Researchers receive grant to prospectively study cancer risk among firefighters

A $1.5 million federal grant will help researchers from University of Arizona and other institutions conduct a long-term study of cancer in firefighters.

The collaborative project — funded through a Department of Homeland Security Federal Emergency Management Agency Assistance to Firefighters grant — will include the Tuscon Fire Department and three other departments in in Arizona, the Boston Fire Department, and multiple fire departments in southern Florida.

Jefferey L. Burgess

“We still do not understand which exposures are the most important and the specific cellular mechanisms by which the exposures are causing cancer,” Jefferey L. Burgess, MD, MS, MPH, associate dean for research and professor at University of Arizona’s Mel and Enid Zuckerman College of Public Health, said in a press release. “This information is necessary to determine the best ways to help prevent cancer in firefighters.”

HemOnc Today spoke with Burgess about the research effort and its potential implications.

Question: What does research show about cancer in firefighters?

Answer: There have been a number of studies looking at cancer rates in firefighters in different areas of the world. In the United States, a study conducted by the National Institute for Occupational Safety and Health showed an increased rate of cancer deaths in firefighters compared with the general population. There was an even higher rate for specific cancers. For example, deaths from cancers of the gastrointestinal tract and kidneys were increased between 25% and 30%, and deaths from mesothelioma — resulting from asbestos exposure — were increased 100%.

Q: What do you and your colleagues hope to determine in your study?

A : Most previous studies have been retrospective, meaning firefighters are studied once they have already developed cancer. However, ours is a prospective study, so we are starting with firefighters who are new recruits, as well as those who have been fighting fires for years, and we are following them forward over time. This will allow us to do a number of things that we cannot do with a retrospective study. For example, we can collect blood during annual medical evaluations, and we can look for changes over time that lead to cancer. Specifically, we will look at what exposure to carcinogens are doing in terms of changing epigenetic markers that eventually lead to cancer. We also can better measure the exposure that firefighters have to cancer-causing agents, which has always been a challenge in retrospective studies.

Q: Who will be included in the study and what is the anticipated timeline?

A: The grant is to establish the framework for a longer and larger study. The initial grant is for 3 years. With the blood samples that we will be drawing, we will be looking for changes in epigenetic markers that can lead to cancer. There also is a survey component in which we will be collecting information about the number of fires they have fought, their diet and family histories. We will need to apply for additional funding to extend the study for 30 years or more, as it can take that long for some cancers to develop following carcinogenic exposures.

Q: What are some potential interventions to p rotect firefighters from cancer- causing chemicals ?

A: This study and others are measuring the extent of carcinogen exposure by different routes. This includes how much gets absorbed through the skin, as well as what they are breathing in. In addition, we are looking at the tasks that each firefighter carries out during a fire, such as those who go into a building, home or place of fire and those who stand at the fire truck near diesel fumes. With this approach, we hope to find ways to reduce their exposure and, therefore, lower their cancer risk. Firefighters are already starting to wash their gear more frequently because the chemicals from fires build up in and on the fabric, and every time they put their gear on, they are exposed to those chemicals again. Firefighters also are reducing their exposure risk is by using skin wipes after fires. They are looking at new types of hoods that will reduce skin deposition of chemicals in smoke. When we have more information on which interventions are most effective for reducing cancer risk, we will share this information with the wider population of firefighters.

Q: What does a grant like this mean to you and your collaborators?

A: This is a much larger project than just the team at University of Arizona, and we are very happy to have the opportunity to help lead this initial study. We are just one part of a much larger group of fire service and academic partners that are working to reduce cancer risk in firefighters. Of course, when you have a grant like this, it is a wonderful opportunity for our faculty and firefighters to work together to find answers to important questions.

Q: Do you have any plans for further research?

A: We plan to expand this study to a larger number of firefighters and be able to follow them for 30 years or more. We will need additional funding from other government agencies to enlarge and prolong the study, but our current study will provide the framework and initial results for future grant applications. – by Jennifer Southall

For more information:

Jefferey L. Burgess, MD, MS, MPH, can be reached at The University of Arizona, 1401 E. University Blvd., Tucson, AZ 85721; email: jburgess@email.arizona.edu.

