title: French firefighter mortality: analysis over a 30-year period.
abstract: OBJECTIVE
  To explore mortality of French professional male firefighters.
  
  
  METHODS
  Standardized mortality ratios (SMR) were calculated for 10,829 professional male firefighters employed in 1979 and compared with the French male population between 1979-2008. Firefighters were identified from 89 French administrative departments (93% of population).
  
  
  RESULTS
  One thousand six hundred forty two deaths were identified, representing significantly lower all-cause mortality than in the general population (SMR = 0.81; 95%CI: 0.77-0.85). SMR increased with age and was not different from 1 for firefighters >70 years. No significant excess of mortality was observed for any specific cause, but a greater number of deaths than expected were found for various digestive neoplasms (rectum/anus, pancreas, buccal-pharynx, stomach, liver, and larynx).
  
  
  CONCLUSIONS
  We observed lower all and leading-cause mortality likely due to the healthy worker effect in this cohort, with diseases of the respiratory system considerably lower (SMR = 0.57). Non-significant excesses for digestive neoplasms are notable, but should not be over-interpreted at this stage.
authors.affiliation: Université de Bordeaux Segalen, Bordeaux, France; Institut de Santé Publique d'Epidémiologie et de Développement, Université de Bordeaux Segalen, Bordeaux, France; INSERM U897-Epidemiology and Biostatistics, Bordeaux, France.
authors.forename: Brice
authors.initials: B
authors.lastname: Amadeo
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Marchand
authors.forename: Frédéric
authors.initials: F
authors.lastname: Moisan
authors.forename: Stéphane
authors.initials: S
authors.lastname: Donnadieu
authors.forename: Coureau
authors.initials: C
authors.lastname: Gaëlle
authors.forename: Mathoulin-Pélissier
authors.initials: MP
authors.lastname: Simone
authors.forename: Christian
authors.initials: C
authors.lastname: Lembeye
authors.forename: Ellen
authors.initials: E
authors.lastname: Imbernon
authors.forename: Patrick
authors.initials: P
authors.lastname: Brochard
mesh_terms: D000059:Accidents / Q000401:mortality; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality; D002423:Cause of Death; D015331:Cohort Studies; D016208:Databases, Factual; D003644:Death Certificates; D061388:Firefighters / Q000706:statistics & numerical data*; D005390:Fires / Q000517:prevention & control; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality; D013405:Suicide / Q000706:statistics & numerical data; D055815:Young Adult
keywords: France; death certificates; epidemiology; firefighter; mortality; neoplasm