Editing Firefighter (section)

====Cancer====
[[File:Sailors participate in a fire drill exercise aboard USS Bainbridge (DDG 96). (40730256683).jpg|thumb|Smoke can expose firefighters to a variety of carcinogens]]
Cancer risk in the U.S. fire service is a topic of growing concern. Recent studies suggest that due to their exposure on the fireground, firefighters may be at an increased risk for certain types of cancer and other chronic diseases.<ref name="Daniels-2014">{{Cite journal |last1=Daniels |first1=Robert D. |last2=Kubale |first2=Travis L. |last3=Yiin |first3=James H. |last4=Dahm |first4=Matthew M. |last5=Hales |first5=Thomas R. |last6=Baris |first6=Dalsu |last7=Zahm |first7=Shelia H. |last8=Beaumont |first8=James J. |last9=Waters |first9=Kathleen M. |last10=Pinkerton |first10=Lynne E. |date=June 2014 |title=Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009) |journal=Occupational and Environmental Medicine |language=en |volume=71 |issue=6 |pages=388–397 |doi=10.1136/oemed-2013-101662 |issn=1351-0711 |pmc=4499779 |pmid=24142974}}</ref><ref>{{Cite journal |last1=LeMasters |first1=Grace K. |last2=Genaidy |first2=Ash M. |last3=Succop |first3=Paul |last4=Deddens |first4=James |last5=Sobeih |first5=Tarek |last6=Barriera-Viruet |first6=Heriberto |last7=Dunning |first7=Kari |last8=Lockey |first8=James |date=November 2006 |title=Cancer Risk Among Firefighters: A Review and Meta-analysis of 32 Studies |url=http://journals.lww.com/00043764-200611000-00014 |journal=Journal of Occupational and Environmental Medicine |language=en |volume=48 |issue=11 |pages=1189–1202 |doi=10.1097/01.jom.0000246229.68697.90 |issn=1076-2752 |pmid=17099456 |s2cid=1659335}}</ref><ref>{{Cite book |url=https://www.worldcat.org/oclc/1066415095 |title=Painting, Firefighting, and Shiftwork. |date=2010 |publisher= |others=International Agency for Research on Cancer |isbn=9789283215981 |location= |oclc=1066415095}}</ref><ref>{{Cite journal |last1=Laroche |first1=Elena |last2=L'Espérance |first2=Sylvain |date=March 3, 2021 |title=Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews |journal=International Journal of Environmental Research and Public Health |language=en |volume=18 |issue=5 |pages=2519 |doi=10.3390/ijerph18052519 |issn=1660-4601 |pmc=7967542 |pmid=33802629 |doi-access=free}}</ref><ref>{{Cite journal |last1=Hwang |first1=Jooyeon |last2=Xu |first2=Chao |last3=Agnew |first3=Robert J. |last4=Clifton |first4=Shari |last5=Malone |first5=Tara R. |date=January 2021 |title=Health Risks of Structural Firefighters from Exposure to Polycyclic Aromatic Hydrocarbons: A Systematic Review and Meta-Analysis |journal=International Journal of Environmental Research and Public Health |language=en |volume=18 |issue=8 |pages=4209 |doi=10.3390/ijerph18084209 |pmc=8071552 |pmid=33921138 |doi-access=free}}</ref><ref>{{Cite journal |last1=Jalilian |first1=Hamed |last2=Ziaei |first2=Mansour |last3=Weiderpass |first3=Elisabete |last4=Rueegg |first4=Corina Silvia |last5=Khosravi |first5=Yahya |last6=Kjaerheim |first6=Kristina |date=November 15, 2019 |title=Cancer incidence and mortality among firefighters |journal=International Journal of Cancer |language=en |volume=145 |issue=10 |pages=2639–2646 |doi=10.1002/ijc.32199 |issn=0020-7136 |pmid=30737784 |s2cid=73451966|doi-access=free |hdl=10037/17313 |hdl-access=free }}</ref><ref>{{Cite journal |last1=Soteriades |first1=Elpidoforos S. |last2=Kim |first2=Jaeyoung |last3=Christophi |first3=Costas A. |last4=Kales |first4=Stefanos N. |date=November 1, 2019 |title=Cancer Incidence and Mortality in Firefighters: A State-of-the-Art Review and Meta-َAnalysis |url=http://journal.waocp.org/article_88817.html |journal=Asian Pacific Journal of Cancer Prevention |language=en |volume=20 |issue=11 |pages=3221–3231 |doi=10.31557/APJCP.2019.20.11.3221 |issn=2476-762X |pmc=7063017 |pmid=31759344}}</ref><ref>{{Cite journal |last1=Casjens |first1=Swaantje |last2=Brüning |first2=Thomas |last3=Taeger |first3=Dirk |date=October 2020 |title=Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences |journal=International Archives of Occupational and Environmental Health |language=en |volume=93 |issue=7 |pages=839–852 |doi=10.1007/s00420-020-01539-0 |issn=0340-0131 |pmc=7452930 |pmid=32306177|bibcode=2020IAOEH..93..839C }}</ref><ref>{{Cite journal |last1=Lee |first1=David J. |last2=Koru-Sengul |first2=Tulay |last3=Hernandez |first3=Monique N. |last4=Caban-Martinez |first4=Alberto J. |last5=McClure |first5=Laura A. |last6=Mackinnon |first6=Jill A. |last7=Kobetz |first7=Erin N. |date=April 2020 |title=Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014) |url=|journal=American Journal of Industrial Medicine |language=en |volume=63 |issue=4 |pages=285–299 |doi=10.1002/ajim.23086 |issn=0271-3586 |pmid=31930542 |s2cid=210191181}}</ref><ref>{{Cite journal |last1=Pinkerton |first1=Lynne |last2=Bertke |first2=Stephen J. |last3=Yiin |first3=James |last4=Dahm |first4=Matthew |last5=Kubale |first5=Travis |last6=Hales |first6=Thomas |last7=Purdue |first7=Mark |last8=Beaumont |first8=James J. |last9=Daniels |first9=Robert |date=February 2020 |title=Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update |journal=Occupational and Environmental Medicine |language=en |volume=77 |issue=2 |pages=84–93 |doi=10.1136/oemed-2019-105962 |issn=1351-0711 |pmid=31896615 |pmc=10165610 |s2cid=209677270|doi-access=free }}</ref> Additionally, large international studies generally support the finding from U.S. studies that firefighters have elevated rates of cancer, with some variation by cancer site.<ref>{{Cite journal |last1=Ahn |first1=Yeon-Soon |last2=Jeong |first2=Kyoung-Sook |last3=Kim |first3=Kyoo-Sang |date=September 2012 |title=Cancer morbidity of professional emergency responders in Korea |url=http://oem.bmj.com/cgi/content/short/68/Suppl_1/A37-a|journal=American Journal of Industrial Medicine |language=en |volume=55 |issue=9 |pages=768–778 |doi=10.1002/ajim.22068 |pmid=22628010 |s2cid=41791288}}</ref><ref>{{Cite journal |last1=Amadeo |first1=Brice |last2=Marchand |first2=Jean-Luc |last3=Moisan |first3=Frédéric |last4=Donnadieu |first4=Stéphane |last5=Coureau |first5=Gaëlle |last6=Mathoulin-Pélissier |first6=Simone |last7=Lembeye |first7=Christian |last8=Imbernon |first8=Ellen |last9=Brochard |first9=Patrick |date=2015 |title=French firefighter mortality: Analysis over a 30-year period |url=|journal=American Journal of Industrial Medicine |language=en |volume=58 |issue=4 |pages=437–443 |doi=10.1002/ajim.22434 |issn=1097-0274 |pmid=25708859}}</ref><ref>{{Cite journal |last1=Glass |first1=D. C. |last2=Pircher |first2=S. |last3=Monaco |first3=A. Del |last4=Hoorn |first4=S. Vander |last5=Sim |first5=M. R. |date=November 1, 2016 |title=Mortality and cancer incidence in a cohort of male paid Australian firefighters |url=https://oem.bmj.com/content/73/11/761 |journal=Occupational and Environmental Medicine |language=en |volume=73 |issue=11 |pages=761–771 |doi=10.1136/oemed-2015-103467 |issn=1351-0711 |pmid=27456156 |s2cid=43114491}}</ref><ref>{{Cite journal |last1=Glass |first1=Deborah C. |last2=Del Monaco |first2=Anthony |last3=Pircher |first3=Sabine |last4=Vander Hoorn |first4=Stephen |last5=Sim |first5=Malcolm R. |date=September 2017 |title=Mortality and cancer incidence among male volunteer Australian firefighters |url=https://oem.bmj.com/lookup/doi/10.1136/oemed-2016-104088 |journal=Occupational and Environmental Medicine |language=en |volume=74 |issue=9 |pages=628–638 |doi=10.1136/oemed-2016-104088 |issn=1351-0711 |pmid=28391245 |s2cid=32602571}}</ref><ref>{{Cite journal |last1=Glass |first1=Deborah Catherine |last2=Del