Risk of asthma and chronic obstructive pulmonary disease in a large historical cohort of Danish firefighters

Pedersen, Julie Elbæk; Petersen, Kajsa Ugelvig; Ebbehøj, Niels Erik; Bonde, Jens Peter; Hansen, Johnni

doi:10.1136/oemed-2018-105234

Cited by 17 publications

(21 citation statements)

References 32 publications

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“…Firefighting is a dangerous profession that has the potential for both short-and long-term health consequences, such as cancer and respiratory diseases. [13][14][15][16][17][18][19][20][21][22] Firefighters exposed to the WTC disaster may have substantially greater risks of these and other health conditions. 12,25 population for WTC-exposed firefighters so that health outcomes in WTC disaster-exposed workers can be evaluated, independent of firefighting exposures.…”

Section: Discussionmentioning

confidence: 99%

“…Firefighting has been associated with cancer and other health risks, such as asthma, because of the potential for inhalation and contact exposures to harmful substances. [13][14][15][16][17][18][19][20][21][22] Thus, firefighting exposures outside of work at the WTC site may confound studies of the association between WTC exposure and disease outcomes in WTCexposed firefighters. Conversely, hiring standards for firefighters require that applicants meet stringent health criteria.…”

Section: Introductionmentioning

confidence: 99%

“…One of the largest groups of WTC‐exposed rescue/recovery workers is made up of firefighters from the Fire Department of the City of New York (FDNY). Firefighting has been associated with cancer and other health risks, such as asthma, because of the potential for inhalation and contact exposures to harmful substances 13–22 . Thus, firefighting exposures outside of work at the WTC site may confound studies of the association between WTC exposure and disease outcomes in WTC‐exposed firefighters.…”

Section: Introductionmentioning

confidence: 99%

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Assembling the Career Firefighter Health Study cohort: A methods overview

Zeig‐Owens

Singh

Triplett

et al. 2021

American J Industrial Med

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Background: Studies of World Trade Center (WTC)-exposed rescue/recovery workers report the increased occurrence of health conditions after work at the WTC disaster site. However, the extent to which these associations are due to WTC exposure is unclear, in part due to the lack of suitable comparison groups. Accordingly, we identified a previously assembled National Institute for Occupational Safety and Health (NIOSH) cohort of career firefighters from three US cities (n = 29,992). Here, we document the challenges in establishing this non-WTC-exposed firefighter cohort for the goal of tracking and comparing cancer and chronic health conditions in WTC-exposed and non-WTC-exposed firefighters.Methods: Follow-up process included institutional review board applications, data use agreements, state cancer registry linkages and vital status determination for the NIOSH firefighter cohort. After completion of these steps, we undertook outreach to the three original city fire departments and union officials, before contact tracing and direct recruitment of 14,566 living firefighters to complete a confidential health survey. We staggered recruitment efforts by the city, using letters, postcards, emails, videos, and telephone outreach. Participants who completed the survey received $10.Results: A total of 4962 of 14,566 alive firefighters responded to the baseline survey (34.1% response rate). Respondents were older and more likely to be non-Hispanic white than nonrespondents. Conclusions:We provide an overview of the process for the first survey to collect information on physical and mental health conditions among US firefighters. The data collected will have an important impact on studies of WTC rescue/recovery work, firefighting, and related health conditions.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Assembling the Career Firefighter Health Study cohort: A methods overview

Zeig‐Owens

Singh

Triplett

et al. 2021

American J Industrial Med

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“…The study population constitutes all seafarers with a permanent address in Denmark aged 18-65 years at the baseline of 2002 and 2012. As employees, including seafarers, are normally characterized by being healthier than the general population [21,22], an external occupation reference group, namely people working in agriculture, was used to reduce a potential healthy worker effect. The two cohorts of seafarers and farmers in 2002 and 2012 consisted of 56,216 and 42,000 individuals, respectively.…”

Section: Study and Reference Populationmentioning

confidence: 99%

Hospital contacts due to cardiovascular and respiratory diseases and neoplasms among seafarers compared to farmers: a Danish register-based cohort study

