National Firefighter Registry for Cancer explained

National Firefighter Registry for Cancer
Type:Program
Parent Agency:U.S. National Institute for Occupational Safety and Health
Parent Agency Type:agency
Website:https://www.cdc.gov/NFR

The National Firefighter Registry for Cancer (NFR) is a voluntary registry of firefighters in the United States used to evaluate cancer rates and risk factors in the U.S. fire service through collecting relevant occupational, lifestyle, and health information on firefighters. It aims to use these data to reduce cancer in firefighters.

The NFR was created by the Firefighter Cancer Registry Act of 2018 in response to growing evidence of carcinogenic exposures and increased risk for cancer faced by firefighters.[1] It opened to registration by firefighters in April 2023.[2] [3] [4] The NFR is maintained by the U.S. National Institute for Occupational Safety and Health (NIOSH).

Background

Cancer among firefighters

Cancer risk in the U.S. fire service is a topic of growing concern. Firefighters regularly encounter carcinogenic materials and hazardous contaminants on the fireground.[5] Several studies have documented airborne and/or dermal exposures to carcinogenic compounds during firefighting, as well as contamination on turnout gear and other equipment worn by firefighters.[6] [7] [8] [9] [10]  Some of these compounds have been shown to absorb into firefighters’ bodies.[11] [12] Some firefighters also work with hazardous materials and are trained to control and clean up dangerous materials such as oil spills and chemical accidents.[13] In addition to chemical exposures, night shift work has been classified by IARC as a probable human carcinogen.[14]

Unlike structural firefighters, wildland firefighters typically do not wear respiratory protection, and may inhale particulate and other compounds emitted by the wildfires.[15] A risk assessment conducted using an exposure–response analysis concluded that wildland firefighters could have an increased risk of lung cancer mortality.[16]

Recent studies suggest that exposure on the fireground may increase risk to firefighters of certain types of cancer and other chronic diseases.[17] [18] [19] [20] [21] [22] [23] [24] [25] [26] In addition to epidemiological studies, several mechanistic studies using biomarkers have found evidence of DNA damage, oxidative stress, and epigenetic changes related to firefighters' exposures.[27] [28] [29] [30] [31] [32]

In 2022, IARC completed an evaluation on the carcinogenicity of the occupation of firefighting and reached a consensus classifying it as a known human carcinogen. This classification was based on sufficient evidence for increased risk of mesothelioma and bladder cancer among firefighters. Limited evidence of increasing risk among firefighters was also found for five other cancers: colon, prostate, testicular, melanoma of the skin, and non-Hodgkin lymphoma.[33]

Data sources

While U.S. state cancer registries provide rich data for studying cancer in the U.S., they often do not provide comprehensive information on cancer patients’ work history[34] [35] [36] and workplace practices, making it challenging to use this data source alone for studying cancer in firefighters. It is also important to collect information on personal and lifestyle risk factors (e.g. tobacco and alcohol use, sleep deprivation, diet, and physical activity) in the U.S. fire service to better understand how they may affect the relationship between firefighting and cancer.[37] [38] [39]

Due to the lack of central and comprehensive sources of data, research on cancer rates amongst firefighters has been challenging. Although some evidence suggests the risk for specific cancer types could vary for male, female, and non-white firefighters,[40] [41] [42] [43]  the strength of the evidence related to cancer in demographic subgroups is limited because many previous studies have mainly comprised white male samples of firefighters. Larger samples of female firefighters and minority groups are needed before the conclusions can be drawn about cancer risk across the nation’s diverse fire service.[44] [45] Additionally, the research on cancer for some subspecialty groups of firefighters, such as firefighter trainers, is limited.[46]

Creation and implementation

Firefighter Cancer Registry Act of 2018
Passedbody2:Senate
Passeddate3:2018-06-22
Passedbody3:House
Longtitle:An Act to require the Secretary of Health and Human Services to develop a voluntary registry to collect data on cancer incidence among firefighters
Signeddate:2018-07-07
Signedpresident:Donald Trump
Passedvote2:by unanimous consent with amendment
Passeddate2:2018-05-10
Passedvote1:by voice vote
Enacted By:115th
Passeddate1:2017-09-12
Passedbody1:House
Committees:United States House Committee on Energy and Commerce
Introduceddate:2017-02-07
Introducedby:Chris Collins
Introducedin:House
Passedvote3:by unanimous consent

