Sarasota, FL (WorkersCompensation.com) – Among the more controversial aspects of the workers’ compensation system is the idea of presumptions, in which employers, rather than workers bear the burden of proof in a claim. While COVID-19 has brought the issue into focus, many states had previously adopted presumptions for frontline workers, especially targeting various cancers and Post-traumatic Stress Disorder.
Having a clearer understanding of whether, to what extent and how workers contract certain conditions may help better address these controversial claims. It also may aid organizations in reducing or even eliminating the risks altogether. That’s the goal of a Canadian study that sheds new light on cancer hazards facing firefighters and police.
“Firefighters and police demonstrated some similar as well as some unique cancer risks,” the researchers wrote in the BMJ Journal Occupational and Environmental Medicine. “Findings from this larger worker population may have important implications for workplace and policy-level changes to improve preventative measures and reduce potential exposures to known carcinogenic hazards.”
Known and suspected carcinogenic exposures as well as high-stress environments are a reality for police and firefighters. Research has indicated firefighters, in particular, are at increased risk of certain cancers, though relatively few studies focus on law enforcement officers.
“Firefighters may be exposed to both fire-related (eg, heavy metals, polycyclic aromatic hydrocarbon) and non-fire-related (eg, shiftwork, diesel engine exhaust carcinogens),” they wrote. “Police may be exposed to shiftwork and engine exhaust during their job.”
The authors compared claims of firefighters and police with those of the general working population in Ontario, for the years 1983 – 2020. Using the Occupational Disease Surveillance System, the researchers identified the affected frontline workers by using lost-time workers’ compensation claims data and followed for cancer in the Ontario Cancer Registry. The final tally included 13,642 firefighters and 22,595 police.
“Our findings support those of previous studies and provide evidence of increased risk of other cancer sites with previously limited evidence,” the authors concluded. “Firefighters and police had increased risk of cancer of the prostate and colon and of melanoma. Additionally, firefighters had increased risk of pancreatic, testicular and kidney cancer, and non-Hodgkin’s lymphoma and leukemia, while police had increased risk of thyroid, bladder and female breast cancer.”
Prostate cancer was noted as a risk factor for the firefighters in the study, similar to previous findings. The researchers found a higher risk than had been previous reported.
“Although it is unclear what exposures are linked to prostate cancer in firefighters, few factors have been postulated,” they wrote. “Night and rotating shiftwork are common in protective services occupations and have been suspected to be involved in cancer development through disruption of the circadian rhythm.”
To date there has been limited evidence supporting the idea of firefighting as a risk for testicular cancer. But the researchers observed a higher risk compared to all other workers – 156 percent. They also had twice the risk compared to police officers.
Firefighters also had higher incidents of leukemia compared to all other workers.
Certain other cancers were cited as having higher incident rates compared to all other workers. They included
- Bladder cancer. The 12 percent increased risk was in line with other previous studies.
- Mesothelioma. This risk “became significant” when it was restricted to comparison with the police.
- Melanoma. There was “a more than twofold statistically excess risk,” they said. “Firefighters may be exposed to solar radiation while working outside during calls, training or performing errands. They also have the potential to be exposed to PCB through inhalation or dermal absorption when exposed to fire and smoke.”
In comparison to police, firefighters also had an elevated risk of mesothelioma and testicular cancer.
Risks for prostate and colon cancer and melanoma were similar to those found among firefighters.
There was an increased risk in testicular cancer, although it was described as “non-statistically significant,” especially when compared to firefighters.
Bladder cancer was more of a risk for police, similar to findings from previous studies in Switzerland and the U.S. The U.S. research found a fourfold increased mortality rate among police with at least 40 years of experience.
Melanoma risk was similar to that found among firefighters, with a “more than twofold statistically significant excess risk” compared to all other workers.
The authors did find a decreased risk of lung and laryngeal cancer among both firefighters and police.
“Many of our findings attenuated when comparing firefighters with the police and vice versa, which may imply that there are common exposures involved, compared with other workers in the cohort. For example, shiftwork should be further investigated given the elevated risk of breast, prostate and colon cancer in these occupations,” the researchers concluded. “This can lead to the protection of workers and improvement of prevention strategies.”