Evidence map›Paper›PMID 25673342›Full record

ArticleOccupational and environmental medicine2015

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).

Robert D Daniels, Stephen Bertke, Matthew M Dahm, James H Yiin, Travis L Kubale, Thomas R Hales, Dalsu Baris, Shelia H Zahm, James J Beaumont, Kathleen M Waters and 1 more

Registry-linked trialAbstract readComparative StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Occupational and environmental medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06931561 (Occupational Cancer Screening in Firefighters), which is not on this map. Cited by 67 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06931561 narecruitingnot on this mapstarted 2025, after this paper: background citation

Occupational Cancer Screening in Firefighters: A Pilot Study Within the Inova Health System

TypeinterventionalSponsorInova Health Care ServicesRan2025 to 2028Enrolled800ConditionsCancerArmsWhole Body MRI, Whole Body Ultrasound, MCD Assay, Occupational Exposure Questionnaire
3 · Its place in the literature

Who cites it

67 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews.International journal of environmental research and public health · 2021
    Pooled it
  4. Pooled it
  5. Article
  6. Article
  7. Article
  8. Differential metabolic profiles by training fire exposure in female firefighters.International journal of hygiene and environmental health · 2026
    Article
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  15. Differential metabolic profiles by Hispanic ethnicity among male Tucson firefighters.Metabolomics : Official journal of the Metabolomic Society · 2025
    Article
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  17. Review
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  19. Review
  20. Article

7 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Robert D DanielsDivision of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
Stephen BertkeDivision of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
Matthew M DahmDivision of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
James H YiinDivision of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
Travis L KubaleDivision of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
Thomas R HalesDivision of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
Dalsu BarisDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Gaithersburg, Maryland, USA.
Shelia H ZahmDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Gaithersburg, Maryland, USA.
James J BeaumontUC Davis Department of Public Health Sciences, University of California Davis, Davis, California, USA.
Kathleen M WatersDivision of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.
Lynne E PinkertonDivision of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA.

Funding

Studies of Occupational CancerZIACP010120 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI LAN, QING · 2009 to 2025
$34.4M
Intramural CDC HHS CC999999NCI NIH HHS N01 PC035136NCI NIH HHS N01 PC035139NCI NIH HHS N01-PC-35136NCI NIH HHS N01-PC-35139NCI NIH HHS N02 PC015105PHS HHS U55/CCR921930-02
6 · The paper itself

Abstract

objectivesTo examine exposure-response relationships between surrogates of firefighting exposure and select outcomes among previously studied US career firefighters.

methodsEight cancer and four non-cancer outcomes were examined using conditional logistic regression. Incidence density sampling was used to match each case to 200 controls on attained age. Days accrued in firefighting assignments (exposed-days), run totals (fire-runs) and run times (fire-hours) were used as exposure surrogates. HRs comparing 75th and 25th centiles of lagged cumulative exposures were calculated using loglinear, linear, log-quadratic, power and restricted cubic spline general relative risk models. Piecewise constant models were used to examine risk differences by time since exposure, age at exposure and calendar period.

resultsAmong 19,309 male firefighters eligible for the study, there were 1333 cancer deaths and 2609 cancer incidence cases. Significant positive associations between fire-hours and lung cancer mortality and incidence were evident. A similar relation between leukaemia mortality and fire-runs was also found. The lung cancer associations were nearly linear in cumulative exposure, while the association with leukaemia mortality was attenuated at higher exposure levels and greater for recent exposures. Significant negative associations were evident for the exposure surrogates and colorectal and prostate cancers, suggesting a healthy worker survivor effect possibly enhanced by medical screening.

conclusionsLung cancer and leukaemia mortality risks were modestly increasing with firefighter exposures. These findings add to evidence of a causal association between firefighting and cancer. Nevertheless, small effects merit cautious interpretation. We plan to continue to follow the occurrence of disease and injury in this cohort.

Indexed as

Cause of DeathAdultAgedAge DistributionChicagoCohort StudiesFirefightersHumansIncidenceLeukemiaLung NeoplasmsMaleMiddle AgedOccupational DiseasesOccupational ExposurePhiladelphia

Identifiers

PMID25673342
PMCPMC4558385

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.