Lung Cancer Among Firefighters: Smoking-Adjusted Risk Estimates in a Pooled Analysis of Case-Control Studies.
The aim of this study was to explore lung cancer risk among firefighters, with adjustment for smoking.



We used pooled information from the SYNERGY project including 14 case-control studies conducted in Europe, Canada, New Zealand, and China, with lifetime work histories and smoking habits for 14,748 cases of lung cancer and 17,543 controls. We estimated odds ratios by unconditional logistic regression with adjustment for smoking and having ever been employed in a job known to present an excess risk of lung cancer.



There was no increased lung cancer risk overall or by specific cell type among firefighters (n = 190), neither before nor after smoking adjustment. We observed no significant exposure-response relationship in terms of work duration.



We found no evidence of an excess lung cancer risk related to occupational exposure as a firefighter.
The Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (Drs Bigert, Gustavsson); International Agency for Research on Cancer, Lyon, France (Drs Straif, Schüz, Olsson); Institute for Prevention and Occupational Medicine of the German Social Accident Insurance - Institute of the Ruhr-Universität Bochum (IPA), Bochum, Germany (Drs Taeger, Pesch, Kendzia, Brüning); Inserm, Centre for Research in Epidemiology and Population Health (CESP), U1018, Environmental Epidemiology of Cancer Team (Drs Stücker, Guida); Université Paris-Sud, UMRS 1018, F-94807, Villejuif, France (Drs Stücker, Guida); Institut für Epidemiologie I, Deutsches Forschungszentrum für Gesundheit und Umwelt, Neuherberg (Dr Brüske); Institute of Medical Informatics, Biometry and Epidemiology, Ludwig Maximilians University (Dr Wichmann); Helmholtz Center Munich, Institute of Epidemiology I (Dr Wichmann); Institute of Medical Statistics and Epidemiology, Technical University Munich, Munich, Germany (Dr Wichmann); Department of Clinical Sciences and Community Health, Università degli Studi di Milano and IRCCS Ca' Granda Foundation, Milan, Italy (Dr Pesatori); National Cancer Institute, Bethesda, Maryland (Drs Landi, Caporaso); Division of Occupational and Environmental Health, School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China (Drs Tse, Yu); Research Centre of University of Montréal Hospital Centre, University of Montréal, Montréal, Quebec, Canada (Drs Siemiatycki, Lavoué); Cancer Epidemiology Unit, Department of Medical Sciences, University of Turin, Turin, Italy (Drs Richiardi, Mirabelli); Department of Environmental Medicine and Public Health, University of Padua, Padua, Italy (Dr Simonato); Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany (Dr Jöckel); Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany (Drs Ahrens, Pohlabeln); CIBERESP, University of Oviedo, Oviedo, Spain (Dr Tardón); Russian Cancer Research Centre, Moscow, Russia (Dr Zaridze); Roy Castle Lung Cancer Research Programme, Cancer Research Centre, University of Liverpool, Liverpool, UK (Dr Field); Centre for Public Health Research, Massey University, Wellington, New Zealand (Drs 't Mannetje, Pearce); Public Health Ontario, Toronto (Dr McLaughlin); Occupational Cancer Research Centre, Cancer Care Ontario, Ontario, Toronto, Canada (Dr Demers); The Nofer Institute of Occupational Medicine, Lodz (Dr Szeszenia-Dabrowska); The M Sklodowska-Curie Cancer Center and Institute of Oncology, Warsaw, Poland (Dr Lissowska); National Public Health Center, Budapest, Hungary (Dr Rudnai); Regional Authority of Public Health, Banska Bystrica, Slovakia (Dr Fabianova); Institute of Public Health, Bucharest, Romania (Dr Stanescu Dumitru); Institute of Hygiene and Epidemiology, 1st Faculty of Medicine, Charles University, Prague (Dr Bencko); Masaryk Memorial Cancer Institute, Brno, Czech Republic (Dr Foretova); Palacky University, Faculty of Medicine, Olomouc (Dr Janout); Faculty of Medicine, Ostrava University, Ostrava, Czech Republic (Dr Janout); The Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York (Dr Boffetta); Institute for Risk Assessment Sciences, Utrecht, the Netherlands (Drs Peters, Vermeulen, Kromhout); and Occupational Respiratory Epidemiology, School of Population Health, University of Western Australia, Perth, Western Australia, Australia (Dr Peters).
Carolina
C
Bigert
Per
P
Gustavsson
Kurt
K
Straif
Dirk
D
Taeger
Beate
B
Pesch
Benjamin
B
Kendzia
Joachim
J
Schüz
Isabelle
I
Stücker
Florence
F
Guida
Irene
I
Brüske
Heinz-Erich
HE
Wichmann
Angela C
AC
Pesatori
Maria Teresa
MT
Landi
Neil
N
Caporaso
Lap Ah
LA
Tse
Ignatius Tak-Sun
IT
Yu
Jack
J
Siemiatycki
Jérôme
J
Lavoué
Lorenzo
L
Richiardi
Dario
D
Mirabelli
Lorenzo
L
Simonato
Karl-Heinz
KH
Jöckel
Wolfgang
W
Ahrens
Hermann
H
Pohlabeln
Adonina
A
Tardón
David
D
Zaridze
John K
JK
Field
Andrea
A
't Mannetje
Neil
N
Pearce
John
J
McLaughlin
Paul
P
Demers
Neonila
N
Szeszenia-Dabrowska
Jolanta
J
Lissowska
Peter
P
Rudnai
Eleonora
E
Fabianova
Rodica
R
Stanescu Dumitru
Vladimir
V
Bencko
Lenka
L
Foretova
Vladimir
V
Janout
Paolo
P
Boffetta
Susan
S
Peters
Roel
R
Vermeulen
Hans
H
Kromhout
Thomas
T
Brüning
Ann C
AC
Olsson
D002170:Canada; D016022:Case-Control Studies; D002681:China; D005060:Europe; D061388:Firefighters; D006801:Humans; D008175:Lung Neoplasms / Q000453:epidemiology*; D009520:New Zealand; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D016017:Odds Ratio; D012307:Risk Factors; D012907:Smoking