National Firefighter Registry for Cancer

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National Firefighter Registry for Cancer
National Firefighter Registry logo.svg
Program overview
FormedJuly 7, 2018 (2018-07-07)
Parent agencyU.S. National Institute for Occupational Safety and Health
Website https://www.cdc.gov/NFR

The National Firefighter Registry for Cancer (NFR) is a voluntary registry of firefighters in the United States used to evaluate cancer rates and risk factors in the U.S. fire service through collecting relevant occupational, lifestyle, and health information on firefighters. It aims to use these data to reduce cancer in firefighters.

Contents

The NFR was created by the Firefighter Cancer Registry Act of 2018 in response to growing evidence of carcinogenic exposures and increased risk for cancer faced by firefighters. [1] It opened to registration by firefighters in April 2023. [2] [3] [4] The NFR is maintained by the U.S. National Institute for Occupational Safety and Health (NIOSH).

Background

Cancer among firefighters

A firefighter exits a burning building BC2A0522.jpg
A firefighter exits a burning building
Firefighter using a water hose on fire truck to extinguish a portion of a forest fire DON028 Topanup bushfire 1 III-2015.jpg
Firefighter using a water hose on fire truck to extinguish a portion of a forest fire
A firefighter moving through a bush fire WFF firefighter.jpg
A firefighter moving through a bush fire

Cancer risk in the U.S. fire service is a topic of growing concern. Firefighters regularly encounter carcinogenic materials and hazardous contaminants on the fireground. [1] [5] Several studies have documented airborne and/or dermal exposures to carcinogenic compounds during firefighting, as well as contamination on turnout gear and other equipment worn by firefighters. [6] [7] [8] [9] [10]  Some of these compounds have been shown to absorb into firefighters’ bodies. [11] [12] Some firefighters also work with hazardous materials and are trained to control and clean up dangerous materials such as oil spills and chemical accidents. [13] In addition to chemical exposures, night shift work has been classified by IARC as a probable human carcinogen. [14]

Unlike structural firefighters, wildland firefighters typically do not wear respiratory protection, and may inhale particulate and other compounds emitted by the wildfires. [15] A risk assessment conducted using an exposure–response analysis concluded that wildland firefighters could have an increased risk of lung cancer mortality. [16]

Recent studies suggest that exposure on the fireground may increase risk to firefighters of certain types of cancer and other chronic diseases. [17] [18] [19] [20] [21] [22] [23] [24] [25] [26] In addition to epidemiological studies, several mechanistic studies using biomarkers have found evidence of DNA damage, oxidative stress, and epigenetic changes related to firefighters' exposures. [27] [28] [29] [30] [31] [32] [33]

In 2022, IARC completed an evaluation on the carcinogenicity of the occupation of firefighting and reached a consensus classifying it as a known human carcinogen. This classification was based on sufficient evidence for increased risk of mesothelioma and bladder cancer among firefighters. Limited evidence of increasing risk among firefighters was also found for five other cancers: colon, prostate, testicular, melanoma of the skin, and non-Hodgkin lymphoma. [34]

Data sources

While U.S. state cancer registries provide rich data for studying cancer in the U.S., they often do not provide comprehensive information on cancer patients’ work history [35] [36] [37] and workplace practices, making it challenging to use this data source alone for studying cancer in firefighters. It is also important to collect information on personal and lifestyle risk factors (e.g. tobacco and alcohol use, sleep deprivation, diet, and physical activity) in the U.S. fire service to better understand how they may affect the relationship between firefighting and cancer. [38] [39] [40]

Due to the lack of central and comprehensive sources of data, research on cancer rates amongst firefighters has been challenging. Although some evidence suggests the risk for specific cancer types could vary for male, female, and non-white firefighters, [41] [42] [43] [44]  the strength of the evidence related to cancer in demographic subgroups is limited because many previous studies have mainly comprised white male samples of firefighters. Larger samples of female firefighters and minority groups are needed before the conclusions can be drawn about cancer risk across the nation’s diverse fire service. [45] [46] Additionally, the research on cancer for some subspecialty groups of firefighters, such as firefighter trainers, is limited. [47]

Creation and implementation

Firefighter Cancer Registry Act of 2018
Great Seal of the United States (obverse).svg
Long titleAn Act to require the Secretary of Health and Human Services to develop a voluntary registry to collect data on cancer incidence among firefighters
Enacted bythe 115th United States Congress
Citations
Public law Pub. L. Tooltip Public Law (United States)  115–194 (text) (PDF)
Codification
U.S.C. sections created 42 U.S.C.   § 280e-5
Legislative history

