Key Features.
To identify cancer incidence and occupational disease related to firefighting, the Registry-based Epidemiological Study of Cancer in Fire Units and Emergency Officers (RESCUE) was established. This multi-data linkage cohort includes firefighters in South Korea who were registered in 2021 and undergoes regular annual follow-up.
The RESCUE cohort comprised 45 436 Korean firefighters who agreed to participate, all actively serving as of 2021 as a baseline. The mean age of the cohort was 38.1 years, with 91% being male. Annual follow-ups have been conducted and, to date, one wave has been completed, with an attrition rate of 1.7% and a completion rate of 98.3%.
The data set was linked to special medical examinations that were conducted between 2018 and 2020, and has been annually updated with cancer registry data, National Health Insurance Service claims and death information from Statistics Korea. The cancer registry data have been followed up since December 2021. The main categories of data collected include cancer diagnoses, health examination results and mortality information.
Any researcher interested in exploring RESCUE cohort data can access it upon reasonable request by contacting the corresponding author at jkjun@ncc.re.kr.
Why was the cohort set up?
The Registry-based Epidemiological Study of Cancer in Fire Units and Emergency Officers (RESCUE) cohort is a multi-data linkage-based study that was initiated to identify cancer incidence in Korean firefighters. It continuously monitors cancer incidence through cancer registry data linkage and identifies occupational and common diseases related to firefighting. In 2022, the International Agency for Research on Cancer (IARC) announced in Monographs Volume 132 that firefighting was classified as a Group 1 carcinogen, providing sufficient evidence for an increased risk of cancers such as bladder cancer and mesothelioma in humans.1,2 As firefighters are exposed to carcinogens, there have been longstanding concerns that cumulative exposure increases their cancer risk.2,3 Traditionally, the occupational hazards associated with fire services, such as falling buildings and smoke inhalation, have been largely limited to the consequences of performing essential job functions; however, the risk of cancer is also a growing concern.4 Several epidemiological studies have examined cancer incidence and mortality risk among firefighters.5–8 Strong heterogeneity has been reported for the risk estimates of overall cancer, whereas moderate to strong heterogeneity has been reported for those of some site-specific cancers, including those of the buccal cavity and pharynx, brain, nervous system, lung, skin and prostate.5,8,9
Continuing to study existing and new cohorts of firefighters is important to improve understanding of the health effects associated with this potentially hazardous occupation. There are several firefighter cohorts, with many based in the USA. The US Centers for Disease Control and Prevention created a registry to accurately monitor the incidence and risk factors of cancer among US firefighters and evaluate control measures for prevention.10 In response, the National Firefighter Registry began enrolment in April 2023.11 In 2016, the Fire Fighter Cancer Cohort Study, funded by the Federal Emergency Management Agency based in the USA, established a national framework, which aims to collect and integrate firefighter epidemiological surveys, biomarkers and exposure data with a specific focus on carcinogenic exposure and health effects.12 Apart from cancer, other studies have also investigated occupational hazards and the risks of other diseases. For example, Firefighter Obesity Research—Workplace Assessment to Reduce Disease, based in California, USA, is a representative large-scale study that is aimed at preventing long-term diseases caused by obesity.13,14
Firefighters face higher occupational risks than the general population.15 They also exhibit higher standardized incidence ratios for cancer compared with non-firefighters.16 Fire smoke, originating from various burning materials and conditions, varies in toxicity.9 Additionally, firefighters experience more significant lung function deterioration than general workers due to firefighting exposure levels, smoke and the use of respiratory personal protective equipment.16 Several cohort studies have been conducted to address these concerns. The Firefighter Research on the Enhancement of Safety and Health cohort aimed to identify the risk factors of cardiovascular disease and mental disorders among Korean firefighters.13 Most studies have utilized National Health Insurance claim data, investigated work-related incidents conducted by the National Fire Agency (NFA) over a 5-year span or only included firefighters who worked in emergency services.13,15,17,18 Thus, there remains a need for a cohort that represents the entire Korean firefighter population. The RESCUE cohort aims to fill this gap by encompassing the entire Korean fire service, ensuring comprehensive data collection and analysis for all firefighters.
