Cancer incidence amongst UK firefighters

Abstract

Firefighters suffer an increased risk of cancer from exposures to chemicals released from fires. Our earlier research has found that fire toxicants not only remain on firefighters’ PPE, but are also tracked back to fire stations. The UK Firefighter Contamination Survey assesses firefighters’ risk of developing cancer due to occupational exposure to fire toxins. Over 4% of surveyed firefighters were found to have a cancer diagnosis, with the age-specific cancer rate up to 323% higher (35–39 year olds) than that of the general population. Firefighters who had served ≥ 15 years were 1.7 times more likely to develop cancer than those who had served less time. Firefighters were at least twice as likely to be diagnosed with cancer if they noticed soot in their nose/throat (odds ratio (OR) = 2.0, 1.1–3.5), or remained in their PPE for more than four hours after attending a fire incident (OR = 2.3, 1.1–5.2). Also associated with an increased likelihood of cancer was: eating while wearing PPE (OR = 1.8, 1.2–2.7); failing to store clean/dirty PPE separately (OR = 1.3, 1.0–1.7); working in a station that smells of fire (OR = 1.3, 1.0–1.8) or not having designated (separated) clean and dirty areas (OR = 1.4, 1.1–1.7); using an on-site washing machine to launder fire hoods (OR = 1.3, 1.0–1.7); feeling that cleaning is not taken seriously at work (OR = 1.5, 1.2–2.0).

Culture and awareness of occupational health risks amongst UK firefighters

“…The majority (62%) of firefighters in the UK Fire and Rescue Service have not received any training on fire contaminants and their health effects. This is particularly concerning given that a lack of training increased the odds ratios for firefighters engaging in a variety of behaviours/practices which not only increase their exposure to harmful contaminants, but also increase their likelihood of developing cancer 11 . These behaviours/practices either expose firefighters directly (e.g.…”

“…As discussed in previous parts of the UK Firefighter Contamination Survey analysis 10,11,19 , the survey may be subject to participation bias.…”

“…In this manuscript, a lack of training on fire contaminants and belief in the BoH were treated as independent variables, and engagement in certain negative contamination behaviours/practices treated as dependent variables. Crude odds ratios were not adjusted for other factors associated with the outcome variables as in other analyses of the UK Firefighter Contamination Survey 11,19 , due to the large variety of outcomes assessed in this manuscript. While it may have been possible to devise a list of plausible risk factors (e.g.…”

Scottish Firefighters Occupational Cancer and Disease Mortality Rates: 2000-2020

“…Over 85% of recently surveyed UK firefighters reported noticing soot in their nose and throat after attending a fire, with those noticing soot in the nose/throat for more than a day being twice as likely to report a cancer diagnosis than those who did not notice soot in their nose/throat after incidents [ 15 ]. Similarly, just over 85% and 56% of recently surveyed firefighters reported eating while wearing PPE or with sooty hands respectively (with those eating while wearing PPE being 1.8 times more likely to report a cancer diagnosis than those who do not engage in this practice [ 15 ]). Occupational exposure to soot has previously been associated with an increased incidence of oesophageal cancers in the UK [ 16 ].…”

“…through standardising decontamination procedures [ 28 ]. However, there is currently no formal preventative cancer or other disease monitoring programme in place for UK firefighters [ 15 ].…”