PT - JOURNAL ARTICLE AU - Lynne Pinkerton AU - Stephen J Bertke AU - James Yiin AU - Matthew Dahm AU - Travis Kubale AU - Thomas Hales AU - Mark Purdue AU - James J Beaumont AU - Robert Daniels TI - Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update AID - 10.1136/oemed-2019-105962 DP - 2020 Feb 01 TA - Occupational and Environmental Medicine PG - 84--93 VI - 77 IP - 2 4099 - http://oem.bmj.com/content/77/2/84.short 4100 - http://oem.bmj.com/content/77/2/84.full SO - Occup Environ Med2020 Feb 01; 77 AB - Objectives To update the mortality experience of a previously studied cohort of 29 992 US urban career firefighters compared with the US general population and examine exposure-response relationships within the cohort.Methods Vital status was updated through 2016 adding 7 years of follow-up. Cohort mortality compared with the US population was evaluated via life table analyses. Full risk-sets, matched on attained age, race, birthdate and fire department were created and analysed using the Cox proportional hazards regression to examine exposure-response associations between select mortality outcomes and exposure surrogates (exposed-days, fire-runs and fire-hours). Models were adjusted for a potential bias from healthy worker survivor effects by including a categorical variable for employment duration.Results Compared with the US population, mortality from all cancers, mesothelioma, non-Hodgkin's lymphoma (NHL) and cancers of the oesophagus, intestine, rectum, lung and kidney were modestly elevated. Positive exposure-response relationships were observed for deaths from lung cancer, leukaemia and chronic obstructive pulmonary disease (COPD).Conclusions This update confirms previous findings of excess mortality from all cancers and several site-specific cancers as well as positive exposure-response relations for lung cancer and leukaemia. New findings include excess NHL mortality compared with the general population and a positive exposure-response relationship for COPD. However, there was no evidence of an association between any quantitative exposure measure and NHL.