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Non-cancer health risks in firefighters: a systematic review
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Jeong Ah Kim, Soo Yeon Song, Wonjeong Jeong, Jae Kwan Jun
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Epidemiol Health. 2022;44:e2022109. Published online November 16, 2022
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DOI: https://doi.org/10.4178/epih.e2022109
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Abstract
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Abstract
osFirefighters are occupationally exposed to hazardous factors that may increase their risk of disease. However, non-cancer disease risk in firefighters has not been systematically examined. This systematic review aimed to identify non-cancer disease risk in firefighters and determine whether the risk differs according to job characteristics. We searched the Cochrane Library, Embase, PubMed, and KoreaMed databases using relevant keywords from their inception to April 30, 2021. The Risk of Bias Assessment Tool for Non-randomized Studies version 2.0 was used to assess the quality of evidence. Due to study heterogeneity, a narrative synthesis was presented. The systematic literature search yielded 2,491 studies, of which 66 met the selection and quality criteria. We confirmed that the healthy worker effect is strong in firefighters as compared to the general population. We also identified a significant increase in the incidence of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder (PTSD) in firefighters compared to other occupational groups. Contradictory results for the risk of PTSD and anxiety disorders related to rank were reported. Sufficient evidence for increased risk of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and PTSD was available. The risk of non-cancer diseases varied depending on job type, years of service, and rank. However, caution should be exercised when interpreting the results because the classification criteria for firefighters’ jobs and ranks differ by country.
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Summary
Korean summary
본 연구는 소방관과 비암성 질환과의 직업관련성을 파악하기 위해 체계적 문헌고찰을 수행하였다. 소방관은 근골격계 질환, 협심증, 심근경색, 외상후 스트레스 장애 등 일부 질환에서 일관된 직업관련성이 보고되었다. 하지만 대부분의 연구에서 연구결과가 건강근로자효과의 영향을 보정하지 못하였고 근무형태, 근무조건, 근무강도 등에 따라 일관되지 못한 결과를 보고하고 있다.
Key Message
In firefighters, risks of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder were increased constantly.
Due to the failure to avoid the healthy-worker effect, consistent relationship between firefighters and non-cancerous diseases has not been reported.
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Citations
Citations to this article as recorded by 
- Associations between Recognition and Behaviors Regarding the Use, Washing and Management of Firefighting Protection Suits and Public Health Awareness of Occupational Exposure Risks among Firefighters
Soo Jin Kim, Seunghon Ham Fire.2024; 7(5): 156. CrossRef
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Trends in breast cancer screening rates among Korean women: results from the Korean National Cancer Screening Survey, 2005-2020
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Soo Yeon Song, Yun Yeong Lee, Hye Young Shin, Bomi Park, Mina Suh, Kui Son Choi, Jae Kwan Jun
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Epidemiol Health. 2022;44:e2022111. Published online November 24, 2022
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DOI: https://doi.org/10.4178/epih.e2022111
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6,953
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167
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6
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Abstract
Summary
PDF Supplementary Material
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Abstract
OBJECTIVES Since 2002, the Korean government has provided breast cancer screening as part of the National Cancer Screening Program. This study reported trends in the screening rate among Korean women from 2005 to 2020, including organized and opportunistic screening for breast cancer.
METHODS Data from the Korean National Cancer Screening Survey, an annual cross-sectional nationwide survey, were collected using a structured questionnaire between 2005 and 2020. The study population included 23,702 women aged 40-74 years with no history of cancer. We estimated the screening rate based on the current recommendation of biennial mammographic screening for breast cancer. In addition, a joinpoint trend analysis was performed for breast cancer screening rates among various subgroups.
RESULTS In 2020, the breast cancer screening rate was 63.5%, reflecting an annual increase of 7.72% (95% confidence interval 5.53 to 9.95) between 2005 and 2012, followed by non-significant trends thereafter. In particular, a significant decrease in the breast cancer screening rate was observed in the subgroups aged 50-59 years old, with 12-15 years of education, and living in rural areas.
CONCLUSIONS Although there has been substantial improvement in breast cancer screening rates in Korean women, the trend has flattened in recent years. Therefore, continual efforts are required to identify subgroups with unmet needs and solve barriers to the uptake of breast cancer screening.
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Summary
Korean summary
본 연구는 2005년에서 2020년까지 암검진수검행태조사 자료를 이용하여 40세 이상의 우리나라 여성의 유방암 검진 수검률이 추이에 대해 분석하였다. 우리나라 유방암 검진 수검률은 2020년 현재 63.5%이다. 하지만 지속적으로 증가하던 유방암 검진 수검률의 추이는 2012년 이후 정체되어 있으며 일부 사회경제적 계층에서는 감소하는 경향을 보였다.
Key Message
In Korea, despite of the high level of breast cancer screening rate, decreasing trends in some socioeconomic classes after 2012.
Continual efforts are required to identify subgroup with unmet needs and barriers to the uptake of breast cancer screening.
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Citations
Citations to this article as recorded by 
- A cross-national investigation of CT, MRI, PET, mammography, and radiation therapy resources and utilization
Takahiro Aoyama, Yutaro Koide, Hidetoshi Shimizu, Atsushi Urikura, Tomoki Kitagawa, Shingo Hashimoto, Hiroyuki Tachibana, Takeshi Kodaira Japanese Journal of Radiology.2025; 43(1): 109. CrossRef - Current and future burden of breast cancer in Asia: A GLOBOCAN data analysis for 2022 and 2050
Mengxia Fu, Zhiming Peng, Min Wu, Dapeng Lv, Yanping Li, Shuzhen Lyu The Breast.2025; 79: 103835. CrossRef - Exploring age-standardized cancer incidence rates and regional disparities: A retrospective cohort study of 8 major cancers in South Korea
Dagyeong Lee, Hye-won Yun, Nayeon Kim, Juwon Park, Kyu-won Jung, Mina Suh, Dong Wook Shin Cancer Epidemiology.2024; 91: 102594. CrossRef - Contrasting income-based inequalities in incidence and mortality of breast cancer in Korea, 2006-2015
Jinwook Bahk, Hee-Yeon Kang, Young-Ho Khang, Kyunghee Jung-Choi Epidemiology and Health.2024; 46: e2024074. CrossRef - Determining risk‐adapted starting age and interval for breast cancer screening based on reproductive and hormonal factors
Tung Hoang, Jeonghee Lee, So‐Youn Jung, Jeongseon Kim International Journal of Cancer.2024;[Epub] CrossRef - Why is the screening rate in lung cancer still low? A seven-country analysis of the factors affecting adoption
Charlotte Poon, Tim Wilsdon, Iqra Sarwar, Alexander Roediger, Megan Yuan Frontiers in Public Health.2023;[Epub] CrossRef - Mammographic Breast Density and Risk of Ovarian Cancer in Korean Women
Thi Xuan Mai Tran, Soyeoun Kim, Boyoung Park Cancer Epidemiology, Biomarkers & Prevention.2023; 32(12): 1690. CrossRef
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