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Non-cancer health risks in firefighters: a systematic review

정원정|송수연|Jun Jae Kwan|Kim Jeong Ah
한국역학회 (Korean Society of Epidemiology)|2022.01|Epidemiology and Health|제44권 |pp. 1-22|DOI 10.4178/epih.e2022109

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참고문헌

키워드

Post-traumatic stress disorderMyocardial infarctionFirefightersOccupational healthMusculoskeletal diseasesChest pain

초록

Firefighters are occupationally exposed to hazardous factors which may increase their risk of disease. Non-cancer disease risk in firefighters has not been systematically examined. This systematic review aimed at identifying non-cancer disease risk in firefighters and determining whether a risk difference exists 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. Because of study heterogeneity, a narrative synthesis was presented. The systematic literature search yielded 2491 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 displayed a significant increase in the incidence of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder in firefighters compared to other occupational groups. Contradicting results around PTSD and anxiety disorders risks related to rank were reported. Sufficient evidence for increased risk of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder was available. There was a difference in the risk of non-cancer disease 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.

Abstract

Firefighters are occupationally exposed to hazardous factors which may increase their risk of disease. Non-cancer disease risk in firefighters has not been systematically examined. This systematic review aimed at identifying non-cancer disease risk in firefighters and determining whether a risk difference exists 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. Because of study heterogeneity, a narrative synthesis was presented. The systematic literature search yielded 2491 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 displayed a significant increase in the incidence of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder in firefighters compared to other occupational groups. Contradicting results around PTSD and anxiety disorders risks related to rank were reported. Sufficient evidence for increased risk of lumbar disc herniation, lower back pain, angina pectoris, acute myocardial infarction, and post-traumatic stress disorder was available. There was a difference in the risk of non-cancer disease 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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