Wildland firefighter exposure and female cancer risk: currently available evidence.

The James M. Inhofe National Defence Authorization Act for Fiscal Year 2023 established that certain illnesses and diseases are to be deemed as proximately caused by employment in federal fire protection activities. However, cancers affecting female wildland firefighters were not included on this list and are recommended for further evaluation. We present the best available scientific evidence for the risk of breast and gynaecological cancers associated with exposures that are commonly measured in the wildland fire environment, including benzene, polycyclic aromatic hydrocarbons, and particulate matter. Epidemiology and experimental studies assessing these exposures have reported an increased risk for female breast and gynaecological cancers in other occupations or from indoor sources and the ambient environment (ie air pollution). Currently, there are 29 individual states in the United States that have laws that establish a presumption that female cancers contracted by firefighters are the result of occupational exposure. We highlight the link between common carcinogen exposures measured in the wildland fire environment with the risk of female cancers, which should be considered when evaluating the scientific evidence available for the inclusion of these cancers to be deemed as proximately caused by wildland firefighting.