Currently, there is still a lack of extensive data on the relationship between on-duty firefighters who are exposed to unspecified harmful substances and diseases such as cancer. Therefore, the RESCUE cohort was established to provide data on occupational risks that will guide the formulation of health policies that are suitable for firefighters. The RESCUE cohort provides extensive data on Korean firefighters, including personal information, special medical examination data and regular updates on cancer registry data, medical-claim data and death information. These data sets are collected through data linkage.
Who is in the cohort?
Data were collected to investigate the health effects of exposure to harmful factors that are related to firefighting. We aim to collect information from the NFA regarding all municipal and wildland firefighters who are working in Korea and enrol them in our study. This study targeted firefighters who were in service as of January 2021 as the baseline. We linked data from special medical examinations that were conducted between 2018 to 2020 to classify the health status of the cohort participants who were enrolled in 2021. Furthermore, cancer registry data from the Korea Central Cancer Registry will be continuously linked for each participant, starting in 2021. The cancer registry data are a project of the Ministry of Health and Welfare of Korea, who collects, manages and analyses nationwide statistical data related to cancer, including the current status of cancer in Korea. Additionally, a special medical examination is required to be conducted annually in accordance with the ‘Enforcement Degree of the Framework Act on Health, Safety and Welfare of Firefighting Officials’ for the health of workers. These examinations include factors related to harmful issues such as noise, cardiovascular disease and heavy metals. Depending on the results of the examination, measures such as job placement may be required. Special medical examination data of the firefighters were obtained from the Central 911 Rescue Headquarters and 18 cities and provinces between 2018 and 2020. Data from 19 regions were included. Some cities and provinces were excluded because the data for some years were not available; these included Sejong (2018 − 19) and Gyeongnam (2019). In total, 248 fire departments, fire academics and fire stations were included, including one Central 911 Rescue Headquarters, 81 in a metropolitan city and 166 others (Figure 1). Of the firefighters who were currently working in South Korea, 83.9% agreed to participate. Among them, 45 436 firefighters who could undergo special medical examinations were included in the final cohort.
Figure 1.
Locations of 248 fire departments, fire academies and fire stations in South Korea
How often have they been followed up?
This cohort regularly tracked and observed firefighters who registered in 2021 by using personal resident registration numbers. The cohort was established in 2021 as the baseline year and is regularly followed up every year (Figure 2). The data are continuously updated with cancer registry data from the Korea Central Cancer Registry, medical data from the National Health Insurance Service claims database and death information for all causes, including cancer-related deaths, from Statistics Korea. This enables us to track each individual’s cancer incidence, progression and death. Cancer registry data have been investigated since 2021; as of now (December 2023), they are being updated annually and continue to be linked to a cohort of firefighters. Cancer registry data were estimated to have 98.3% completeness.19
Figure 2.
Flow chart of firefighters cohort. aThe final cohort of 45 436 firefighters all had special medical exam data collected in 2018–20
What has been measured?
Validated questionnaires were used to collect data on the fire stations and the demographic and health characteristics of the participants. Personal data included age, sex, job, position, first appointment date, name of examination institution, examination date and location of fire department. Based on their primary role designation, the participants were classified into office administrators, fire-control workers, paramedics and rescue workers, and unknown categories. Office administrators included individuals who worked at the reception and those involved in internal work, administration, education and psychology. Fire-control workers were responsible for extinguishing fires. Paramedics and rescue workers were involved in first-aid or rescue work. Each participant’s job classification was determined based on their primary task, ensuring no overlap between participants.
