@article{298bfe1573744a3f9d556d42955b9547,
title = "Comparing cancer risk estimates using occupational record linkage approaches in male Florida firefighters",
abstract = "Background: Firefighters have an increased risk of cancer, but variations in reported results could be due to differences in occupational case ascertainment. This study compares cancer risk estimates generated by identifying firefighters from their occupational title available in the Florida Cancer Data System (FCDS) versus identification by a linkage method between the FCDS and the Florida State Fire Marshal's Office. Methods: Florida firefighter employment records (1972–2012; n = 109,009) were linked with FCDS data (1981–2014; ~3.3 million records), identifying 3760 primary cancers in male firefighters. Using the FCDS occupational data field we identified 1831 male cancer cases in those classified as firefighters, first-line supervisors of firefighting and prevention workers, fire inspectors, emergency medical technicians, or paramedics. Age and calendar year-adjusted odds ratios (aOR) and 95% confidence intervals for firefighters versus non-firefighters were calculated for both groups. Results: For skin cancers the risk estimate for FCDS-indentified firefighters was substantially lower than in the employment-record-linked firefighters (aOR = 1.06; 0.87–1.29 vs. 1.54; 1.37–1.73), but for endocrine system cancers it was greater (aOR = 2.36; 1.77–3.14 vs. 2.08; 1.71–2.53). Remaining cancer risk estimates were in the same direction for the two samples except for lymphoma (aOR = 1.10; 0.90–1.34 vs. 0.86; 0.75–0.99). Conclusion: Reliance on occupational title in cancer registry records to characterize firefighter cancer risk may result in estimates that are over- or underestimated depending on cancer site. The authors recommend moving toward national linkages between cancer registries and certification or other administrative records, which are a vital resource for firefighter cancer research.",
keywords = "Florida, cancer risk, firefighters, occupation",
author = "McClure, {Laura A.} and Tulay Koru-Sengul and Hernandez, {Monique N.} and Caban-Martinez, {Alberto J.} and Kobetz, {Erin N.} and Lee, {David J.}",
note = "Funding Information: The authors wish to acknowledge the State of Florida and their firefighter colleagues for their continued support and ongoing contributions to the Firefighter Cancer Initiative at Sylvester Comprehensive Cancer Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The data used in this report were collected by the Florida State Fire Marshal's Office and the Florida Cancer Data System (FCDS), the statewide cancer registry funded by the Florida Department of Health (DOH), and the Centers for Disease Control and Prevention's National Program of Cancer Registries (CDC‐NPCR). The views expressed herein are solely those of the authors and do not necessarily reflect those of the DOH or CDC‐NPCR. This study was supported by funds from Florida State Appropriation #2382 A ( http://umiamihealth.org/sylvester-comprehensive-cancer-center/research/firefighter-cancerinitiative ). Research reported in this publication was also supported by the National Cancer Institute of the National Institutes of Health under Award Number P30CA240139. Funding Information: The authors wish to acknowledge the State of Florida and their firefighter colleagues for their continued support and ongoing contributions to the Firefighter Cancer Initiative at Sylvester Comprehensive Cancer Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The data used in this report were collected by the Florida State Fire Marshal's Office and the Florida Cancer Data System (FCDS), the statewide cancer registry funded by the Florida Department of Health (DOH), and the Centers for Disease Control and Prevention's National Program of Cancer Registries (CDC-NPCR). The views expressed herein are solely those of the authors and do not necessarily reflect those of the DOH or CDC-NPCR. This study was supported by funds from Florida State Appropriation #2382 A (http://umiamihealth.org/sylvester-comprehensive-cancer-center/research/firefighter-cancerinitiative). Research reported in this publication was also supported by the National Cancer Institute of the National Institutes of Health under Award Number P30CA240139.",
year = "2021",
month = feb,
doi = "10.1002/ajim.23205",
language = "English (US)",
volume = "64",
pages = "78--83",
journal = "American Journal of Industrial Medicine",
issn = "0271-3586",
publisher = "Wiley-Liss Inc.",
number = "2",
}