TABLE C-1 Epidemiologic Studies Cited in Chapter 6: Health Outcomes

Study and Design Population Exposure Outcomes Adjustments Limitations and Comments
Aronson et al. 1994 Retrospective cohort study. [Respiratory-s; Circulatory-k; Cancer-k; All Cause-k] 5,414 firefighters who had worked at any time between 1950 and 1989 at six fire departments in Metropolitan Toronto. Includes 777 deaths. Employed as a firefighter (yes/ no); years since first exposure (first employment); years of exposure (years of employment). Cause of death. Compared with general male population of Ontario. Total Cohort: Brain cancer and other NS tumors (ICD9 191-192): SMR 201, 95% CI 110-337; Other Malignant Neoplasms (ICD9 195-199): SMR 238, 95% CI 145-367; Diabetes mellitus (ICD9 250): SMR 35, 95% CI 9-88; Chronic rheumatic heart disease (ICD 393-398, 424.0-424.3): SMR 15, 95% CI 0.4-85; Aortic aneurysm (ICD9 441): SMR 226, 95% CI 136-354; Symptoms/Ill-defined (ICD9 780-799): SMR 17, 95% CI 0.4-95); External Causes (ICD9 E800-999): SMR 71, 95% CI 55-90) Modified life-table approach; subjects censored at age 85 years; cata stratified by years since first employment, age, and duration of employment. Multiple testing-findings labeled as statistically significant by chance alone; healthy worker effect and survivor effect.
Age 60-84: Aortic aneurysm: SMR 245, 95% CI 140-398; Chronic bronchitis, asthma, and emphysema: 155, 95% CI 101-227; Digestive system diseases: SMR 156, 95% CI 100-232; Gallbladder diseases: 420, 95% CI 136-980; all other causes NS.
Aronson et al. 1996 Registry-based case-control study [Reproductive-s] 9,340 Fathers of all children with congenital heart defects matched to 9,340 Toronto fathers of children without an anomaly, from the Toronto birth registry 1979-1986. Father’s occupation as a firefighter in Toronto. Cardiac congenital anomalies. 11 case and 9 controls had fathers who were firefighters (OR 1.22, 95% CI 0.46-3.33). Matched on birth year, maternal age at birth, birth order, parents’ birth places (in or out of Ontario), and mother’s marital status at birth.
Bandaranayke et al. 1993 Case-control study [Neurological-s] 245 firefighters exposed to a chemical fire in 1984, and 217 unexposed firefighters matched for age and years of service in New Zealand. Presence at a chemical fire in 1984. Nervous system dysfunction. More exposed firefighters exhibited CNS dysfunction than unexposed firefighters (in 4 categories of symptoms, all p<0.025). Firefighters score poorly on more neuropsychological tests (RR 1.32, 95% CI 1.11-1.57), particularly psychomotor tests (RR 1.51, 95% CI 1.33-1.71, compared to unexposed firefighters. Matched for age and years of service. Tests conducted 4 years after the fire event; 3 cases of testicular cancer described.

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