The profession of firefighter is elevated to the highest classification for cancer risk

With advice from a team of scientists including a public health researcher from the University of Miami, the World Health Organization’s Cancer Division has reclassified firefighting as a Group 1 carcinogenic occupation.

There is no doubt that becoming a firefighter is a dangerous job.

But beyond the obvious perils of saving lives, research reveals that the profession also carries other risks. Chief among them: cancer.

It was this discovery that led to the creation of the Sylvester Comprehensive Cancer Center. Fire Fighters Cancer Initiative (FCI) in 2015. Now, the disturbing trend has captured the attention of global health researchers.

Alberto Caban-Martinez, deputy director of the FCI and associate professor of public health sciences at the Miller School of Medicine at the University of Miami, was one of 25 scientists to join a panel from the International Center for Research on Cancer (IARC), the specialist cancer division of the World Health Organization, which recently decided to reclassify firefighting as a carcinogenic line of work. The new IARC designation, Group 1, means that the profession of firefighter is carcinogenic to humans, whereas previous classifications only considered the possibility that firefighters could get cancer.

“It is also another issue of the road which shows that firefighters are exposed to carcinogens and that exercising this profession is carcinogenic,” said Caban-Martinez, an occupational epidemiologist.

Caban-Martinez visits the Florida State Fire College in Ocala. Photo courtesy of Alberto Caban-Martinez.

Recently published in the medical journal The Lancet, the results say this dangerous link exists because as part of their daily work, firefighters come across a range of toxins known to cause cancer. They also concluded that there is sufficient evidence for bladder cancer and mesothelioma among firefighters worldwide, while there is also limited evidence for colon, prostate and testicular cancers, as well as skin cancer (melanoma) and non-Hodgkin’s lymphoma.

Now that the profession is deemed carcinogenic, it could pave the way for more regulations and funding to protect firefighters, as well as those already battling cancer, Caban-Martinez said.

Erin Kobetz, who leads the FCI and is associate director of population science and cancer disparity at Sylvester, said it was a critical step for the global community to recognize the dangers that firefighters face.

“The evidence is overwhelming that firefighting is associated with an increased risk of cancer, and this finding ensures that first responders won’t have to push for disability and other benefits associated with a diagnosis of cancer,” said Kobetz, who also serves as vice president of research and academia. scholarship and professor of public health sciences.

According to a 2013 study According to the National Institute for Occupational Safety and Health, firefighters are 9% more likely to face a cancer diagnosis and 14% more likely than the average person to experience a cancer-related death.

The decision to reclassify came after the scientific team spent months reviewing studies from around the world published since 2010 on cancer and firefighters, Caban-Martinez pointed out. A full IARC monograph explaining their reasoning will be published in 2023.

However, Caban-Martinez noted that the new designation demonstrates the hard work and research of the CFI over the past seven years.

“This work shows the international impact of our research on cancer control and prevention in firefighters,” he said.

The FCI was conceived around 2014, when the Miami-Dade Fire Department brought several years of medical records to Sylvester researchers, demonstrating that too many of their firefighters were falling victim to the disease. Researchers like Kobetz and Caban-Martinez began investigating fire departments in South Florida and quickly learned that cancer in the fire departments was not limited to those who had combed through the rubble. of the September 11 attacks. In 2015, the State of Florida appropriated funds to formalize FCI.

Since then, a team of nearly 30 Sylvester researchers has studied the types of cancers that plague South Florida firefighters. Many have worked to create new training to protect those on the front lines from harmful toxins, encouraging them to wear protective respirators and to clean themselves and their gear after visiting a disaster scene.

The CFI has also created a green bucket response, which includes dish soap, scrub brushes and wipes for firefighters to clean their gear before leaving the scene, and the group has distributed these to more than 4,000 trucks. across the state of Florida. Last year, additional funding from the state and the Salah Foundation enabled the CFI to build a mobile clinic that performs physical exams of firefighters in Miami-Dade County and offers cancer screenings. The CFI hopes to expand the program.

Two years ago, Caban-Martinez, Kobetz and David Lee, chair of the department of public health sciences at the Miller School of Medicine, published a study on the links between cancer and firefighters in Florida. From 1984 to 2014, they learned that male firefighters had a 66% higher risk than the general Florida population of getting testicular cancer, that they had a 55% increased risk of getting skin cancer and a 36% increased risk of contracting prostate cancer. . They were also twice as likely to have thyroid cancer and had a 19% increased risk of developing advanced colon cancer. Additionally, female firefighters – who make up about a tenth of the service – are 2.5 times more likely to suffer from brain tumors and 2.4 times more likely to have thyroid cancer. They are also at an increased risk of melanoma.

“We’re also seeing firefighters getting cancer at an earlier age than the general population and that’s likely because of their occupational exposure to carcinogenic compounds,” Caban-Martinez said.

Among other things, he said he believed the new reclassification would also help researchers further study the various cancers that firefighters endure around the world and hopefully offer new solutions to protect them.

“Because so many other cancers have been identified and listed in this IARC monograph, it will also inspire more research to identify gaps, so that these cancers are further treated,” Caban-Martinez said.

Michael A. Bynum