Mortality Due to Malignant and Non-Malignant Diseases in Korean Professional Emergency Responders

Objective This study was conducted to estimate the cause-specific mortality in male emergency responders (ER), compare with that of Korean men. Mortality was also compared between more experienced firefighters (i.e., firefighters employed >= 20 years and firefighters employed >= 10 to <20 years) and less experienced firefighters and non-firefighters (i.e., firefighters employed <10 years and non-firefighters) to investigate associations between mortality and exposure to occupational hazards. Methods The cohort was comprised of 33,442 males who were employed as ERs between 1980 and 2007 and not deceased as of 1991. Work history was merged with the death registry from the National Statistical Office of Korea to follow-up on mortality between 1992 and 2007. Standardized mortality ratios (SMR) for ERs were calculated in reference to the Korean male population. Adjusted relative risks (ARRs) of mortalities for firefighters employed >= 20 years and >= 10 years to <20 years were calculated in reference to non-firefighters and firefighters employed <10 years. Results Overall (SMR=0.43, 95% CI=0.39-0.47) and some kinds of cause-specific mortalities were significantly lower among ERs compared with the Korean male population. No significant increase in mortality was observed across the major ICD-10 classifications among ERs. Mortality due to exposure to smoke, fire, and flames (SMR=3.11, 95% CI=1.87-4.85), however, was significantly increased among ERs. All-cause mortality (ARR=1.46, 95% CI=1.13-1.89), overall cancer mortality (ARR=1.54, 95% CI=1.02-2.31) and mortality of external injury, poisoning and external causes (ARR=3.13, 95% CI=1.80-5.46) were significantly increased among firefighters employed >= 20 years compared to those of non-firefighters and firefighters employed <10 years. Conclusions An increase in mortality due to all cancer and external injury, poisoning, and external causes in firefighters employed >= 20 years compared with non- firefighters and firefighters employed <10 years suggests occupational exposure.