Cancer Prevention and Wellness Clinic
Please call us to schedule an appointment
305-243-FIRE (3473).
Current/Ongoing Projects
Cancer Screening Prevention & Education
Cancer Prevention and Wellness Clinic | Principal Investigator: Dr. Erin Kobetz | Project Manager: Johanna Garibaldi
Facilitate firefighter access to cancer education, research, and screenings (such as breast, skin, esophageal, prostate, testicular, and thyroid cancer screenings).
Firefighter Cancer Prevention Educational Curriculum | Principal Investigator: Dr. Natasha Schaefer Solle | Project Manager: Lilli Resto
The Educational Curriculum project team is collaborating with the Gordon Center for Research in Medical Education and Florida fire departments to develop a curriculum for cancer prevention in the fire service. The knowledge gained during the Health Communication project has helped inform the development of this curriculum.
Women's Florida Firefighter Cohort Study | Principal Investigator: Dr. Natasha Schaefer Solle | Project Manager: Lilli Resto
The purpose of the proposed study is to understand occupational and lifestyle cancer exposure risks in Florida female firefighters. We also aim to assess the reproductive health of firefighter women and examine the association between exposure to polycyclic aromatic hydrocarbons (PAH) and change in the vaginal microbiome.
Study Link: www.miami.edu/FCIFemaleFF
Mental Health Concerns of USAR Firefighters: A Qualitative Study | Principal Investigator: Dr. Natasha Schaefer Solle Project Manager: Samuel Comerford
The purpose of this pilot study is to learn through the collection of qualitative data more about urban search and rescue (USAR) firefighters and the mental health concerns they may experience due to the performance of their duties in urban search and rescue scenes with the hope of creating manuals/guidelines on what they can do and where to go to improve their mental health.
Study Link: www.miami.edu/FCIMHC
Firefighter Cancer Survivorship Program | Principal Investigator: Dr. Natasha Schaefer Solle | Project Manager: Cynthia Beaver
Investigators are developing cancer survivorship education modules, including videos, for cancer survivors. The Firefighter Cancer Survivorship Program is to create and implement firefighter specific cognitive-behavioral stress and self-management (CBSM) intervention to improve the health-related quality of life (HRQoL) in firefighters treated for cancer through development of cancer survivorship education modules, including videos, for cancer survivors.
Study Link: www.miami.edu/FCIsurvivorship
Assessment of Firefighter Diet Quality and Lifestyle Behaviors | Principal Investigator: Dr. Natasha Schaefer Solle | Project Manager: Lilli Resto
The purpose of this study is to collect baseline health information and cancer risk factors (ex: social and behavioral factors, etc.) of fire rescue workers and look for potential associations between health history, lifestyle behaviors including diet, and cancer risk.
PBDE & Thyroid Function | Principal Investigator: Dr. Natasha Schaefer Solle | Project Manager: Samuel Comerford
Investigators examined the association between PBDE levels and thyroid function of active South Florida firefighters. The project worked to describe and characterize the quality and quantity of PBDE present in the blood of firefighters by type of occupational exposure (i.e., years in the fire service, job title, firefighter duties).
Occupational and Environmental Carcinogen Exposure
Annual Cancer Survey | Principal Investigator: Dr. Natasha Schaefer Solle | Project Manager: Addison Testoff & Roger Noriega
Using data collected through a survey that firefighters will complete annually, investigators are working to understand cancer risks specific to Florida firefighters and create a database of the risks and behaviors of all Florida firefighters.