The Firefighter Cancer Registry Act of 2018 bill was introduced in the U.S. House of Representatives on February 7, 2017, by Robert Menendez.[47] [48] It required the Centers for Disease Control and Prevention to create a registry designed to collect data on cancer rates among U.S. firefighters.[49] [50] [51] The bill was passed with unanimous and bipartisan approval[52] [53] [54] [55] on July 7, 2018.[56]

The Congressional Budget Office estimated that the bill would cost around 10 million dollars.[57] However, the Republican Policy Committee stated that the cost of the bill would be offset by a reduction in the funding of the CDC.[58] NIOSH, part of the CDC, has been given authority to lead this effort, beginning in fiscal year 2019, with input from the scientific and firefighting communities.

It opened to registration by firefighters in April 2023. As of October 2023, over 48,000 firefighters had enrolled.

Operation

The proposed approach for the NFR states it will be a voluntary workplace health surveillance system of U.S. firefighters over the age of 18 years. The main goal of the NFR, according to the text of the law, is "to develop and maintain…a voluntary registry of firefighters to collect relevant health and occupational information of such firefighters for purposes of determining cancer incidence."[59] [60] According to the Republican Policy Committee's summary, the NFR aims to provide decision makers with data to help them create new protocols to protect firefighters. It aims to register around 200,000 firefighters across a variety of demographics within 5 years of launch. NIOSH plans to recruit firefighters through various communication channels (e.g., NFR website and newsletter, social media, local/state/national unions, affinity groups, trade journals, conference attendees) or directly from selected rosters of firefighters.

Participation in the NFR is entirely voluntary and is open to all firefighters, including retired ones. Firefighters who register will provide their name, date of birth, and sex; and may also provide information about their lifestyle and exposures. Following the initial enrollment, participants may be given voluntary yearly questionnaires. NIOSH can then use this information to track past and future diagnoses of cancer among NFR participants by matching with data from state cancer registries to understand how firefighters’ work impacts their risk of developing cancer.[61]

Cancer is a nationally notifiable condition, and thus all U.S. states track diagnoses of cancer in a state cancer registry.[62] The NFR plans to also seek additional details about participant’s types of emergency responses attended and exposures by working with fire departments and exposure tracking programs (if applicable), and by administering follow-up questionnaires to registered firefighters. Because cancer has a long latency period – which is the time between exposure to carcinogens and the development of cancer – the NFR will monitor cancer outcomes for decades.

The NFR program receives input and guidance from the NFR Subcommittee, a subcommittee of the NIOSH Board of Scientific Counselors (a Federal Advisory Committee), consisting of 12 rotating subject matter experts in firefighting, epidemiology, medicine, or public health.[63] [64]

Firefighter enrollment

All members can enroll through a web portal. NIOSH states that any information gathered through the program will only be accessible to NIOSH researchers and will be protected with multi-factor authentication and "multiple layers of encryption." Firefighters may access the web portal through the dedicated NFR website (https://www.cdc.gov/niosh/firefighters/registry.html or https://www.cdc.gov/NFR) or by directly accessing the web portal. To complete enrollment in the NFR, participants will need to set up an account, complete an informed consent document, user profile, and enrollment questionnaire.

The user profile will serve to collect basic information from the firefighter that could change over time and hence can be accessed and updated by the user. The enrollment questionnaire will collect information on employment/workplace characteristics, exposure, demographics, lifestyle factors, comorbidities, and other confounders. Most questions are optional. The enrollment process, including the questionnaire, is designed to take 30–45 minutes to complete if all questions are answered. Following enrollment, NIOSH will send NFR participants notifications for periodic voluntary follow-up questionnaires (e.g., one per year) to be filled out through the web portal.