Monaco |first2=Anthony |last3=Pircher |first3=Sabine |last4=Vander Hoorn |first4=Stephen |last5=Sim |first5=Malcolm Ross |date=April 2019 |title=Mortality and cancer incidence among female Australian firefighters |url=https://pubmed.ncbi.nlm.nih.gov/30674605 |journal=Occupational and Environmental Medicine |volume=76 |issue=4 |pages=215–221 |doi=10.1136/oemed-2018-105336 |issn=1470-7926 |pmid=30674605 |s2cid=59226066}}</ref><ref>{{Cite journal |last1=Harris |first1=M. Anne |last2=Kirkham |first2=Tracy L. |last3=MacLeod |first3=Jill S. |last4=Tjepkema |first4=Michael |last5=Peters |first5=Paul A. |last6=Demers |first6=Paul A. |date=October 2018 |title=Surveillance of cancer risks for firefighters, police, and armed forces among men in a Canadian census cohort |url=|journal=American Journal of Industrial Medicine |language=en |volume=61 |issue=10 |pages=815–823 |doi=10.1002/ajim.22891 |pmid=30073696 |s2cid=51905238}}</ref><ref>{{Cite journal |last1=Kirstine Ugelvig Petersen |first1=Kajsa |last2=Pedersen |first2=Julie Elbaek |last3=Bonde |first3=Jens Peter |last4=Ebbehoej |first4=Niels Erik |last5=Hansen |first5=Johnni |date=April 2018 |title=Long-term follow-up for cancer incidence in a cohort of Danish firefighters |url=https://oem.bmj.com/lookup/doi/10.1136/oemed-2017-104660 |journal=Occupational and Environmental Medicine |language=en |volume=75 |issue=4 |pages=263–269 |doi=10.1136/oemed-2017-104660 |issn=1351-0711 |pmid=29055884 |s2cid=4395029}}</ref><ref>{{Cite journal |last1=Petersen |first1=Kajsa Ugelvig |last2=Pedersen |first2=Julie Elbæk |last3=Bonde |first3=Jens Peter |last4=Ebbehøj |first4=Niels Erik |last5=Hansen |first5=Johnni |date=August 2018 |title=Mortality in a cohort of Danish firefighters; 1970–2014 |url=http://oem.bmj.com/cgi/content/short/74/Suppl_1/A110-b|journal=International Archives of Occupational and Environmental Health |language=en |volume=91 |issue=6 |pages=759–766 |doi=10.1007/s00420-018-1323-6 |issn=0340-0131 |pmid=29808435 |bibcode=2018IAOEH..91..759P |s2cid=44168738}}</ref><ref name="Pukkala-2014">{{Cite journal |last1=Pukkala |first1=Eero |last2=Martinsen |first2=Jan Ivar |last3=Weiderpass |first3=Elisabete |last4=Kjaerheim |first4=Kristina |last5=Lynge |first5=Elsebeth |last6=Tryggvadottir |first6=Laufey |last7=Sparén |first7=Pär |last8=Demers |first8=Paul A |date=June 2014 |title=Cancer incidence among firefighters: 45 years of follow-up in five Nordic countries |url=https://oem.bmj.com/lookup/doi/10.1136/oemed-2013-101803 |journal=Occupational and Environmental Medicine |language=en |volume=71 |issue=6 |pages=398–404 |doi=10.1136/oemed-2013-101803 |issn=1351-0711 |pmid=24510539 |s2cid=24392558}}</ref>

A 2015 retrospective [[longitudinal study]] showed that firefighters are at higher risk for certain types of [[cancer]]. Firefighters had [[mesothelioma]], which is caused by [[asbestos]] exposure, at twice the rate of the non-firefighting working population. Younger firefighters (under age 65) also developed [[bladder cancer]] and [[prostate cancer]] at higher rates than the general population. The risk of [[bladder cancer]] may be present in [[women in firefighting|female firefighters]], but research is inconclusive as of 2014.<ref>{{cite web |last=Daniels |first=Robert D. |date=17 December 2014 |title=Is There a Link Between Firefighting and Cancer? – Epidemiology in Action |url=http://blogs.cdc.gov/niosh-science-blog/2014/12/17/cancer-ff/ |access-date=6 January 2015 |publisher=National Institute for Occupational Safety and Health}}</ref><ref>{{cite web |date=25 July 2014 |title=Study of Cancer among U.S. Fire Fighters |url=https://www.cdc.gov/niosh/firefighters/ffCancerStudy.html |access-date=6 January 2015 |publisher=National Institute for Occupational Safety and Health}}</ref> Preliminary research from 2015 on a large cohort of US firefighters showed a direct relationship between the number of hours spent fighting fires and [[lung cancer]] and [[leukemia]] mortality in firefighters. This link is a topic of continuing research in the medical community, as is cancer mortality in general among firefighters.