Cherry Nicola, Fedun Mike, Galarneau Jean-Michel, Senkevics Doryen, Zadunayski Tanis
Division of Preventive Medicine, University of Alberta, 8303 112 St, Edmonton, Alberta, T6G 2T4, Canada.
Government of Alberta, 9920 108 St, Edmonton, Alberta, T5K 2M4, Canada.
Ann Work Expo Health. 2025 Feb 25;69(2):132-146. doi: 10.1093/annweh/wxae089.
Very little is known about the effects on the health of work as a wildland firefighter over repeated fire seasons. In Alberta, where the fire season runs from 1 March to 31 October, the great majority of firefighters are hired seasonally. We examined whether there was a dose-response relationship between hours of firefighting and ill-health.
A cohort was established linking employment records from Alberta Wildfire to administrative health data and cancer records. The employment records contained information on each deployment for all firefighters with employment from 1998 to 2022. Health records had details of diagnoses recorded at all physician consultations for the same period. Cancer records included diagnostic information for all confirmed cancers in the province. Exposure indices (hours worked) were related to health outcomes, with relative risk estimated by multilevel Poisson regression, using data lagged by 10 years for cancer outcomes.
Of 16,816 firefighters with employment records, 12,731 were matched on name, age, and sex in health records and were living in Alberta at the end of at least one fiscal year. One in three had only been employed for one fire season with 10% employed in 10 or more years. The overall mean cumulative exposure was 795 h with 568 h of sustained attack (SA). In multivariable regression, adjusted for age, sex, and inferred First Nation origin, the risk of chronic obstructive pulmonary disease (COPD) and pneumonia increased with hours of firefighting on foot and decreased with fighting less complex fires or holding a permanent appointment. Hours of firefighting in the year of health report were protective for cardiovascular disease (CVD) and mental ill-health but the risk of injury from external causes increased with firefighting hours. The risk of COPD, pneumonia, and asthma increased with cumulative hours over multiple fire seasons of SA firefighting and decreased with cumulative hours fighting less complex fires. Risks of CVD and mental ill-health were also positively related to cumulative hours of SA. No increase in risk was found with cancer incidence (all cancers, bladder cancer, lung cancer, skin: melanoma or nonmelanoma), with exposures unlagged or lagged by 10 years.
Wildland firefighters were found to be at increased risk of lung conditions, both acutely in the year of firefighting and in subsequent years. No increased risk was found for cancer.
对于在多个火灾季节从事野外消防员工作对健康的影响，我们了解甚少。在阿尔伯塔省，火灾季节从3月1日持续到10月31日，绝大多数消防员是季节性雇佣的。我们研究了灭火时长与健康不佳之间是否存在剂量反应关系。
建立了一个队列，将阿尔伯塔野火局的就业记录与行政健康数据及癌症记录相联系。就业记录包含了1998年至2022年期间所有有工作经历的消防员每次部署的信息。健康记录有同期所有医生诊疗时记录的诊断细节。癌症记录包括该省所有确诊癌症的诊断信息。暴露指数（工作时长）与健康结果相关，通过多级泊松回归估计相对风险，癌症结果使用滞后10年的数据。
在16816名有就业记录的消防员中，12731人在健康记录中的姓名、年龄和性别相匹配，并且在至少一个财政年度末居住在阿尔伯塔省。三分之一的人仅工作过一个火灾季节，10%的人工作了10年或更长时间。总体平均累积暴露时长为795小时，其中持续扑救时长为568小时。在多变量回归中，经年龄、性别和推断的原住民血统调整后，慢性阻塞性肺疾病（COPD）和肺炎的风险随着徒步灭火时长的增加而增加，随着扑救不太复杂的火灾或持有长期任命而降低。健康报告当年的灭火时长对心血管疾病（CVD）和精神健康不佳有保护作用，但外部原因导致的受伤风险随着灭火时长增加。SA灭火多个火灾季节的累积时长增加，COPD、肺炎和哮喘的风险增加，而扑救不太复杂火灾的累积时长增加则风险降低。CVD和精神健康不佳的风险也与SA的累积时长呈正相关。无论暴露数据是否滞后或滞后10年，癌症发病率（所有癌症、膀胱癌、肺癌、皮肤癌：黑色素瘤或非黑色素瘤）均未发现风险增加。
发现野外消防员肺部疾病风险增加，在灭火当年及随后几年均如此。未发现癌症风险增加。