Other sources of information

In addition to roster information, NIOSH plans to request fire incident records dating back to January 1, 2010, or earlier when available, from fire departments for some participants. Fire departments are required to collect some basic information about fire incidents under the National Fire Incident Reporting System (NFIRS) established by the U.S. Fire Administration. (The U.S. Fire Administration is in the process of replacing NFIRS with a new system called the National Emergency Response Information System (NERIS).) Department incident records will provide NIOSH investigators with apparatus and incident-specific information to be used as surrogates of exposure for exposure-response analyses. Specific variables of interest requested from department incident records may include: incident number, fire station, apparatus, incident type (structure fire, car fire, etc.), on scene time, off scene time, job assignments, number of fire runs, and duration at fires. NIOSH will explore the most efficient and least burdensome way of obtaining incident records from participating fire departments.

Notes and References

  1. Marques. M Matilde. Berrington de Gonzalez. Amy. Beland. Frederick A.. Browne. Patience. Demers. Paul A. Lachenmeier. Dirk W. Bahadori. Tina. Barupal. Dinesh K.. Belpoggi. Fiorella. Comba. Pietro. Dai. Min. June 2019. Advisory Group recommendations on priorities for the IARC Monographs. The Lancet Oncology. en. 20. 6. 763–764. 10.1016/S1470-2045(19)30246-3. 31005580. 128350881.
  2. Web site: Saurman . Alex . 2023-04-20 . NIOSH's National Firefighter Registry Established to Learn More About Firefighting and Cancer, Increase Health of These First Responders . 2023-09-22 . Occupational Health & Safety . en-US.
  3. Web site: Petrus . Carli . 2023-04-18 . National Firefighter Registry for Cancer could benefit local departments . 2023-09-22 . WTVG . en.
  4. Web site: Woodhouse . Murphy . 2023-05-12 . Wildland firefighters strongly encouraged to enroll in new national registry for cancer . 2023-09-22 . Boise State Public Radio . en.
  5. IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. 2010. Painting, firefighting, and shiftwork. IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. 98. 9–764. 1017-1606. 4781497. 21381544.
  6. J. JANKOVIC, W. JONES, J. BURKHART, G. NOONAN. 1991. Environmental study of firefighters. Annals of Occupational Hygiene. 35. 6. 581–602. 10.1093/annhyg/35.6.581. 1768008.
  7. Bolstad-Johnson. Dawn M.. Burgess. Jefferey L.. Crutchfield. Clifton D.. Storment. Steve. Gerkin. Richard. Wilson. Jeffrey R.. September 2000. Characterization of Firefighter Exposures During Fire Overhaul. AIHAJ - American Industrial Hygiene Association. en. 61. 5. 636–641. 10.1080/15298660008984572. 11071414. 1529-8663.
  8. Austin. C. C.. Wang. D.. Ecobichon. D. J.. Dussault. G.. Characterization of Volatile Organic Compounds in Smoke at Municipal Structural Fires. July 15, 2001. Journal of Toxicology and Environmental Health, Part A. en. 63. 6. 437–458. 10.1080/152873901300343470. 11482799. 36263955. 1528-7394.
  9. Fent . Kenneth W. . Alexander . Barbara . Roberts . Jennifer . Robertson . Shirley . Toennis . Christine . Sammons . Deborah . Bertke . Stephen . Kerber . Steve . Smith . Denise . Horn . Gavin . October 3, 2017 . Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures . Journal of Occupational and Environmental Hygiene . en . 14 . 10 . 801–814 . 10.1080/15459624.2017.1334904 . 1545-9624 . 28636458 . 44916370. free . 2142/101922 . free .