Study Link: REDCap (miami.edu)
Publications
Fayne R, Forouzandeh M, De Bedout V, et al. Skin cancer screening using total body photography and digital dermoscopy: A pilot study among Florida firefighters. J Am Acad Dermatol. 2022;86(3):700-703. doi:10.1016/j.jaad.2021.01.106
PMID: 33684491
Caban-Martinez AJ, Hughes J, Bator C. A Total Worker Health Approach to Skin Exposure Assessment: Experiences from the Firefighter Cancer Initiative. Ann Work Expo Health. 2021;65(2):143-147. doi:10.1093/annweh/wxaa066
PMID: 32618337
McClure LA, Koru-Sengul T, Hernandez MN, et al. Availability and accuracy of occupation in cancer registry data among Florida firefighters. PLoS One. 2019;14(4):e0215867. Published 2019 Apr 30. doi:10.1371/journal.pone.0215867
PMID: 31039169
Moore KJ, Koru-Sengul T, Alvarez A, et al. Safety Gear Decontamination Practices Among Florida Firefighters: Analysis of a Text-Based Survey Methodology. Workplace Health Saf. 2018;66(11):522-529. doi:10.1177/2165079918754331
PMID: 29480764
Moore KJ, Caban-Martinez AJ, Kirsner RS, et al. Firefighter Skin Cancer and Sun Protection Practices: Evidence From the Florida Firefighter Cancer Initiative. JAMA Dermatol. 2018;154(2):219-221. doi:10.1001/jamadermatol.2017.4254
PMID: 29238830
F2IRE Cohort | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Addison Testoff & Roger Noriega
The purpose of this study is to annually collect health information and cancer risk factors (ex: family history, social and behavioral factors, etc.) of Florida Fire Rescue workers once a year. Firefighters will complete a survey that will ask questions related to the type of exposures they have encountered and their cancer screening practices and will have the option of providing biological samples. We aim to collect a representative sample of the Florida fire departments; therefore, the departments have been randomized and will be contacted directly but staff team members.
Advancing Epidemiology of Retired Firefighters Aging Longitudinally (AERIAL) Cohort Study | Principal Investigator: Dr. Natasha Schaefer Solle | Project Manager: Addison Testoff & Roger Noriega
Using data collected through a survey retired firefighters will complete annually, investigators are working to understand cancer risks specific to Florida firefighters and create a database of the risks and behaviors of all Florida firefighters. Originally launched in the Annual Cancer Survey (ACS) initiative’s second year (2016-2017), AERIAL now focuses on retired firefighters and seeks to understand what cancers are diagnosed during retirement among previously active combat firefighters and what occupational exposures during active employment and/or hygiene factors led to cancers.
Study Link: https://redcap.miami.edu/surveys/?s=K8MD3XH99L
Firefighter Tumor Bank | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Johanna Garibaldi
Firefighters are exposed to different harmful chemicals during fire incident response; these exposures give rise to different types of cancers in the firefighter workforce compared to the general population. The national firefighter tumor bank stores specimens for future evaluation of the molecular mechanisms of these tumors in an effort to understand cancer development in the fire service and improve treatment.
Surfside Assessment of First responders Exposures (SAFE) Cohort | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Paola Louzado Feliciano
The main objective of this prospective, longitudinal cohort study is to provide biomonitoring surveillance for first responders and volunteers who were deployed to the Champlain building collapse in Surfside, FL. The study will follow these participants over the course of a year, during which they will be asked to complete surveys and provide toenail samples to assess their exposure to heavy metals. Participants located in Florida will also be invited to provide blood samples.
Publications
A.J. Caban-Martinez, U. Bakali, D. Urwin et al., Environmental/Occupational Exposures among First Responders of the Surfside Building Collapse, Annals of Epidemiology, https://doi.org/10.1016/j.annepidem.2021.08.009
Heavy Metal Exposure Assessment using Toenails (HEAT) from Firefighters | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Alex Stewart & Paola Louzado Feliciano
During their work, firefighters are exposed to a multitude of known or suspected carcinogens. One exposure of particular concern is the exposure to heavy metals. The HEAT project evaluates the use of toenails as a biomarker of long-term exposure to heavy metals in firefighters and characterizes the presence and quantity of heavy metals found in firefighters.
Direct Respiratory Assessment of Firefighter Tactics (DRAFT) Cohort Study | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Hannah Kling
The purpose of this study is to assess the lung health and cancer risk factors in firefighters who are also Emergency Medical Technicians (EMT) during the COVID-19 pandemic. The main objective is to examine lung function changes in firefighters/EMTs/First Responders in relation to SARS-CoV-2 infection and radon exposure over five years.
Aerosol Measurement and Characterization from Firefighter Training | Principal Investigator: Dr. Caban, Dr. Biswas| Project Manager: Shruti Choudhary
Firefighters can be exposed to high concentration of toxic aerosols and gases via respiratory, oral and dermal routes. They are exposed to elevated levels of fine and submicron size aerosols during overhaul activities and also in areas of the firehouse where they spend a large proportion of their shift. The goal of this study is to use a suite of aerosol instrument to quantify and characterize firefighter aerosol exposure during their work duties.