Health-related data examined through special medical examination included height, weight, waist circumference, body mass index, and systolic and diastolic blood pressure. We also evaluated fasting blood sugar, triglycerides, glycosuria, proteinuria, haematuria, urobilinogen, pyuria, nitrite (urinary nitrite) and alpha-fetoprotein levels, which were chosen based on their availability from the data source and their relevance to common health issues in the cohort. The variables used in this study are described in detail in Supplementary Table S1 (available as Supplementary data at IJE online). Special medical examinations categorize health results into three groups: healthy, probable diseases and possible diseases. This classification is important, as it serves as the criteria for determining the suitability of continuous task performance. Probable diseases indicate the necessity for follow-up examination due to the risk of progressing to an occupational or common disease. Possible diseases display signs of occupational or common disease, which necessitates follow-up care. Participants with probable diseases exhibit conditions or symptoms, whereas those with possible diseases do not meet the criteria for a disease; however, there is a possibility of occurrence that requires observation. The disease codes for common and occupational diseases are shown in Supplementary Table S2 (available as Supplementary data at IJE online). Annual follow-up through cancer registry data enables continuous monitoring of cancer incidence and death data from Statistics Korea are used to track mortality, providing comprehensive long-term insights into cancer incidence and outcomes.
What has it found?
A total of 45 436 firefighters participated in this cohort, including 9379 office administrators, 20 191 fire-control workers, 14 819 paramedics and rescue workers, and others whose roles were unknown. The mean age was 38.1 years for all the firefighters, 41.7 years for the office administrators, 38.9 years for the fire-control workers, 34.6 years for the paramedics and rescue workers, and 39.8 years for those whose roles were unknown. Ninety-one percent of the total participants were male. When compared by position, there were 15 043 (33.1%) firefighters, including 1081 (11.5%) office administrators, 7225 (35.8%) fire-control workers, 6580 (44.4%) paramedics and rescue workers, and 157 (15.0%) whose roles were unknown. Of the total participants, 3.2% tested positive for proteinuria, 3.5% tested positive for haematuria and 6.7% tested positive for urobilinogen, with each measurement taken at baseline during the special medical examination. The other baseline characteristics of the participants are shown in Table 1.
Table 1.
Baseline characteristics of firefighters according to job classification
