Firefighter Cancer Research

What to know

The National Firefighter Registry (NFR) for Cancer is designed to help researchers examine the relationship between firefighting and cancer. Below you will find research on firefighter cancer risk, exposures, and controls.

Black firefighter helmet with purple cancer ribbon on front; "NFR" under the helmet

Publications and reports

Cancer risk

  • Tsai RJ, Luckhaupt SE, Schumacher P, Cress RD, Deapen DM, Calvert GM. Risk of cancer among firefighters in California, 1988-2007 [2015]. Am J Ind Med 58(7):715-29. doi: 10.1002/ajim.22466. PMID: 25943908; PMCID: PMC4527530.
  • Dahm MM, Bertke S, Allee S, Daniels RD[2015]. Creation of a retrospective job-exposure matrix using surrogate measures of exposure for a cohort of US career firefighters from San Francisco, Chicago, and Philadelphia. Occup Environ Med 72(9):670-7. doi: 10.1136/oemed-2014-102790. PMID: 26163543; PMCID: PMC4576837.
  • Daniels RD, Bertke S, Dahm MM, Yiin JH, Kubale TL, Hales TR, Baris D, Zahm SH, Beaumont JJ, Waters KM, Pinkerton LE [2015]. 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). Occup Environ Med 72(10):699-706. doi: 10.1136/oemed-2014-102671. PMID: 25673342; PMCID: PMC4558385.

Biological exposures to polycyclic aromatic hydrocarbons (PAHs), volatile organic compounds (VOCs), and flame retardants

  • Fent KW, Mayer AC, Toennis C, Sammons D, Robertson S, Chen IC, Bhandari D, Blount BC, Kerber S, Smith DL, Horn GP [2022]. Firefighters' urinary concentrations of VOC metabolites after controlled-residential and training fire responses. Int J Hyg Environ Health 242:113969. https://doi.org/10.1016/j.ijheh.2022.113969.
  • Mayer AC, Fent KW, Wilkinson A, Chen IC, Kerber S, Smith DL, Kesler RM, Horn GP. [2022]. Characterizing exposure to benzene, toluene, and naphthalene in firefighters wearing different types of new or laundered PPE. Int J Hyg Environ Health 240:113900. https://doi.org/10.1016/j.ijheh.2021.113900.
  • Fent KW, Toennis C, Sammons D, Robertson S, Bertke S, Calafat AM, Pleil JD, Wallace M, Kerber S, Smith D, Horn GP. [2020]. Firefighters' absorption of PAHs and VOCs during controlled residential fires by job assignment and fire attack tactic.J Expo Sci Environ Epidemiol 30(2), 338–349. https://doi.org/10.1038/s41370-019-0145-2.
  • Fent KW, Toennis C, Sammons D, Robertson S, Bertke S, Calafat AM, Pleil JD, Geer Wallace MA, Kerber S, Smith DL, Horn GP. [2019]. Firefighters' and instructors' absorption of PAHs and benzene during training exercises. Int J Hyg Environ Health 222(7), 991–1000. https://doi.org/10.1016/j.ijheh.2019.06.006.
  • Fent KW, Eisenberg J, Snawder J, Sammons D, Pleil JD, Stiegel, MA, Mueller C, Horn GP, Dalton J. [2014]. Systemic exposure to PAHs and benzene in firefighters suppressing controlled structure fires. Ann Occup Hyg 58(7), 830–845. https://doi.org/10.1093/annhyg/meu036.
  • Mayer AC, Fent KW, Chen IC, Sammons D, Toennis C, Robertson S, Kerber S, Horn GP, Smith D L, Calafat AM, Ospina M, Sjodin A [2021]. Characterizing exposures to flame retardants, dioxins, and furans among firefighters responding to controlled residential fires. Int J Hyg Environ Health 236:113782. https://doi.org/10.1016/j.ijheh.2021.113782

Environmental exposures during or after fire responses:

Contamination control

  • Horn GP, Fent KW, Kerber S, Smith DL [2022]. Hierarchy of contamination control in the fire service: Review of exposure control options to reduce cancer risk. J Occup Environ Hyg 19(9), 538–557. https://doi.org/10.1080/15459624.2022.2100406.
  • Kesler RM, Mayer A, Fent KW, Chen IC, Deaton AS, Ormond RB, Smith DL, Wilkinson A, Kerber S, Horn GP [2021]. Effects of firefighting hood design, laundering and doffing on smoke protection, heat stress and wearability. Ergonomics, 64(6), 755–767. https://doi.org/10.1080/00140139.2020.1867241.
  • Horn GP, Kerber S, Andrews J, Kesler RM, Newman H, Stewart JW, Fent KW, Smith DL [2021]. Impact of repeated exposure and cleaning on protective properties of structural firefighting turnout gear. Fire Technol 57(2), 791–813. https://doi.org/10.1007/s10694-020-01021-w.
  • Mayer AC, Horn GP, Fent KW, Bertke SJ, Kerber S, Kesler RM, Newman H, Smith DL [2020]. Impact of select PPE design elements and repeated laundering in firefighter protection from smoke exposure. J Occup Environ Hyg 17(11-12), 505–514. https://doi.org/10.1080/15459624.2020.1811869.
  • Horn GP, Kerber S, Fent KW, Smith DL [2020]. Management of irefighters' chemical & cardiovascular exposure risks on the fireground. Int Fire Serv J Leadersh Manag14:7-16. PMID: 35673618; PMCID: PMC9169513.
  • Mayer AC, Fent KW, Bertke S, Horn GP, Smith DL, Kerber S, La Guardia MJ [2019]. Firefighter hood contamination: Efficiency of laundering to remove PAHs and FRs. J Occup Environ Hyg, 16(2), 129–140. https://doi.org/10.1080/15459624.2018.1540877.
  • Fent KW, Alexander B, Roberts J, Robertson S, Toennis C, Sammons D, Bertke S, Kerber S, Smith D, Horn G [2017]. Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures. J Occup Environ Hyg, 14(10), 801–814. https://doi.org/10.1080/15459624.2017.1334904.
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Content Source:
National Institute for Occupational Safety and Health