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Ontario Cancer Facts

Firefighters in Ontario at increased risk of certain cancers

Nov 2022

Highlights

 

  • A study by the Occupational Cancer Research Centre found that Ontario firefighters have an increased risk of developing certain cancers, including testicular cancer, melanoma and prostate cancer, when compared with other workers in Ontario.
  • The International Agency for Research on Cancer has reclassified firefighting as a Group 1 human carcinogen (cancer-causing) with sufficient evidence for mesothelioma and bladder cancer and limited evidence for several other cancer sites.
  • These findings highlight the need for new policies and prevention measures to reduce carcinogen exposure among firefighters, as well as new research to study the risk of emerging hazards such as flame retardants.

 

A recent study released in March 2022 by the Occupational Cancer Research Centre at Ontario Health found that firefighters in Ontario have an overall increased risk of developing any cancer compared with other Ontario workers (any cancer, hazard ratio [HR] = 1.23). A hazard ratio shows how often an event (such as a cancer diagnosis) happens in one group compared with another group. A hazard ratio above 1.00 means the group being studied has a greater risk than the reference group. Ontario firefighters also have an increased risk of developing specific cancers, including the following (see figure):

  • Testicular cancer (HR = 2.56)
  • Melanoma (HR = 2.38)
  • Prostate cancer (HR = 1.43)
  • Colon cancer (HR = 1.39)
  • Non-Hodgkin lymphoma (HR = 1.35)

Although the study showed that firefighters have an increased risk of mesothelioma and bladder cancer, the increase was not statistically significant.

Selected cancer risk among firefighters (n=13,642) compared with all other workers in the Ontario Occupational Disease Surveillance System, 1983 to 2020

Selected Cancer Risk Among Firefighters

Note: Estimates were adjusted for age at start of follow-up, birth year and sex. A hazard ratio (HR) above 1.00 indicates a greater risk of the cancer compared with the reference group (all other workers in the cohort).
Data from the Occupational Disease Surveillance System, 1983 to 2020, reported in Sritharan et al, Occup Environ Med. 2022; 0:1-7.

Selected cancer risk among firefighters (n=13,642) compared with all other workers in the Ontario Occupational Disease Surveillance System, 1983 to 2020
Cancer site Hazard Ratio (HR) 95% LOWER CONFIDENCE LIMIT 95% UPPER CONFIDENCE LIMIT
Any cancer 1.23 1.17 1.29
Bladder 1.15 0.96 1.37
Non-Hodgkin lymphoma 1.35 1.11 1.64
Colon 1.39 1.19 1.63
Prostate 1.43 1.31 1.57
Mesothelioma 1.56 0.86 2.84
Melanoma 2.38 1.99 2.84
Testis 2.56 1.78 3.68

Note: Estimates were adjusted for age at start of follow-up, birth year and sex. A hazard ratio (HR) above 1.00 indicates a greater risk of the cancer compared with the reference group (all other workers in the cohort).
Data from the Occupational Disease Surveillance System, 1983 to 2020, reported in Sritharan et al, Occup Environ Med. 2022; 0:1-7.

The findings from this study align with previous research. In June 2022, the International Agency for Research on Cancer (IARC) classified firefighting as carcinogenic to humans (IARC Group 1), with sufficient evidence for mesothelioma and bladder cancer, and limited evidence for colon cancer, prostate cancer, testicular cancer, melanoma and non-Hodgkin’s lymphoma.

Firefighters are exposed to many known and suspected carcinogens at work.When fighting fires, they may be exposed to polycyclic aromatic hydrocarbons, metals and particulate matter in smoke, and asbestos from older building materials. Firefighters may also be exposed to diesel engine exhaust from fire trucks and may work night shiftwork (a probable cause of cancer, IARC Group 2A).

These findings highlight the need for new policies and prevention measures to reduce carcinogen exposure among firefighters, as well as new research to study the risk of emerging hazards, such as flame retardants. To learn more about cancer risk among Ontario firefighters, as well as other occupations and industries, visit the Occupational Disease Statistics website

If you have comments or questions, please send us an email

References

  1. Sritharan J, Kirkham TL, MacLeod J, Marjerrison N, Lau A, Dakouo M, et al. Cancer risk among firefighters and police in the Ontario workforce. Occup Environ Med. 2022;0:1-7.
  2. Demers PA, DeMarini DM, Fent KW, Glass DC, Hansen J, Adetona O, et al. Carcinogenicity of occupational exposure as a firefighter. Lancet Oncol. 2022;23(8):985-986.
  3. International Agency for Research on Cancer. IARC monographs on the identification of carcinogenic hazards to humans. Volume 132: Occupational exposure as a firefighter (in press). Lyon: International Agency for Research on Cancer; June 7–14, 2022.