The Firefighter Cancer Registry Act of 2018 bill was introduced in the U.S. House of Representatives on February 7, 2017, by Robert Menendez. [48] [49] It required the Centers for Disease Control and Prevention to create a registry designed to collect data on cancer rates among U.S. firefighters. [50] [51] [52] The bill was passed with unanimous and bipartisan approval [53] [54] [55] [56] on July 7, 2018. [57]

The Congressional Budget Office estimated that the bill would cost around 10 million dollars. [57] [58] However, the Republican Policy Committee stated that the cost of the bill would be offset by a reduction in the funding of the CDC. [59] NIOSH, part of the CDC, has been given authority to lead this effort, beginning in fiscal year 2019, with input from the scientific and firefighting communities. [57]

It opened to registration by firefighters in April 2023. [2] As of October 2023, over 48,000 firefighters had enrolled.

Operation

Video made by NIOSH detailing how the National Firefighter Registry works

The proposed approach for the NFR states it will be a voluntary workplace health surveillance system of U.S. firefighters over the age of 18 years. The main goal of the NFR, according to the text of the law, is "to develop and maintain…a voluntary registry of firefighters to collect relevant health and occupational information of such firefighters for purposes of determining cancer incidence." [60] [61] According to the Republican Policy Committee's summary, the NFR aims to provide decision makers with data to help them create new protocols to protect firefighters. [57] It aims to register around 200,000 firefighters across a variety of demographics within 5 years of launch. [60] NIOSH plans to recruit firefighters through various communication channels (e.g., NFR website and newsletter, social media, local/state/national unions, affinity groups, trade journals, conference attendees) or directly from selected rosters of firefighters. [60] [62]

Participation in the NFR is entirely voluntary and is open to all firefighters, including retired ones. Firefighters who register will provide their name, date of birth, and sex; and may also provide information about their lifestyle and exposures. Following the initial enrollment, participants may be given voluntary yearly questionnaires. [62] NIOSH can then use this information to track past and future diagnoses of cancer among NFR participants by matching with data from state cancer registries to understand how firefighters’ work impacts their risk of developing cancer. [60] [62]

Cancer is a nationally notifiable condition, and thus all U.S. states track diagnoses of cancer in a state cancer registry. [63] The NFR plans to also seek additional details about participant’s types of emergency responses attended and exposures by working with fire departments and exposure tracking programs (if applicable), and by administering follow-up questionnaires to registered firefighters. Because cancer has a long latency period – which is the time between exposure to carcinogens and the development of cancer – the NFR will monitor cancer outcomes for decades. [60] [62]

The NFR program receives input and guidance from the NFR Subcommittee, a subcommittee of the NIOSH Board of Scientific Counselors (a Federal Advisory Committee), consisting of 12 rotating subject matter experts in firefighting, epidemiology, medicine, or public health. [64] [65]

Firefighter enrollment

All members can enroll through a web portal. NIOSH states that any information gathered through the program will only be accessible to NIOSH researchers and will be protected with multi-factor authentication and "multiple layers of encryption." [62] Firefighters may access the web portal through the dedicated NFR website (https://www.cdc.gov/niosh/firefighters/registry.html or https://www.cdc.gov/NFR) or by directly accessing the web portal. To complete enrollment in the NFR, participants will need to set up an account, complete an informed consent document, user profile, and enrollment questionnaire. [60] [62]

The user profile will serve to collect basic information from the firefighter that could change over time and hence can be accessed and updated by the user. The enrollment questionnaire will collect information on employment/workplace characteristics, exposure, demographics, lifestyle factors, comorbidities, and other confounders. Most questions are optional. The enrollment process, including the questionnaire, is designed to take 30–45 minutes to complete if all questions are answered. [60] [62] Following enrollment, NIOSH will send NFR participants notifications for periodic voluntary follow-up questionnaires (e.g., one per year) to be filled out through the web portal. [60] [62]

Other sources of information

In addition to roster information, NIOSH plans to request fire incident records dating back to January 1, 2010, or earlier when available, from fire departments for some participants. Fire departments are required to collect some basic information about fire incidents under the National Fire Incident Reporting System (NFIRS) established by the U.S. Fire Administration. (The U.S. Fire Administration is in the process of replacing NFIRS with a new system called the National Emergency Response Information System (NERIS).) Department incident records will provide NIOSH investigators with apparatus and incident-specific information to be used as surrogates of exposure for exposure-response analyses. Specific variables of interest requested from department incident records may include: incident number, fire station, apparatus, incident type (structure fire, car fire, etc.), on scene time, off scene time, job assignments, number of fire runs, and duration at fires. NIOSH will explore the most efficient and least burdensome way of obtaining incident records from participating fire departments. [60] [62]

