In 2010 the International Agency for Research on Cancer (IARC) classified work as a firefighter; Occupational exposure as a firefighter is possibly carcinogenic to humans (Group 2B) (WHO-IARC, 2010). This decision was based on studies showing elevated risk of prostate cancer, testicular cancer, multiple myeloma and non-Hodgkin’s lymphoma (NHL) (LeMasters et al., 2006). The elevated risk was associated to job title and duration of employment. The relationships between occupational exposure to specific carcinogenic substances and incident cancer disease among firefighters have not been studied, however.

Firefighters can be exposed to carcinogenic substances that are released during fires. Exposure to probable and possible carcinogenic substances have been demonstrated during knock down and overhaul of fires including asbestos, benzene, polycyclic aromatic hydrocarbons (PAH), formaldehyde, 1,3-butadiene, polychlorinated and polybrominated biphenyls and diesel exhaust (WHO-IARC, 2010).

The quality of personal protective equipment has developed gradually during the last decades, but its use may also have made it possible for firefighters to operate in more hazardous situations and more extreme exposures. Even smoke diving with a modern self-contained breathing apparatus (SCBA) may give measureable exposure to PAHs through dermal routes (Laitinen et al., 2012 and NIOSH, 2013). Additionally, during the final stage of firefighting, the overhaul, the use of personal protection equipment is often discontinued, although incomplete combustion products in the form of smoke, vapours and gases may still be present.

Information on exposure to chemical agents among Norwegian firefighters is limited because no measurements have been carried out in the past. Studies from other countries provide information on agents that firefighters can be exposed to, but results may not be representative for Norwegian firefighters because of differences in fire extinguishing methods and building materials for houses and movables. Several exposure-reducing measures have been implemented during the last decade in Norway in order to reduce the potential chemical exposure when working as a firefighter. However, the effect of these exposure-reducing measures has not been evaluated. Assessment of current exposure to known carcinogens is important for the evaluation of cancer risks among firefighters using current fire extinguishing methods.

This study is a collaboration between STAMI and the Cancer Registry of Norway and has two main objectives:

  • To evaluate the association between occupational history and cancer risk among firefighters.
  • To evaluate the association between specific exposures and cancer risk.


STAMI is in charge of the part of the study that explores Norwegian firefighter’s current exposure to known carcinogens during extinguishing different types of real fires and controlled residential fires, knock down and overhaul. The following aims where established:

  • Assess among minimum 100 firefighters changes in concentrations of urinary biomarkers of exposure to benzene and polycyclic aromatic hydrocarbons (PAHs) before, immediately after and six hours after the work related to real fires and controlled residential fires.
  • Assess among a sub-group of 20 firefighters with a minimum duration of employment of 20 years as a smoke diver and still working as a smoke diver concentrations of persistent organic pollutants (POPs) and compare these concentrations with concentrations in the Norwegian general population.
  • Assess among firefighters time-weighted average (TWA) concentrations of known carcinogens in fire smoke (e.g. benzene, 1,3-butadiene, PAHs, formaldehyde, acetaldehyde outside and inside the firefighters protective clothing during extinguishing of controlled residential fires and car fires.
  • Assess among firefighters dermal exposure to PAHs on the neck during controlled residential fires and car fires by using a wipe sampling method.

Project group

Project leader: Raymond Olsen

Project group: Karl-Christian Nordby, Hilde Notø, Hanne Line Daae, Kristin Helmersmo, Erika Zardin, Karoline Kåsin.