Journal of Korean Society of Occupational and Environmental Hygiene (한국산업보건학회지)

Korean Industrial Hygiene Association (한국산업보건학회)
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Risk Analysis of All Types of Cancer among Firefighters and Police Officers Using National Health Insurance Claim Data

건강보험 청구 자료를 이용한 소방 및 경찰공무원의 암 종별 위험도 분석

  • Lee, Woo-Ri (Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center) ;
  • Yun, Byungyoon (Department of Preventive Medicine, Yonsei University College of Medicine) ;
  • Yoo, Ki-Bong (Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University) ;
  • Yoon, Jin-Ha (Department of Preventive Medicine, Yonsei University College of Medicine)
  • 이우리 (국립암센터 국가암관리사업본부 암관리정책부) ;
  • 윤병윤 (연세대학교 의과대학 예방의학교실) ;
  • 유기봉 (연세대학교 SWDH대학 보건행정학부) ;
  • 윤진하 (연세대학교 의과대학 예방의학교실)
  • Received : 2022.08.12
  • Accepted : 2022.09.20
  • Published : 2022.09.30
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Abstract

Objectives: Firefighters and police officers are exposed to various occupational hazards. No studies in Korea have investigated the occurrence of cancer by type of cancer for the two occupations. This study aims to investigate the risk of occurrences associated with types of cancers in firefighters and police officers. Methods: Utilizing National Health Insurance(NHI) Claims data from 2006-2015, the study included 8,871,468 general workers, 25,001 firefighters, and 102,274 police officers. Using general workers as a control group, we calculated the standardized incidence ratios(SIR) by types of cancer for firefighters and police officers. After calculating the SIR for all subjects, the SIR was calculated by stratifying according to gender. Results: SIR of colon cancer 1.38(95% CI, 1.11-1.69), cancer of the liver and intrahepatic bile ducts 1.27(95% CI, 1.04-1.54), and 1.88(95% CI, 1.28-2.65) bladder cancer were higher firefighters than general workers. SIR of Lip, oral cavity, and pharynx 1.26(95% CI, 1.07-1.47), Stomach 1.14(95% CI, 1.06-1.23), colon 1.33(95% CI, 1.21-1.46), liver and intrahepatic bile ducts 1.21(95% CI, 1.10-1.32), pancreas 1.24(95% CI, 1.02-1.49), other skin 1.60(95% CI, 1.26-2.00), bladder 1.27(95% CI, 1.04-1.54), other urinary tract 1.46(95% CI, 1.27-1.68), other parts of central nervous system 1.68(95% CI, 1.10-2.46) were higher police officers than general workers. Conclusions: Both firefighters and police officers are exposed to various cancer occurrence risks, necessitating the development of occupational medical protection measures to reduce risk exposure factors.

Keywords

Acknowledgement

본 연구의 데이터는 직업환경의학회와 건강보험공단으로부터 MOU의 일환으로 제공 받았습니다. 본 연구는 국민건강보험공단의 빅데이터를 활용하여 분석하였으며 자료를 제공하여주신 건강보험공단의 관계자께 깊은 감사를 드립니다.