  10. Mayer. Alexander C.. Fent. Kenneth W.. Bertke. Stephen. Horn. Gavin P.. Smith. Denise L.. Kerber. Steve. La Guardia. Mark J.. February 1, 2019. Firefighter hood contamination: Efficiency of laundering to remove PAHs and FRs. Journal of Occupational and Environmental Hygiene. en. 16. 2. 129–140. 10.1080/15459624.2018.1540877. 1545-9624. 8647047. 30427284.
  11. Beitel. Shawn C.. Flahr. Leanne M.. Hoppe-Jones. Christiane. Burgess. Jefferey L.. Littau. Sally R.. Gulotta. John. Moore. Paul. Wallentine. Darin. Snyder. Shane A.. February 1, 2020. Assessment of the toxicity of firefighter exposures using the PAH CALUX bioassay. Environment International. en. 135. 105207. 10.1016/j.envint.2019.105207. 31812113. 208870627. 0160-4120. free. 10356/148860. free.
  12. Fent. Kenneth W.. Toennis. Christine. Sammons. Deborah. Robertson. Shirley. Bertke. Stephen. Calafat. Antonia M.. Pleil. Joachim D.. Wallace. M. Ariel Geer. Kerber. Steve. Smith. Denise. Horn. Gavin P.. March 2020. Firefighters' absorption of PAHs and VOCs during controlled residential fires by job assignment and fire attack tactic. Journal of Exposure Science & Environmental Epidemiology. en. 30. 2. 338–349. 10.1038/s41370-019-0145-2. 1559-0631. 7323473. 31175324.
  13. Pukkala . Eero . Martinsen . Jan Ivar . Weiderpass . Elisabete . Kjaerheim . Kristina . Lynge . Elsebeth . Tryggvadottir . Laufey . Sparén . Pär . Demers . Paul A . June 2014 . Cancer incidence among firefighters: 45 years of follow-up in five Nordic countries . Occupational and Environmental Medicine . en . 71 . 6 . 398–404 . 10.1136/oemed-2013-101803 . 1351-0711 . 24510539 . 24392558.
  14. Web site: IARC Monographs Volume 124: Night Shift Work – IARC . September 1, 2022 . www.iarc.who.int.
  15. Web site: Firefighters : Occupational Outlook Handbook: : U.S. Bureau of Labor Statistics. February 1, 2022. www.bls.gov. en-us.
  16. Navarro . Kathleen M. . Kleinman . Michael T. . Mackay . Chris E. . Reinhardt . Timothy E. . Balmes . John R. . Broyles . George A. . Ottmar . Roger D. . Naher . Luke P. . Domitrovich . Joseph W. . June 2019 . Wildland firefighter smoke exposure and risk of lung cancer and cardiovascular disease mortality . Environmental Research . en . 173 . 462–468 . 2019ER....173..462N . 10.1016/j.envres.2019.03.060 . 30981117 . 108987257.
  17. Daniels . Robert D . Kubale . Travis L . Yiin . James H . Dahm . Matthew M . Hales . Thomas R . Baris . Dalsu . Zahm . Shelia H . Beaumont . James J . Waters . Kathleen M . Pinkerton . Lynne E . June 2014 . Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009) . Occupational and Environmental Medicine . en . 71 . 6 . 388–397 . 10.1136/oemed-2013-101662 . 1351-0711 . 4499779 . 24142974.
  18. LeMasters . Grace K. . Genaidy . Ash M. . Succop . Paul . Deddens . James . Sobeih . Tarek . Barriera-Viruet . Heriberto . Dunning . Kari . Lockey . James . November 2006 . Cancer Risk Among Firefighters: A Review and Meta-analysis of 32 Studies . Journal of Occupational and Environmental Medicine . en . 48 . 11 . 1189–1202 . 10.1097/01.jom.0000246229.68697.90 . 1076-2752 . 17099456 . 1659335.
  19. Book: Painting, Firefighting, and Shiftwork. . 2010 . International Agency for Research on Cancer . 9789283215981 . 1066415095.
  20. Laroche . Elena . L’Espérance . Sylvain . March 3, 2021 . Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews . International Journal of Environmental Research and Public Health . en . 18 . 5 . 2519 . 10.3390/ijerph18052519 . 1660-4601 . 7967542 . 33802629 . free.
