Cancer Prevention Studies

Fire Fighter Cancer Cohort Study (FFCCS)

Funded by U.S. Department of Homeland Security, Federal Emergency Management Association, Assistance to Firefighter Grant, EMW-2015-FP-00213 awarded to the University of Arizona.

Study Partners

The FFCCS’s 2017 Oversight and Protection Board Meeting in Columbus, OH. Courtesy of the Fire Protection Research Foundation.

Purpose & Objectives

The purpose of this three-year research proposal is to develop and test a framework for establishing a long-term firefighter multicenter prospective cohort study (> 10,000 firefighters) focused on carcinogenic exposures and effects. The specific aims are to:

1. Establish an oversight and planning board to provide study oversight, foster communication among fire organizations and help develop a long-term funding plan;
2. Create and test a cohort study data coordinating center and harmonized survey data protocols;
3. Develop and evaluate an exposure tracking system paired with quantitative exposure data to construct a firefighter carcinogen exposure matrix; and
4. Create a biomarker analysis center and evaluate the association between cumulative firefighter exposures and epigenetic effects.

Courtesy of the University of Miami.

Methods

The study will build on recent and developing firefighter cancer prevention studies in Arizona, Florida and Massachusetts, adding volunteer and combination fire departments

1. An Oversight and Planning Board will be established by the Fire Protection Research Foundation (FPRF) in association with the National Fallen Firefighter Foundation (NFFF) Fire Service Occupational Cancer Alliance (FSOCA) to provide oversight of the study through collaboration among fire service organizations, academia, and government agencies, and develop a long-term funding and sustainability plan.
   
   Courtesy of the Fire Protection Research Foundation.
2. Data Coordination Center will design, develop and evaluate a framework for a multicenter prospective cohort study of firefighters and cancer risk, including standardized participant survey data collection tools and analysis protocols sufficient to address the short- and long-term study objectives as well as linkage with long-term outcome data including cancer development.
   Courtesy of the University of Miami and Boston Fire Department.
3. An Exposure Assessment Center will develop a carcinogen exposure matrix using information gleaned from self-reported and quantitative exposure measurements to provide improved occupational exposure data for comparison with epigenetic outcomes and eventual cancer outcomes. Carcinogen exposures associated with specific fire types and job tasks will be evaluated across fire departments through exhaled breath monitoring and analysis of urine for absorbed contaminants, providing information to guide exposure reduction strategies.
   

   Courtesy of the University of Miami and Boston Fire Department
4. The Biomarker Analysis Center will carry out pilot studies of epigenetic markers of cancer effect and cancer risk comparing firefighters with a range of cumulative exposures and non-firefighter controls. For these purposes, blood and buccal cells will be collected during annual medical surveillance evaluations.
   

Anticipated Outcomes

The proposed research will: establish the framework necessary for the subsequent development of a large multicenter cohort study of cancer in the fire service; advance our understanding of firefighter exposures to carcinogens; and help identify biomarkers of carcinogen effect and cancer risk.

More information can be found on the College of Public Health website and the Firefighter Cancer Cohort Study Virtual Home

Cancer Prevention in the Fire Service: Exposure Assessment, Toxic Effects and Risk Management

Grant: Funded by the U.S. Department of Homeland Security, Federal Emergency Management Association, Assistance to Firefighter Grant, EMW-2014-FP-00200 awarded to the University of Arizona.

Study Partners

Tucson Fire Department
WellAmerica, LLC

Courtesy of Tucson Fire Department.

Purpose and Objectives

The purpose of the proposed research is to identify effective methods of reducing firefighter exposure to carcinogens and associated toxins through completing these goals:

1. Evaluate exposure to carcinogens throughout the work shift

   
   Courtesy of Tucson Fire Department.
2. Measure biomarkers (short for biological markers) of carcinogenic effect in relation to workplace exposures
   Biomarker:
   A biologic feature that can be used to measure the presence or progress of disease or the effects of treatment. For example, prostate specific antigen (PSA) is a biomarker for cancer of the prostate.
3. Within a risk management framework, test the effectiveness of interventions to reduce fire service carcinogen exposure and effects.

Methods

Study Design and Sampling:

Exposure to particulates and volatile chemicals will be measured at the fireground and in-transit.

Courtesy of Tucson Fire Department.

Diesel particulate matter monitoring during responses and in the fire station will also be completed. Blood and urine collected during annual medical surveillance evaluations and various samples post-fireground activities will be analyzed for chemical contaminants.

Courtesy of Tucson Fire Department.

Biomarkers of carcinogenic effect will also be analyzed pre- and post-exposure, and evaluated for association with measured chemical contaminants.

Courtesy of Dr. Shane Snyder.

Blood and urine collected during annual medical surveillance evaluations and various samples post-fireground activities will be analyzed for chemical contaminants.

Courtesy of Dr. Kyoung Sook Jeoung.

The extent to which firefighter chemical exposures and biomarkers of effect can be reduced by following risk management steps will be determined.

Courtesy of Tucson Fire Department.

Standard Operating Procedures, Courtesy of Tucson Fire Department

Download Emergency Scene Wash Down Protocol.docx

Download Emergency Scene Wash Down Policy.docx

Just the Washdown.mp4

More information can be found on the College of Public Health website.

Biomarkers of carcinogenic effect in Public Safety Personnel- Pilot Study

Grant: Pilot Study, UA funded

Study partners

Courtesy of London Fire Brigade.

Tucson and surrounding area fire departments
London Fire Brigade, London, England, Britain
University of Arizona Police Department
WellAmerica, LLC

Courtesy of Tucson Fire Department.

Purpose and Objectives

This pilot project is designed to determine if there currently exists a good biomarker to identify early effects of carcinogen exposure and/or cancer risk in public safety officers.

The goals of this project are to:
1) Perform a pilot study, with up to 80 subjects, and measure the biomarkers of chemical exposure, biological effects, and cancer risk
2) Analyze biological samples for carcinogenic effects

Courtesy of Tucson Fire Department.

Methods

Study Design and Sampling:

Establish the feasibility of working with public safety clinical facilities to recruit, consent, collect, and deliver samples for analysis from public safety officers (firefighters, law enforcement, emergency medical personnel, and other public service personnel.

Courtesy of London Fire Brigade.

Analyze samples (buccal cells, blood, urine) to measure biomarkers of chemical exposure, biological effects, and cancer risk

Analyze medical history via medical records supplied by WellAmerica personnel, for results of tests performed, such as but not limited to their latest annual physical to include laboratory results, lung function test results, and to obtain a list from the subject of fire responses for up to 3 months and other exposures for up to 12 months and personal history of smoking and of cancer

Refine the list of blood, urine, and buccal cell assays for future studies

Take part in a training fire involving a 5-20 person subset of the larger pilot study subject base or a prescribed burn involving 5-20 wildland firefighters or EMTs, to measure personal exposure to smoke particulates and fumes/gasses and to evaluate changes in buccal cell, urine, and blood that reflect exposure to carcinogens or carcinogenic effect

Courtesy of Tucson Fire Department.