| Variables | Total | Office administrators | Fire-control workers | Paramedics and rescue workers | Unknown | |||||
|---|---|---|---|---|---|---|---|---|---|---|
| Total | 45 436 | 9379 | 20 191 | 14 819 | 1047 | |||||
| Age (years) | 38.1 | ± 9.0 | 41.7 | ± 8.3 | 38.9 | ± 9.6 | 34.6 | ± 7.2 | 39.8 | ± 8.8 |
| Sex | ||||||||||
| Male | 41 381 | (91.1) | 8385 | (89.4) | 19 426 | (96.2) | 12 598 | (85.0) | 972 | (92.8) |
| Female | 4055 | (8.9) | 994 | (10.6) | 765 | (3.8) | 2221 | (15.0) | 75 | (7.2) |
| Location of fire departments | ||||||||||
| National 911 Rescue Headquarters | 262 | (0.6) | 13 | (0.1) | 27 | (0.1) | 151 | (1.0) | 71 | (6.8) |
| Metropolitan city | 16 398 | (36.1) | 3239 | (34.5) | 7628 | (37.8) | 5032 | (34.0) | 499 | (47.7) |
| Others | 28 776 | (63.3) | 6127 | (65.3) | 12 536 | (62.1) | 9636 | (65.0) | 477 | (45.6) |
| Position | ||||||||||
| Unknown | 804 | (1.8) | 64 | (0.7) | 158 | (0.8) | 100 | (0.7) | 482 | (46.0) |
| Fireman | 15 043 | (33.1) | 1081 | (11.5) | 7225 | (35.8) | 6580 | (44.4) | 157 | (15.0) |
| Senior Fireman | 8617 | (19.0) | 1776 | (18.9) | 2713 | (13.4) | 4035 | (27.2) | 93 | (8.9) |
| Fire Sergeant | 8905 | (19.6) | 2244 | (23.9) | 4104 | (20.3) | 2440 | (16.5) | 117 | (11.2) |
| Fire Lieutenant | 9416 | (20.7) | 2396 | (25.5) | 5386 | (26.7) | 1502 | (10.1) | 132 | (12.6) |
| Fire Captain | 2067 | (4.5) | 1312 | (14.0) | 563 | (2.8) | 139 | (0.9) | 53 | (5.1) |
| Assistant Fire Chief | 508 | (1.1) | 438 | (4.7) | 38 | (0.2) | 21 | (0.1) | 11 | (1.1) |
| Fire Chief | 76 | (0.2) | 68 | (0.7) | 4 | (0.02) | 2 | (0.01) | 2 | (0.2) |
| Body measurements | ||||||||||
| Height (cm) | 172.9 | ± 6.3 | 172.3 | ± 6.3 | 173.4 | ± 5.8 | 172.6 | ± 6.8 | 172.7 | ± 6.0 |
| Weight (kg) | 74.1 | ± 11.8 | 73.7 | ± 11.6 | 74.7 | ± 11.8 | 73.5 | ± 11.9 | 74.1 | ± 10.5 |
| Waist circumference (cm) | 82.0 | ± 7.9 | 82.7 | ± 8.0 | 82.4 | ± 7.6 | 81.1 | ± 8.2 | 82.6 | ± 7.7 |
| Body mass index (kg/m2) | 24.3 | ± 3.6 | 24.4 | ± 3.6 | 24.4 | ± 3.5 | 24.2 | ± 3.7 | 24.7 | ± 3.1 |
| Biological measurements | ||||||||||
| Systolic blood pressure (mmHg) | 122.2 | ± 19.1 | 172.3 | ± 19.7 | 173.4 | ± 19.0 | 172.6 | ± 19.1 | 172.7 | ± 13.8 |
| Diastolic blood pressure (mmHg) | 75.3 | ± 12.8 | 73.7 | ± 11.0 | 74.7 | ± 14.1 | 73.5 | ± 12.2 | 74.1 | ± 9.3 |
| Fasting blood sugar (mg/dL) | 96.7 | ± 14.7 | 82.7 | ± 15.8 | 82.4 | ± 15.5 | 81.1 | ± 12.7 | 82.6 | ± 14.7 |
| Triglyceride (mg/dL) | 126.3 | ± 88.0 | 136.1 | ± 92.3 | 128.9 | ± 88.7 | 116.4 | ± 83.0 | 130.7 | ± 89.1 |
| Glycosuria (mg/dL) | ||||||||||
| Unknown | 2180 | (4.8) | 567 | (6.0) | 971 | (4.8) | 632 | (4.3) | 10 | (1.0) |
| Negative (–) | 42 924 | (94.5) | 8741 | (93.2) | 19 045 | (94.3) | 14 110 | (95.2) | 1028 | (98.2) |
| Positive (+) | 263 | (0.6) | 57 | (0.6) | 144 | (0.7) | 53 | (0.4) | 9 | (0.9) |
| Trace | 69 | (0.2) | 14 | (0.1) | 31 | (0.2) | 24 | (0.2) | 0 | (0.0) |