Related Research Articles

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A carcinogen is any substance, radionuclide, or radiation that promotes carcinogenesis. This may be due to the ability to damage the genome or to the disruption of cellular metabolic processes. Several radioactive substances are considered carcinogens, but their carcinogenic activity is attributed to the radiation, for example gamma rays and alpha particles, which they emit. Common examples of non-radioactive carcinogens are inhaled asbestos, certain dioxins, and tobacco smoke. Although the public generally associates carcinogenicity with synthetic chemicals, it is equally likely to arise from both natural and synthetic substances. Carcinogens are not necessarily immediately toxic; thus, their effect can be insidious.

Coal tar is a thick dark liquid which is a by-product of the production of coke and coal gas from coal. It is a type of creosote. It has both medical and industrial uses. Medicinally it is a topical medication applied to skin to treat psoriasis and seborrheic dermatitis (dandruff). It may be used in combination with ultraviolet light therapy. Industrially it is a railroad tie preservative and used in the surfacing of roads. Coal tar was listed as a known human carcinogen in the first Report on Carcinogens from the U.S. Federal Government, issued in 1980.

<span class="mw-page-title-main">Isocyanate</span> Chemical group (–N=C=O)

In organic chemistry, isocyanate is the functional group with the formula R−N=C=O. Organic compounds that contain an isocyanate group are referred to as isocyanates. An organic compound with two isocyanate groups is known as a diisocyanate. Diisocyanates are manufactured for the production of polyurethanes, a class of polymers.

Acrylamide (or acrylic amide) is an organic compound with the chemical formula CH2=CHC(O)NH2. It is a white odorless solid, soluble in water and several organic solvents. From the chemistry perspective, acrylamide is a vinyl-substituted primary amide (CONH2). It is produced industrially mainly as a precursor to polyacrylamides, which find many uses as water-soluble thickeners and flocculation agents.

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<span class="mw-page-title-main">Trichloroethylene</span> Chemical compound

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<span class="mw-page-title-main">1,4-Dioxane</span> Chemical compound

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Occupational lung diseases comprise a broad group of diseases, including occupational asthma, industrial bronchitis, chronic obstructive pulmonary disease (COPD), bronchiolitis obliterans, inhalation injury, interstitial lung diseases, infections, lung cancer and mesothelioma. These can be caused directly or due to immunological response to an exposure to a variety of dusts, chemicals, proteins or organisms. Occupational cases of interstitial lung disease may be misdiagnosed as COPD, idiopathic pulmonary fibrosis, or a myriad of other diseases; leading to a delay in identification of the causative agent.