  21. Hwang . Jooyeon . Xu . Chao . Agnew . Robert J. . Clifton . Shari . Malone . Tara R. . January 2021 . Health Risks of Structural Firefighters from Exposure to Polycyclic Aromatic Hydrocarbons: A Systematic Review and Meta-Analysis . International Journal of Environmental Research and Public Health . en . 18 . 8 . 4209 . 10.3390/ijerph18084209 . 8071552 . 33921138 . free.
  22. Jalilian . Hamed . Ziaei . Mansour . Weiderpass . Elisabete . Rueegg . Corina Silvia . Khosravi . Yahya . Kjaerheim . Kristina . November 15, 2019 . Cancer incidence and mortality among firefighters . International Journal of Cancer . en . 145 . 10 . 2639–2646 . 10.1002/ijc.32199 . 0020-7136 . 30737784 . 73451966 . free. 10037/17313 . free .
  23. Soteriades . Elpidoforos S . Kim . Jaeyoung . Christophi . Costas A . Kales . Stefanos N . November 1, 2019 . Cancer Incidence and Mortality in Firefighters: A State-of-the-Art Review and Meta-َAnalysis . Asian Pacific Journal of Cancer Prevention . en . 20 . 11 . 3221–3231 . 10.31557/APJCP.2019.20.11.3221 . 2476-762X . 7063017 . 31759344.
  24. Casjens . Swaantje . Brüning . Thomas . Taeger . Dirk . October 2020 . Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences . International Archives of Occupational and Environmental Health . en . 93 . 7 . 839–852 . 10.1007/s00420-020-01539-0 . 0340-0131 . 7452930 . 32306177.
  25. Lee . David J. . Koru‐Sengul . Tulay . Hernandez . Monique N. . Caban‐Martinez . Alberto J. . McClure . Laura A. . Mackinnon . Jill A. . Kobetz . Erin N. . April 2020 . Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981‐2014) . American Journal of Industrial Medicine . en . 63 . 4 . 285–299 . 10.1002/ajim.23086 . 0271-3586 . 31930542 . 210191181.
  26. Pinkerton . Lynne . Bertke . Stephen J . Yiin . James . Dahm . Matthew . Kubale . Travis . Hales . Thomas . Purdue . Mark . Beaumont . James J . Daniels . Robert . February 2020 . Mortality in a cohort of US firefighters from San Francisco, Chicago and Philadelphia: an update . Occupational and Environmental Medicine . en . 77 . 2 . 84–93 . 10.1136/oemed-2019-105962 . 1351-0711 . 31896615 . 10165610 . 209677270 . free.
  27. Abreu. Ana. Costa. Carla. Pinho e Silva. Susana. Morais. Simone. do Carmo Pereira. Maria. Fernandes. Adília. Moraes de Andrade. Vanessa. Teixeira. João Paulo. Costa. Solange. August 3, 2017. Wood smoke exposure of Portuguese wildland firefighters: DNA and oxidative damage evaluation. Journal of Toxicology and Environmental Health, Part A. 80. 13–15. 596–604. 10.1080/15287394.2017.1286896. 1528-7394. 28524757. 10216/111908. 205867973. free.
  28. Adetona. Olorunfemi. Simpson. Christopher D. Li. Zheng. Sjodin. Andreas. Calafat. Antonia M. Naeher. Luke P. November 11, 2015. Hydroxylated polycyclic aromatic hydrocarbons as biomarkers of exposure to wood smoke in wildland firefighters. Journal of Exposure Science & Environmental Epidemiology. 27. 1. 78–83. 10.1038/jes.2015.75. 26555473. 5140750. 1559-0631.
  29. Andersen. Maria Helena Guerra. Saber. Anne Thoustrup. Clausen. Per Axel. Pedersen. Julie Elbæk. Løhr. Mille. Kermanizadeh. Ali. Loft. Steffen. Ebbehøj. Niels. Hansen. Åse Marie. Pedersen. Peter Bøgh. Koponen. Ismo Kalevi. February 24, 2018. Association between polycyclic aromatic hydrocarbon exposure and peripheral blood mononuclear cell DNA damage in human volunteers during fire extinction exercises. Mutagenesis. en. 33. 1. 105–115. 10.1093/mutage/gex021. 29045708. 0267-8357. free.