| Proteinuria (mg/d) | ||||||||||
| Unknown | 1996 | (4.4) | 500 | (5.3) | 897 | (4.4) | 589 | (4.0) | 10 | (1.0) |
| Negative (–) | 39 716 | (87.4) | 8191 | (87.3) | 17 626 | (87.3) | 12 986 | (87.6) | 913 | (87.2) |
| Positive (+) | 1452 | (3.2) | 263 | (2.8) | 651 | (3.2) | 471 | (3.2) | 67 | (6.4) |
| Trace | 2272 | (5.0) | 425 | (4.5) | 1017 | (5.0) | 773 | (5.2) | 57 | (5.4) |
| Haematuria | ||||||||||
| Unknown | 2082 | (4.6) | 499 | (5.3) | 929 | (4.6) | 645 | (4.4) | 9 | (0.9) |
| Negative (–) | 41 215 | (90.7) | 8415 | (89.7) | 18 410 | (91.2) | 13 397 | (90.4) | 993 | (94.8) |
| Positive (+) | 1597 | (3.5) | 357 | (3.8) | 607 | (3.0) | 600 | (4.0) | 33 | (3.2) |
| Trace | 542 | (1.2) | 108 | (1.2) | 245 | (1.2) | 177 | (1.2) | 12 | (1.1) |
| Urinary urobilinogen | ||||||||||
| Unknown | 3745 | (8.2) | 829 | (8.8) | 1653 | (8.2) | 1228 | (8.3) | 35 | (3.3) |
| Negative (–) | 29 932 | (65.9) | 6111 | (65.2) | 13 531 | (67.0) | 9728 | (65.6) | 562 | (53.7) |
| Positive (+) | 3031 | (6.7) | 649 | (6.9) | 1259 | (6.2) | 974 | (6.6) | 149 | (14.2) |
| Trace | 8728 | (19.2) | 1790 | (19.1) | 3748 | (18.6) | 2889 | (19.5) | 301 | (28.7) |
| Pyuria | ||||||||||
| Unknown | 5320 | (11.7) | 1111 | (11.8) | 2380 | (11.8) | 1766 | (11.9) | 63 | (6.0) |
| Negative (–) | 38 923 | (85.7) | 8008 | (85.4) | 17 419 | (86.3) | 12 537 | (84.6) | 959 | (91.6) |
| Positive (+) | 1087 | (2.4) | 239 | (2.5) | 351 | (1.7) | 479 | (3.2) | 18 | (1.7) |
| Trace | 106 | (0.2) | 21 | (0.2) | 41 | (0.2) | 37 | (0.2) | 7 | (0.7) |
| Nitrite (urinary nitrite) | ||||||||||
| Unknown | 2113 | (4.7) | 470 | (5.0) | 945 | (4.7) | 673 | (4.5) | 25 | (2.4) |
| Negative (–) | 43 111 | (94.9) | 8872 | (94.6) | 19 123 | (94.7) | 14 097 | (95.1) | 1019 | (97.3) |
| Positive (+) | 108 | (0.2) | 19 | (0.2) | 48 | (0.2) | 38 | (0.3) | 3 | (0.3) |
| Trace | 104 | (0.2) | 18 | (0.2) | 75 | (0.4) | 11 | (0.1) | 0 | (0.0) |
| Alpha-fetoprotein (AFP) | ||||||||||
| Unknown | 26 222 | (57.7) | 5408 | (57.7) | 11 485 | (56.9) | 8583 | (57.9) | 746 | (71.3) |
| Negative (–) | 18 247 | (40.2) | 3783 | (40.3) | 8253 | (40.9) | 5914 | (39.9) | 297 | (28.4) |
| Positive (+) | 967 | (2.1) | 188 | (2.0) | 453 | (2.2) | 322 | (2.2) | 4 | (0.4) |
Values in parentheses are percentages, whereas the ± values denote standard deviations.
Table 2 shows the baseline characteristics of 262 firefighters at the Central 911 Rescue Headquarters. In total, 151 (57.6%) were paramedics and rescue workers, and 27 (10.3%) were fire-control workers. The mean age of the firefighters in the Central 911 Rescue Headquarters was 38.0 years and 98.5% were male. Table 3 presents the results of special medical examinations among Korean firefighters. Of the 45 436 individuals, 16 387 were deemed to be healthy workers, 5628 had probable occupational diseases and 435 had possible occupational diseases.
Table 2.