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References

  1. 1 2 Marques, M Matilde; Berrington de Gonzalez, Amy; Beland, Frederick A.; Browne, Patience; Demers, Paul A; Lachenmeier, Dirk W; Bahadori, Tina; Barupal, Dinesh K.; Belpoggi, Fiorella; Comba, Pietro; Dai, Min (June 2019). "Advisory Group recommendations on priorities for the IARC Monographs". The Lancet Oncology. 20 (6): 763–764. doi:10.1016/S1470-2045(19)30246-3. PMID   31005580. S2CID   128350881.
  2. 1 2 Saurman, Alex (April 20, 2023). "NIOSH's National Firefighter Registry Established to Learn More About Firefighting and Cancer, Increase Health of These First Responders". Occupational Health & Safety. Retrieved September 22, 2023.
  3. ↑ Petrus, Carli (April 18, 2023). "National Firefighter Registry for Cancer could benefit local departments". WTVG. Retrieved September 22, 2023.
  4. ↑ Woodhouse, Murphy (May 12, 2023). "Wildland firefighters strongly encouraged to enroll in new national registry for cancer". Boise State Public Radio. Retrieved September 22, 2023.
  5. ↑ IARC Working Group on the Evaluation of Carcinogenic Risks to Humans (2010). "Painting, firefighting, and shiftwork". IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. 98: 9–764. ISSN   1017-1606. PMC   4781497 . PMID   21381544.
  6. ↑ J. JANKOVIC, W. JONES, J. BURKHART, G. NOONAN (1991). "Environmental study of firefighters". Annals of Occupational Hygiene. 35 (6): 581–602. doi:10.1093/annhyg/35.6.581. PMID   1768008.{{cite journal}}: CS1 maint: multiple names: authors list (link)
  7. ↑ Bolstad-Johnson, Dawn M.; Burgess, Jefferey L.; Crutchfield, Clifton D.; Storment, Steve; Gerkin, Richard; Wilson, Jeffrey R. (September 2000). "Characterization of Firefighter Exposures During Fire Overhaul". AIHAJ - American Industrial Hygiene Association. 61 (5): 636–641. doi:10.1080/15298660008984572. ISSN   1529-8663. PMID   11071414.
  8. ↑ Austin, C. C.; Wang, D.; Ecobichon, D. J.; Dussault, G. (July 15, 2001). "Characterization of Volatile Organic Compounds in Smoke at Municipal Structural Fires". Journal of Toxicology and Environmental Health, Part A. 63 (6): 437–458. doi:10.1080/152873901300343470. ISSN   1528-7394. PMID   11482799. S2CID   36263955.
  9. ↑ Fent, Kenneth W.; Alexander, Barbara; Roberts, Jennifer; Robertson, Shirley; Toennis, Christine; Sammons, Deborah; Bertke, Stephen; Kerber, Steve; Smith, Denise; Horn, Gavin (October 3, 2017). "Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures". Journal of Occupational and Environmental Hygiene. 14 (10): 801–814. doi: 10.1080/15459624.2017.1334904 . hdl: 2142/101922 . ISSN   1545-9624. PMID   28636458. S2CID   44916370.
  10. ↑ Mayer, Alexander C.; Fent, Kenneth W.; Bertke, Stephen; Horn, Gavin P.; Smith, Denise L.; Kerber, Steve; La Guardia, Mark J. (February 1, 2019). "Firefighter hood contamination: Efficiency of laundering to remove PAHs and FRs". Journal of Occupational and Environmental Hygiene. 16 (2): 129–140. doi:10.1080/15459624.2018.1540877. ISSN   1545-9624. PMC   8647047 . PMID   30427284.
  11. ↑ Beitel, Shawn C.; Flahr, Leanne M.; Hoppe-Jones, Christiane; Burgess, Jefferey L.; Littau, Sally R.; Gulotta, John; Moore, Paul; Wallentine, Darin; Snyder, Shane A. (February 1, 2020). "Assessment of the toxicity of firefighter exposures using the PAH CALUX bioassay". Environment International. 135: 105207. doi: 10.1016/j.envint.2019.105207 . hdl: 10356/148860 . ISSN   0160-4120. PMID   31812113. S2CID   208870627.
  12. ↑ Fent, Kenneth W.; Toennis, Christine; Sammons, Deborah; Robertson, Shirley; Bertke, Stephen; Calafat, Antonia M.; Pleil, Joachim D.; Wallace, M. Ariel Geer; Kerber, Steve; Smith, Denise; Horn, Gavin P. (March 2020). "Firefighters' absorption of PAHs and VOCs during controlled residential fires by job assignment and fire attack tactic". Journal of Exposure Science & Environmental Epidemiology. 30 (2): 338–349. doi:10.1038/s41370-019-0145-2. ISSN   1559-0631. PMC   7323473 . PMID   31175324.