  30. Keir. Jennifer L. A.. Akhtar. Umme S.. Matschke. David M. J.. Kirkham. Tracy L.. Chan. Hing Man. Ayotte. Pierre. White. Paul A.. Blais. Jules M.. November 7, 2017. Elevated Exposures to Polycyclic Aromatic Hydrocarbons and Other Organic Mutagens in Ottawa Firefighters Participating in Emergency, On-Shift Fire Suppression. Environmental Science & Technology. en. 51. 21. 12745–12755. 10.1021/acs.est.7b02850. 29043785. 2017EnST...5112745K. 0013-936X.
  31. Hoppe-Jones. C.. Beitel. S.. Burgess. J. L.. Snyder. S.. Flahr. L.. Griffin. S.. Littau. S.. Jeong. K. S.. Zhou. J.. Gulotta. J.. Moore. P.. April 1, 2018. 515 Use of urinary biomarkers and bioassays to evaluate chemical exposure and activation of cancer pathways in firefighters. Occupational and Environmental Medicine. en. 75. Suppl 2. A412–A413. 10.1136/oemed-2018-ICOHabstracts.1178. 80490930. 1351-0711. free.
  32. Jeong. Kyoung Sook. Zhou. Jin. Griffin. Stephanie C.. Jacobs. Elizabeth T.. Dearmon-Moore. Devi. Zhai. Jing. Littau. Sally R.. Gulotta. John. Moore. Paul. Peate. Wayne F.. Richt. Crystal M.. May 2018. MicroRNA Changes in Firefighters. Journal of Occupational & Environmental Medicine. en. 60. 5. 469–474. 10.1097/JOM.0000000000001307. 1076-2752. 5959213. 29465512.
  33. Demers . Paul A . DeMarini . David M . Fent . Kenneth W . Glass . Deborah C . Hansen . Johnni . Adetona . Olorunfemi . Andersen . Maria HG . Freeman . Laura E Beane . Caban-Martinez . Alberto J . Daniels . Robert D . Driscoll . Timothy R . Goodrich . Jaclyn M . Graber . Judith M . Kirkham . Tracy L . Kjaerheim . Kristina . August 2022 . Carcinogenicity of occupational exposure as a firefighter . The Lancet Oncology . en . 23 . 8 . 985–986 . 10.1016/S1470-2045(22)00390-4.
  34. Freeman . MaryBeth B. . Pollack . Lori A. . Rees . Judy R. . Johnson . Christopher J. . Rycroft . Randi K. . Rousseau . David L. . Hsieh . Mei-Chin . enhancement of NPCR for comparative effectiveness research team . August 2017 . Capture and coding of industry and occupation measures: Findings from eight National Program of Cancer Registries states . American Journal of Industrial Medicine . 60 . 8 . 689–695 . 10.1002/ajim.22739 . 1097-0274 . 5769461 . 28692191.
  35. Silver . Sharon R. . Tsai . Rebecca J. . Morris . Cyllene R. . Boiano . James M. . Ju . Jun . Scocozza . Marilyn S. . Calvert . Geoffrey M. . June 2018 . Codability of industry and occupation information from cancer registry records: Differences by patient demographics, casefinding source, payor, and cancer type . American Journal of Industrial Medicine . 61 . 6 . 524–532 . 10.1002/ajim.22840 . 1097-0274 . 29574892 . 4308062.
  36. McClure . Laura A. . Koru-Sengul . Tulay . Hernandez . Monique N. . Mackinnon . Jill A. . Solle . Natasha Schaefer . Caban-Martinez . Alberto J. . Lee . David J. . Kobetz . Erin . April 30, 2019 . Availability and accuracy of occupation in cancer registry data among Florida firefighters . PLOS ONE . en . 14 . 4 . e0215867 . 2019PLoSO..1415867M . 10.1371/journal.pone.0215867 . 1932-6203 . 6490882 . 31039169 . free.
  37. Daniels . Robert D. . Bertke . Stephen . Dahm . Matthew M. . Yiin . James H. . Kubale . Travis L. . Hales . Thomas R. . Baris . Dalsu . Zahm . Shelia H. . Beaumont . James J. . Waters . Kathleen M. . Pinkerton . Lynne E. . October 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) . Occupational and Environmental Medicine . 72 . 10 . 699–706 . 10.1136/oemed-2014-102671 . 1470-7926 . 4558385 . 25673342.
