Prostate cancer in firefighting and police work: a systematic review and meta-analysis of epidemiologic studies

Jeavana Sritharan (1, 2) , Manisha Pahwa (2) , Paul Demers (1, 3, 2) , Shelley Harris (1, 2) , Donald Cole (1) , Marie-Élise Parent (4)

1 University of Toronto
2 Occupational Cancer Research Centre
3 SFU.ca - Simon Fraser University = Université Simon Fraser
4 INRS-IAF - Institut Armand Frappier

OBJECTIVES: We conducted a systematic review and meta-analysis to evaluate potential associations between firefighting and police occupations, and prostate cancer incidence and mortality. METHODS: Original epidemiological studies published from 1980 to 2017 were identified through PubMed and Web of Science. Studies were included if they contained specific job titles for ever/never firefighting and police work and associated prostate cancer risk estimates with 95% confidence intervals (CI). Study quality was assessed using a 20-point checklist. Prostate cancer meta-risk estimates (mRE) and corresponding 95% CIs were calculated for firefighting and police work separately and by various study characteristics using random effects models. Between-study heterogeneity was evaluated using the I2 score. Publication bias was assessed using Begg's and Egger's tests. RESULTS: A total of 26 firefighter and 12 police studies were included in the meta-analysis, with quality assessment scores ranging from 7 to 19 points. For firefighter studies, the prostate cancer incidence mRE was 1.17 (95% CI = 1.08-1.28, I2 = 72%) and the mortality mRE was 1.12 (95% CI = 0.92-1.36, I2 = 50%). The mRE for police incidence studies was 1.14 (95% CI = 1.02-1.28; I2 = 33%); for mortality studies, the mRE was 1.08 (95% CI = 0.80-1.45; I2 = 0%). By study design, mREs for both firefighter and police studies were similar to estimates of incidence and mortality. CONCLUSION: Small excess risks of prostate cancer were observed from firefighter studies with moderate to substantial heterogeneity and a relatively small number of police studies, respectively. There is a need for further studies to examine police occupations and to assess unique and shared exposures in firefighting and police work.

Mots clés: Mortality; Meta-analysis; Incidence; Firefighters; Police; Prostate cancer risk; Occupation; Epidemiology; Systematic review

Domaines: Sciences du Vivant [q-bio]

Jeavana Sritharan, Manisha Pahwa, Paul Demers, Shelley Harris, Donald Cole, et al.. Prostate cancer in firefighting and police work: a systematic review and meta-analysis of epidemiologic studies. Environmental Health, 2017, 16 (1), pp.124. ⟨10.1186/s12940-017-0336-z⟩. ⟨pasteur-01854618⟩