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The National Institute for Occupational Safety and Health (NIOSH)








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										**Cancer risk:**
Tsai RJ, Luckhaupt SE, Schumacher P, Cress RD, Deapen DM, Calvert GM. Risk of cancer among firefighters in California, 1988-2007 [2015]. Am J Ind Med *58*(7):715-29. doi: 10.1002/ajim.22466. PMID: 25943908; PMCID: PMC4527530.
Dahm MM, Bertke S, Allee S, Daniels RD[2015]. Creation of a retrospective job-exposure matrix using surrogate measures of exposure for a cohort of US career firefighters from San Francisco, Chicago, and Philadelphia. Occup Environ Med *72*(9):670-7. doi: 10.1136/oemed-2014-102790. PMID: 26163543; PMCID: PMC4576837.
Daniels RD, Bertke S, Dahm MM, Yiin JH, Kubale TL, Hales TR, Baris D, Zahm SH, Beaumont JJ, Waters KM, Pinkerton LE [2015]. Exposure-response relationships for select cancer and non-cancer health outcomes in a cohort of U.S. firefighters from San Francisco, Chicago, and Philadelphia (1950-2009). Occup Environ Med *72*(10):699-706. doi: 10.1136/oemed-2014-102671. PMID: 25673342; PMCID: PMC4558385.**Biological Exposures to Polycyclic Aromatic Hydrocarbons (PAHs), Volatile Organic Compounds (VOCs), and Flame Retardants:**
Fent KW, Mayer AC, Toennis C, Sammons D, Robertson S, Chen IC, Bhandari D, Blount BC, Kerber S, Smith DL, Horn GP [2022]. Firefighters’ urinary concentrations of VOC metabolites after controlled-residential and training fire responses. Int J Hyg Environ Health *242*:113969. https://doi.org/10.1016/j.ijheh.2022.113969.
Mayer AC, Fent KW, Wilkinson A, Chen IC, Kerber S, Smith DL, Kesler RM,  Horn GP. [2022]. Characterizing exposure to benzene, toluene, and naphthalene in firefighters wearing different types of new or laundered PPE. Int J Hyg Environ Health *240*:113900. https://doi.org/10.1016/j.ijheh.2021.113900.
Fent KW, Toennis C, Sammons D, Robertson S, Bertke S, Calafat AM, Pleil JD, Wallace M, Kerber S, Smith D, Horn GP. [2020]. Firefighters’ absorption of PAHs and VOCs during controlled residential fires by job assignment and fire attack tactic.
J Expo Sci Environ Epidemiol *30*(2), 338–349. https://doi.org/10.1038/s41370-019-0145-2.
Fent KW, Toennis C, Sammons D, Robertson S, Bertke S, Calafat AM, Pleil JD, Geer Wallace MA, Kerber S, Smith DL, Horn GP. [2019]. Firefighters’ and instructors’ absorption of PAHs and benzene during training exercises. Int J Hyg Environ Health *222*(7), 991–1000. https://doi.org/10.1016/j.ijheh.2019.06.006.
Fent KW, Eisenberg J, Snawder J, Sammons D, Pleil JD, Stiegel, MA, Mueller C, Horn GP, Dalton J. [2014]. Systemic exposure to PAHs and benzene in firefighters suppressing controlled structure fires. Ann Occup Hyg *58*(7), 830–845. https://doi.org/10.1093/annhyg/meu036.
Mayer AC, Fent KW, Chen IC, Sammons D, Toennis C, Robertson S, Kerber S, Horn GP, Smith D L, Calafat AM, Ospina M, Sjodin A [2021]. Characterizing exposures to flame retardants, dioxins, and furans among firefighters responding to controlled residential fires. Int J Hyg Environ Health *236*:113782. https://doi.org/10.1016/j.ijheh.2021.113782**Environmental Exposures during or after Fire Responses:**
Horn GP, Madrzykowski D, Neumann DL, Mayer AC, Fent KW [2022]. Airborne contamination during post-fire investigations: hot, warm and cold scenes. J Occup Environ Hyg*19*(1):35-49. doi: 10.1080/15459624.2021.2002343. PMID: 34762010
Fent KW, LaGuardia M, Luellen D, McCormick S, Mayer A, Chen IC, Kerber S, Smith D, Horn GP [2020]. Flame retardants, dioxins, and furans in air and on firefighters’ protective ensembles during controlled residential firefighting. *Environ Intl* *140*: 105756. https://doi.org/10.1016/j.envint.2020.105756.
