Reducing Risk of Cancer from Exposure to Smoke: An Action Plan for Firefighters, First Responders, Residents Exposed to Wildfire Smoke

摘要

Firefighters are at increased risk for developing and dying from many different cancers, including prostate, testicular, colon, bladder, thyroid, melanoma, rectal, and lung. Firefighters are exposed not only to smoke at the time of the fire, but also products of combustion in overhaul after a fire and from contaminated gear and clothing. This smoke is comprised of many different toxicants, including toxic metals, gases, particulates, and other air toxics, that are not just inhaled, but also absorbed trans-dermally and ingested. Exposure to smoke has been shown to increase markers of inflammation including IL-8, VEGF, TNF-al and CRPhs, as well as decreases in glutathione and other anti-oxidants. Exposures to smoke can lead to epigenetic changes in genes, as well as strand breaks in DNA, which increases risk for cancer. Reducing risk for cancer includes decreasing exposures, protecting cells against exposures that do occur, and diagnosing cancers at an earlier stage to reduce mortality. Several studies have shown that firefighters who increase SCBA (self contained breathing apparatus) use and use enhanced decontamination practices, have lower levels of PAH's2. B vitamins, NAC, Glutathione, Melatonin, Sulforaphane, omega-3 fatty acids, and alpha lipoic acid have all been shown to either protect tissues from damage, enhance break down & clearance, and/or protect DNA from damage of various smoke toxicants.3 Several organizations, including the IAFC (International Association of Fire Chiefs) recommend enhanced screening for firefighters for colorectal, testicular, prostate, breast, bladder and skin cancers.