Evaluation of fireground exposures using urinary PAH metabolites

J Expo Sci Environ Epidemiol. 2021 Sep;31(5):913-922. doi: 10.1038/s41370-021-00311-x. Epub 2021 Mar 2.


Background: Firefighters have increased cancer incidence and mortality rates compared to the general population, and are exposed to multiple products of combustion including known and suspected carcinogens.

Objective: The study objective was to quantify fire response exposures by role and self-reported exposure risks.

Methods: Urinary hydroxylated metabolites of polycyclic aromatic hydrocarbons (PAH-OHs) were measured at baseline and 2-4 h after structural fires and post-fire surveys were collected.

Results: Baseline urine samples were collected from 242 firefighters. Of these, 141 responded to at least one of 15 structural fires and provided a post-fire urine. Compared with baseline measurements, the mean fold change of post-fire urinary PAH-OHs increased similarly across roles, including captains (2.05 (95% CI 1.59-2.65)), engineers (2.10 (95% CI 1.47-3.05)), firefighters (2.83 (95% CI 2.14-3.71)), and paramedics (1.84 (95% CI 1.33-2.60)). Interior responses, smoke odor on skin, and lack of recent laundering or changing of hoods were significantly associated with increased post-fire urinary PAH-OHs.

Significance: Ambient smoke from the fire represents an exposure hazard for all individuals on the fireground; engineers and paramedics in particular may not be aware of the extent of their exposure. Post-fire surveys identified specific risks associated with increased exposure.

Keywords: Cancer; Dermal exposure; Inhalation exposure; Polycyclic aromatic hydrocarbons; Vulnerable occupations; Workplace exposures.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Air Pollutants, Occupational* / analysis
  • Firefighters*
  • Fires*
  • Humans
  • Occupational Exposure* / analysis
  • Polycyclic Aromatic Hydrocarbons* / analysis


  • Air Pollutants, Occupational
  • Polycyclic Aromatic Hydrocarbons