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      Cancer risk among firefighters and police in the Ontario workforce

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          Abstract

          Objective

          Firefighters and police often work in high-stress, complex environments with known and suspected carcinogenic exposures. We aimed to characterise cancer incidence among firefighters and police.

          Methods

          The Occupational Disease Surveillance System (ODSS) was used to identify workers employed as firefighters or police in Ontario. A cohort of workers were identified using lost-time workers’ compensation claims data and followed for cancer in the Ontario Cancer Registry (1983–2020). Cox proportional hazard models were used to estimate HRs and 95% CIs for primary site-specific cancer diagnoses adjusted for age at start of follow-up, birth year and sex.

          Results

          A total of 13 642 firefighters and 22 595 police were identified in the cohort. Compared with all other workers in the ODSS, firefighters and police had increased risk of prostate cancer (firefighters: HR=1.43, 95% CI 1.31 to 1.57; police: HR=1.47, 95% CI 1.35 to 1.59), colon cancer (firefighters: HR=1.39, 95% CI 1.19 to 1.63; police: HR=1.39, 95% CI 1.21 to 1.60) and skin melanoma (firefighters: HR=2.38, 95% CI 1.99 to 2.84; police: HR=2.27, 95% CI 1.96 to 2.62). Firefighters also had increased risk of cancer of the pancreas, testis and kidney, as well as non-Hodgkin’s lymphoma and leukaemia. Police had increased risk of thyroid, bladder and female breast cancer. When compared directly with the police, firefighters had an elevated risk of mesothelioma and testicular cancer.

          Conclusions

          Firefighters and police demonstrated some similar as well as some unique cancer risks. Findings from this larger worker population may have important implications for workplace and policy-level changes to improve preventative measures and reduce potential exposures to known carcinogenic hazards.

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          Most cited references40

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          Preventable exposures associated with human cancers.

          Information on the causes of cancer at specific sites is important to cancer control planners, cancer researchers, cancer patients, and the general public. The International Agency for Research on Cancer (IARC) Monograph series, which has classified human carcinogens for more than 40 years, recently completed a review to provide up-to-date information on the cancer sites associated with more than 100 carcinogenic agents. Based on IARC's review, we listed the cancer sites associated with each agent and then rearranged this information to list the known and suspected causes of cancer at each site. We also summarized the rationale for classifications that were based on mechanistic data. This information, based on the forthcoming IARC Monographs Volume 100, offers insights into the current state-of-the-science of carcinogen identification. Use of mechanistic data to identify carcinogens is increasing, and epidemiological research is identifying additional carcinogens and cancer sites or confirming carcinogenic potential under conditions of lower exposure. Nevertheless, some common human cancers still have few (or no) identified causal agents.
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            Recommendations on screening for prostate cancer with the prostate-specific antigen test.

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

              To examine mortality patterns and cancer incidence in a pooled cohort of 29 993 US career firefighters employed since 1950 and followed through 2009.
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                Author and article information

                Journal
                Occup Environ Med
                Occup Environ Med
                oemed
                oem
                Occupational and Environmental Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1351-0711
                1470-7926
                August 2022
                30 March 2022
                : 79
                : 8
                : 533-539
                Affiliations
                [1 ] departmentOccupational Cancer Research Centre , Ontario Health , Toronto, Ontario, Canada
                [2 ] departmentDalla Lana School of Public Health , University of Toronto , Toronto, Ontario, Canada
                [3 ] departmentDepartment of Research , Cancer Registry of Norway , Oslo, Norway
                Author notes
                [Correspondence to ] Dr Jeavana Sritharan, Occupational Cancer Research Centre, Ontario Health, Toronto, Canada; jeavana.sritharan@ 123456ontariohealth.ca
                Author information
                http://orcid.org/0000-0001-8228-1632
                Article
                oemed-2021-108146
                10.1136/oemed-2021-108146
                9304109
                35354650
                674cc4aa-cff3-4cbb-92fa-cf367a4abc29
                © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:  http://creativecommons.org/licenses/by-nc/4.0/.

                History
                : 29 November 2021
                : 05 March 2022
                Funding
                Funded by: Ontario Ministry of Labour, Training and Skills Development;
                Award ID: 14-R-029
                Funded by: Public Health Agency of Canada;
                Award ID: 1516-HQ-000066
                Categories
                Workplace
                1506
                Original research
                Custom metadata
                unlocked

                Occupational & Environmental medicine
                firefighters,occupational health,public health surveillance,epidemiology

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