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Original research
Firefighter occupation is associated with increased risk for laryngeal and hypopharyngeal squamous cell carcinoma among men from the Greater Boston area
  1. Scott M Langevin1,2,
  2. Melissa Eliot3,
  3. Rondi A Butler3,
  4. Michael McClean4,
  5. Karl T Kelsey3,5
  1. 1 Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
  2. 2 University of Cincinnati Cancer Center, Cincinnati, Ohio, USA
  3. 3 Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
  4. 4 Deparment of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA
  5. 5 Department of Pathology & Laboratory Medicine, Brown University Warren Alpert Medical School, Providence, Rhode Island, USA
  1. Correspondence to Dr Scott M Langevin, Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA; langevst{at}


Objective Firefighters are exposed to a wide variety of carcinogens during the line of duty, including several associated with head and neck cancer. Existing studies assessing head and neck cancer risk with firefighting have predominately included occupational cohorts or registry data, which are limited by inability to adjust for smoking and alcohol consumption—major risk factors for head and neck cancer. Our objective was to assess the risk of head and neck cancer among men with an occupational history as a firefighter.

Methods This work was conducted using male subjects from a large population-based case–control study of head and neck cancer from the greater Boston area using self-reported occupational history (718 cases and 905 controls).

Results An occupational history as a firefighter was reported for 11 cases and 14 controls. Although no significant association was observed overall, we observed substantial increased risk for hypopharyngeal and laryngeal squamous cell carcinoma among professional municipal firefighters who had a light or no smoking history (OR=8.06, 95% CI 1.74 to 37.41), with significantly increasing risk per decade as a firefighter (OR=2.10, 95% CI 1.06 to 4.14).

Conclusion Professional municipal firefighters may be at increased risk for hypopharyngeal and laryngeal squamous cell carcinoma due to carcinogenic exposures encountered during the line of duty.

  • epidemiology
  • cancer
  • fire fighters

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  • Contributors The study was conceived by SML and KTK. Epidemiological/occupational data was collected by MM and KTK, and firefighting data were compiled by SML, RAB and ME. Data analysis was performed by SML. The manuscript was drafted by SML; all authors were involved in editing of the manuscript for intellectual content.

  • Funding This work was supported by the National Institutes of Health (NIH)/NID National Institute of Dental and Craniofacial Research (NIDCR) grant 1R21DE027227 to SML; NIH/National Cancer Institute (NCI) grants R01CA121147, R01CA100679 and R01CA078609 to KTK; and American Cancer Society Research Scholar grant 132476-RSG-18-148-01-CCE to SML.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No data are available.