<ref>{{cite journal |vauthors=Daniels RD, Bertke S, Dahm MM, Yiin JH, Kubale TL, Hales TR, Baris D, Zahm SH, Beaumont JJ, Waters KM, Pinkerton LE |year=2015 |title=Exposure-response relationships for select cancer and non-cancer health outcomes in a cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009) |journal=Occupational and Environmental Medicine |volume=72 |issue=10 |pages=699–706 |doi=10.1136/oemed-2014-102671 |pmc=4558385 |pmid=25673342}}</ref>

In addition to [[Epidemiology|epidemiological]] studies, mechanistic studies have used [[biomarker]]s to investigate exposures' effects on biological changes that could be related to cancer development. Several of these studies have found evidence of [[DNA damage]], [[oxidative stress]], and [[Epigenetics|epigenetic]] changes related to firefighters' exposures.<ref>{{Cite journal |last1=Abreu |first1=Ana |last2=Costa |first2=Carla |last3=Pinho e Silva |first3=Susana |last4=Morais |first4=Simone |last5=do Carmo Pereira |first5=Maria |last6=Fernandes |first6=Adília |last7=Moraes de Andrade |first7=Vanessa |last8=Teixeira |first8=João Paulo |last9=Costa |first9=Solange |date=August 3, 2017 |title=Wood smoke exposure of Portuguese wildland firefighters: DNA and oxidative damage evaluation |url=|journal=Journal of Toxicology and Environmental Health, Part A |volume=80 |issue=13–15 |pages=596–604 |doi=10.1080/15287394.2017.1286896 |issn=1528-7394 |pmid=28524757 |bibcode=2017JTEHA..80..596A |hdl=10216/111908 |s2cid=205867973|hdl-access=free }}</ref><ref>{{Cite journal |last1=Adetona |first1=Olorunfemi |last2=Simpson |first2=Christopher D. |last3=Li |first3=Zheng |last4=Sjodin |first4=Andreas |last5=Calafat |first5=Antonia M. |last6=Naeher |first6=Luke P. |date=November 11, 2015 |title=Hydroxylated polycyclic aromatic hydrocarbons as biomarkers of exposure to wood smoke in wildland firefighters |url=|journal=Journal of Exposure Science & Environmental Epidemiology |volume=27 |issue=1 |pages=78–83 |doi=10.1038/jes.2015.75 |issn=1559-0631 |pmc=5140750 |pmid=26555473}}</ref><ref>{{Cite journal |last1=Andersen |first1=Maria Helena Guerra |last2=Saber |first2=Anne Thoustrup |last3=Clausen |first3=Per Axel |last4=Pedersen |first4=Julie Elbæk |last5=Løhr |first5=Mille |last6=Kermanizadeh |first6=Ali |last7=Loft |first7=Steffen |last8=Ebbehøj |first8=Niels |last9=Hansen |first9=Åse Marie |last10=Pedersen |first10=Peter Bøgh |last11=Koponen |first11=Ismo Kalevi |date=February 24, 2018 |title=Association between polycyclic aromatic hydrocarbon exposure and peripheral blood mononuclear cell DNA damage in human volunteers during fire extinction exercises |url=https://academic.oup.com/mutage/article/33/1/105/4553087 |journal=Mutagenesis |language=en |volume=33 |issue=1 |pages=105–115 |doi=10.1093/mutage/gex021 |issn=0267-8357 |pmid=29045708|doi-access=free }}</ref><ref>{{Cite journal |last1=Keir |first1=Jennifer L. A. |last2=Akhtar |first2=Umme S. |last3=Matschke |first3=David M. J. |last4=Kirkham |first4=Tracy L. |last5=Chan |first5=Hing Man |last6=Ayotte |first6=Pierre |last7=White |first7=Paul A. |last8=Blais |first8=Jules M. |date=November 7, 2017 |title=Elevated Exposures to Polycyclic Aromatic Hydrocarbons and Other Organic Mutagens in Ottawa Firefighters Participating in Emergency, On-Shift Fire Suppression |url=https://pubs.acs.org/doi/10.1021/acs.est.7b02850 |journal=Environmental Science & Technology |language=en |volume=51 |issue=21 |pages=12745–12755 |bibcode=2017EnST...5112745K |doi=10.1021/acs.est.7b02850 |issn=0013-936X |pmid=29043785}}</ref><ref>{{Cite journal |last1=Hoppe-Jones |first1=C. |last2=Beitel |first2=S. |last3=Burgess |first3=J. L. |last4=Snyder |first4=S. |last5=Flahr |first5=L. |last6=Griffin |first6=S. |last7=Littau |first7=S. |last8=Jeong |first8=K. S. |last9=Zhou |first9=J. |last10=Gulotta |first10=J. |last11=Moore |first11=P. |date=April 1, 2018 |title=515 Use of urinary biomarkers and bioassays to evaluate chemical exposure and activation of cancer pathways in firefighters |url=https://oem.bmj.com/content/75/Suppl_2/A412.2 |journal=Occupational and Environmental Medicine |language=en |volume=75 |issue=Suppl 2 |pages=A412–A413 |doi=10.1136/oemed-2018-ICOHabstracts.1178 |issn=1351-0711 |s2cid=80490930|doi-access=free }}</ref><ref>{{Cite journal |last1=Jeong |first1=Kyoung Sook |last2=Zhou |first2=Jin |last3=Griffin |first3=Stephanie C. |last4=Jacobs |first4=Elizabeth T. |last5=Dearmon-Moore |first5=Devi |last6=Zhai |first6=Jing |last7=Littau |first7=Sally R. |last8=Gulotta |first8=John |last9=Moore |first9=Paul |last10=Peate |first10=Wayne F. |last11=Richt |first11=Crystal M. |date=May 2018 |title=MicroRNA Changes in Firefighters |journal=Journal of Occupational & Environmental Medicine |language=en |volume=60 |issue=5 |pages=469–474 |doi=10.1097/JOM.0000000000001307 |issn=1076-2752 |pmc=5959213 |pmid=29465512}}</ref><ref>{{Citation |last1=Oliveira |first1=M. |title=Levels of urinary biomarkers of exposure and potential genotoxic risks in firefighters |date=March 14, 2018 |url=|work=Occupational Safety and Hygiene VI |pages=267–271 |publisher=CRC Press |doi=10.1201/9781351008884-47 |isbn=978-1-351-00888-4 |last2=Delerue-Matos |first2=C. |last3=Morais |first3=S. |last4=Slezakova |first4=K. |last5=Pereira |first5=M.C. |last6=Fernandes |first6=A. |last7=Costa |first7=S. |last8=Teixeira |first8=J.P.}}</ref>

Firefighters regularly encounter [[Carcinogen|carcinogenic materials]] and hazardous contaminants, which is thought to contribute to their excess cancer risk. Dozens of chemicals classified by the [[International Agency for Research on Cancer]] (IARC) as known or probable carcinogens have been identified on the fireground.<ref name="linkinghub.elsevier.com">{{Cite journal |last1=Marques |first1=M. Matilde |last2=Berrington de Gonzalez |first2=Amy |last3=Beland |first3=Frederick A. |last4=Browne |first4=Patience |last5=Demers |first5=Paul A. |last6=Lachenmeier |first6=Dirk W. |last7=Bahadori |first7=Tina |last8=Barupal |first8=Dinesh K. |last9=Belpoggi |first9=Fiorella |last10=Comba |first10=Pietro |last11=Dai |first11=Min |date=June 2019 |title=Advisory Group recommendations on priorities for the IARC Monographs |url= |journal=The Lancet Oncology |language=en |volume=20 |issue=6 |pages=763–764 |doi=10.1016/S1470-2045(19)30246-3 |pmid=31005580 |s2cid=128350881}}</ref><ref>{{Cite journal |last=IARC Working Group on the Evaluation of Carcinogenic Risks to Humans |date=2010 |title=Painting, firefighting, and shiftwork |journal=IARC Monographs on the Evaluation of Carcinogenic Risks to Humans |volume=98 |pages=9–764 |issn=1017-1606 |pmc=4781497 |pmid=21381544}}</ref> Several studies have documented airborne and/or dermal exposures to carcinogenic compounds during firefighting, as well as contamination on [[Bunker gear|turnout gear]] and other equipment worn by firefighters.