Increased risk of bladder cancer for firefighters

It seems like there are more and more chronic diseases that firefighters are predisposed to get. Now you can add bladder cancer to the list.

ScienceDaily (May 15, 2008) — A new study presented at the Annual Scientific Meeting of the American Urological Association (AUA) suggests that firefighters may be at an increased risk of developing transitional cell carcinoma (TCC, or bladder cancer) and should be considered for routine annual screening. Currently, no guidelines exist for regular TCC screening.

Researchers are from the University of California, San Francisco.

It is well known that prolonged exposure to certain environmental pollutants and chemicals puts humans at a major risk for developing bladder cancer. As the body absorbs carcinogenic chemicals, such as cigarette smoke, the chemicals are transferred to the blood, filtered out by the kidneys and expelled from the body through the urine. Greater concentrations of chemicals in the urine can damage the endothelial lining of the bladder and increase a patient’s odds of developing transitional cell carcinoma (TCC). Firefighters, who are regularly exposed to smoke and chemical fumes, may be at a higher risk for developing the disease than other groups.

Researchers explored this possibility in a screening study of 1,286 active and retired San Francisco firefighters. From August 2006 to March 2007, the subjects – mean age 45 (SD+9.7) – participated in voluntary urine dipstick testing and point-of-care NMP-22 testing. 93 Patients tested positive for hematuria and six tested positive for NMP-22. These 99 patients were referred for upper tract imaging, cystoscopy and urine cytology. Of the group, a single firefighter tested positive for both NMP-22 and hematuria, with two patients – both retired firefighters – ultimately diagnosed with TCC.

The age and sex-adjusted incidence for TCC is 36 per 100,000. These findings represent a higher incidence, suggesting that retired firefighters may be a high-risk group.

In Canada, the British Columbia government recognizes as an occupational hazard for firefighters the following diseases:

  • testicular cancer
  • lung cancer in non-smokers
  • brain cancer
  • bladder cancer
  • kidney cancer
  • ureter cancer
  • colorectal cancer
  • non-Hodgkin’s lymphoma
  • leukemia

This means that full-time, volunteer, part-time, and paid on-call firefighters suffering from the diseases will qualify for worker’s compensation and benefits, without having to prove individually that the diseases are linked to their jobs.

Rather sobering, don’t you think?

Cancer cluster among firefighters

The Firegeezer blog, which always has excellent information about the broad topic of firefighting, had a recent post about a cancer cluster in Queensland, Australia. In part:

” […] Firefighters assigned to the station have a 62% higher rate of brain cancer than the rest of the state.”

Coincidentally, two days ago there was a news story containing preliminary research findings that linked brain cancer with polluted air, and specifically diesel exhaust. Firefighters have a hard time avoiding both.
firefighter smoke
Here is an excerpt from the story about the research:

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Dr. Julia Ljubimova found something disturbing when she probed the brains of rats exposed to air pollution: The dirty air appeared to trigger changes indicating the earliest stage of brain tumors.

Ljubimova, an oncologist and researcher at Cedars-Sinai Medical Center in Los Angeles, stressed that she is not ready to say air pollution is a cause of brain cancer.

“I don’t want to scare anyone, because this is preliminary data,” she said. “But we found something very important.”

Her work suggests that fine particles like those found in diesel soot can switch on firefighter smoke structure firethe tumor genes that many people inherit, jump-starting the disease process that results in brain tumors.

Hundreds of studies have linked air pollution to early deaths, heart attacks, reduced lung function, lung cancer and various other health problems. Ljubimova is among a handful of scientists who are focused on finding out what air pollution does to people’s brains.
Photos by Bill Gabbert