Study to assess breast cancer risk for female firefighters

Firefighters are exposed to flame retardants,
diesel exhaust and other toxic chemicals,
which may affect their health.

When firefighters rush out the firehouse doors, sirens screeching on the way to fight fires, they put their lives on the line in more ways than one.

In responding to roughly 28,000 fire calls a year, members of the San Francisco Fire Department are routinely exposed to flame retardants, diesel exhaust and other toxic chemicals that seep out of raging infernos and work their way into the air.

A growing body of evidence strongly suggests that exposure increases firefighters’ risk of developing cancer. But until now, studies have focused on men.

That’s about to change. Members of the San Francisco Fire Department are working with researchers at UC Berkeley, UCSF and the Silent Spring Institute to find out whether exposure to toxic chemicals increases the risks of breast cancer in female firefighters.

The project, known as the Women Firefighters Biomonitoring Collaborative Study, has been under way for about a year.

“Since breast cancer is a cancer that more commonly affects women, and because of anecdotal evidence that the firefighters have been experiencing (many cases of breast cancer), we wanted to see if there was a link,” said Jessica Trowbridge, a UC Berkeley researcher who is coordinating the study.

Trowbridge and her colleagues are gathering blood and urine samples from about 160 women — 80 San Francisco firefighters and 80 city office workers who will serve as the control group — to use in measuring chemical, hormone and melatonin levels.

They will also measure the lengths of the women’s telomeres, caps on the ends of chromosomes that are associated with aging and cancer, also thought to be related to chemical exposure and working demanding night shifts.

Firefighters in general have higher rates of cancer, especially respiratory, digestive and urinary system varieties, a recent National Institute for Occupational Safety and Health study found.

That study included women, but there weren't enough of them to draw robust conclusions about their cancer risks, according to the Centers for Disease Control and Prevention.

With about 225 female firefighters, San Francisco is better equipped than most cities for a study like this: Women make up about 13 percent of its firefighting population, said Heather Buren, a lieutenant and paramedic with the fire department who is working on the study.

In 2011, less than 5 percent of firefighters nationwide were women, according to the Bureau of Labor Statistics.

Researchers will also test for other chemicals that could contribute to higher rates of cancer in both groups of women, who are probably exposed to personal care and household products as well.

There has been a cultural shift with respect to chemical exposure. For one, firefighters now have better breathing masks, which they’re encouraged to wear for longer periods of time in toxic environments.

There are also rules prohibiting members of the department from storing their turnouts — the suits they wear to fight fires — in firehouse rooms where they eat and sleep.

The San Francisco Firefighters Cancer Prevention Foundation, which organizes screenings and promotes cancer prevention in the department, is partially responsible for those changes. It was formed in 2006 by Tony Stefani, a retired firefighter who himself fought cancer.

Researchers have nearly finished enrolling participants for the breast cancer study. They hope to have results published in two years. The women who participate in the study will be able to see their individual results when they are complete.

Source: San Francisco Gate. This article has been edited for length.

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OSHA seeks input on chemical exposures at work

National dialogue on chemical exposures and permissible exposure limits in the workplace launched

Only a fraction of thousands of chemicals
used today has been tested - and that
info is often outdated, experts say.

The U.S. Department of Labor's Occupational Safety and Health Administration announced it is launching a national dialogue with stakeholders on ways to prevent work-related illness caused by exposure to hazardous substances.

The first stage of this dialogue is a request for information on the management of hazardous chemical exposures in the workplace and strategies for updating permissible exposure limits.

OSHA's PELs, which are regulatory limits on the amount or concentration of a substance in the air, are intended to protect workers against the adverse health effects of exposure to hazardous substances.

Ninety-five percent of OSHA's current PELs, which cover fewer than 500 chemicals, have not been updated since their adoption in 1971.

The agency's current PELs cover only a small fraction of the tens of thousands of chemicals used in commerce, many of which are suspected of being harmful.

Substantial resources are required to issue new exposure limits or update existing workplace exposure limits, as courts have required complex analyses for each proposed PEL.

"Many of our chemical exposure standards are dangerously out of date and do not adequately protect workers," said Assistant Secretary of Labor for Occupational Safety and Health Dr. David Michaels.

"While we will continue to work on updating our workplace exposure limits, we are asking public health experts, chemical manufacturers, employers, unions and others committed to preventing workplace illnesses to help us identify new approaches to address chemical hazards."

OSHA is seeking public comment regarding current practices and future methods for updating PELs, as well as new strategies for better protecting workers from hazardous chemical exposures. Specifically, the agency requests suggestions on:

• Possible streamlined approaches for risk assessment and feasibility analyses and
• Alternative approaches for managing chemical exposures, including control banding, task-based approaches and informed substitution.

The goal of this public dialogue is to give stakeholders a forum to develop innovative, effective approaches to improve the health of workers in the United States.

In the coming months, OSHA will announce additional ways for members of the public to participate in the conversation.

The comment period for the RFI lasts for 180 days. Instructions for submitting comments are available in the Federal Register, Docket No. OSHA-2012-0023.

Source: OSHA

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Exposure to Inhaled Agents at Work Means 1 in 4 of Operated Chronic Sinusitis Patients Fail to Recover

Photo: David Castillo Dominici

Researchers in Belgium say exposure to occupational agents at work should be taken into account as a risk factor for the occurrence of chronic rhinosinusitis (CRS). They say that continued exposure at work may also be the cause of its recurrence or persistence, as evidenced by the need for revision surgery.

This conclusion on the chronic sinusitis study will be discussed, alongside other issues at the 9th Symposium on Experimental Rhinology and Immunology of the Nose, in Belgium next week.

Acute and chronic rihnosinusitis (ARS and CRS) are common diseases affecting up to 10 per cent of the Western population and are usually treated by functional endoscopic sinus surgery (FESS) when medical treatment fails. However 10 to 15 per cent of operated patients respond insufficiently to FESS with the main reason believed to be exposure to inhaled noxious agents. The recent studies involving a controlled patient population further point to evidence that occupational exposure represents a large risk factor for the occurrence of rhinosinusitits and its recurrence after surgery.

Occupational agents that were most frequently mentioned by patients and controls are: bleach, inorganic dust, paints, cement, thinner, ammonia, white spirit, fuel gas and acetone with cleaners, caretakers, housewives, builders, painters, carpenters and mechanics the occupations most at risk.

The conclusion, spearheaded by Professor Peter Hellings from the Department of ENT at University Hospital Leuven, reveal that in addition to the continued need to prevent harmful chemical exposure at work, there is a further necessity for more research in this area through prospective clinical studies as well as fundamental research exploring pathophysiological mechanisms of occupational upper airway disease.