  38. Book: Humans, IARC Working Group on the Evaluation of Carcinogenic Risk to . Personal Habits and Indoor Combustions . 2012 . International Agency for Research on Cancer . 978-92-832-0137-3 . [Place of publication not identified] . 1021252135.
  39. Book: Cancer Epidemiology and Prevention . December 21, 2017 . Oxford University Press . 978-0-19-023866-7 . Thun . Michael . 1 . en . 10.1093/oso/9780190238667.001.0001 . Linet . Martha S. . Cerhan . James R. . Haiman . Christopher A. . Schottenfeld . David.
  40. Daniels. Robert D. Kubale. Travis L. Yiin. James H. Dahm. Matthew M. Hales. Thomas R. Baris. Dalsu. Zahm. Shelia H. Beaumont. James J. Waters. Kathleen M. Pinkerton. Lynne E. June 2014. Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950–2009). Occupational and Environmental Medicine. en. 71. 6. 388–397. 10.1136/oemed-2013-101662. 1351-0711. 4499779. 24142974.
  41. Tsai. Rebecca J.. Luckhaupt. Sara E.. Schumacher. Pam. Cress. Rosemary D.. Deapen. Dennis M.. Calvert. Geoffrey M.. May 6, 2015. Risk of cancer among firefighters in California, 1988-2007. American Journal of Industrial Medicine. 58. 7. 715–729. 10.1002/ajim.22466. 25943908. 4527530. 0271-3586.
  42. Lee . David J. . Koru-Sengul . Tulay . Hernandez . Monique N. . Caban-Martinez . Alberto J. . McClure . Laura A. . Mackinnon . Jill A. . Kobetz . Erin N. . April 2020 . Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014) . American Journal of Industrial Medicine . 63 . 4 . 285–299 . 10.1002/ajim.23086 . 1097-0274 . 31930542. 210191181 .
  43. Ma . Fangchao . Fleming . Lora E. . Lee . David J. . Trapido . Edward . Gerace . Terence A. . September 2006 . Cancer incidence in Florida professional firefighters, 1981 to 1999 . Journal of Occupational and Environmental Medicine . 48 . 9 . 883–888 . 10.1097/01.jom.0000235862.12518.04 . 1076-2752 . 16966954. 45179842 .
  44. Web site: Employed persons by detailed occupation, sex, race, and Hispanic or Latino ethnicity . February 1, 2022 . www.bls.gov . en-us.
  45. Web site: 2018 . NFPA report - U.S. fire department profile . February 1, 2022 . www.nfpa.org.
  46. Glass . D. C. . Del Monaco . A. . Pircher . S. . Vander Hoorn . S. . Sim . M. R. . October 2016 . Mortality and cancer incidence at a fire training college . Occupational Medicine (Oxford, England) . 66 . 7 . 536–542 . 10.1093/occmed/kqw079 . 1471-8405 . 27371948 . free.
  47. Web site: Collins . Chris . July 7, 2018 . H.R.931 - 115th Congress (2017-2018): Firefighter Cancer Registry Act of 2018 . live . https://web.archive.org/web/20220920192307/https://www.congress.gov/bill/115th-congress/house-bill/931 . September 20, 2022 . September 30, 2022 . www.congress.gov.
  48. Web site: Menendez . Robert . April 25, 2018 . S.382 - 115th Congress (2017-2018): Firefighter Cancer Registry Act of 2018 . live . https://web.archive.org/web/20220920194112/https://www.congress.gov/bill/115th-congress/senate-bill/382 . September 20, 2022 . September 30, 2022 . www.congress.gov.
  49. Web site: Bill would establish firefighter cancer registry . March 17, 2022 . www.safetyandhealthmagazine.com . en.
  50. Web site: US Launches First National Firefighter Cancer Registry . live . https://web.archive.org/web/20210805055938/https://www.asbestos.com/news/2019/03/18/national-firefighter-cancer-registry/ . August 5, 2021 . September 27, 2022 . Mesothelioma Center - Vital Services for Cancer Patients & Families . en.
  51. Book: One Hundred Fifteenth Congress of the United States of America . en . https://web.archive.org/web/20220324234241/https://cswab.org/wp-content/uploads/2018/09/Firefighter-Registry-Act-2018.pdf . March 24, 2022 . live.
