Chloracne in firefighters

An epidemiologic study of cancer and other causes of mortality in San Francisco firefighters

To test the hypothesis that firefighter exposures may increase cancer risk, mortality rates were calculated for 3,066 San Francisco Fire Department firefighters employed between 1940 and 1970. Vital status was ascertained through 1982, and observed and expected rates, rate ratios (RR), and 95% confidence intervals (CI) were computed using United States death rates for comparison. The total number deceased (1,186) was less than expected and there were fewer cancer deaths than expected. However, there were significant excess numbers of deaths from esophageal cancer (12 observed, 6 expected), cirrhosis and other liver diseases (59 observed, 26 expected), and accidental falls (21 observed, 11 expected). There were 24 line-of-duty deaths, which were primarily due to vehicular injury, falls, and asphyxiation. Heart disease and respiratory disease deaths occurred significantly less often than expected. It was concluded that the increased risks of death from esophageal cancer and cirrhosis and other liver diseases may have been due to firefighter exposures, alcohol consumption, or interaction between alcohol and exposures. Because this was an older cohort and firefighter exposures have changed due to the increasing use of synthetic materials, it is recommended that the effects of modern-day exposures be further studied.

Mortality of a municipal-worker cohort: IV. Fire fighters

Morbidity and mortality studies of fire fighters have produced varied and inconsistent findings regarding the potential chronic effects of fire fighting including respiratory disease, cardiovascular disease, and cancer. The mortality experience of 1,867 white male fire fighters who were employed for the City of Buffalo a minimum of five years with at least one year as a fire fighter was studied. Vital status was determined for 99% of the cohort, resulting in 470 observed deaths. The fire fighter cohort was characteristic of a healthy worker population. All-cause mortality was close to the expected standardized mortality ratio (SMR) = 95, and significantly lower than expected mortality was seen for all external causes (SMR = 67)--in particular, for suicide (SMR = 21) and respiratory diseases (SMR = 48). Significantly elevated SMRs were found for benign neoplasms (SMR = 417), cancer of the colon (SMR = 183), and cancer of the bladder (SMR = 286). Cause-specific mortality is presented by number of years employed, calendar year of death, year of hire, and latency. Cancer mortality was significantly higher in the long-term fire fighters, and risk of mortality from all malignant neoplasms tended to increase with increasing latency. Patterns in risk of mortality among fire fighters for cancers of the bladder, colon, and brain are intriguing. Additional follow-up of this cohort and initiation of cancer morbidity studies would be helpful in further clarifying the potential long-term effects of fire fighting on cancer risk.