References

  1. Boffetta P & Silverman DT. A meta-analysis of bladder cancer and diesel exhaust exposure. Epidemiol 2001;125-130 (https://www.jstor.org/stable/3703690)
  2. Boulanger M, Morlais F, Bouvier V, Galateau-Salle F, Guittet L et al. Digestive cancers and occupational asbestos exposure: incidence study in a cohort of asbestos plant workers. Occup Environ Med 2015;72(11):792-797 (http://dx.doi.org/10.1136/oemed-2015-102871)
  3. Cormier JN, Xing Y, Ding M, Lee JE, Mansfield PF et al. Ethnic differences among patients with cutaneous melanoma. Arch Intern Med 2006;166(17): 1907-1914 (10.1001/archinte.166.17.1907)
  4. Daniels RD, Kubale TL, Yiin JH, Dahm MM, Hales TR et al. Mortality and cancer incidence in a pooled cohort of US firefighters from San Francisco, Chicago and Philadelphia (1950-2009). Occup Environ Med 2014; 71(6):388-397 (http://dx.doi.org/10.1136/oemed2013-101662)
  5. Demers PA, DeMarini DM, Fent KW, Glass DC, Hansen J et al. Carcinogenicity of occupational exposure as a firefighter. Lancet Oncol 2022;23(8):985-986. (https://doi.org/10.1016/S1470-2045(22)00390-4)
  6. Doolan G, Benke G, Giles G. An update on occupation and prostate cancer. Asian Pac J Cancer Prev 2014;15(2):501-516 (https://doi.org/10.7314/APJCP.2014.15.2.501)
  7. Dulay LER, Galvan MDKP, Puyaoan RJM, Sison AAY, Natanauan NS. et al. Occupational noise exposure of traffic enforcers in selected streets in the city of Manila. Acta Med Philipp 2018;52(3) (https://doi.org/10.47895/amp.v52i3.406)
  8. Dun A, Zhao X, Jin X, Wei T, Gao X et al. Association between night-shift work and cancer risk: updated systematic review and meta-analysis. Front Oncol 2020;10:1006 (https://doi.org/10.3389/fonc.2020.01006)
  9. Finkelstein MM. Cancer incidence among Ontario police officers. Am J Ind Med 1998;34(2):157-62 (https://doi.org/10.1002/(SICI)1097-0274(199808)34:2<157::AID-AJIM8>3.0.CO;2-U)
  10. Han M, Jung YS, Kim WH, Cheon JH, Park S. Cancer risk in patients with intestinal Behcet's disease: a Nationwide population-based study. Gut liver 2018a;12(4):433 (10.5009/gnl17324)
  11. Han M, Park S, Park JH, Hwang SS, Kim I. Do police officers and firefighters have a higher risk of disease than other public officers? A 13-year nationwide cohort study in South Korea. BMJ open 2018b;8(1):e019987 (http://dx.doi.org/10.1136/bmjopen-2017-019987)
  12. Harris MA, Kirkham TL, MacLeod JS, Tjepkema M, Peters PA et al. Surveillance of cancer risks for firefighters, police, and armed forces among men in a Canadian census cohort. Am J Ind Med 2018;61(10):815-823 (https://doi.org/10.1002/ajim.22891)
  13. Hu Y, Zhang L, Bai Z, Zhu T, Zhang H et al. PAHs exposure assessment for traffic police officers during duty time in Tianjin, China. Epidemiol 2006; 17(6):S459-S460
  14. International Agency for Research on Cancer (IARC). IARC monographs on the identification of carcinogenic hazards to humans. World Health Organization 2019
  15. Jalilian H, Ziaei M, Weiderpass E, Rueegg CS, Khosravi Y et al. Cancer incidence and mortality among firefighters. Int J Cancer 2019;145(10):2639-2646 (https://doi.org/10.1002/ijc.32199)
  16. Jankovic J, Jones W, Burkhart J, Noonan G. Environmental study of firefighters. Ann Occup Hyg 1991;35(6):581-602 (https://doi.org/10.1093/annhyg/35.6.581)
  17. Jetelina KK, Molsberry RJ, Gonzalez JR, Beauchamp AM, Hall T. Prevalence of mental illness and mental health care use among police officers. JAMA Netw Open 2020;3(10):e2019658-e2019658 (10.1001/jamanetworkopen.2020.19658)
  18. Jung YS, Han M, Park S, Kim WH, Cheon JH. Cancer risk in the early stages of inflammatory bowel disease in Korean patients: a nationwide population-based study. J Crohns Colitis 2017;11(8):954-962 (https://doi.org/10.1093/ecco-jcc/jjx040)
  19. Khan RK & Strand MA. Road dust and its effect on human health: a literature review. Epidemiol Health 2018;40 (10.4178/epih.e2018013)
  20. Kim J, Shin SJ, Kang HT. The association between triglyceride-glucose index, cardio-cerebrovascular diseases, and death in Korean adults: A retrospective study based on the NHIS-HEALS cohort. PloS One 2021;16(11):e0259212 (https://doi.org/10.1371/journal.pone.0259212)
  21. Lee DJ, Koru-Sengul T, Hernandez MN, Caban-Martinez AJ, McClure LA et al. Cancer risk among career male and female Florida firefighters: Evidence from the Florida Firefighter Cancer Registry (1981-2014). Am J Ind Med 2020;63(4):285-299 (https://doi.org/10.1002/ajim.23086)