Fent KW, Mayer A, Bertke S, Kerber S, Smith D, Horn GP [2019]. Understanding airborne contaminants produced by different fuel packages during training fires. J Occup Environ Hyg *16*(8), 532–543. https://doi.org/10.1080/15459624.2019.1617870.
Fent KW, Evans DE, Babik K, Striley C, Bertke S, Kerber S, Smith D, Horn GP [2018]. Airborne contaminants during controlled residential fires. J Occup Environ Hyg *15*(5), 399–412. https://doi.org/10.1080/15459624.2018.1445260.
Evans DE, Fent KW [2015]. Ultrafine and respirable particle exposure during vehicle fire suppression. Environ Sci Process Impacts *17*(10), 1749-1759. https://doi.org/10.1039/c5em00233h
Volatile organic compounds off-gassing from firefighters’ personal protective equipment ensembles after use. J Occup Environ Hyg *12*(6), 404–414.
Fent KW, Evans DE. [2011]. Assessing the risk to firefighters from chemical vapors and gases during vehicle fire suppression. J Environ Monit *13*(3), 536–543.**Contamination Control:**
Horn GP, Fent KW, Kerber S, Smith DL [2022]. Hierarchy of contamination control in the fire service: Review of exposure control options to reduce cancer risk. J Occup Environ Hyg *19*(9), 538–557. https://doi.org/10.1080/15459624.2022.2100406.
Kesler RM, Mayer A, Fent KW, Chen IC, Deaton AS, Ormond RB, Smith DL, Wilkinson A, Kerber S, Horn GP [2021]. Effects of firefighting hood design, laundering and doffing on smoke protection, heat stress and wearability. Ergonomics*,* *64*(6), 755–767. https://doi.org/10.1080/00140139.2020.1867241.
Horn GP, Kerber S, Andrews J, Kesler RM, Newman H, Stewart JW, Fent KW, Smith DL [2021]. Impact of repeated exposure and cleaning on protective properties of structural firefighting turnout gear. Fire Technol *57*(2), 791–813. https://doi.org/10.1007/s10694-020-01021-w.
Mayer AC, Horn GP, Fent KW, Bertke SJ, Kerber S, Kesler RM, Newman H, Smith DL [2020]. Impact of select PPE design elements and repeated laundering in firefighter protection from smoke exposure. J Occup Environ Hyg *17*(11-12), 505–514. https://doi.org/10.1080/15459624.2020.1811869.
Horn GP, Kerber S, Fent KW, Smith DL [2020]. Management of irefighters’ chemical & cardiovascular exposure risks on the fireground. **Int Fire Serv J Leadersh Manag*14*:7-16. PMID: 35673618; PMCID: PMC9169513.
Mayer AC, Fent KW, Bertke S, Horn GP, Smith DL, Kerber S, La Guardia MJ [2019]. Firefighter hood contamination: Efficiency of laundering to remove PAHs and FRs. J Occup Environ Hyg, *16*(2), 129–140. https://doi.org/10.1080/15459624.2018.1540877.
Fent KW, Alexander B, Roberts J, Robertson S, Toennis C, Sammons D, Bertke S, Kerber S, Smith D, Horn G [2017]. Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures. J Occup Environ Hyg, *14*(10), 801–814. https://doi.org/10.1080/15459624.2017.1334904.
							
					
							Last Reviewed:  April 13, 2023						Source: 	National Institute for Occupational Safety and Health
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