  13. ↑ Pukkala, Eero; Martinsen, Jan Ivar; Weiderpass, Elisabete; Kjaerheim, Kristina; Lynge, Elsebeth; Tryggvadottir, Laufey; Sparén, Pär; Demers, Paul A (June 2014). "Cancer incidence among firefighters: 45 years of follow-up in five Nordic countries". Occupational and Environmental Medicine. 71 (6): 398–404. doi:10.1136/oemed-2013-101803. ISSN   1351-0711. PMID   24510539. S2CID   24392558.
  14. ↑ "IARC Monographs Volume 124: Night Shift Work – IARC". www.iarc.who.int. Retrieved September 1, 2022.
  15. ↑ "Firefighters : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics". www.bls.gov. Retrieved February 1, 2022.
  16. ↑ Navarro, Kathleen M.; Kleinman, Michael T.; Mackay, Chris E.; Reinhardt, Timothy E.; Balmes, John R.; Broyles, George A.; Ottmar, Roger D.; Naher, Luke P.; Domitrovich, Joseph W. (June 2019). "Wildland firefighter smoke exposure and risk of lung cancer and cardiovascular disease mortality". Environmental Research. 173: 462–468. Bibcode:2019ER....173..462N. doi:10.1016/j.envres.2019.03.060. PMID   30981117. S2CID   108987257.
  17. ↑ Daniels, Robert D; Kubale, Travis L; Yiin, James H; Dahm, Matthew M; Hales, Thomas R; Baris, Dalsu; Zahm, Shelia H; Beaumont, James J; Waters, Kathleen M; Pinkerton, Lynne E (June 2014). "Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009)". Occupational and Environmental Medicine. 71 (6): 388–397. doi:10.1136/oemed-2013-101662. ISSN   1351-0711. PMC   4499779 . PMID   24142974.
  18. ↑ LeMasters, Grace K.; Genaidy, Ash M.; Succop, Paul; Deddens, James; Sobeih, Tarek; Barriera-Viruet, Heriberto; Dunning, Kari; Lockey, James (November 2006). "Cancer Risk Among Firefighters: A Review and Meta-analysis of 32 Studies". Journal of Occupational and Environmental Medicine. 48 (11): 1189–1202. doi:10.1097/01.jom.0000246229.68697.90. ISSN   1076-2752. PMID   17099456. S2CID   1659335.
  19. ↑ Painting, Firefighting, and Shiftwork. International Agency for Research on Cancer. 2010. ISBN   9789283215981. OCLC   1066415095.{{cite book}}: CS1 maint: others (link)
  20. ↑ Laroche, Elena; L’Espérance, Sylvain (March 3, 2021). "Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews". International Journal of Environmental Research and Public Health. 18 (5): 2519. doi: 10.3390/ijerph18052519 . ISSN   1660-4601. PMC   7967542 . PMID   33802629.
  21. ↑ Hwang, Jooyeon; Xu, Chao; Agnew, Robert J.; Clifton, Shari; Malone, Tara R. (January 2021). "Health Risks of Structural Firefighters from Exposure to Polycyclic Aromatic Hydrocarbons: A Systematic Review and Meta-Analysis". International Journal of Environmental Research and Public Health. 18 (8): 4209. doi: 10.3390/ijerph18084209 . PMC   8071552 . PMID   33921138.
  22. ↑ Jalilian, Hamed; Ziaei, Mansour; Weiderpass, Elisabete; Rueegg, Corina Silvia; Khosravi, Yahya; Kjaerheim, Kristina (November 15, 2019). "Cancer incidence and mortality among firefighters". International Journal of Cancer. 145 (10): 2639–2646. doi: 10.1002/ijc.32199 . hdl: 10037/17313 . ISSN   0020-7136. PMID   30737784. S2CID   73451966.
  23. ↑ Soteriades, Elpidoforos S; Kim, Jaeyoung; Christophi, Costas A; Kales, Stefanos N (November 1, 2019). "Cancer Incidence and Mortality in Firefighters: A State-of-the-Art Review and Meta-َAnalysis". Asian Pacific Journal of Cancer Prevention. 20 (11): 3221–3231. doi:10.31557/APJCP.2019.20.11.3221. ISSN   2476-762X. PMC   7063017 . PMID   31759344.
  24. ↑ Casjens, Swaantje; Brüning, Thomas; Taeger, Dirk (October 2020). "Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences". International Archives of Occupational and Environmental Health. 93 (7): 839–852. doi:10.1007/s00420-020-01539-0. ISSN   0340-0131. PMC   7452930 . PMID   32306177.
  25. ↑ Lee, David J.; Koru‐Sengul, Tulay; Hernandez, Monique N.; Caban‐Martinez, Alberto J.; McClure, Laura A.; Mackinnon, Jill A.; Kobetz, Erin N. (April 2020). "Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981‐2014)". American Journal of Industrial Medicine. 63 (4): 285–299. doi:10.1002/ajim.23086. ISSN   0271-3586. PMID   31930542. S2CID   210191181.