Baseline characteristics of firefighters at National 911 Rescue Headquarters
| Variables | Total [ n/mean (%) SD] | Office administrators [ n/mean (%) SD] | Fire-control workers [ n/mean (%) SD] | Paramedics and rescue workers [ n/mean (%) SD] | Unknown [n/mean (%) SD] | P-value |
|---|---|---|---|---|---|---|
| Central 911 Rescue Headquarters | 262 | 13 | 27 | 151 | 71 | |
| Demographic characteristics | ||||||
| Age (years) | 38.0 ± 7.6 | 38.9 ± 7.6 | 43.7 ± 6.7 | 36.4 ± 7.0 | 39.3 ± 8.1 | <0.0001 |
| Sex | 0.1704 | |||||
| Male | 258 (98.5) | 12 (92.3) | 27 (100) | 148 (98.0) | 71 (100) | |
| Female | 4 (1.5) | 1 (7.7) | 0 (0) | 3 (2.0) | 0 (0) | |
| Body measurements | ||||||
| Height (cm) | 174.8 ± 5.7 | 173.3 ± 5.7 | 174.9 ± 5.5 | 174.9 ± 5.7 | 174.9 ± 5.8 | 0.7994 |
| Weight (kg) | 76.4 ± 9.2 | 73.0 ± 12.2 | 76.4 ± 12.6 | 76.6 ± 8.2 | 76.8 ± 9.0 | 0.5816 |
| Waist circumference (cm) | 82.2 ± 6.4 | 81.4 ± 8.1 | 83.3 ± 8.7 | 82.3 ± 6.0 | 81.9 ± 6.0 | 0.7556 |
| Body mass index (kg/m²) | 24.9 ± 2.5 | 24.2 ± 3.8 | 24.9 ± 3.4 | 25.0 ± 2.2 | 25.0 ± 2.6 | 0.7556 |
| Biological measurements | ||||||
| Systolic blood pressure (mmHg) | 121.1 ± 12.0 | 116.7 ± 13.7 | 121.8 ± 9.4 | 122.2 ± 10.7 | 119.5 ± 14.8 | 0.2385 |
| Diastolic blood pressure (mmHg) | 74.1 ± 8.6 | 74.9 ± 9.1 | 72.9 ± 7.3 | 74.1 ± 8.5 | 74.4 ± 9.3 | 0.8553 |
| Fasting blood sugar (mg/dL) | 101.3 ± 15.9 | 99.5 ± 8.2 | 101.2 ± 10.0 | 100.7 ± 18.6 | 103.1 ± 12.5 | 0.7374 |
| Triglyceride (mg/dL) | 129.5 ± 94.7 | 131.9 ± 83.3 | 147.6 ± 120.1 | 123.2 ± 85.4 | 135.4 ± 105.0 | 0.5896 |
Table 3.
The results of the special medical examinations among Korean firefighters
| Total | 45 436 | (100.0%) |
|---|---|---|
| Healthy workers | 16 387 | (36.1%) |
| Probable occupational disease | 5628 | (12.4%) |
| Probable common disease | 17 917 | (39.4%) |
| Possible occupational disease | 435 | (1.0%) |
| Possible common disease | 4468 | (9.8%) |
| Othersa | 601 | (1.3%) |
All enrolled firefighters undergo special medical examinations, except for those who retire or have new employment. Supplementary Table S2 (available as Supplementary data at IJE online) shows the diseases included in occupational and common diseases.
Individuals who were subjected to additional examination or those who failed to complete the examination due to factors such as retirement.
The RESCUE cohort study identifies health issues related to firefighting through the linkage of epidemiological data from Korean firefighters. Special medical examinations provide information on occupational and other common diseases. To assess cancer incidence among firefighters, cancer registry data, medical-claims data and death information will be regularly linked and updated. Firefighters are heavily exposed to various physical, psychological, chemical and biological hazards during their occupational activities, including emergency rescue, first aid and fire extinguishing.20,21 A previous study showed that the prevalence of stomach cancer was higher in firefighters than in the general population (479.7 per 100 000 firefighters; the age-standardized prevalence rate of male Koreans was 425.6 per 100 000).22 In a meta-analysis of 32 studies, prostate cancer, testicular cancer and non-Hodgkin’s lymphoma were associated with firefighting activities.21 Therefore, it is essential to create a registry of Korean firefighters to collect data on their health outcomes and identify the risks of cancer and other diseases.
