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Workplace
Original research
Cancer risk among firefighters and police in the Ontario workforce
  1. Jeavana Sritharan1,
  2. Tracy L Kirkham1,2,
  3. Jill MacLeod1,
  4. Niki Marjerrison1,3,
  5. Ashley Lau1,
  6. Mamadou Dakouo1,
  7. Chloë Logar-Henderson1,
  8. Tenzin Norzin1,
  9. Nathan L DeBono1,2,
  10. Paul A Demers1,2
  1. 1 Occupational Cancer Research Centre, Ontario Health, Toronto, Ontario, Canada
  2. 2 Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
  3. 3 Department of Research, Cancer Registry of Norway, Oslo, Norway
  1. Correspondence to Dr Jeavana Sritharan, Occupational Cancer Research Centre, Ontario Health, Toronto, Canada; jeavana.sritharan{at}ontariohealth.ca

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.

  • firefighters
  • occupational health
  • public health surveillance
  • epidemiology

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available.

http://creativecommons.org/licenses/by-nc/4.0/

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/.

https://doi.org/10.1136/oemed-2021-108146

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    Data availability statement

    Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available.

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    Footnotes

    • Contributors PAD conceived of the work, provided overall support for the design of this work, and is the guarantor of the overall content. JS conducted data preparation, created the analysis plan and drafted the manuscript and tables. MD and AL assisted with the analyses. JS, TLK, JM, NM, AL, MD, CL-H, TN, NLD and PAD participated in the interpretation of the data, provided critical review of the work and the manuscript, and provided expertise in occupational health.

    • Funding This work was supported by the Ontario Ministry of Labour, Training and Skills Development (14-R-029) and the Public Health Agency of Canada (1516-HQ-000066). The Occupational Cancer Research Centre is supported by the Ontario Ministry of Labour, Training and Skills Development, the Canadian Cancer Society, and the Ontario Health agency.

    • Competing interests None declared.

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