Journal
OCCUPATIONAL AND ENVIRONMENTAL MEDICINE
Volume 79, Issue 8, Pages 533-539Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/oemed-2021-108146
Keywords
firefighters; occupational health; public health surveillance; epidemiology
Categories
Funding
- Ontario Ministry of Labour, Training and Skills Development [14-R-029]
- Public Health Agency of Canada [1516-HQ-000066]
- Ontario Ministry of Labour, Training and Skills Development
- Canadian Cancer Society
- Ontario Health agency
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Firefighters and police have higher risks of prostate cancer, colon cancer, and skin melanoma compared to other workers, with firefighters also at higher risk for pancreatic, testicular, and kidney cancer, as well as non-Hodgkin's lymphoma and leukemia. Police have increased risks of thyroid, bladder, and female breast cancer. The findings have important implications for improving preventative measures and reducing potential exposures to carcinogenic hazards in the workplace.
Objective Firefighters and police often work in high-stress, complex environments with known and suspected carcinogenic exposures. We aimed to characterise cancer incidence among firefighters and police. Methods The Occupational Disease Surveillance System (ODSS) was used to identify workers employed as firefighters or police in Ontario. A cohort of workers were identified using lost-time workers' compensation claims data and followed for cancer in the Ontario Cancer Registry (1983-2020). Cox proportional hazard models were used to estimate HRs and 95% CIs for primary site-specific cancer diagnoses adjusted for age at start of follow-up, birth year and sex. Results A total of 13 642 firefighters and 22 595 police were identified in the cohort. Compared with all other workers in the ODSS, firefighters and police had increased risk of prostate cancer (firefighters: HR=1.43, 95% CI 1.31 to 1.57; police: HR=1.47, 95% CI 1.35 to 1.59), colon cancer (firefighters: HR=1.39, 95% CI 1.19 to 1.63; police: HR=1.39, 95% CI 1.21 to 1.60) and skin melanoma (firefighters: HR=2.38, 95% CI 1.99 to 2.84; police: HR=2.27, 95% CI 1.96 to 2.62). Firefighters also had increased risk of cancer of the pancreas, testis and kidney, as well as non-Hodgkin's lymphoma and leukaemia. Police had increased risk of thyroid, bladder and female breast cancer. When compared directly with the police, firefighters had an elevated risk of mesothelioma and testicular cancer. Conclusions Firefighters and police demonstrated some similar as well as some unique cancer risks. Findings from this larger worker population may have important implications for workplace and policy-level changes to improve preventative measures and reduce potential exposures to known carcinogenic hazards.
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