Cancer Epidemiologic Surveillance Program
Personal Exposure Reporter (PER) | Principal Investigator: Dr. Barbara Millet | Project Manager: Dr. Alberto Caban-Martinez
FCI’s Personal Exposure Reporter (PER) allows firefighters to document occupational exposures to hazardous agents and facilitates access to exposure data on any internet-enabled device. The main objectives for PER are to collect data for detecting occupational hazard exposure and to analyze that data, allowing firefighters to gain greater awareness of their health and wellness and allowing researchers to identify health risks. Our research focuses on identification and validation of the PER reporting variables, informing the design of system features, and ensuring usability of the developed system. We will continue to validate system efficacy and explore system refinements to accommodate expansion of data collection to support other fire service roles and incident types and to enhance system features to include visual reporting and analysis.
Publications
Millet B. Integrating User-Centered Design Into the Sylvester Firefighter Cancer Initiative’s Personal Exposure Reporter. Ergonomics in Design. 2021;0(0). https://doi.org/10.1177/10648046211051196 Sage Journals
Environmental Sampling Program
Environmental Sampling Program | Principal Investigator: Dr. Sylvia Daunert | Project Manager: Umer Bakali
The Environmental Sampling Program (ESP) is specialized in the development of field-deployable sampling techniques, including passive samplers and portable gas sensing systems, for the detection of toxic volatile and semi-volatile organic compounds in various firefighting groups. Notably, these include structural and wildland firefighters as well as fire investigators. In addition, the ESP also develops methods for detecting risk compounds and biomarkers in clinical samples collected from firefighters and provides analytical and instrumentation expertise for evaluating occupational chemical exposure in samples collected by the Firefighter Cancer Initiative at large.
Publications
Kafkoutsou AL, Yang YP, Zeynaloo E, et al. Impact of Firefighting Aqueous Film-Forming Foams on Human Cell Proliferation and Cellular Mortality. J Occup Environ Med. 2022;64(5):e340-e344. doi:10.1097/JOM.0000000000002527
PMID: 35250009
Firefighter Wristband Exposure Survey | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Umer Bakali
Established in 2016, the Firefighter Wristband Exposure Survey employs a simple, lightweight, and non-invasive passive sampling methodology employing silicone wristbands for capture and analysis of structural firefighters’ occupational carcinogenic exposures. Exposures have been described at fire scenes, in fire stations, and from firefighter turnout gear. Silicone wristbands have since been used with other firefighting subgroups. Findings from this study were published in 2020 in Ecotoxicology and Environmental Safety.
Publications
Caban-Martinez AJ, Louzado-Feliciano P, Santiago KM, et al. Objective Measurement of Carcinogens Among Dominican Republic Firefighters Using Silicone-Based Wristbands. J Occup Environ Med. 2020;62(11):e611-e615. doi:10.1097/JOM.0000000000002006
PMID: 32826549
Baum JLR, Bakali U, Killawala C, et al. Evaluation of silicone-based wristbands as passive sampling systems using PAHs as an exposure proxy for carcinogen monitoring in firefighters: Evidence from the firefighter cancer initiative. Ecotoxicol Environ Saf. 2020;205:111100. doi:10.1016/j.ecoenv.2020.111100
PMID: 32911453
Assessment of Wildland Firefighters’ Carcinogenic Exposures | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Umer Bakali
Wildland firefighters sustain significant and prolonged chemical exposure to wildland fire smoke during wildland fire and prescribed burn events. Compared to their structural firefighting counterparts in cities and towns, wildland firefighters don lighter personal protective equipment, making them more susceptible to dermal and inhalational exposures. Firsthand data on wildland firefighters’ exposures are difficult to acquire due to the danger and austerity of their occupational environments, which limit accessibility for researchers and scientific equipment. This project aims to assess wildland firefighters’ exposures using minimally-encumbering and non-invasive sampling methodologies, including silicone wristbands and dermal swabbing.
Analyses of Volatilized Carcinogens in the Vicinity of Active Fire Situations | Principal Investigator: Dr. Sylvia Daunert | Project Manager: Umer Bakali
Carcinogens emitted during structural fires may migrate away from the fire scene and into the immediate surroundings, including in the cold zone and warm zone of these fire situations, in which no danger or a non-immediate threat to life exists, respectively. In these areas, firefighters may not be donning their full turnout gear or self-contained breathing apparatus, leading to an increased exposure risk to gases and particulate matter emitted by the fire. The goals of this project are to: 1) Determine the presence of volatilized carcinogens outside of the structure to help inform guidelines for determining the borders of the warm zone, and 2) Develop and refine portable solid-state sensing equipment that can be integrated into firefighter gear to help communicate the presence of toxic compounds in the air surrounding active fire situations. Findings from passive sampling of the warm and cold zones of fire situations were published in 2021 in Ecotoxicology and Environmental Safety.