  26. ↑ Pinkerton, Lynne; Bertke, Stephen J; Yiin, James; Dahm, Matthew; Kubale, Travis; Hales, Thomas; Purdue, Mark; Beaumont, James J; Daniels, Robert (February 2020). "Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update". Occupational and Environmental Medicine. 77 (2): 84–93. doi: 10.1136/oemed-2019-105962 . ISSN   1351-0711. PMC   10165610 . PMID   31896615. S2CID   209677270.
  27. ↑ Abreu, Ana; Costa, Carla; Pinho e Silva, Susana; Morais, Simone; do Carmo Pereira, Maria; Fernandes, Adília; Moraes de Andrade, Vanessa; Teixeira, João Paulo; Costa, Solange (August 3, 2017). "Wood smoke exposure of Portuguese wildland firefighters: DNA and oxidative damage evaluation". Journal of Toxicology and Environmental Health, Part A. 80 (13–15): 596–604. doi:10.1080/15287394.2017.1286896. hdl: 10216/111908 . ISSN   1528-7394. PMID   28524757. S2CID   205867973.
  28. ↑ Adetona, Olorunfemi; Simpson, Christopher D; Li, Zheng; Sjodin, Andreas; Calafat, Antonia M; Naeher, Luke P (November 11, 2015). "Hydroxylated polycyclic aromatic hydrocarbons as biomarkers of exposure to wood smoke in wildland firefighters". Journal of Exposure Science & Environmental Epidemiology. 27 (1): 78–83. doi:10.1038/jes.2015.75. ISSN   1559-0631. PMC   5140750 . PMID   26555473.
  29. ↑ Andersen, Maria Helena Guerra; Saber, Anne Thoustrup; Clausen, Per Axel; Pedersen, Julie Elbæk; Løhr, Mille; Kermanizadeh, Ali; Loft, Steffen; Ebbehøj, Niels; Hansen, Åse Marie; Pedersen, Peter Bøgh; Koponen, Ismo Kalevi (February 24, 2018). "Association between polycyclic aromatic hydrocarbon exposure and peripheral blood mononuclear cell DNA damage in human volunteers during fire extinction exercises". Mutagenesis. 33 (1): 105–115. doi: 10.1093/mutage/gex021 . ISSN   0267-8357. PMID   29045708.
  30. ↑ Keir, Jennifer L. A.; Akhtar, Umme S.; Matschke, David M. J.; Kirkham, Tracy L.; Chan, Hing Man; Ayotte, Pierre; White, Paul A.; Blais, Jules M. (November 7, 2017). "Elevated Exposures to Polycyclic Aromatic Hydrocarbons and Other Organic Mutagens in Ottawa Firefighters Participating in Emergency, On-Shift Fire Suppression". Environmental Science & Technology. 51 (21): 12745–12755. Bibcode:2017EnST...5112745K. doi:10.1021/acs.est.7b02850. ISSN   0013-936X. PMID   29043785.
  31. ↑ Hoppe-Jones, C.; Beitel, S.; Burgess, J. L.; Snyder, S.; Flahr, L.; Griffin, S.; Littau, S.; Jeong, K. S.; Zhou, J.; Gulotta, J.; Moore, P. (April 1, 2018). "515 Use of urinary biomarkers and bioassays to evaluate chemical exposure and activation of cancer pathways in firefighters". Occupational and Environmental Medicine. 75 (Suppl 2): A412–A413. doi: 10.1136/oemed-2018-ICOHabstracts.1178 . ISSN   1351-0711. S2CID   80490930.
  32. ↑ Jeong, Kyoung Sook; Zhou, Jin; Griffin, Stephanie C.; Jacobs, Elizabeth T.; Dearmon-Moore, Devi; Zhai, Jing; Littau, Sally R.; Gulotta, John; Moore, Paul; Peate, Wayne F.; Richt, Crystal M. (May 2018). "MicroRNA Changes in Firefighters". Journal of Occupational & Environmental Medicine. 60 (5): 469–474. doi:10.1097/JOM.0000000000001307. ISSN   1076-2752. PMC   5959213 . PMID   29465512.
  33. ↑ Oliveira, M.; Delerue-Matos, C.; Morais, S.; Slezakova, K.; Pereira, M.C.; Fernandes, A.; Costa, S.; Teixeira, J.P. (March 14, 2018), "Levels of urinary biomarkers of exposure and potential genotoxic risks in firefighters", Occupational Safety and Hygiene VI, CRC Press, pp. 267–271, doi:10.1201/9781351008884-47, ISBN   978-1-351-00888-4 , retrieved February 1, 2022
  34. ↑ Demers, Paul A; DeMarini, David M; Fent, Kenneth W; Glass, Deborah C; Hansen, Johnni; Adetona, Olorunfemi; Andersen, Maria HG; Freeman, Laura E Beane; Caban-Martinez, Alberto J; Daniels, Robert D; Driscoll, Timothy R; Goodrich, Jaclyn M; Graber, Judith M; Kirkham, Tracy L; Kjaerheim, Kristina (August 2022). "Carcinogenicity of occupational exposure as a firefighter". The Lancet Oncology. 23 (8): 985–986. doi:10.1016/S1470-2045(22)00390-4.