<ref>{{Cite journal |first1=J. |last1=Jankovic |first2=W. |last2=Jones |first3=J. |last3=Burkhart |first4=G. |last4=Noonan |year=1991 |title=Environmental study of firefighters |url=|journal=Annals of Occupational Hygiene |volume=35 |issue=6 |pages=581–602 |doi=10.1093/annhyg/35.6.581 |pmid=1768008}}</ref><ref>{{Cite journal |last1=Bolstad-Johnson |first1=Dawn M. |last2=Burgess |first2=Jefferey L. |last3=Crutchfield |first3=Clifton D. |last4=Storment |first4=Steve |last5=Gerkin |first5=Richard |last6=Wilson |first6=Jeffrey R. |date=September 2000 |title=Characterization of Firefighter Exposures During Fire Overhaul |url=|journal=AIHAJ - American Industrial Hygiene Association |language=en |volume=61 |issue=5 |pages=636–641 |doi=10.1080/15298660008984572 |issn=1529-8663 |pmid=11071414}}</ref><ref>{{Cite journal |last1=Austin |first1=C. C. |last2=Wang |first2=D. |last3=Ecobichon |first3=D. J. |last4=Dussault |first4=G. |date=July 15, 2001 |title=Characterization of Volatile Organic Compounds in Smoke at Municipal Structural Fires |url=|journal=Journal of Toxicology and Environmental Health, Part A |language=en |volume=63 |issue=6 |pages=437–458 |doi=10.1080/152873901300343470 |issn=1528-7394 |pmid=11482799 |bibcode=2001JTEHA..63..437A |s2cid=36263955}}</ref><ref name="Fent-2017">{{Cite journal |last1=Fent |first1=Kenneth W. |last2=Alexander |first2=Barbara |last3=Roberts |first3=Jennifer |last4=Robertson |first4=Shirley |last5=Toennis |first5=Christine |last6=Sammons |first6=Deborah |last7=Bertke |first7=Stephen |last8=Kerber |first8=Steve |last9=Smith |first9=Denise |last10=Horn |first10=Gavin |date=October 3, 2017 |title=Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures |journal=Journal of Occupational and Environmental Hygiene |language=en |volume=14 |issue=10 |pages=801–814 |doi=10.1080/15459624.2017.1334904 |issn=1545-9624 |pmid=28636458 |s2cid=44916370|doi-access=free |hdl=2142/101922 |hdl-access=free }}</ref><ref>{{Cite journal |last1=Mayer |first1=Alexander C. |last2=Fent |first2=Kenneth W. |last3=Bertke |first3=Stephen |last4=Horn |first4=Gavin P. |last5=Smith |first5=Denise L. |last6=Kerber |first6=Steve |last7=La Guardia |first7=Mark J. |date=February 1, 2019 |title=Firefighter hood contamination: Efficiency of laundering to remove PAHs and FRs |journal=Journal of Occupational and Environmental Hygiene |language=en |volume=16 |issue=2 |pages=129–140 |doi=10.1080/15459624.2018.1540877 |issn=1545-9624 |pmc=8647047 |pmid=30427284}}</ref> Some of these compounds have been shown to absorb into firefighters' bodies.<ref>{{Cite journal |last1=Beitel |first1=Shawn C. |last2=Flahr |first2=Leanne M. |last3=Hoppe-Jones |first3=Christiane |last4=Burgess |first4=Jefferey L. |last5=Littau |first5=Sally R. |last6=Gulotta |first6=John |last7=Moore |first7=Paul |last8=Wallentine |first8=Darin |last9=Snyder |first9=Shane A. |date=February 1, 2020 |title=Assessment of the toxicity of firefighter exposures using the PAH CALUX bioassay |journal=Environment International |language=en |volume=135 |pages=105207 |doi=10.1016/j.envint.2019.105207 |issn=0160-4120 |pmid=31812113 |s2cid=208870627|doi-access=free |bibcode=2020EnInt.13505207B |hdl=10356/148860 |hdl-access=free }}</ref><ref>{{Cite journal |last1=Fent |first1=Kenneth W. |last2=Toennis |first2=Christine |last3=Sammons |first3=Deborah |last4=Robertson |first4=Shirley |last5=Bertke |first5=Stephen |last6=Calafat |first6=Antonia M. |last7=Pleil |first7=Joachim D. |last8=Wallace |first8=M. Ariel Geer |last9=Kerber |first9=Steve |last10=Smith |first10=Denise |last11=Horn |first11=Gavin P. |date=March 2020 |title=Firefighters' absorption of PAHs and VOCs during controlled residential fires by job assignment and fire attack tactic |journal=Journal of Exposure Science & Environmental Epidemiology |language=en |volume=30 |issue=2 |pages=338–349 |doi=10.1038/s41370-019-0145-2 |issn=1559-0631 |pmc=7323473 |pmid=31175324|bibcode=2020JESEE..30..338F }}</ref>