Herttua¹,

Jb²

2019

Preprint

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Background Seafaring has an occupational environment with many health risks. On the other hand, regular medical examinations are mandatory to get permission for working onboard. The present study examined incidence of neoplasms, cardiovascular and respiratory diseases among Danish seafarers compared with farmers, as a relevant land-based trade.Methods The participants were all seafarers or farmers aged 18-65 years at the baseline and residing in Denmark. Two cohorts with baselines in 2002 (n=56,216) and 2012 (n=42,000) were linked to records from Danish health registers. We calculated incident rates and the hazard ratios of hospital contacts using Cox regression models separately for men and women.Results In all disease categories, the risk for hospital contact was higher among male seafarers compared with male farmers. The adjusted hazard ratios for the 2012 cohort for neoplasms, cardiovascular and respiratory diseases were 1.36 (95% CI: 1.17 to 1.58), 1.16 (95% CI: 1.01 to 1.32), and 1.51 (95% CI: 1.28 to 1.78), respectively. Among female seafarers, the hazard ratio for the 2012 cohort for respiratory diseases was 1.58 (95% CI: 1.18 to 2.10), but for cardiovascular diseases 0.73 (95% CI: 0.54 to 0.99). Between the 2002 and 2012 cohort, the incident rates and differences decreased in cardiovascular diseases and increased in neoplasms and respiratory diseases, particularly in men.Conclusions Findings of this register-based cohort study suggest that, regardless of mandatory and regular medical examinations, seafaring is associated with a substantially increased risk of respiratory diseases in both sexes, and neoplasms and cardiovascular diseases among men.

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“…Several studies have shown associations between firefighting and various negative health outcomes, including certain cancers, 1–5 cardiovascular disease, 6 lung disease (ie, asthma), 7 and infertility 8 . As modern firefighters only spend approximately 0.75% to 2.7% of their professional time per year extinguishing fires, 9 it is not obvious how or if firefighting per se affects the risk of these diseases.…”

Section: Introductionmentioning

confidence: 99%

Full employment history of Danish firefighters potentially involving additional exposures, 1964‐2015

Pedersen

Petersen

Hansen

2020

American J Industrial Med

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Background This study aimed to demonstrate the possibility of using data on full employment history to describe occupational patterns of Danish firefighters that may indicate additional hazards encountered by these workers. Methods An established cohort of Danish full‐time and part‐time/volunteer firefighters was used in the study (N = 9952) as well as occupational history covering the period 1964‐2015, which was retrieved from a nationwide pension fund with compulsory membership. The most frequently held employments other than firefighting, together with temporal patterns of these employments, were explored in descriptive analyses. Results Besides working in the firefighter service, both full‐time and part‐time/volunteer firefighters had frequently been employed in the military and the police (55% and 38%) and more than 10% of both types of firefighters in a number of blue‐collar jobs, including construction‐related jobs (eg, masonry, joining, carpentry, insulation, and installation), laundry and dry cleaning, the auto industry, and rubber and plastic production. Part‐time/volunteer firefighters had more frequently been employed in the machine industry, fabricated metal production, the wood and furniture industry, and farming. Both types of firefighters were initially employed in other jobs before their employment in firefighting. Conclusion The cohort of Danish firefighters had frequently been working in other professions potentially exposing them to additional hazardous exposures, and occupational patterns varied by type of firefighter employment. Accounting for full employment history is, for that reason, considered essential when exploring associations between specific professions and health outcomes.

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Risk of asthma and chronic obstructive pulmonary disease in a large historical cohort of Danish firefighters

Cited by 17 publications

References 32 publications

Assembling the Career Firefighter Health Study cohort: A methods overview

Assembling the Career Firefighter Health Study cohort: A methods overview

Hospital contacts due to cardiovascular and respiratory diseases and neoplasms among seafarers compared to farmers: a Danish register-based cohort study

Full employment history of Danish firefighters potentially involving additional exposures, 1964‐2015

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