  35. ↑ Freeman, MaryBeth B.; Pollack, Lori A.; Rees, Judy R.; Johnson, Christopher J.; Rycroft, Randi K.; Rousseau, David L.; Hsieh, Mei-Chin; enhancement of NPCR for comparative effectiveness research team (August 2017). "Capture and coding of industry and occupation measures: Findings from eight National Program of Cancer Registries states". American Journal of Industrial Medicine. 60 (8): 689–695. doi:10.1002/ajim.22739. ISSN   1097-0274. PMC   5769461 . PMID   28692191.
  36. ↑ Silver, Sharon R.; Tsai, Rebecca J.; Morris, Cyllene R.; Boiano, James M.; Ju, Jun; Scocozza, Marilyn S.; Calvert, Geoffrey M. (June 2018). "Codability of industry and occupation information from cancer registry records: Differences by patient demographics, casefinding source, payor, and cancer type". American Journal of Industrial Medicine. 61 (6): 524–532. doi:10.1002/ajim.22840. ISSN   1097-0274. PMID   29574892. S2CID   4308062.
  37. ↑ McClure, Laura A.; Koru-Sengul, Tulay; Hernandez, Monique N.; Mackinnon, Jill A.; Solle, Natasha Schaefer; Caban-Martinez, Alberto J.; Lee, David J.; Kobetz, Erin (April 30, 2019). "Availability and accuracy of occupation in cancer registry data among Florida firefighters". PLOS ONE. 14 (4): e0215867. Bibcode:2019PLoSO..1415867M. doi: 10.1371/journal.pone.0215867 . ISSN   1932-6203. PMC   6490882 . PMID   31039169.
  38. ↑ Daniels, Robert D.; Bertke, Stephen; Dahm, Matthew M.; Yiin, James H.; Kubale, Travis L.; Hales, Thomas R.; Baris, Dalsu; Zahm, Shelia H.; Beaumont, James J.; Waters, Kathleen M.; Pinkerton, Lynne E. (October 2015). "Exposure-response relationships for select cancer and non-cancer health outcomes in a cohort of U.S. firefighters from San Francisco, Chicago and Philadelphia (1950-2009)". Occupational and Environmental Medicine. 72 (10): 699–706. doi:10.1136/oemed-2014-102671. ISSN   1470-7926. PMC   4558385 . PMID   25673342.
  39. ↑ Humans, IARC Working Group on the Evaluation of Carcinogenic Risk to (2012). Personal Habits and Indoor Combustions. [Place of publication not identified]: International Agency for Research on Cancer. ISBN   978-92-832-0137-3. OCLC   1021252135.
  40. ↑ Thun, Michael; Linet, Martha S.; Cerhan, James R.; Haiman, Christopher A.; Schottenfeld, David, eds. (December 21, 2017). Cancer Epidemiology and Prevention. Vol. 1. Oxford University Press. doi:10.1093/oso/9780190238667.001.0001. ISBN   978-0-19-023866-7.
  41. ↑ Daniels, Robert D; Kubale, Travis L; Yiin, James H; Dahm, Matthew M; Hales, Thomas R; Baris, Dalsu; Zahm, Shelia H; Beaumont, James J; Waters, Kathleen M; Pinkerton, Lynne E (June 2014). "Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009)". Occupational and Environmental Medicine. 71 (6): 388–397. doi:10.1136/oemed-2013-101662. ISSN   1351-0711. PMC   4499779 . PMID   24142974.
  42. ↑ Tsai, Rebecca J.; Luckhaupt, Sara E.; Schumacher, Pam; Cress, Rosemary D.; Deapen, Dennis M.; Calvert, Geoffrey M. (May 6, 2015). "Risk of cancer among firefighters in California, 1988-2007". American Journal of Industrial Medicine. 58 (7): 715–729. doi:10.1002/ajim.22466. ISSN   0271-3586. PMC   4527530 . PMID   25943908.
  43. ↑ Lee, David J.; Koru-Sengul, Tulay; Hernandez, Monique N.; Caban-Martinez, Alberto J.; McClure, Laura A.; Mackinnon, Jill A.; Kobetz, Erin N. (April 2020). "Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014)". American Journal of Industrial Medicine. 63 (4): 285–299. doi:10.1002/ajim.23086. ISSN   1097-0274. PMID   31930542. S2CID   210191181.
  44. ↑ Ma, Fangchao; Fleming, Lora E.; Lee, David J.; Trapido, Edward; Gerace, Terence A. (September 2006). "Cancer incidence in Florida professional firefighters, 1981 to 1999". Journal of Occupational and Environmental Medicine. 48 (9): 883–888. doi:10.1097/01.jom.0000235862.12518.04. ISSN   1076-2752. PMID   16966954. S2CID   45179842.
