Work Conditions and Practices in Norwegian Fire Departments From 1950 Until Today: A Survey on Factors Potentially Influencing Carcinogen Exposure

Abstract

Background Meta-analyses have shown firefighters to be at an increased risk of several cancer types. Occupational carcinogen exposure may explain these increased risks. This study aims to describe Norwegian fire departments' work conditions from 1950 until today, focusing on factors relevant for potential occupational carcinogen exposure. Methods With the help of a reference group, we developed a questionnaire on topics related to occupational exposure to carcinogens for the period 1950–2018. Selected Norwegian fire departments provided department-specific responses. Results Sixteen departments, providing fire services for 48% of the Norwegian population as of 2019 and mainly consisting of professional firefighters, responded to our questionnaire. The introduction of synthetic firefighting foams, more regular live fire training, the introduction of chemical diving, and a higher number of diesel-driven fire service vehicles were identified as changes thought to increase exposure to occupational carcinogens. Changes thought to decrease exposure included the switch from negative to positive pressure self-contained breathing apparatuses, the use of self-contained breathing apparatuses during all phases of firefighting, the use of ventilating fans during firefighting, increased attention to flammable materials used during live fire training, increased attention to handling and cleaning of turnout gear and other equipment, and installment of exhaust removal systems in apparatus bays. Conclusion Norwegian fire departments' work conditions have seen several changes since 1950, and this could influence firefighters' occupational carcinogen exposure. A peak of carcinogen exposure may have occurred in the 1970s and 1980s before recent changes have reduced exposure.

Cancer incidence in sites potentially related to occupational exposures: 58 years of follow-up of firefighters in the Norwegian Fire Departments Cohort

“…Of those invited, 14 accepted, and 1 additional department self-selected. As of 2019, these 15 participating fire departments provided firefighting services for nearly 50% of the Norwegian population (16), and the geographical distribution of the participating fire departments reflected that of the general population.…”

“…Occupational exposures to carcinogens such as asbestos, diesel exhaust and some PAH, relevant for firefighters, are risk factors for lung and laryngeal cancer (24)(25)(26). Positive-pressure SCBA is the most important protection against inhalation of toxicants for firefighters, and in Norway, positive-pressure SCBA has been increasingly used since the 1980s (16).…”

“…The risk patterns we observed may be an indication that these exposures were greater among firefighters with earlier periods of first employment. Improvements through recent decades in the quality, use, and maintenance of SCBA and personal protective equipment and the installment of local exhaust removal systems in Norwegian fire departments may have contributed to reduced exposures (16), and may correspond to the near-expected incidence observed among firefighters who began working more recently.…”

“…However, systemic exposures have been detected even when SCBA was used, suggesting that exposure to carcinogens via dermal absorption and off-gassing from contaminated equipment can still occur (3,11,14). Further, in Norway, SCBA is not yet widely used through all stages of firefighting (16).…”

Early detection of prostate cancer in firefighters: a register-based study of prognostic factors and survival

“…A lower age at diagnosis was also observed for firefighters and the reference occupations in the pre-PSA era. Though Norwegian national guidelines for health check-ups in firefighters did not exist before 1994, most large fire departments had routines for health check-ups going back to the 1950s (unpublished material gathered for 23 ). Increased diagnostic intensity through regular health check-ups could have been, and can still be, mediated in other ways than through higher rates of PSA-testing.…”