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Meta-Analysis
. 2020 Oct;93(7):839-852.
doi: 10.1007/s00420-020-01539-0. Epub 2020 Apr 18.

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

Swaantje Casjens  1 , Thomas Brüning  2 , Dirk Taeger  2
Affiliations
Meta-Analysis

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

Swaantje Casjens et al. Int Arch Occup Environ Health. 2020 Oct.

Abstract

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.

Keywords: Cancer; Firefighting; Incidence; Mortality; Region-specific differences; Secular trend.

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Conflict of interest statement

Dirk Taeger received speaker honoraria from accident insurance institutions for the industrial and public sectors. All authors declare that they have no conflict of interest.

Figures

Fig. 1
Fig. 1
PRISMA flowchart of literature search for cancer in firefighters
Fig. 2
Fig. 2
Secular trends of standardized incidence ratios of selected cancer types presented with 95% confidence intervals
Fig. 3
Fig. 3
Secular trends of standardized mortality ratios of selected cancer types presented with 95% confidence intervals
See this image and copyright information in PMC

Comment in

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