Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009)

Objectives To examine mortality patterns and cancer incidence in a pooled cohort of 29 993 US career firefighters employed since 1950 and followed through 2009. Methods Mortality and cancer incidence were evaluated by life table methods with the US population referent. Standardised mortality (SMR) a...

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Vydáno v:	Occupational and environmental medicine (London, England) Ročník 71; číslo 6; s. 388 - 397
Hlavní autoři:	Daniels, Robert D, Kubale, Travis L, Yiin, James H, Dahm, Matthew M, Hales, Thomas R, Baris, Dalsu, Zahm, Shelia H, Beaumont, James J, Waters, Kathleen M, Pinkerton, Lynne E
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	London BMJ Publishing Group 01.06.2014 BMJ Publishing Group LTD
Témata:	Adult Aged Asbestos Asbestos - adverse effects Biological and medical sciences Brain research Cancer Cancer incidence Careers Cause of Death Chicago - epidemiology Chronic obstructive pulmonary disease Cohort Studies Death Digestive System Neoplasms - epidemiology Digestive System Neoplasms - etiology Digestive System Neoplasms - mortality Epidemiology Female Fire departments Fire fighting Fire service Fire stations Firefighters Fires Humans Incidence Job titles Life tables Lung Neoplasms - epidemiology Lung Neoplasms - etiology Lung Neoplasms - mortality Male Medical sciences Mesothelioma Mesothelioma - epidemiology Mesothelioma - etiology Mesothelioma - mortality Mesothelioma, Malignant Middle Aged Mortality Mortality patterns Multiple myeloma Multiple tumors. Solid tumors. Tumors in childhood (general aspects) Neoplasms - epidemiology Neoplasms - etiology Occupational Diseases - epidemiology Occupational Diseases - etiology Occupational Diseases - mortality Occupational Exposure - adverse effects Occupational medicine Philadelphia - epidemiology Prostate Public health. Hygiene-occupational medicine Respiratory Tract Neoplasms - epidemiology Respiratory Tract Neoplasms - etiology Respiratory Tract Neoplasms - mortality San Francisco - epidemiology Sensitivity analysis Social security Testes Tumors Urinary bladder White people Workplace California United States North America Illinois America Pennsylvania San Francisco Chicago Philadelphia United States > US San Francisco California Chicago Illinois 2009 Human Cohort study Mortality Firefighter Malignant tumor Occupational exposure Epidemiology Occupational medicine Cancer Incidence Longitudinal studies < Methodology, speciality
ISSN:	1351-0711, 1470-7926, 1470-7926
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Shrnutí:	Objectives To examine mortality patterns and cancer incidence in a pooled cohort of 29 993 US career firefighters employed since 1950 and followed through 2009. Methods Mortality and cancer incidence were evaluated by life table methods with the US population referent. Standardised mortality (SMR) and incidence (SIR) ratios were determined for 92 causes of death and 41 cancer incidence groupings. Analyses focused on 15 outcomes of a priori interest. Sensitivity analyses were conducted to examine the potential for significant bias. Results Person-years at risk totalled 858 938 and 403 152 for mortality and incidence analyses, respectively. All-cause mortality was at expectation (SMR=0.99, 95% CI 0.97 to 1.01, n=12 028). There was excess cancer mortality (SMR=1.14, 95% CI 1.10 to 1.18, n=3285) and incidence (SIR=1.09, 95% CI 1.06 to 1.12, n=4461) comprised mainly of digestive (SMR=1.26, 95% CI 1.18 to 1.34, n=928; SIR=1.17, 95% CI 1.10 to 1.25, n=930) and respiratory (SMR=1.10, 95% CI 1.04 to 1.17, n=1096; SIR=1.16, 95% CI 1.08 to 1.24, n=813) cancers. Consistent with previous reports, modest elevations were observed in several solid cancers; however, evidence of excess lymphatic or haematopoietic cancers was lacking. This study is the first to report excess malignant mesothelioma (SMR=2.00, 95% CI 1.03 to 3.49, n=12; SIR=2.29, 95% CI 1.60 to 3.19, n=35) among US firefighters. Results appeared robust under differing assumptions and analytic techniques. Conclusions Our results provide evidence of a relation between firefighting and cancer. The new finding of excess malignant mesothelioma is noteworthy, given that asbestos exposure is a known hazard of firefighting.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
ISSN:	1351-0711 1470-7926 1470-7926
DOI:	10.1136/oemed-2013-101662