SynthesisFrontiers in public health2026
Non-cancer mortality among firefighters: a meta-analytic review of heart disease, stroke, respiratory disease, liver disease, accidents, and suicide.
Synthesis in Frontiers in public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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Authors and funding
7 authors.
Funding
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Abstract
Introduction: Firefighting is a hazardous occupation linked to elevated cancer risk. However, occupational exposures unique to this profession may also contribute to non-cancer morbidity and mortality. To better understand firefighters' health risks, it is essential to examine causes of death beyond cancer. Methods: Following PRISMA guidelines, we conducted a systematic review and meta-analysis of population-based studies published between 1978 and 2025. Studies reporting standardized mortality ratios (SMRs) for non-cancer causes of death were identified through database searches. We estimated pooled SMRs and 95% confidence intervals using random-effects models, tested for publication bias and study quality, and conducted moderator analyses. Results: Twenty-five studies were included for final meta-analysis. Firefighters exhibited significantly lower mortality rate for heart disease (SMR = 0.64; 95%CI: 0.51-0.80), cerebrovascular disease (SMR = 0.67; 95%CI: 0.50-0.90), diabetes mellitus (SMR = 0.48; 95%CI: 0.32-0.70), intentional self-harm/suicide (SMR = 0.52; 95%CI: 0.39-0.70), chronic lower respiratory disease (SMR = 0.71; 95%CI: 0.55-0.91), and accidents/injuries (SMR = 0.77; 95%CI: 0.62-0.98) compared to the general population. In contrast, evidence for respiratory infections ( Conclusion: Firefighters experience lower mortality from multiple non-cancer causes, potentially due to occupational fitness requirements and the healthy worker effect. However, parity in mortality from liver disease and pneumonia/influenza warrant further investigation into behavioral factors and occupational exposures. Our results refine the healthy worker effect by identifying cause-specific gaps and priorities for targeted prevention and surveillance.
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