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Occupational Exposure as a Firefighter

IARC Monographs on the Identification of Carcinogenic Hazards to Humans Volume 132

IARC

2023

ISBN-13

978-92-832-0131-1

ISBN-13

978-92-832-0199-1

Other languages

No other languages


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This volume of the IARC Monographs provides an evaluation of the carcinogenicity of occupational exposure as a firefighter.

Occupational exposure as a firefighter is complex and includes a variety of hazards resulting from fires and non-fire events. Firefighters can have diverse roles, responsibilities, and employment (e.g. full-time, part-time, volunteer) that vary widely across countries and change over their careers. Firefighters respond to various types of fire (e.g. structure, wildland, and vehicle fires) and other events (e.g. vehicle accidents, medical incidents, hazardous material releases, and building collapses). Wildland fires are increasingly encroaching on urban areas. Changes in types of fire, building materials, and personal protective equipment have resulted in significant changes in firefighter exposures over time.

Firefighters may be exposed to combustion products from fires (e.g. polycyclic aromatic hydrocarbons, particulate matter), building materials (e.g. asbestos), chemicals in firefighting foams (e.g. per- and polyfluorinated substances), flame retardants, diesel exhaust, as well as other hazards (e.g. night shift work and ultraviolet or other radiation).

An IARC Monographs Working Group reviewed evidence from cancer studies and mechanistic studies in humans to assess the carcinogenic hazard to humans of occupational exposure as a firefighter and concluded that:

Occupational exposure as a firefighter is carcinogenic to humans (Group 1).

Annex 1. Supplementary material for Section 1, Exposure Characterization 

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Table S1.2 Number of firefighters, by employment status, in 57 countries

Table S1.11 Biomonitoring methods for chemical and physical agents excluding fire smoke components

Table S1.12 Levels of carbon monoxide, polycyclic aromatic hydrocarbons, particulate matter, and volatile and semi-volatile organic compounds measured at structure fires

Table S1.13 Levels of carbon monoxide, polycyclic aromatic hydrocarbons, particulate matter, and volatile and semi-volatile organic compounds measured at wildland fires

Table S1.14 Levels of carbon monoxide, polycyclic aromatic hydrocarbons, particulate matter, and volatile and semi-volatile organic compounds measured at vehicle fires

Table S1.15 Levels of carbon monoxide, polycyclic aromatic hydrocarbons, particulate matter, and volatile and semi-volatile organic compounds measured at other fire types

Table S1.22 Measures of compounds other than fire smoke and polycyclic aromatic hydrocarbons in the firefighting setting

Table S1.25 Biomarkers of exposure other than fire smoke and polycyclic aromatic hydrocarbons

The following tables were produced in draft form by the Working Group and were subsequently fact-checked but not edited:

Table S1.28 Exposure assessment review and critique for epidemiological studies on cancer and occupational exposure as a firefighter

Table S1.29 Criteria for rating quality of exposure assessment of epidemiological studies of firefighters

Table S1.30 Exposure assessment review and critique for mechanistic studies on cancer and occupational exposure as a firefighter

Annex 2. Supplementary material for Section 2, Cancer in Humans 

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Table S2.2 Cohort and case–control studies only reporting having ever worked as a firefighter and cancers of the lung and respiratory system, including mesothelioma

Table S2.4 Cohort and case–control studies only reporting having ever worked as a firefighter and cancers of the urogenital system

Table S2.6 Cohort and case–control studies only reporting having ever worked as a firefighter and cancers of lymphatic and haematopoietic tissues

Table S2.8 Cohort and case–control studies only reporting having ever worked as a firefighter and cancers of the skin, thyroid, and brain

Table S2.10 Studies only reporting having ever worked as a firefighter and cancers of the colon and rectum, oesophagus, stomach, and other sites

Table S2.11 Cohort studies reporting occupational characteristics of firefighters and cancer of all sites combined

Table S2.12 Cohort and case–control and cohort studies only reporting having ever worked as a firefighter and cancer of all sites combined

Supplementary material: Annexes 1 and 2