Standardised mortality and incidence ratios in firefighters for select outcomes compared to results from a recent meta-analysis
| Underlying cause (ICD-10 codes) | Current study results (US population referent) | Meta-analysis of LeMasters et al14* | ||||||
|---|---|---|---|---|---|---|---|---|
| Mortality (1950–2009)† | Cancer incidence (1985–2009) | |||||||
| All cancers | First cancer | Studies | SRE (95% CI), Likelihood rating | |||||
| Obs | SMR (95% CI) | Obs | SIR (95% CI) | Obs | SIR (95% CI) | |||
| All cancers (C00-C97) | 3285 | 1.14 (1.10 to 1.18) | 4461 | 1.09 (1.06 to 1.12) | 3890 | 1.09 (1.06 to 1.12) | 25 | 1.05 (1.00 to 1.09), 3 |
| MN oesophagus (C15) | 113 | 1.39 (1.14 to 1.67) | 90 | 1.62 (1.31 to 2.00) | 80 | 1.71 (1.36 to 2.13) | 8 | 1.16 (0.86 to 1.57), 3 |
| MN stomach (C16) | 110 | 1.10 (0.91 to 1.33) | 93 | 1.15 (0.93 to 1.40) | 72 | 1.02 (0.80 to 1.28) | 13 | 1.22 (1.04 to 1.44), 2 |
| MN intestine (C17-C18) | 326 | 1.30 (1.16 to 1.44) | 398 | 1.21 (1.09 to 1.33) | 351 | 1.29 (1.16 to 1.43) | NA | NA |
| MN large intestine (C18) | 264 | 1.31 (1.16 to 1.48) | 381 | 1.21 (1.09 to 1.34) | 335 | 1.28 (1.15 to 1.43) | 25 | 1.21 (1.03 to 1.54), 2 |
| MN small intestine (C17) | 8 | 1.66 (0.72 to 3.27) | 17 | 1.15 (0.67 to 1.85) | 16 | 1.43 (0.82 to 2.33) | NA | NA |
| MN rectum (C19-C21) | 89 | 1.45 (1.16 to 1.78) | 166 | 1.11 (0.95 to 1.30) | 140 | 1.09 (0.91 to 1.28) | 13 | 1.29 (1.10 to 1.51), 2 |
| MN lung (C33-C34) | 1046 | 1.10 (1.04 to 1.17) | 716 | 1.12 (1.04 to 1.21) | 602 | 1.13 (1.04 to 1.22) | 19 | 1.03 (0.97 to 1.08), 3 |
| MN breast (C50) | 8 | 1.39 (0.60 to 2.73) | 26 | 1.26 (0.82 to 1.85) | 24 | 1.32 (0.84 to 1.96) | NA | NA |
| MN prostate (C61) | 282 | 1.09 (0.96 to 1.22) | 1261 | 1.03 (0.98 to 1.09) | 1176 | 1.03 (0.97 to 1.09) | 13 | 1.28 (1.15 to 1.43), 1 |
| MN other male genital (C60, C62-C63) | <5 | 0.47 (0.13 to 1.20) | 17 | 0.62 (0.36 to 0.99) | 17 | 0.67 (0.39 to 1.07) | NA | NA |
| MN testes (C62) | <5 | 0.73 (0.15 to 2.14) | 15 | 0.75 (0.42 to 1.24) | 15 | 0.79 (0.44 to 1.30) | 4 | 2.02 (1.30 to 3.13), 2 |
| MN kidney (C64-C66) | 94 | 1.29 (1.05 to 1.58) | 166 | 1.27 (1.09 to 1.48) | 129 | 1.24 (1.04 to 1.48) | 12 | 1.07 (0.78 to 1.46), 3 |
| MN bladder (C67-C68)‡ | 84 | 0.99 (0.79 to 1.22) | 316 | 1.12 (1.00 to 1.25) | 272 | 1.18 (1.05 to 1.33) | 11 | 1.20 (0.97 to 1.48), 3 |
| MN brain (C47, C70-C72) | 73 | 1.01 (0.79 to 1.27) | 51 | 1.02 (0.76 to 1.34) | 48 | 1.06 (0.78 to 1.41) | 19 | 1.32 (1.12 to 1.54), 2 |
| NHL (C46.3, C82-C85, C88.0, C88.3, C91.4, C96)§ | 123 | 1.17 (0.97 to 1.40) | 170 | 0.99 (0.85 to 1.15) | 145 | 0.99 (0.83 to 1.16) | 8 | 1.51 (1.31 to 1.73), 1 |
| Leukaemia (C91.0-C91.3, C91.5-C91.9, C92-C95) | 122 | 1.10 (0.91 to 1.31) | 100 | 0.94 (0.77 to 1.15) | 85 | 0.93 (0.74 to 1.15) | 8 | 1.14 (0.98 to 1.31), 2 |
| Multiple myeloma (C88.7, C88.9, C90) | 42 | 0.89 (0.64 to 1.20) | 36 | 0.72 (0.50 to 0.99) | 33 | 0.75 (0.52 to 1.06) | 10 | 1.53 (1.21 to 1.94), 1 |
| Other cancers:¶ | ||||||||
| Mesothelioma (C45) | 12 | 2.00 (1.03 to 3.49) | 35 | 2.29 (1.60 to 3.19) | 26 | 2.00 (1.31 to 2.93) | NA | NA |
| MN buccal and pharynx (C00-C14) | 94 | 1.40 (1.13 to 1.72) | 174 | 1.39 (1.19 to 1.62) | 148 | 1.41 (1.20 to 1.66) | 9 | 1.23 (0.96 to 1.55), 2 |
*Results from Table 5 of LeMasters et al14; likelihood of cancer risk by meta-analysis criteria: 1=probable, 2=possible, 3=unlikely.
†SMRs restricted to 1960–2009 for MN large intestine, MN small intestine, and MN testes and 2000–2009 for mesothelioma.
‡Urinary bladder incidence included in situ (D09.0) and invasive cases as per SEER protocol.
§NHL incidence data exclude Kaposi sarcoma (C46.3).
¶Sites not listed among cancers of a priori interest but reporting statistically significant excess mortality and cancer incidence.
ICD-10, International Classification of Diseases, 10th Revision; MN, malignancy; NA, not applicable; NHL, non-Hodgkin lymphoma; Obs, observed; SEER, Surveillance, Epidemiology and End Results; SIR, standardised incidence ratio; SMR, standardised mortality ratio; SRE, summary risk estimate.