Disclosure: Burgess reports no relevant financial disclosures.

A $1.5 million federal grant will help researchers from University of Arizona and other institutions conduct a long-term study of cancer in firefighters.

The collaborative project — funded through a Department of Homeland Security Federal Emergency Management Agency Assistance to Firefighters grant — will include the Tuscon Fire Department and three other departments in in Arizona, the Boston Fire Department, and multiple fire departments in southern Florida.

Jefferey L. Burgess

“We still do not understand which exposures are the most important and the specific cellular mechanisms by which the exposures are causing cancer,” Jefferey L. Burgess, MD, MS, MPH, associate dean for research and professor at University of Arizona’s Mel and Enid Zuckerman College of Public Health, said in a press release. “This information is necessary to determine the best ways to help prevent cancer in firefighters.”

HemOnc Today spoke with Burgess about the research effort and its potential implications.

Question: What does research show about cancer in firefighters?

Answer: There have been a number of studies looking at cancer rates in firefighters in different areas of the world. In the United States, a study conducted by the National Institute for Occupational Safety and Health showed an increased rate of cancer deaths in firefighters compared with the general population. There was an even higher rate for specific cancers. For example, deaths from cancers of the gastrointestinal tract and kidneys were increased between 25% and 30%, and deaths from mesothelioma — resulting from asbestos exposure — were increased 100%.

Q: What do you and your colleagues hope to determine in your study?

A : Most previous studies have been retrospective, meaning firefighters are studied once they have already developed cancer. However, ours is a prospective study, so we are starting with firefighters who are new recruits, as well as those who have been fighting fires for years, and we are following them forward over time. This will allow us to do a number of things that we cannot do with a retrospective study. For example, we can collect blood during annual medical evaluations, and we can look for changes over time that lead to cancer. Specifically, we will look at what exposure to carcinogens are doing in terms of changing epigenetic markers that eventually lead to cancer. We also can better measure the exposure that firefighters have to cancer-causing agents, which has always been a challenge in retrospective studies.

Q: Who will be included in the study and what is the anticipated timeline?

A: The grant is to establish the framework for a longer and larger study. The initial grant is for 3 years. With the blood samples that we will be drawing, we will be looking for changes in epigenetic markers that can lead to cancer. There also is a survey component in which we will be collecting information about the number of fires they have fought, their diet and family histories. We will need to apply for additional funding to extend the study for 30 years or more, as it can take that long for some cancers to develop following carcinogenic exposures.

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Q: What are some potential interventions to p rotect firefighters from cancer- causing chemicals ?

A: This study and others are measuring the extent of carcinogen exposure by different routes. This includes how much gets absorbed through the skin, as well as what they are breathing in. In addition, we are looking at the tasks that each firefighter carries out during a fire, such as those who go into a building, home or place of fire and those who stand at the fire truck near diesel fumes. With this approach, we hope to find ways to reduce their exposure and, therefore, lower their cancer risk. Firefighters are already starting to wash their gear more frequently because the chemicals from fires build up in and on the fabric, and every time they put their gear on, they are exposed to those chemicals again. Firefighters also are reducing their exposure risk is by using skin wipes after fires. They are looking at new types of hoods that will reduce skin deposition of chemicals in smoke. When we have more information on which interventions are most effective for reducing cancer risk, we will share this information with the wider population of firefighters.

Q: What does a grant like this mean to you and your collaborators?

A: This is a much larger project than just the team at University of Arizona, and we are very happy to have the opportunity to help lead this initial study. We are just one part of a much larger group of fire service and academic partners that are working to reduce cancer risk in firefighters. Of course, when you have a grant like this, it is a wonderful opportunity for our faculty and firefighters to work together to find answers to important questions.

Q: Do you have any plans for further research?

A: We plan to expand this study to a larger number of firefighters and be able to follow them for 30 years or more. We will need additional funding from other government agencies to enlarge and prolong the study, but our current study will provide the framework and initial results for future grant applications. – by Jennifer Southall

For more information:

Jefferey L. Burgess, MD, MS, MPH, can be reached at The University of Arizona, 1401 E. University Blvd., Tucson, AZ 85721; email: jburgess@email.arizona.edu.

Disclosure: Burgess reports no relevant financial disclosures.