Mortality and cancer incidence among female Australian firefighters

Abstract

ObjectivesTo investigate the mortality and cancer incidence of female firefighters, a group where there are limited published findings.MethodsParticipating fire agencies supplied records of individual firefighters including the number and type of incidents attended. The cohort was linked to the Australian National Death Index and Australian Cancer Database. Standardised mortality ratios and standardised cancer incidence ratios were calculated separately for paid and volunteer firefighters. Volunteer firefighters were grouped into tertiles by the duration of service and by a number of incidents attended and relative mortality ratios and relative incidence ratios calculated.ResultsFor volunteer firefighters (n=37 962), the overall risk of mortality and risk from all major causes of death were reduced when compared with the general population whether or not they had ever attended incidents. Volunteer firefighters had a similar cancer incidence when compared with the general population for most major cancer categories. Female volunteer firefighters have usually attended few fires. Of those who had turned out to incidents, only one-third had attended more than 12 fires about half the number for male volunteers. Mortality and cancer incidence for paid female firefighters (n=1682) were similar to the general population but the numbers were small and so power was limited.ConclusionsFemale volunteer firefighters have a cancer incidence similar to the general population but a reduced risk of mortality which is likely to be a result of a ‘healthy volunteer’ effect.Most of the paid female firefighters were relatively recent recruits and it will be important to monitor the health of this group as more women are recruited to front-line firefighting roles.

Cancer in female firefighters: The clinicobiological, psychological, and social perspectives

“…As this study features a set of 256 cases of cancer or preinvasive cancer reported by female firefighters, the question arises as to what types of cancers have been disclosed and how the frequency, biological nature, and clinical characteristics of these cancers compare to those experienced among women in the general public. Similar to other accounts ( 9 , 11 , 12 , 28 ), this study observed a wide variety of different types of cancers. In order of descending frequency, these were comprised of breast, cervical, melanoma, skin, uterine, colorectal, thyroid, and ovarian cancer, among others.…”

“…Cancer mechanism-wise, the skin is the largest organ of the body, is a very metabolically active tissue, and covers a wide surface area. As fire-generated carcinogens penetrate bunker gear and are absorbed into hot, moist skin, this would provide, in contrast to solar-derived ultraviolet exposure, a rationale for the higher melanoma rates consistently reported among firefighters ( 8 , 11 , 12 , 46 ). Fortunately, the melanoma cases in this study did not appear to be more aggressive than those observed in the public.…”

Exposure to wildfire-related PM2.5 and site-specific cancer mortality in Brazil from 2010 to 2016: A retrospective study

“…In line with our results, increased risks of some respiratory system, digestive tract, skin, and male reproductive cancers were reported in firefighters, but some protective associations were also observed, which again may be due to the healthy volunteer effect [49][50][51][52][53][54]. Consistent with previous studies, lung cancer was not observed to have a higher mortality risk associated with wildfire-related PM 2.5 exposure, while statistically significant associations were observed in female and older populations with non-wildfire PM 2.5 in the current study [46][47][48][49][50][51][52][53][54]. However, our previous study conducted in the same population and over a similar study period showed significant associations between all-source PM 2.5 and lung cancer mortality for all subgroups (both sexes and age groups) [55].…”

“…The American Cancer Society (ACS) Cancer Prevention Study II demonstrated that wildland firefighters have an increased risk of lung cancer mortality [45]. Studies from Australia AU : Pleasecheckthattheeditstothesentence}Stu showed possible increased risks of colorectal and prostate cancers in paid male wildfire firefighters, colorectal and kidney cancer in male firefighters, and all malignancies in female wildfire firefighters [46][47][48]. However, no increased cancer mortality risks were observed, which may be due to the "healthy volunteer" effect [46][47][48].…”

“…Studies from Australia AU : Pleasecheckthattheeditstothesentence}Stu showed possible increased risks of colorectal and prostate cancers in paid male wildfire firefighters, colorectal and kidney cancer in male firefighters, and all malignancies in female wildfire firefighters [46][47][48]. However, no increased cancer mortality risks were observed, which may be due to the "healthy volunteer" effect [46][47][48]. No other studies of cancer among wildfire firefighters were identified in the literature.…”