  45. ↑ "Employed persons by detailed occupation, sex, race, and Hispanic or Latino ethnicity". www.bls.gov. Retrieved February 1, 2022.
  46. ↑ "NFPA report - U.S. fire department profile". www.nfpa.org. 2018. Retrieved February 1, 2022.
  47. ↑ Glass, D. C.; Del Monaco, A.; Pircher, S.; Vander Hoorn, S.; Sim, M. R. (October 2016). "Mortality and cancer incidence at a fire training college". Occupational Medicine (Oxford, England). 66 (7): 536–542. doi: 10.1093/occmed/kqw079 . ISSN   1471-8405. PMID   27371948.
  48. ↑ Collins, Chris (July 7, 2018). "H.R.931 - 115th Congress (2017-2018): Firefighter Cancer Registry Act of 2018". www.congress.gov. Archived from the original on September 20, 2022. Retrieved September 30, 2022.
  49. ↑ Menendez, Robert (April 25, 2018). "S.382 - 115th Congress (2017-2018): Firefighter Cancer Registry Act of 2018". www.congress.gov. Archived from the original on September 20, 2022. Retrieved September 30, 2022.
  50. ↑ "Bill would establish firefighter cancer registry". www.safetyandhealthmagazine.com. Retrieved March 17, 2022.
  51. ↑ "US Launches First National Firefighter Cancer Registry". Mesothelioma Center - Vital Services for Cancer Patients & Families. Archived from the original on August 5, 2021. Retrieved September 27, 2022.
  52. ↑ One Hundred Fifteenth Congress of the United States of America (PDF). Archived (PDF) from the original on March 24, 2022.
  53. ↑ Otis, Ginger Adams. "Chuck Schumer wants Congress to create voluntary health registry that tracks firefighters with cancer". nydailynews.com. Archived from the original on March 17, 2022. Retrieved March 17, 2022.
  54. ↑ "Breaking News: House Unanimously Approves Firefighter Cancer Registry Act – Virginia Department of Fire Programs". www.vafire.com. Archived from the original on June 29, 2022. Retrieved September 30, 2022.
  55. ↑ "H.R. 931 Archives". Congressional Fire Services Institute. Archived from the original on November 26, 2020. Retrieved September 30, 2022.
  56. ↑ "Bipartisan Firefighter Cancer Registry Act Signed into Law". U.S. Senator Amy Klobuchar. Archived from the original on September 20, 2022. Retrieved September 30, 2022.
  57. 1 2 3 4 "Firefighter Cancer Registry Act of 2018 (2018 - H.R. 931)". GovTrack.us. Retrieved May 9, 2022.
  58. ↑ "S. 382, Firefighter Cancer Registry Act of 2018 | Congressional Budget Office". www.cbo.gov. June 12, 2018. Archived from the original on May 19, 2022. Retrieved September 30, 2022.
  59. ↑ "H.R. 931, FIREFIGHTER CANCER REGISTRY ACT". RPC. Archived from the original on December 23, 2018.
  60. 1 2 3 4 5 6 7 8 9 Fent, Kenneth W.; Siegel, Miriam; Mayer, Alexander; Wilkinson, Andrea; Raudabaugh, Jill (October 16, 2020). "National Firefighter Registry (NFR) Draft Protocol" (PDF). U.S. National Institute for Occupational Safety and Heath. Retrieved September 14, 2022.
  61. ↑ "National Firefighter Registry". IAFF. Archived from the original on January 11, 2022. Retrieved September 30, 2022.
  62. 1 2 3 4 5 6 7 8 9 "National Firefighter Registry - FAQ". U.S. National Institute for Occupational Safety and Health. September 6, 2022. Retrieved September 15, 2022.
  63. ↑ White, Mary C.; Babcock, Frances; Hayes, Nikki S.; Mariotto, Angela B.; Wong, Faye L.; Kohler, Betsy A.; Weir, Hannah K. (December 15, 2017). "The history and use of cancer registry data by public health cancer control programs in the United States". Cancer. 123 (Suppl 24): 4969–4976. doi:10.1002/cncr.30905. ISSN   1097-0142. PMC   5846186 . PMID   29205307.
  64. ↑ "National Firefighter Registry Subcommittee (NFRS)". U.S. National Institute for Occupational Safety and Health. September 6, 2022. Retrieved September 15, 2022.
  65. ↑ NFFF (June 8, 2021). "National Firefighter Registry Updates". Everyone Goes Home. Archived from the original on September 20, 2021. Retrieved September 30, 2022.
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