Objectives To investigate mortality and cancer incidence of paid male Australian firefighters and of subgroups of firefighters by era of first employment, duration of employment and number and type of incidents attended.
Methods Participating fire agencies supplied records of individual firefighters including their job histories and incidents attended. The cohort was linked to the Australian National Death Index and Australian Cancer Database. SMRs and SIRs were calculated. Firefighters were grouped into tertiles by duration of employment and by number of incidents attended and relative mortality ratios and relative incidence ratios calculated. Analyses were carried out separately for full-time and part-time male firefighters.
Results Compared to the Australian population, there were significant increases in overall risk of cancer, for all paid firefighters SIR 1.09 (95% CI 1.03 to 1.14), in prostate cancer, full-time firefighters 1.23 (95% CI 1.10 to 1.37), part-time 1.51 (1.28 to 1.77), and melanoma full-time 1.45 (95% CI 1.26 to 1.66), part-time firefighters 1.43 (95% CI 1.15 to 1.76). Kidney cancer was associated with longer service in internal analyses for paid firefighters. Prostate cancer was associated with longer service and increased attendance at fires, particularly structural fires for full-time firefighters.The overall risk of mortality was significantly decreased and almost all major causes of death were significantly reduced for paid firefighters.
Conclusions Male paid firefighters have an increased risk of cancer. They have reduced mortality compared with the general population, which is likely to be a result of a strong healthy worker effect and likely lower smoking rates among firefighters compared with the Australian population.
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Contributors DCG and MRS received funding from the Australasian Fire and Emergency Council for a cancer and mortality study of Australian firefighters which has been completed. They obtained the funding, designed and oversaw the study. SP, ADM and DCG carried out the data cleaning and matching. SVH carried out the statistical analyses. DCG wrote the draft manuscript, which has been seen, edited and approved by the other authors.
Funding The study was funded by a grant from the Australasian Fire and Emergency Service Authorities Council.
Competing interests None declared.
Ethics approval Ethics approval was granted by the human research ethics committees of Monash University, the state and territory cancer registries, the AIHW and the National Coronial Information System.
Provenance and peer review Not commissioned; externally peer reviewed.
Data sharing statement Data sharing will be considered on a case-by-case basis, but will need to be discussed with the funding body. Contact the corresponding author initially.