In addition to chemical exposures, firefighters often work 24-hr shifts or longer, and may respond to emergencies at night. Night [[shift work]] has been classified as a probable human carcinogen by IARC.<ref>{{Cite web |title=IARC Monographs Volume 124: Night Shift Work – IARC |url=https://www.iarc.who.int/news-events/iarc-monographs-volume-124-night-shift-work/ |access-date=September 1, 2022 |website=www.iarc.who.int}}</ref> Some firefighters also work with [[Dangerous goods|hazardous materials]] and trained to control and clean up these dangerous materials, such as [[oil spill]]s and [[chemical accident]]s. As firefighters combat a fire and clean up hazardous materials, there is a risk of harmful chemicals coming in contact with their skin if it penetrates their [[personal protective equipment]] (PPE).<ref name="Pukkala-2014" /> In June 2022, IARC classified occupational exposure as a firefighter as "carcinogenic to humans."<ref>{{Cite journal |last1=Demers |first1=Paul A. |last2=DeMarini |first2=David M. |last3=Fent |first3=Kenneth W. |last4=Glass |first4=Deborah C. |last5=Hansen |first5=Johnni |last6=Adetona |first6=Olorunfemi |last7=Andersen |first7=Maria H. G. |last8=Freeman |first8=Laura E. Beane |last9=Caban-Martinez |first9=Alberto J. |last10=Daniels |first10=Robert D. |last11=Driscoll |first11=Timothy R. |date=July 1, 2022 |title=Carcinogenicity of occupational exposure as a firefighter |url= |journal=The Lancet Oncology |language=en |volume=23 |issue=8 |pages=985–986 |doi=10.1016/S1470-2045(22)00390-4 |issn=1470-2045 |pmid=35780778 |s2cid=250227232}}</ref>

Firefighters are in addition to carcinogenic chemicals, firefighters can be exposed to [[radiation]] ([[alpha radiation]], [[beta radiation]], and [[gamma radiation]]).<ref name="IARC">{{cite journal |title=Painting, firefighting, and shiftwork |journal=IARC Monographs on the Evaluation of Carcinogenic Risks to Humans / World Health Organization, International Agency for Research on Cancer |volume=98 |pages=9–764 |year=2010 |pmid=21381544 |pmc=4781497|author1=IARC Working Group on the Evaluation of Carcinogenic Risks to Humans }}</ref>

There are many types of firefighters. Most research on firefighters' cancer risk has involved structural or municipal career firefighters. [[Wildfire suppression|Wildland firefighters]] are specially trained firefighters tasked with controlling [[Wildfire|forest fires]]. They frequently create fire lines, which are swathes of cut-down trees and dug-up grass placed in the path of the fire. This is designed to deprive the fire of fuel. Wildland firefighting is a physically demanding job with many acute hazards. Wildland firefighters may hike several miles while carrying heavy equipment during the wildfire season, which has increased in duration over time, especially in the western United States. Unlike structural firefighters, wildland firefighters typically do not wear [[Respirator|respiratory protection]], and may inhale [[Particulates|particulate]] and other compounds emitted by the wildfires. They also use [[Controlled burn|prescribed fires]] to burn potential fire fuel under controlled conditions.<ref>{{Cite web |title=Firefighters: Occupational Outlook Handbook: U.S. Bureau of Labor Statistics |url=https://www.bls.gov/ooh/protective-service/firefighters.htm#tab-2 |access-date=February 1, 2022 |website=www.bls.gov |language=en-us}}</ref> To examine cancer risk for wildland firefighters, a risk assessment was conducted using an exposure-response relationship for risk of lung cancer mortality and measured particulate matter exposure from smoke at wildfires. This study concluded that wildland firefighters could have an increased risk of lung cancer mortality.