Firefighters are regularly exposed to various contaminants, including benzopyrene, carbon monoxide and formaldehyde.6,23 A large cohort that links various data is necessary to comprehend the characteristics of Korean firefighters and to gain insight into occupational disease and cancer. In our study, only 8.9% of participants were female firefighters. However, the proportion of female firefighters has been increasing and previous studies have shown that they have a higher incidence of overall cancer risk and mortality than office workers.24
What are the main strengths and weaknesses?
This RESCUE cohort study had several limitations. First, there may have been selection bias, as only those who agreed to provide personal information were included as final participants. However, all firefighters are legally required to undergo a special medical examination and the cancer registry data are 98.3% complete. These data could represent the entire firefighter population, given that 83.9% of the firefighters who are working in South Korea were included. Moreover, some participants may have been healthy workers because certain professionals, such as firefighters and the military, have to undergo strenuous physical and endurance examinations to assess their physical health.25 Additionally, health behaviour-related factors that can affect cancer incidence were not included in this cohort. However, some of these factors will be assessed through the physical function tests or biochemical tests that are included in this study. Despite these limitations, the RESCUE cohort has several noteworthy advantages. The RESCUE cohort was obtained from the NFA and included a large number of firefighters with accurate information. Moreover, as a nationwide population-based cancer registry, medical-claims data and death information are linked to this baseline information; health information of the firefighters can be monitored; health outcomes such as cancer can be identified; and health management policies for firefighters can be established. Moreover, this RESCUE cohort confirmed the prevalence of possible or probable diseases, including cancer, which could provide information about occupational diseases that are related to firefighting activities and other common diseases.
We have emphasized the importance of the creation of a cohort of firefighters with health outcomes, including cancer, which may be related to occupational hazards. Cancer registry data, medical-claims data and death information, which will be regularly updated, can serve as extensive sources of data for monitoring the health outcomes of firefighters. Therefore, this cohort can provide foundational insights to create another cohort of Korean firefighters. A system for monitoring diseases, such as cancer, among firefighters and to collect and investigate data systematically and continuously is needed. This will facilitate the prevention of disease and the improvement of the health of firefighters by analysing the prevalence and trends of certain diseases over time.
Can I get hold of the data? Where can I find out more?
The RESCUE cohort data are not freely available, but the data sets can be accessed after obtaining reasonable approval from the corresponding author (jkjun@ncc.re.kr). International researchers can contact the corresponding author for additional information regarding collaboration and data access.
Ethics approval
This study was approved by the Institutional Review Board of the National Cancer Center (IRB number: NCC2021-0262). Written informed consent was obtained from the participating firefighters from the National Fire Agency. This study adhered to the principles of the Declaration of Helsinki.
Supplementary Material
Acknowledgements
Not applicable.
Contributor Information
Wonjeong Jeong, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
Yoon A Kim, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
Soo Yeon Song, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.
Dong-Hee Koh, Department of Occupational and Environmental Medicine, International St Mary's Hospital, Catholic Kwandong University, Incheon, Republic of Korea.
Hyoung-Ryoul Kim, Department of Occupational and Environmental Medicine, College of Medicine, The Catholic University of Korea.
Jae-Lim Cho, Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Changsoo Kim, Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Jae Kwan Jun, National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea; Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
Data availability
See ‘Can I get hold of the data?’ above.
Supplementary data
Supplementary data are available at IJE online.
Author contributions
The study was conceived and designed by Jae Kwan Jun and Changsoo Kim. The formal analysis and methodology were implemented by Yoon A Kim and Soo Yeon Song. The initial drafts of the manuscript were written by Wonjeong Jeong. Assistance in drafting the manuscript was provided by Dong-Hee Koh, Hyoung-Ryoul Kim and Jae-Lim Cho. The manuscript preparation was supervised by Jae Kwan Jun, the corresponding author of this work. All authors read and approved the final manuscript.
Use of artificial intelligence (AI) tools
None declared.
Funding
This work was supported by the National Fire Agency (grant number 202100180001) and a Grant-in-Aid for Cancer Research and Control from the National Cancer Center of Korea (grant number 2210771–3).
Conflict of interest
None declared.
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Data Availability Statement
See ‘Can I get hold of the data?’ above.