Fire Fighters, Combustion Products, and Urothelial Cancer

Abstract

Urothelial cancer may be induced by different workplace chemicals, including carcinogenic aromatic amines, coke oven fumes, and cigarette smoking. The general impact of combustion products on urothelial cancer risk of exposed persons is still controversial. This raises the question whether fire fighters may have an increased risk for urothelial cancer. The present review compiles the literature on combustion products, possibly relevant for fire fighters, and the available studies on urinary bladder cancer risk in fire fighters. Chemical analyses of smoke from experimental fires as well as from fires in cities, wildlands, and industry do not indicate a generally elevated risk of bladder cancer in fire fighters. This is supported by studies on bladder cancer in fire fighters. Based on mortality studies, studies on exposures, and cancer incidence, we conclude that an elevated risk of urothelial cancer in fire fighters, in general, is not confirmed. Only in professional fire fighters more severely exposed for decades, having started their career some decades before, occupational exposure might be discussed as causative for urothelial cancer.

Validation of RiskCheck Bladder Cancer ©, Version 5.0 for Risk-Adapted Screening of Bladder Cancer

“…The time of smoking cessation reduces the risk score, but never to a nonsmoking level [25]. (3) The occupational risk is justifiable if someone had been working >2 years with ingredients accepted as possible cancer inductive oncogens [26,27,28]. (4) In respect to the medical induced risk pelvic irradiation, cyclophosphamide therapy [29], chronic bladder inflammation [30] and arsenic exposure [31] correlate with duration of disease or exposure, whereas bilharzial exposure [32] alone was defined as risk inducing.…”

Evaluation of a Bladder Cancer Cluster in a Population of Criminal Investigators with the Bureau of Alcohol, Tobacco, Firearms and Explosives—Part 2: The Association of Cancer Risk and Fire Scene Investigation

“…Guidotti and Clough [21] expressed particular concern for exposures during the clean-up phase related to the smoldering of synthetic materials and the release of trapped gasses from porous materials, and this concern applies to fire investigation activities. Several authors offer detailed reviews of the general toxicologic aspects of fire smoke and summaries of findings of fire scene exposure monitoring projects [21–23]. Most recently, the International Agency for Research on Cancer published a monograph on firefighting which focuses on the results of studies measuring exposures to carcinogens found in smoke at fires [24].…”

Evaluation of Pulmonary Function Tests in Working Firemen

“…Smoke exposure may result in acute bronchitis, chronic obstructive pulmonary disease, chronic interstitial pneumonia, pulmonary arterial hypertension, and interstitial lung disease (19)(20)(21). The risk of cardiovascular diseases and cancer increases (1,3). As a result, cardiopulmonary morbidity and mortality increase (22).…”

“…Carbon monoxide, carbon dioxide, particulate matter, nitrogen dioxide, methane, and formaldehyde are shown to be major air pollutants (5-7). Polycyclic aromatic hydrocarbons, acrolein, ozone, acetaldehyde, volatile organic compounds (VOCs) like toluene, benzene, xylene, acetic acid, and phenol are present in fire smoke (2,3,(8)(9)(10). The amount and intensity of toxins may vary depending on the location and duration of the fire.…”

“…Fire smoke contains many air pollutants. The smoke contains high concentrations of toxic gases, aerosols, and particulate matter (1)(2)(3). While large particles accumulate on the upper airways, small particles reach the peripheral airways and alveoli.…”