Publications
(Bakali et al. 2021, Mapping carcinogen exposure across urban fire incident response arenas using passive silicone-based samplers.)
DOI: http://dx.doi.org/10.1016/j.ecoenv.2021.112929
Development of a Firefighter Cancer Risk Assessment Model from Clinical Samples | Principal Investigator: Dr. Sylvia Daunert
Polycyclic aromatic hydrocarbons (PAHs) are toxic byproducts of combustion and ubiquitous environmental pollutants, which can cause carcinogenesis through epigenetic modification. Firefighters are routinely exposed to these contaminants and numerous studies have described a high incidence of various cancer types in firefighters compared to the general population. The aim of this study is to develop a non-invasive risk assessment tool to evaluate firefighters’ health risk based on internalized polycyclic aromatic hydrocarbons (PAHs), expression of the DNA repair genes, and the presence of oxidative stress biomarkers in clinical samples, in addition to years of active firefighting service.
Completed Projects
Cancer Screening Prevention & Education
Occupational Chemical Exposures and the Vaginal Microbiome of Female Firefighters | Principal Investigator: Dr. Natasha Schaefer Solle | Completed
The purpose of the proposed study is to examine the association between exposure to polycyclic aromatic hydrocarbons (PAH) and change in the vaginal microbiome of female firefighters in Florida.
Understanding Retired Firefighters' Perceptions of Cancer and Wellness | Principal Investigator: Dr. Natasha Schaefer Solle | Completed
The purpose of this pilot study is to collect qualitative data using focus groups to learn about the perceptions of health and cancer risk of retired firefighters from fire departments in Palm Beach County. This study will provide an opportunity to better understand how firefighter retirees’ prior workplace hazards may have impacted their current health and cancer screening practices.
Addressing Cervical Cancer in Female Firefighters | Principal Investigator: Dr. Natasha Schaefer Solle | Completed
The Firefighter Cancer Initiative (FCI) research team studied cervical cancer risk in female firefighters. The NIOSH-funded project, “Addressing Cervical Cancer in Female Firefighters” led by Dr. Natasha Schaefer Solle, provided US female firefighters with a one-time, free home-based HPV test as well as other tests for research. Participants also received educational materials on HPV and cancer prevention.
Facilitators and Barriers to Cancer Screening Among Black firefighters | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Completed
The goals of this pilot study are to 1) identify and prioritize facilitators and barriers to cancer screening among Black firefighters in Florida, and 2) discuss preferred interventions that can improve cancer screening practices for high-risk cancers among Black firefighters in Florida, therefore, reducing the burden of cancer among the firefighter workforce longterm.
Characterizing Hearing and Balance Function Loss in Populations with Exposure to Hazardous Noise | Principal Investigator: Dr. Natasha Schaefer Solle | Completed
The purpose of this study is to characterize and assess the burden of hearing and balance function loss in populations with occupational exposure to hazardous noise.
Snapp HA, Schaefer Solle N, Millet B, Rajguru SM. Subclinical Hearing Deficits in Noise-Exposed Firefighters. Int J Environ Res Public Health. 2022;19(17):11028. Published 2022 Sep 3. doi:10.3390/ijerph191711028
PMID: 36078744
Psychometric Evaluation of a Survey Measuring Facilitators and to Maintaining a Healthy Weight among Firefighters | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
The aim of this study is to develop and psychometrically evaluate a survey that will measure the facilitators and barriers to maintaining a healthy weight among firefighters.
Health Communication | Principal Investigator: Dr. Tyler Harrison | Completed
The Health Communication project investigators worked to understand firefighter culture, work, and knowledge about cancer. They also designed education and behavior change campaign materials.
