Overseas studies have shown that paid firefighters have an increased risk of cancer but there is little evidence concerning volunteer firefighters. A retrospective cohort was assembled from Australian firefighting agencies’ personnel records. 

The cohort included 18,032 career full-time, 13,701 part-time paid and 201,056 volunteer firefighters. These were matched to national mortality and cancer incidence records. Death and cancer risks were calculated by sex for the three firefighter groups.  Risk was also calculated by employment duration and using agency incident data.

Mortality was significantly decreased for men from all three firefighter groups and for female volunteer firefighters compared to the general Australian population. This is probably a result of the healthy worker effect and lower smoking rates. No major categories of death were significantly elevated in any of the firefighter groups but deaths from cancer were less reduced than deaths from other causes. 

For male career full-time firefighters, cancer incidence was raised for all cancers combined, prostate cancer and melanoma particularly for those employed >20 years. Prostate cancer but not melanoma showed a trend with increasing number of incidents. For male part-time paid firefighters, cancer incidence was significantly raised for all cancers combined. There was an increase in prostate cancer and melanoma. The pattern of findings was similar for male full-time and part-time paid firefighters which is suggestive that these are employment-related effects. 

Male volunteer firefighters had no overall increased risk of cancer, or increasing risk with service duration, but there was a trend with increasing number of incidents attended.  The strongest association was with prostate cancer. 

There were too few female paid firefighters for meaningful analyses. Cancer incidence for female volunteer firefighters was not raised. 

Further follow up is recommended in five years when the larger number of cancer and death events will increase the power of the study.