Mortality of urban firefighters in alberta, 1927–1987

Abstract

The mortality experience of firefighters has been an active topic of investigation. Collateral toxicological evidence suggests that certain causes of death are likely to be associated with firefighting: lung cancer, heart disease, and obstructive pulmonary disease. To date there has not been a clear and consistent demonstration of excess risk due to occupational exposure for these outcomes, but certain other cancers, including genitourinary, colon and rectum, and leukemias, lymphomas, and myeloma, appear to be consistently elevated. A major unproven hypothesis is that risk increased following the introduction, in the 1950s of combustible plastic furnishing and building materials known to generate toxic combustion products. Mortality by cause of death was examined for two cohorts totalling 3,328 firefighters active from 1927 to 1987 in Edmonton and Calgary, the two major urban centers in the province of Alberta, Canada, examining associations with cohort (before and after the 1950s) and years of service weighted by exposure opportunity. The study attained 96% follow-up of vital status and over 64,983 person-years of observation, yielding 370 deaths. Mortality from all causes was close to the expected standardized mortality ratio (96; 95% confidence limits (CL) 87, 107) as was that for heart disease (110; 95% CL 92, 131), and neither was statistically significant at the p < 0.05 level (N.S.). Excesses were observed for all malignant neoplasms (127; 95% CL 102, 155, p < 0.05) and for cancer of lung (142; 95% CL 91, 211, N.S.), bladder (315; 95% CL 86, 808, N.S.), kidney and ureter (414; 95% CL 166, 853, p < 0.05), colon and rectum (161; 95% CL 88, 271, N.S.), pancreas (155; 95% CL 50, 362, N.S.) and leukemia, lymphoma, and myeloma (127; 95% CL 61, 233, N.S.); obstructive pulmonary diseases (157; 95% CL 79, 281, N.S.). Fire-related causes showed a marked excess (486; 95% CL 233, 895, p < 0.01), but external causes overall showed a significant deficit (66; 95% CL 49, 87, p < 0.05). The lung cancer excess was confined to Edmonton; there was no consistent association with duration of employment, exposure opportunity, or cohort of entry (before or after the 1950s) except that the highest risk was observed among Edmonton firefighters with over 35 weighted years. The excess of cancers of the urinary tract was observed mostly among firefighters entering service after 1950, appeared to increase with length of service and exposure opportunity, and was observed in both cities. An occupational association with heart disease and chronic pulmonary disease is not supported in this study on this population.(ABSTRACT TRUNCATED AT 400 WORDS)

Mortality in Florida professional firefighters, 1972 to 1999

“…Consistent with the results from other cohort studies [Beaumont et al, 1991;Demers et al, 1992;Guidotti, 1993;Tornling et al, 1994;Baris et al, 2001], we found significant decreases in mortality from infectious, allergic/endocrine, circulatory system, respiratory, digestive, and genitourinary diseases, and from external causes. We did not find an increased mortality from cardiovascular or respiratory disease.…”

“…These measures could have further contributed to the lowered overall mortality as well as mortality for all-site combined cancer and sitespecific cancers in male professional firefighters, and may have contributed to a stronger healthy worker effect. Consistent with the majority of epidemiological studies of bladder cancer in firefighters [Vena and Fiedler, 1987;Guidotti, 1993], we found increased morality from bladder cancer in male firefighters (entire cohort: SMR ¼ 1.79; 95% CI: 0.98-3.00; certified 1972-1976: SMR ¼ 1.95; 95% CI: 1.04-3.33). This increased risk for bladder cancer does not appear to be due to tobacco smoking because other tobaccorelated cancers, such as lung and buccal cavity/pharynx cancer, were not increased.…”

Risk for prostate cancer by occupation and industry: A 24-state death certificate study

“…Excess risk of prostate cancer among firefighters was found in our study, particularly among African American men. Findings from the U.S., Canada, and Sweden also found elevated risks for firefighters, but they were not statistically significant [Guidotti, 1993;Demers et al, 1994;Tornling et al, 1994]. Firefighters are exposed to complex mixtures of toxic gases, fumes, and particles due to the increasing introduction of plastics and other synthetic compounds into building materials and furnishings.…”

Occupational risk factors and prostate cancer in U.S. Blacks and Whites

“…Another study reported a significantly increased risk for prostate cancer among firefighters under the age of 65, although no relation was seen with duration of exposure [Siemiatycki et al, 1987]. In other studies of firefighters [Guidotti et al, 1993;Tornling et al, 1994], risk for prostate cancer was only slightly elevated. Risk for prostate cancer was not previously identified among stationary engineers [Kelsh et al, 1997].…”