes measurement of hemoglobin, serum creatinine, serum calcium, and serum free light chain levels; serum protein electrophoresis with immunofixation; 24-hour urine protein electrophoresis; and full-body skeletal imaging with computed tomography, positron emission tomography, or magnetic resonance imaging. The Revised International Staging System combines data from the serum biomarkers β 2 microglobulin, albumin, and lactate dehydrogenase in conjunction with malignant plasma cell genomic features found on fluorescence in situ hybridization-t(4;14), del(17p), and t(14;16)-to assess estimated progression-free survival and overall survival. At diagnosis, 28% of patients are classified as having Revised International Staging stage I multiple myeloma, and these patients have a median 5-year survival of 82%. Among all patients with multiple myeloma, standard first-line (induction) therapy consists of a combination of an injectable proteasome inhibitor (ie, bortezomib), an oral immunomodulatory agent (ie, lenalidomide), and dexamethasone and is associated with median progression-free survival of 41 months, compared with historical reports of 8.5 months without therapy. This induction therapy combined with autologous hematopoietic stem cell transplantation followed by...

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Cancer Risk Among Firefighters: A Review and Meta-analysis of 32 Studies

Abstract: Our results confirm previous findings of an elevated metarelative risk for multiple myeloma among firefighters. In addition, a probable association with non-Hodgkin lymphoma, prostate, and testicular cancer was demonstrated.

Cited by 314 publications

References 42 publications

Worksite wellness program implementation: a model of translational effectiveness

Worksite wellness program implementation: a model of translational effectiveness

The Risk of Prostate Cancer from Occupational Exposures in Male Firefighters

Diagnosis and Management of Multiple Myeloma

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