Cancer incidence and mortality among firefighters
Open accessAbstract
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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Physical and psychological stressors encountered every working shift lead to increased risk for major health conditions such as cardiovascular disease, cancer, and depression in firefighters.
“These physical and psychological stressors encountered every working shift have been shown to lead to increased risk for major health conditions such as cardiovascular disease, cancer, and depression [7,8,9].”
From The Cyclical Battle of Insomnia and Mental Health Impairment in Firefighters: A Narrative Review (2024) · cites this paper as [8]
The Introduction describes firefighters’ occupational exposure to carcinogens, and Implications of our study reports increased risk of some cancers. The cited paper does not establish that stressors encountered every shift cause cardiovascular disease or depression in firefighters, or that the exposures it discusses occur every shift. (LLM, conf=0.88)
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Mandanach, C., Handra, C. M., Rașcu, A., Hohor, S., Gurzu, I. L., Oțelea, M. R., & Raşcu, A. Ş. C. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1667873 · Cited by 5 · see citing works
Jitnarin, N., Poston, W. S. C., Jahnke, S. A., Haddock, C. K., Kelley, H. N., & Severson, H. H. (2021) · PLoS ONE · doi:10.1371/journal.pone.0251128 · Cited by 5 · see citing works
Koslitz, S., Heinrich, B., Käfferlein, H. U., Koch, H. M., Pelzl, T., Pitzke, K., Köster, D., Weiß, T., Harth, V., Brüning, T., et al. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1277812 · Cited by 5 · see citing works
Preliminary analyses of accumulation of carcinogenic contaminants on retired firefighter ensembles
Mitchell, J., Hwang, J., Larson, P. R., Mandal, S., & Agnew, R. J. (2024) · Journal of Occupational and Environmental Hygiene · doi:10.1080/15459624.2023.2296628 · Cited by 5 · see citing works
Wildland Firefighters: A Crucial Weapon for Forest Fire Management. Which Health Risks Do They Face?
Esteves, F., Madureira, J., Teixeira, J. P., & Costa, S. (2024) · Springer eBooks · doi:10.1007/978-3-031-50446-4_9 · Cited by 5 · see citing works
Assessing the Impact of Pre-Soaking to Enhance Laundering Efficacy of Firefighter Turnout Gear
Hossain, M. T., & Ormond, R. B. (2024) · Toxics · doi:10.3390/toxics12080544 · Cited by 5 · see citing works
Examination of Firefighting as an Occupational Exposure Criteria for Lung Cancer Screening
Shah, S. K., Kim, S., Khan, A. A., Krishnan, V., Lally, A., Shah, P., Alex, G. C., Seder, C. W., Liptay, M. J., & Geissen, N. M. (2024) · Lung · doi:10.1007/s00408-024-00736-9 · Cited by 5 · see citing works
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Langevin, S. M., Eliot, M., Butler, R. A., McClean, M. D., & Kelsey, K. T. (2020) · Occupational and Environmental Medicine · doi:10.1136/oemed-2019-106271 · Cited by 5 · see citing works
Cancer Risks among Emergency Medical Services Workers in Ontario, Canada
Sritharan, J., Demers, P. A., Eros, F. R., Berriault, C., Dakouo, M., & Kirkham, T. L. (2023) · Prehospital Emergency Care · doi:10.1080/10903127.2023.2283079 · Cited by 4 · see citing works
Mortality in firefighters: extended follow-up of a Danish cohort, 1970–2021
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Cancer incidence in a cohort of Danish firefighters: An extended long‐term follow‐up 1968–2021
Pedersen, J. E., Petersen, K. U., Andersen, M., Saber, A. T., Vogel, U. B., Ebbehøj, N. E., Jensen, T. K., Wils, R. S., Bonde, J. P., & Hansen, J. (2024) · American Journal of Industrial Medicine · doi:10.1002/ajim.23635 · Cited by 4 · see citing works
Assessing carcinogenic and mutagenic hazards in firefighting: a comprehensive review
Makowski, R., Rogula–Kozłowska, W., & Polańczyk, A. (2025) · Journal of Environmental Science and Health Part C · doi:10.1080/26896583.2025.2530275 · Cited by 4 · see citing works
Strand, L. Å., Rudvin, I., Martinsen, J. I., Fadum, E. A., & Grimsrud, T. K. (2023) · Occupational and Environmental Medicine · doi:10.1136/oemed-2023-108877 · Cited by 4 · see citing works
Meta‐analysis of cancer risks of professional firefighters
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- Authors
- Jalilian, H., Ziaei, M., Weiderpass, E., Rueegg, C. S., Khosravi, Y., & Kjaerheim, K.
- Affiliations
- Hormozgan University of Medical Sciences (IR)
- Bushehr University of Medical Sciences (IR)
- University of Helsinki (FI)
- Oslo University Hospital (NO)
- Alborz University of Medical Sciences (IR)
- Department of Research Cancer Registry of Norway ‐ Institute of Population‐Based Cancer Research Oslo Norway
- Corresponding author
- Khosravi, Yahya
- Venue
- International Journal of Cancer
- Publisher
- Wiley
- Published
- 2019-03
- Volume
- 145
- Issue
- 10
- Pages
- 2639-2646
- ISSN
- 0020-7136 (ISSN-L)
- 1097-0215
- OpenAlex
- W2913794613
- Cited by
- 175
- References
- 102
- Citations by year
- 2026: 11 · 2025: 16 · 2024: 31 · 2023: 32 · 2022: 23 · 2021: 28 · 2020: 28 · 2019: 6
- FWCI
- 5.66
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- Bushehr University of Medical Sciences Repository (Bushehr University of Medical Sciences) (submittedVersion)
- NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
- Funders
- Alborz University of Medical Sciences (1396‐02‐22‐1579)
- Seventh Framework Programme (609020)
- Topics
- Health Sciences › Health Professions › Occupational Therapy › Occupational Health and Performance
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Occupational and environmental lung diseases
- Keywords
- firefighters, occupational cancer, cancer incidence, cancer mortality, occupational exposure, carcinogens, colon cancer, rectal cancer, prostate cancer, testicular cancer, bladder cancer, thyroid cancer, pleural cancer, melanoma, non-Hodgkin lymphoma, cancer risk estimates
- MeSH terms
- Carcinogens, Humans, Neoplasms, Incidence, Survival Analysis, Occupational Exposure, Risk Assessment, Firefighters
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