Firefighter Cancer Rates: The Facts from NIOSH Research

Posted on by Robert D. Daniels, PhD, CHP

In 2010, researchers from the National Institute for Occupational Safety and Health (NIOSH), launched a multi-year study to examine whether firefighters have a higher risk of cancer and other causes of death due to job exposures. The study was a joint effort led by researchers at NIOSH in collaboration with researchers at the National Cancer Institute and the University of California at Davis Department of Public Health Sciences, and supported by the U.S Fire Administration. This study was completed in late 2015.

The study included nearly 30,000 career firefighters from Chicago, Philadelphia, and San Francisco who were employed at any time between 1950 and 2009. NIOSH researchers found that, when compared to the number of cancers expected using U.S. population rates, the firefighters in this study had a modest increase in cancer diagnoses (9% increase) and cancer-related deaths (14% increase). More information about the study can be found at the links below.

Understanding the increased risks faced by firefighters can help target prevention efforts. However, recent media reports have confused the issue by over-stating the cancer risk for firefighters.  We hope that providing the data in this blog and the references below will help prevent further misrepresentation of our data.

Additional information on the study can be found at the NIOSH Cancer Study Topics Page  and in a NIOSH Science Blog. Links to the study publications are provided below.

Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950− 2009)

Exposure–response relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009)

Creation of a retrospective job-exposure matrix using surrogate measures of exposure for a cohort of US career firefighters from San Francisco, Chicago and Philadelphia

Robert D. Daniels, PhD, CHP

Dr. Daniels is a Lead Epidemiologist in the NIOSH Education and Information Division.

 

Posted on by Robert D. Daniels, PhD, CHP

12 comments on “Firefighter Cancer Rates: The Facts from NIOSH Research”

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    After I read this article, I got to have knowledge and add my insight, I happened to look for an article like this, it is very helpful for me and the crowd, the writing is good to read and easy to understand.

    It is said that Cancer is milestone of related chronic Diseases. Maybe it is most effect solution that health practitioner can help Firefighter to prevent possible professional career caused chronic diseases like stomach ulcer, lack of sleep, health problems caused by long term stress factors. By this way, may be the risk of cancer and other causes of death due to job exposures can be reduced dramatically?
    Maxwell Chan

    I’m wondering about the accounting of gender in cancer rates here. Males express an average of 207.9 per 100,000 cancer mortality rate and the average population hits 171.2 per 100,000 cancer mortality while women are 145.4 per 100,000 cancer mortality.

    If firefighters show a 14% increase over the general population’s cancer mortality rate (171.2/100,000) then that would be a 24 (23.968) per 100,000 increase, putting them at 195.168 per 100,000 firemen.

    That rate is actually lower than just the average male’s cancer mortality rate but not by much. When considering that just under 4% of firefighters are female, is it possible that they account for the remaining drop and that firefighters actually express cancer mortality rates at numbers similar to males due to the gender skew to male in the profession?

    I mean, of course mesothelioma increased the risk regardless. I’m just wondering if it was controlled for in any of these studies when considering the general population number to compare.

    All analyses using the US population as the referent were stratified by gender, race (Caucasian, other races), age (age 15–85+ years in 5-year categories), and calendar year (in 5-year categories). The standardized mortality ratio (SMR) is essentially the number of deaths observed in the study population (i.e., firefighters in our study) divided by the number of deaths expected in the U.S. population of the same distribution of gender, race, age, and calendar period as our study population. The expected deaths are calculated from the referent rates in the now ‘standardized’ population. An SMR that is greater than 1 is said to indicate “excess deaths” in the study population.

    we must pay more attention to this situation, because they also risk their lives while working. hopefully there is a new policy related to this research.thanks Eisher

    Why are we only tracking mortality? Many firefighters get cancer earlier in life and continue to work but we fail to be tracked- morbidity?

    I have directly asked this question of Johns Hopkins researchers and was told, “that’s a different department.”

    Researcher are missing firefighter cancers that occur earlier because morbidity is not tracked and these firefighters die outside the tracking. As a result, cancer rates are lower and not related to firefighting.

    My father was a 27-year veteran of the Baltimore City Fire Department (BCFD). In 1998, he was diagnosed with stage 4 pancreatic cancer and within 6 months he was dead. I have long believed, as a former oncology R.N., that his fire fighting was a significant cause of his cancer diagnosis and death. Ten years previous to his cancer dx, he also experienced a heart attack and required a CABG, with three arteries involved. He was an active, vibrant man, recovered quite from the CABG, returned to his home projects, vegetable garden and landscaping activities. Even after his retirement from the BCFD, he got another full-time job as a maintenance man at a local hospital, then took classes to qualify as a specialist in the hospital electronic lock system involving computer work. Losing him was a huge loss not only to our family, but to the hospital community and our neighbors and the firefighter community members who knew and loved him.

    Dr. Daniels:

    I’m very interested in the data you collected from each department individually. I would like to see how data from San Francisco FD compares to that of Chicago and Philadelphia, specifically. Would that be possible? Thank you for your work on this matter.

    So if 22% of the US population dies of cancer, does this study suggest that 36% (22% + 14%) of firefighters will die of cancer, or that 25% (22% x 1.14) of them will die of cancer?

    There are many additional factors that should be considered when predicting lifetime risks; therefore, simple approximations based on estimates from a single observational study are generally not recommended. However for illustrative purposes, if one assumes:
    1. The all cancer SMR (i.e., 1.14) is an adequate approximation of the relative risk of cancer death in career firefighters over a lifetime of exposure;
    2. The lifetime risk of ever dying from cancer from any cause is 22%;

    Then a simple approximation of firefighter lifetime risk of cancer death is 1.14 x 22 = 25 percent. The risk that is attributable to firefighting is the risk in firefighters – the background risk = 25-22 = 3 percent. Thus, in a hypothetical population of 100 career firefighters, 25 are estimated to die from cancer, of which 3 deaths were estimated to result from their exposure.

    Of course, more information is needed to make appropriate risk projections for use in risk management decisions. But this example gives the reader some idea on interpreting findings from the study.

    Thank you both so much for answering that last question! It means a lot to me. And thank you for your study. I think I will talk with my chief about implementing soap and water scrubdowns prior to removal of our SCBA gear. You guys REALLY seem to be making a difference for many of us with your research and by helping to spread the results. Thank you.

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Page last reviewed: May 18, 2018
Page last updated: May 18, 2018