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Research Letter
February 2018

Firefighter Skin Cancer and Sun Protection Practices: Evidence From the Florida Firefighter Cancer Initiative

Author Affiliations
  • 1Division of Environment and Public Health in the Department of Public Health Sciences, University of Miami, Miller School of Medicine, Miami, Florida
  • 2Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
  • 3Division of Epidemiology & Population Health Sciences in the Department of Public Health Sciences, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
  • 4Department of Dermatology & Cutaneous Surgery, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
  • 5Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
  • 6Division of Biostatistics in the Department of Public Health Sciences, Sylvester Comprehensive Cancer Center, University of Miami, Miller School of Medicine, Miami, Florida
JAMA Dermatol. 2018;154(2):219-221. doi:10.1001/jamadermatol.2017.4254

Firefighters serve in a hazardous occupation and face unique dermal exposures. Recent epidemiologic studies have found an elevated risk for skin cancer among firefighters compared with the general population.1 Firefighter exposure studies2 have detected carcinogenic chemicals on firefighter skin and gear following fire-incident response. There is limited research on risk factors and occupational hazards related to skin cancer in the firefighter workforce. We examine skin cancer history, skin cancer screening, and sun protection habits among active Florida firefighters.

The Annual Cancer Survey (ACS) research project of the Firefighter Cancer Initiative launched with a 127-item comprehensive cancer questionnaire administered via REDCap to a nonprobabilistic sample of firefighters and/or paramedics employed in South Florida. We present ACS data collected during the first 12 months of this cross-sectional, convenience study (http://sylvester.org/firefighters). Firefighters were invited and consented by the study team to complete the ACS using a secure iPad device during their regular work shift. Standardized subjective measures assessing for doctor-diagnosed skin cancer, type of skin cancer, frequency of sunburn, tanning bed use in their lifetime, health insurance status, skin cancer screening behavior, and sociodemographic characteristics, as well as job characteristics, were analyzed. Multivariate and univariate logistic regression models were fitted to predict history of skin cancer and sun protection practices. Adjusted odds ratios (aOR) and unadjusted odds ratios (uOR) were calculated with 95% CIs. This study was approved by the University of Miami institutional review board.

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