  22. Lee J, Lee WR, Yoo KB, Cho J, Yoon J et al. Risk of cerebro-cardiovascular diseases among police officers and firefighters: A Nationwide Retrospective Cohort Study. Yonsei Med J 2022;63(6): 585 (10.3349/ymj.2022.63.6.585)
  23. Lee JH, Kim HJ, Han KD, Kim HN, Park YM et al. Cancer risk in 892 089 patients with psoriasis in Korea: a nationwide population-based cohort study. J dermatol 2019;46(2):95-10 (https://doi.org/10.1111/1346-8138.14698)
  24. Lee K, Park SJ, Lim HS. A study of noise-induced hearing loss associated with the work of firefighters. The Korean Society of Occupational and Environmental Medicine(KSOEM). 2007. P.127-128
  25. Lee KM, Chun JB, Park DU, Lee WJ. Methods to minimize or adjust for healthy worker effect in occupational epidemiology. J Environ Health Sci 2011;37(5):342-347 (https://doi.org/10.5668/JEHS.2011.37.5.342)
  26. Levine MS & Radford EP. Occupational exposures to cyanide in Baltimore firefighters. J Occup Med 1978;20(1):53-56 (https://www.jstor.org/stable/45012971) https://doi.org/10.1097/00043764-197801000-00011
  27. Lotz WG, Rinsky RA, Edwards RD. "Occupational Exposure of Police Officers to Microwave Radiation from Traffic Radar Devices" Cincinnati: National Institute for Occupational Safety and Health (NIOSH) 1995
  28. Ma CC, Andrew ME, Fekedulegn D, Gu JK, Hartley TA et al. Shift work and occupational stress in police officers. Saf Health Work 2015;6(1):25-29 (https://doi.org/10.1016/j.shaw.2014.10.001)
  29. Marjerrison N, Jakobsen J, Demers PA, Grimsrud TK, Hansen J et al. Comparison of cancer incidence and mortality in the Norwegian Fire Departments Cohort, 1960-2018. Occup Environ Med 2022 (http://dx.doi.org/10.1136/oemed-2022-108331)
  30. Nam B, Kim H, Jang EJ, Cho SK, Sung YK et al. Malignancy risk in Korean male patients with ankylosing spondylitis. Rheumatol Int 2019;39(10): 1741-1748 (https://doi.org/10.1007/s00296-019-04408-3)
  31. National Health Insurance Sharing Service(NHISS). Sample Research DB: Details of DB and cost. [Accessed 2022 July 31] Available from: https://nhiss.nhis.or.kr/bd/ab/bdaba022eng.do
  32. Orzel RA. Toxicological aspects of firesmoke: polymer pyrolysis and combustion. Occup Med 1993;8(3):414-429
  33. Paget-Bailly S, Cyr D, Luce D. Occupational exposures to asbestos, polycyclic aromatic hydrocarbons and solvents, and cancers of the oral cavity and pharynx: a quantitative literature review. Int Arch Occup Environ Health 2012; 85:341- 51 (https://doi.org/10.1007/s00420-011-0683-y)
  34. Paris C, Thaon I, Herin F, Clin B, Lacourt A et al. Occupational asbestos exposure and incidence of colon and rectal cancers in French men: the asbestos-related diseases cohort (ARDCo-Nut). Environ Health Perspect 2017;125(3):409-415 (https://doi.org/10.1289/EHP153)
  35. Pelucchi C, Gallus S, Garavello W, Bosetti C, La Vecchia C. Cancer risk associated with alcohol and tobacco use: focus on upper aero-digestive tract and liver. Alcohol Res Health. 2006;29(3):193-8
  36. Rao D, Yu H, Bai Y, Zheng X, Xie L. Does night-shift work increase the risk of prostate cancer? A systematic review and meta-analysis. Onco Targets Ther 2015; 8: 2817- 26 (10.2147/OTT.S89769)
  37. Rawla P, Sunkara T, Gaduputi V. Epidemiology of pancreatic cancer: global trends, etiology and risk factors. World J Oncol 2019;10(1):10 (10.14740/wjon1166)
  38. Salehiniya H & Raei M. Oral cavity and lip cancer in the world: an epidemiological review. Biomed Res Ther 2020;7(8):3898-3905 (https://doi.org/10.15419/bmrat.v7i8.619)
  39. Sarin SK, Kumar M, Eslam M, George J, Al Mahtab M et al. Liver diseases in the Asia-Pacific region: a lancet gastroenterology & hepatology commission. Lancet Gastroenterol Hepatol 2020;5(2):167-228 (https://doi.org/10.1016/S2468-1253(19)30342-5)
  40. Smith DR, Devine SUE, Leggat PA, Ishitake T. Alcohol and tobacco consumption among police officers. Kurume Med J 2005;52(1+ 2):63-65 (https://doi.org/10.2739/kurumemedj.52.63)
  41. Sritharan J, Kirkham TL, MacLeod J, Marjerrison N, Lau A et al. Cancer risk among firefighters and police in the Ontario workforce. Occup Environ Med 2020 (http://dx.doi.org/10.1136/oemed-2021-108146)
  42. Treitman RD, BURGESS WA, GOLD A. Air contaminants encountered by firefighters. Am Ind Hyg Assoc J 1980;41(11):796-802 (https://doi.org/10.1080/15298668091425662)
  43. Win KN, Balalla NB, Lwin MZ, Lai A. Noise-induced hearing loss in the police force. Saf Health Work 2015;6(2):134-138 (https://doi.org/10.1016/j.shaw.2015.01.002)
  44. Wirth M, Vena JE, Smith EK, Bauer SE, Violanti J et al. The epidemiology of cancer among police officers. Am J Ind Med 2013;56(4):439-453 (https://doi.org/10.1002/ajim.22145)