Evaluation of a Bladder Cancer Cluster in a Population of Criminal Investigators with the Bureau of Alcohol, Tobacco, Firearms and Explosives—Part 2: The Association of Cancer Risk and Fire Scene Investigation

This study evaluated the association of bladder cancer risk and fire scene investigation within a cohort of white male criminal investigators with the United States Bureau of Alcohol, Tobacco, Firearms and Explosives that was found to be at increased risk for bladder cancer. Medical surveillance data were used in a nested case-control study to determine odds ratios (ORs) estimating the relative risk of the cancer associated with post-fire investigation. The study comprised seven bladder cancer cases and 1525 controls. Six of the cases reported holding assignments associated with post-fire investigation. The OR for bladder cancer was 19.01 (95% confidence interval？=？1.94–186.39) for those holding any one or more of these assignments for one to four years versus zero years and 12.56 (1.14–138.58) for those holding any one or more of these assignments for five or more years versus zero years. The risk for bladder cancer is significantly elevated for those holding post-fire investigation assignments compared to those not holding these assignments. 1. Introduction As presented in Part 1 of this epidemiologic study, a bladder cancer cluster occurred within a cohort of white male criminal investigators working with the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF), United States Department of Justice, between 1994 and 2005 [1]. The cluster was identified through the self-reporting of employees participating in a medical surveillance program which was initially set up to monitor the health of employees dedicated to the investigation of fires and explosions. There were seven self-reported cases in the bladder cancer cluster. Six of the seven were pathology report verified as urinary bladder cancer, five as low grade papillary transitional cell carcinoma, and one as transitional cell carcinoma in situ. In Part 1, analysis of bladder cancer incidence in the study population determined that white male criminal investigators, without regard to work history, were at statistically significant increased risk for bladder cancer [1]. Because six of the seven cases reported holding special assignments associated with post-fire/post-blast scene investigation while employed with ATF, the bladder cancer cluster appeared to be associated with the work on such scenes. Most scenes investigated by ATF are post-fire rather than post-blast and involve municipal structures. Although ATF employees who investigate post-fire scenes typically wait until the fire is out to enter the scene to search for origin and cause, the work still puts them at risk for exposure to a mix