<ref>{{Cite journal |last1=Navarro |first1=Kathleen M. |last2=Kleinman |first2=Michael T. |last3=Mackay |first3=Chris E. |last4=Reinhardt |first4=Timothy E. |last5=Balmes |first5=John R. |last6=Broyles |first6=George A. |last7=Ottmar |first7=Roger D. |last8=Naher |first8=Luke P. |last9=Domitrovich |first9=Joseph W. |date=June 2019 |title=Wildland firefighter smoke exposure and risk of lung cancer and cardiovascular disease mortality |url= |journal=Environmental Research |language=en |volume=173 |pages=462–468 |bibcode=2019ER....173..462N |doi=10.1016/j.envres.2019.03.060 |pmid=30981117 |s2cid=108987257}}</ref> The research on cancer for other subspecialty groups of firefighters is limited, but a recent study of fire instructors in Australia found an exposure-response relationship between training exposures and cancer incidence.<ref>{{Cite journal |last1=Glass |first1=D. C. |last2=Del Monaco |first2=A. |last3=Pircher |first3=S. |last4=Vander Hoorn |first4=S. |last5=Sim |first5=M. R. |date=October 2016 |title=Mortality and cancer incidence at a fire training college |journal=Occupational Medicine (Oxford, England) |volume=66 |issue=7 |pages=536–542 |doi=10.1093/occmed/kqw079 |issn=1471-8405 |pmid=27371948|doi-access=free }}</ref>

Due to the lack of central and comprehensive sources of data, research on cancer rates amongst firefighters has been challenging.<ref name="Daniels-2014"/><ref>{{Cite journal |last1=Tsai |first1=Rebecca J. |last2=Luckhaupt |first2=Sara E. |last3=Schumacher |first3=Pam |last4=Cress |first4=Rosemary D. |last5=Deapen |first5=Dennis M. |last6=Calvert |first6=Geoffrey M. |date=May 6, 2015 |title=Risk of cancer among firefighters in California, 1988-2007 |url=|journal=American Journal of Industrial Medicine |volume=58 |issue=7 |pages=715–729 |doi=10.1002/ajim.22466 |issn=0271-3586 |pmc=4527530 |pmid=25943908}}</ref><ref>{{Cite journal |last1=Lee |first1=David J. |last2=Koru-Sengul |first2=Tulay |last3=Hernandez |first3=Monique N. |last4=Caban-Martinez |first4=Alberto J. |last5=McClure |first5=Laura A. |last6=Mackinnon |first6=Jill A. |last7=Kobetz |first7=Erin N. |date=April 2020 |title=Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014) |url=https://pubmed.ncbi.nlm.nih.gov/31930542 |journal=American Journal of Industrial Medicine |volume=63 |issue=4 |pages=285–299 |doi=10.1002/ajim.23086 |issn=1097-0274 |pmid=31930542 |s2cid=210191181}}</ref><ref>{{Cite journal |last1=Ma |first1=Fangchao |last2=Fleming |first2=Lora E. |last3=Lee |first3=David J. |last4=Trapido |first4=Edward |last5=Gerace |first5=Terence A. |date=September 2006 |title=Cancer incidence in Florida professional firefighters, 1981 to 1999 |url=https://pubmed.ncbi.nlm.nih.gov/16966954 |journal=Journal of Occupational and Environmental Medicine |volume=48 |issue=9 |pages=883–888 |doi=10.1097/01.jom.0000235862.12518.04 |issn=1076-2752 |pmid=16966954 |s2cid=45179842}}</ref> On July 7, 2018, Congress passed the Firefighter Cancer Registry Act of 2018 requiring the [[Centers for Disease Control and Prevention]] to create the [[National Firefighter Registry]] designed to collect data on cancer rates among U.S. firefighters.<ref>{{Cite web |title=Firefighter Cancer Registry Act of 2018 (2018 - H.R. 931) |url=https://www.govtrack.us/congress/bills/115/hr931 |access-date=May 9, 2022 |website=GovTrack.us |language=en}}</ref><ref>{{Cite web |date=2022-09-19 |title=National Firefighter Registry |url=https://www.cdc.gov/niosh/firefighters/registry/index.html |access-date=2022-11-08 |website=U.S. National Institute for Occupational Safety and Health |language=en-us}}</ref><ref>{{Cite web |title=The National Firefighter Registry: An update on the plan to track firefighter cancer |url=https://www.firerescue1.com/cancer/articles/the-national-firefighter-registry-an-update-on-the-plan-to-track-firefighter-cancer-NQ5oPnbOKPDtfWiO/ |url-status=live |archive-url=https://web.archive.org/web/20220407003328/https://www.firerescue1.com/cancer/articles/the-national-firefighter-registry-an-update-on-the-plan-to-track-firefighter-cancer-NQ5oPnbOKPDtfWiO/ |archive-date=April 7, 2022 |access-date=September 30, 2022 |website=FireRescue1 |date=17 March 2022 |language=en}}</ref>