Publications
Harrison TR, Muhamad JW, Yang F, et al. Firefighter attitudes, norms, beliefs, barriers, and behaviors toward post-fire decontamination processes in an era of increased cancer risk. J Occup Environ Hyg. 2018;15(4):279-284. doi:10.1080/15459624.2017.1416389
PMID: 29283320
Harrison TR, Yang F, Morgan SE, et al. The Invisible Danger of Transferring Toxins with Bunker Gear: A Theory-Based Intervention to Increase Postfire Decontamination to Reduce Cancer Risk in Firefighters. J Health Commun. 2018;23(12):999-1007. doi:10.1080/10810730.2018.1535633
PMID: 30346894
Anderson DA, Harrison TR, Yang F, Wendorf Muhamad J, Morgan SE. Firefighter perceptions of cancer risk: Results of a qualitative study. Am J Ind Med. 2017;60(7):644-650. doi:10.1002/ajim.22726
PMID: 28616888
Harrison, TR, Yang, F, Anderson, D, et al. Resilience, culture change, and cancer risk reduction in a fire rescue organization: Clean gear as the new badge of honor. J Contingencies and Crisis Management. 2017; 25: 171– 181. https://doi.org/10.1111/1468-5973.12182
Wiley Online Library
Guardrails | Principal Investigator: Wes Smith | Completed
In year three of the Firefighter Cancer Initiative (2017-2018), the cancer screening project incorporated the Guardrails project, which was initially included as part of the initiative in 2016. The Guardrails Wellness Program used customized nutrition and exercise recommendations to optimize health and combat cancer risk in firefighters.
Occupational and Environmental Carcinogen Exposure
Florida Firefighter Cancer Registry | Principal Investigator: Dr. David Lee | Completed
The Florida Firefighter Cancer Registry project, established in 2015, linked Fire Marshal certification records to Florida Cancer Data System records to identify cancers disproportionality impacting Florida firefighters. This has provided an updated analysis of a linkage done in 2006 that demonstrated elevated risks of several cancers, including bladder, testicular, and thyroid among males, and cervical, Hodgkin’s lymphoma, and thyroid among females.
Firefighter Assessment of Strategies Trumping Cancer (FAST-C) | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
The purpose of this study is to identify factors contributing to cancer prevention in the Florida fire service. We will invite firefighters to answer questions about their fire services approach to occupational health and safety, worksite health promotion, and cancer prevention practices. Our goal is to understand how the fire departments’ organization, practices, and policies impact cancer prevention. This information may help us develop programs to change the types of resources, guidelines, and services offered in fire services.
Publications
Louzado-Feliciano P, Griffin KA, Santiago KM, et al. Fire Service Organizational-Level Characteristics Are Associated With Adherence to Contamination Control Practices in Florida Fire Departments: Evidence From the Firefighter Cancer Initiative. J Occup Environ Med. 2020;62(9):e508-e514. doi:10.1097/JOM.0000000000001953
PMID: 32890221
Marimon MO, Schaefer Solle N, Santiago KM, Fonseca M, Dietz N, Caban-Martinez AJ. Diversity and Inclusion Leaders in US Fire Departments Impact the Type and Number of Diversity and Inclusion Programs Offered. J Occup Environ Med. 2020;62(1):e13-e16. doi:10.1097/JOM.0000000000001780
PMID: 31790062
Caban-Martinez AJ, Solle NS, Feliciano PL, et al. Use of Aqueous Film-Forming Foams and Knowledge of Perfluorinated Compounds Among Florida Firefighters. J Occup Environ Med. 2019;61(5):e227-e231. doi:10.1097/JOM.0000000000001566
PMID: 31045850
Caban-Martinez AJ, Schaefer Solle N, Santiago KM, et al. Impact of Organizational-level Factors on Cancer Screening Activities in Fire Departments: A Cross-sectional Study from the Sylvester Firefighter Cancer Initiative. Cancer Prev Res (Phila). 2019;12(5):335-342. doi:10.1158/1940-6207.CAPR-18-0496
PMID: 30872268
Defining and Operationalizing the Well-Being of Firefighters/Emergency Medical Services (EMS) Workers | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
The purpose of this cross-sectional descriptive, exploratory study is to define and operationalize the well-being of firefighters from the perspective of Firefighters/Emergency Medical Services (EMS) Workers. A conceptual model will be designed and proposed from factors identified by the firefighter/EMS workers and used as a tool to frame the construct, “firefighter/EMS worker well-being.”
Publications
(Kling HE, Maldonado L, St George SM, et al. Firefighter Well-Being Defined and Operationalized at the Organizational and Worker Level: A Qualitative Study. J Occup Environ Med. 2022;64(11):e736-e743. doi:10.1097/JOM.0000000000002685)
F-TRACE Firefighter Tracking, Resources, and Assessment of COVID-19 Epidemiology | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
This Study was to document the seroprevalence of SARS-CoV-2 in a first-responder workforce. As part of a multi-prong approach to COVID-19 surveillance and control for first responders, the F-TRACE project provided firefighters/paramedics with the resources and guidance to minimize the burden of COVID-19 within their workforce and the communities they serve.
