Prostate cancer in firefighting and police work: a systematic review and meta-analysis of epidemiologic studies

Sritharan, Jeavana; Pahwa, Manisha; Demers, Paul A.; Harris, Shelley A.; Cole, Donald C.; Parent, Marie‐Élise

doi:10.1186/s12940-017-0336-z

Cited by 32 publications

(57 citation statements)

References 69 publications

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“…In another recent investigation, Sritharan et al reported the pooled risk of 1.17 (1.08 to 1.28; I 2 :72%) and 1.12 (0.92 to 1.36; I 2 : 50%) for incidence and mortality, respectively. 74 We found similar results for prostate cancer, with significantly elevated incidence, and nonsignificantly elevated mortality.…”

Section: And Sritharansupporting

confidence: 76%

“…Totally, four peer-reviewed meta-analyses including Howe and Burch, 73 Youakim,15 LeMasters et al 14 74 have studied the association of firefighting occupation and some selected malignancies. We compared the current study findings with the recent and comprehensive studies conducted by Sritharan et al and LeMasters et al…”

Section: Comparison To Previous Meta-analysesmentioning

confidence: 99%

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Cancer incidence and mortality among firefighters

Jalilian

Ziaei

Weiderpass

et al. 2019

Intl Journal of Cancer

122

133

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Firefighters are exposed to both known and suspected carcinogens. This study aims to systematically review the literature on the association of firefighting occupation and cancer incidence and mortality, overall and for specific cancer sites. A systematic review using PubMed, Embase, and Web of Science was performed up to January 1, 2018. We extracted risk estimates of cancers and calculated summary incidence risk estimates (SIRE), summary mortality risk estimates (SMRE), and their 95% confidence intervals (CI). Publication bias and risk of bias in individual studies were assessed using Begg's and Egger's tests and the Newcastle‐Ottawa scale (NOS), respectively. We included 50 papers in the review and 48 in the meta‐analysis. We found significantly elevated SIREs for cancer of the colon (1.14; CI 1.06 to 1.21), rectum (1.09; CI 1.00 to 1.20), prostate (1.15; CI 1.05 to 1.27), testis (1.34; CI 1.08 to 1.68), bladder (1.12; CI 1.04 to 1.21), thyroid (1.22; CI 1.01 to 1.48), pleura (1.60; CI 1.09 to 2.34), and for malignant melanoma (1.21; CI 1.02 to 1.45). We found significant SMREs of 1.36 (1.18 to 1.57) and 1.42 (1.05 to 1.90) for rectal cancer and Non‐Hodgkin's lymphoma, respectively. Considering the significantly elevated risk of some cancers in this occupational group, we suggest improving preventive measures and securing adequate and relevant medical attention for this group. Further studies with more accurate and in‐depth exposure assessments are indicated.

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Section: And Sritharansupporting

confidence: 76%

Section: Comparison To Previous Meta-analysesmentioning

confidence: 99%

Cancer incidence and mortality among firefighters

Jalilian

Ziaei

Weiderpass

et al. 2019

Intl Journal of Cancer

122

133

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“…Some meta-analyses have examined the extent of cancer risk among firefighters before and did not find higher overall cancer incidence and mortality as expected (International Agency for Research on Cancer (IARC) 2010; Jalilian et al 2019;Sritharan et al 2017;Crawford et al 2017;LeMasters et al 2006;Youakim 2006;Howe and Burch 1990), although a few single studies reported elevated overall cancer risks (Daniels et al 2014;Glass et al 2016;Guidotti 1993;Pukkala et al 2014). However, meta-analyses found that firefighters were at increased risk of developing or dying from malignant melanoma of the skin (Jalilian et al 2019;Howe and Burch 1990), multiple myeloma (LeMasters et al 2006), mesothelioma (Jalilian et al 2019), digestive (Jalilian et al 2019;LeMasters et al 2006), prostate (Jalilian et al 2019;LeMasters et al 2006;Sritharan et al 2017), testicular (Jalilian et al 2019;LeMasters et al 2006), kidney (Youakim 2006), bladder (Jalilian et al 2019), and thyroid cancer (Jalilian et al 2019), as well as non-Hodgkin lymphoma (Jalilian et al 2019;Youakim 2006;LeMasters et al 2006).…”

Section: Introductionmentioning

confidence: 93%

Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences

Casjens

Brüning

Taeger

2020

Int Arch Occup Environ Health

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Purpose The objective of this study was to conduct a systematic review and meta-analysis to evaluate the cancer risks among firefighters in the time course and from different geographical areas. Method A PubMed search was performed to identify cohort studies about cancer risk and firefighting presented with standardized incidence ratios (SIRs) or standardized mortality ratios (SMRs). Using random-effect models, meta-relative risk estimates (mSIRs, mSMRs) and 95% confidence intervals (CI) were assessed. Cohort studies with employment starting before 1950 were classified as "old", studies starting between 1950 and 1970 as "medium", and later studies as "new". Results The general cancer risk of firefighters was similar to the general population, but mSMR decreased over time (new studies: mSMR = 0.81, 95% CI 0.70-0.92). We observed an increase of mSIR for melanoma of the skin and prostate cancer as well as a decrease of mSIR for stomach cancer with later employment onset. For those cancer sites, we did not observe a secular trend of mSMRs. Regional differences between relative cancer risks were particularly observed for bladder cancer. Conclusions Among other things, innovative firefighting techniques and better personal protective equipment have provided a safer and healthier working environment for firefighters over time leading to a reduction of overall cancer incidence and mortality ratios. Increased general preventive medical checkups and possible additional screenings for firefighters might have led to more findings of malignant melanoma of the skin and prostate cancer in the recent past.

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“…In a meta-analysis of 31 studies, Sritharan et al (2017) evaluated the incidence and mortality risk of prostate cancer for firefighters and police officers. The analysis was based on studies published between 1980 and 2017.…”

Section: Comparisons With Policementioning

confidence: 99%

The economics of firefighter injuries in the United States

Butry¹,

Webb²,

Gilbert³

et al. 2019

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This report identifies, summarizes, and evaluates the available data and the literature describing the economic costs associated with non-fatal firefighter injuries, illnesses, health exposures, and occupational disease ('health outcomes') resulting from line-of-duty activities. National firefighter non-fatal health outcome data, published by the National Fire Protection Association (NFPA), U.S. Fire Administration (USFA), and the Bureau of Labor Statistics (BLS), are compared and contrasted in terms of coverage and detail provided. A survey of the economic injury literature is used to estimate the direct and indirect costs of non-fatal health outcomes. A matching procedure is introduced to combine the statistical and economic data to produce an annual estimate of firefighter non-fatal health outcome costs. The conclusion provides a discussion of the current measurement challenges that prevent a complete and thorough accounting of those costs associated with non-fatal firefighter injuries, illnesses, health exposures, and occupational disease. Data gaps exist, largely due to delays between exposure and the onset of symptoms, in capturing the incidence and economic consequences associated with firefighter cancer and other occupational diseases, including post-traumatic stress injuries.

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Prostate cancer in firefighting and police work: a systematic review and meta-analysis of epidemiologic studies

Cited by 32 publications

References 69 publications

Cancer incidence and mortality among firefighters

Cancer incidence and mortality among firefighters

Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences

The economics of firefighter injuries in the United States

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