  52. Web site: Otis . Ginger Adams . Chuck Schumer wants Congress to create voluntary health registry that tracks firefighters with cancer . live . https://web.archive.org/web/20220317184842/https://www.nydailynews.com/news/politics/chuck-schumer-seeks-registry-track-firefighters-cancer-article-1.2769141 . March 17, 2022 . March 17, 2022 . nydailynews.com.
  53. Web site: Breaking News: House Unanimously Approves Firefighter Cancer Registry Act – Virginia Department of Fire Programs . live . https://web.archive.org/web/20220629173011/https://www.vafire.com/blog/2018/06/27/breaking-news-house-unanimously-approves-firefighter-cancer-registry-act/ . June 29, 2022 . September 30, 2022 . www.vafire.com.
  54. Web site: H.R. 931 Archives . live . https://web.archive.org/web/20201126124112/https://www.cfsi.org/tag/h-r-931/ . November 26, 2020 . September 30, 2022 . Congressional Fire Services Institute . en-US.
  55. Web site: Bipartisan Firefighter Cancer Registry Act Signed into Law . live . https://web.archive.org/web/20220920204240/https://www.klobuchar.senate.gov/public/index.cfm/2018/7/bipartisan-firefighter-cancer-registry-act-signed-into-law . September 20, 2022 . September 30, 2022 . U.S. Senator Amy Klobuchar . en.
  56. Web site: Firefighter Cancer Registry Act of 2018 (2018 - H.R. 931) . May 9, 2022 . GovTrack.us . en.
  57. Web site: June 12, 2018 . S. 382, Firefighter Cancer Registry Act of 2018 Congressional Budget Office . live . https://web.archive.org/web/20220519172225/https://www.cbo.gov/publication/54045 . May 19, 2022 . September 30, 2022 . www.cbo.gov . en.
  58. Web site: H.R. 931, FIREFIGHTER CANCER REGISTRY ACT . dead . https://web.archive.org/web/20181223144815/https://policy.house.gov/legislative/bills/hr-931-firefighter-cancer-registry-act . December 23, 2018 . RPC.
  59. Web site: Fent . Kenneth W. . Siegel . Miriam . Mayer . Alexander . Wilkinson . Andrea . Raudabaugh . Jill . October 16, 2020 . National Firefighter Registry (NFR) Draft Protocol . September 14, 2022 . U.S. National Institute for Occupational Safety and Heath.
  60. Web site: National Firefighter Registry . live . https://web.archive.org/web/20220111101606/https://www.iaff.org/national-firefighter-registry/ . January 11, 2022 . September 30, 2022 . IAFF . en-US.
  61. Web site: September 6, 2022 . National Firefighter Registry - FAQ . September 15, 2022 . U.S. National Institute for Occupational Safety and Health . en-us.
  62. White . Mary C. . Babcock . Frances . Hayes . Nikki S. . Mariotto . Angela B. . Wong . Faye L. . Kohler . Betsy A. . Weir . Hannah K. . December 15, 2017 . The history and use of cancer registry data by public health cancer control programs in the United States . Cancer . 123. Suppl 24 . 4969–4976 . 10.1002/cncr.30905 . 1097-0142 . 5846186 . 29205307.
  63. Web site: September 6, 2022 . National Firefighter Registry Subcommittee (NFRS) . September 15, 2022 . U.S. National Institute for Occupational Safety and Health . en-us.
  64. Web site: NFFF . June 8, 2021 . National Firefighter Registry Updates . live . https://web.archive.org/web/20210920055555/https://www.everyonegoeshome.com/2021/06/08/national-firefighter-registry-updates/ . September 20, 2021 . September 30, 2022 . Everyone Goes Home . en-US.

This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "National Firefighter Registry for Cancer".

Except where otherwise indicated, Everything.Explained.Today is © Copyright 2009-2024, A B Cryer, All Rights Reserved. Cookie policy.