Firefighters and Cancer: A Review of the Current State of Cancer Incidences and Recent Trends in Risk Perception and Risk Reduction Efforts

Abstract

Objective: This paper provides a review of current knowledge and trends in research on firefighters cancer risks and risk reduction efforts and calls for future research focused on European and international firefighters to understand and reduce occupational cancer risk. Cancer incidence: Firefighters face increased occupational cancer risk. Firefighting has been linked with multiple types of cancer, including bladder, colorectal, brain and central nervous system, non-Hodgkin’s lymphoma, skin melanoma, and prostate and testicular cancer, with several others types of cancer being found at increased rates. Cancer risks: Increased occupational cancer risk is, in part, related to carcinogenic exposures at fire events and improper use and cleaning of personal protective equipment (PPE), with role and years in service increasing risk. Risk Perception: Research on efforts to reduce cancer risk are growing, and include examination of firefighter knowledge, attitudes, norms, and behaviors toward decontamination, screening, and healthy eating. Many firefighters report high perceived susceptibility and severity of cancer risk, and identify fire scene exposures, contaminated gear, diet, sleep disruption, chemical exposure from cleaning products, and barriers to medical care as contributing to increased risk. Risk Reduction: Firefighters have strong desire to reduce cancer risk and report generally favorable attitudes toward decontamination practices and proper gear use, but face barriers to reducing those risks, including lack of knowledge, occupational needs, organizational culture, policy, and lack of resources. Behavioral interventions to reduce cancer risk through decontamination efforts and dietary change have demonstrated positive results, however there is a dearth of research on these efforts, especially with European and international firefighters. Future Directions: Future research should focus on understanding European and international firefighters’ knowledge, attitudes, and behaviors toward cancer risk reduction, the impact of the built environment on cancer risk (station layout, clean cabs), improved efforts at tracking exposures, use of new technology and virtual reality in training to reduce cancer risk, and improved understanding of firefighter cancer risk by medical professionals.