Non-cancer health risks in firefighters: a systematic review

Abstract

Firefighters are occupationally exposed to hazardous factors which may increase their risk of disease.Non-cancer disease risk in firefighters has not been systematically examined. This systematic review aimed at identifying non-cancer disease risk in firefighters and determining whether a risk difference exists according to job characteristics.We searched the Cochrane Library, Embase, PubMed, and KoreaMed databases using relevant keywords from their inception to April 30, 2021. The Risk of Bias Assessment Tool for Nonrandomized Studies version 2.0 was used to assess the quality of evidence. Because of study heterogeneity, a narrative synthesis was presented. The systematic literature search yielded 2491 studies, of which 66 met the selection and quality criteria.We confirmed that the healthy worker effect is strong in firefighters as compared to the general population. We also displayed a significant increase in the incidence of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder in firefighters compared to other occupational groups. Contradicting results around PTSD and anxiety disorders risks related to rank were reported.Sufficient evidence for increased risk of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder was available. There was a difference in the risk of non-cancer disease depending on job type, years of service, and rank. However, caution should be exercised when interpreting the results because the classification criteria for firefighters' jobs and ranks differ by country.

Associations between Recognition and Behaviors Regarding the Use, Washing and Management of Firefighting Protection Suits and Public Health Awareness of Occupational Exposure Risks among Firefighters

“…For this reason, firefighters work with the potential risk and possibility of contracting job-related diseases, such as cancer, acute and chronic lung diseases and water-borne diseases [31,42]. If firefighters do not wear PPE completely at the scene of a water accident, they may ingest water-borne viruses or bacteria contained in the water, and vomiting, diarrhea or pneumonia may occur depending on the individual [43,44]. Firefighters engaged in fire work increase the risk of developing cancer by being continuously and repeatedly exposed to carcinogenic substances.…”

Current Status of Intervention Studies on Korean Firefighters and Recommendations for Further Research: A Scoping Review

“…Furthermore, the urgency of re ghting tasks to meet the golden hour for re ghting, rescue, and emergency medical activities can lead to circadian rhythm disruption and stress [13]. A systematic review on non-cancerous health risks among re ghters [14] found that re ghters have a higher risk of mental disorders, hearing impairment, myocardial infarction, and ischemic stroke than the general population. The International Agency for Research on Cancer has classi ed re ghting as a Group 1 carcinogen owing to the elevated risk of cancer associated with occupational exposure among re ghters.…”