Mortality Among Firefighters in Spain: 10 Years of Follow-up.

OBJECTIVES: The objective of this study was to compare mortality rates for the main causes of death and the most frequent sites of cancer in firefighters and all other occupations. METHODS: Mortality was calculated from a longitudinal study conducted between 2001 and 2011 following a total of 9.5 million men aged 20-64 years old who were in employment in 2001. The age-standardized mortality rate for firefighters was calculated for cancer and other causes of death and compared with that for all other occupations using the mortality rate ratio (MRR). RESULTS: No differences were observed between firefighters and all other occupations for overall mortality [MRR = 0.99, 95% confidence interval (CI): 0.91-1.07] or for mortality from cancer in general (MRR = 1.00, 95% CI: 0.89-1.12). No significant differences were observed in mortality by site of cancer, except for mortality from cancer of larynx (MRR = 1.77, 95% CI: 1.01-3.09) and hypopharynx (MRR = 2.96, 95% CI: 1.31-6.69), which presented a higher magnitude in firefighters. Neither was any significant differences observed between the two groups in mortality due to cardiovascular, respiratory, or digestive diseases or in mortality due to external causes. CONCLUSIONS: Exposure to carcinogens combined with a possible failure to use respiratory protection when fighting fires may be responsible for excess mortality from laryngeal and hypopharyngeal cancer in firefighters. In the future, more research is needed on the health of firefighters and strengthening preventive policies for these workers.