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Cancer Risk Among Firefighters: A Review and Meta-analysis of 32 Studies

LeMasters, Grace K. PhD; Genaidy, Ash M. PhD; Succop, Paul PhD; Deddens, James PhD; Sobeih, Tarek MD, PhD; Barriera-Viruet, Heriberto PhD; Dunning, Kari PhD; Lockey, James MD, MS

Journal of Occupational and Environmental Medicine: November 2006 - Volume 48 - Issue 11 - p 1189-1202
doi: 10.1097/01.jom.0000246229.68697.90
Original Articles

Objective: The objective of this study was to review 32 studies on firefighters and to quantitatively and qualitatively determine the cancer risk using a meta-analysis.

Methods: A comprehensive search of computerized databases and bibliographies from identified articles was performed. Three criteria used to assess the probable, possible, or unlikely risk for 21 cancers included pattern of meta-relative risks, study type, and heterogeneity testing.

Results: The findings indicated that firefighters had a probable cancer risk for multiple myeloma with a summary risk estimate (SRE) of 1.53 and 95% confidence interval (CI) of 1.21–1.94, non-Hodgkin lymphoma (SRE = 1.51, 95% CI = 1.31–1.73), and prostate (SRE = 1.28; 95% CI = 1.15–1.43). Testicular cancer was upgraded to probable because it had the highest summary risk estimate (SRE = 2.02; 95% CI = 1.30–3.13). Eight additional cancers were listed as having a “possible” association with firefighting.

Conclusions: Our results confirm previous findings of an elevated metarelative risk for multiple myeloma among firefighters. In addition, a probable association with non-Hodgkin lymphoma, prostate, and testicular cancer was demonstrated.

From Epidemiology and Biostatistics, University of Cincinnati College of Medicine (Dr LeMasters, Dr Succop), Cincinnati, Ohio; Industrial and Manufacturing Engineering and Epidemiology and Biostatistics, University of Cincinnati College of Engineering and College of Medicine (Dr Genaidy), Cincinnati, Ohio; the Department of Mathematical Sciences, University of Cincinnati College of Arts & Sciences (Dr Deddens), Cincinnati, Ohio; the Department of Industrial Medicine and Occupational Diseases, Cairo University Faculty of Medicine (Dr Sobeih), Cairo, Egypt; the Department of Industrial Engineering, Interamerican University of Puerto Rico (Dr Barriera-Viruet), Bayamon, Puerto Rico; the Department of Rehabilitation Sciences, University of Cincinnati Medical Center (Dr Dunning), Cincinnati, Ohio; and Occupational and Environmental Medicine and Pulmonary Medicine, University of Cincinnati College of Medicine (Dr Lockey), Cincinnati, Ohio.

This study was supported in part by a grant from the Ohio Bureau of Workers Compensation.

Address correspondence to: Grace K. LeMasters, PhD, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267-0056; E-mail:

Expert testimony was provided by Drs Grace LeMasters and James E. Lockey in pending workers compensation claim relating to non-Hodgkin’s lymphoma.

©2006The American College of Occupational and Environmental Medicine