Publications
Caban-Martinez AJ, Silvera CA, Santiago KM, et al. COVID-19 Vaccine Acceptability Among US Firefighters and Emergency Medical Services Workers: A Cross-Sectional Study. J Occup Environ Med. 2021;63(5):369-373. doi:10.1097/JOM.0000000000002152
PMID: 33560073
Graham EL, Khaja S, Caban-Martinez AJ, Smith DL. Firefighters and COVID-19: An Occupational Health Perspective. J Occup Environ Med. 2021;63(8):e556-e563. doi:10.1097/JOM.0000000000002297
PMID: 34138822
Caban-Martinez AJ, Schaefer-Solle N, Santiago K, et al. Epidemiology of SARS-CoV-2 antibodies among firefighters/paramedics of a US fire department: a cross-sectional study. Occup Environ Med. 2020;77(12):857-861. doi:10.1136/oemed-2020-106676
PMID: 32764107
Occupational and Non-Occupational Physical Activity Levels Among Firefighters | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
The goals of this pilot study were to (a) describe typical physical activity levels in professional paid firefighters and (b) assess their ability to estimate their own levels of physical activity.
Publications
(Kling H, Santiago K, Benitez L, Schaefer Solle N, Caban-Martinez AJ. Characterizing Objective and Self-Reported Levels of Physical Activity Among Florida Firefighters Across Weight Status Category: A Cross-Sectional Pilot Study. Workplace Health Saf. 2020;68(11):513-518. doi:10.1177/2165079920925505)
Cancer Epidemiologic Surveillance Program
Microbiome, GERD and esophageal cancer in Firefighters | Principal Investigator: Dr. Morgan Sendzischew | Completed
This study aims to analyze and characterize the oral microbiome of South Florida Firefighters. Additionally, we aim to develop a bio-repository of gastrointestinal tissue specimens for South Florida Firefighters with known risk factors for esophageal adenocarcinoma.
Addressing Colorectal Cancer in South Florida Firefighters | Principal Investigator: Dr. Erin Kobetz | Completed
The purpose of this pilot study is to examine the feasibility and acceptability of the Fecal Immunochemical Test (FIT) to screen for colorectal cancer in a sample of active firefighters in South Florida.
Recruited Firefighters’ Assessment of Safety and Health (ReFLASH) Pilot Study | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
The purpose of this study is to learn about the safety and health perceptions of newly recruited firefighters, especially how they plan to protect their health and reduce workplace hazards.
Publications
Schaefer Solle N, Caban-Martinez AJ, Levy RA, et al. Perceptions of health and cancer risk among newly recruited firefighters in South Florida. Am J Ind Med. 2018;61(1):77-84. doi:10.1002/ajim.22785
PMID: 29090827
Firefighter Diversity and Inclusion Analysis | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
Diversity and inclusion in the workforce can lead to increased team synergy, efficiency, and innovative solutions to complex problems across varying organizations. In the U.S. fire service, the workforce demographics are largely homogenous, comprised predominantly of Caucasian males with limited diversity in racial and ethnic backgrounds and genders/non-genders. A strong fire department culture that invests in diversity and inclusion could provide competitive advantages that improve engagement in the communities they serve. The purpose of this analysis is to 1) describe the availability of diversity and inclusion leaders in fire services throughout the U.S., 2) describe characteristics of diversity and inclusion programs in the Fire Service, and 3) characterize and compare the impact of diversity and inclusion leaders within fire services.
Comprehensive De-Identified FCI Dataset for Secondary Analysis | Principal Investigator: Dr. Julia Seay | Completed
This secondary, retroactive data analysis will apply innovative random forest techniques to uncover complex associations between sociodemographic, behavioral, biological factors, and cancer among firefighters using data from previously IRB-approved Firefighter Cancer Initiative studies.
Publications
McClure LA, Koru-Sengul T, Hernandez MN, Caban-Martinez AJ, Kobetz EN, Lee DJ. Comparing cancer risk estimates using occupational record linkage approaches in male Florida firefighters. Am J Ind Med. 2021;64(2):78-83. doi:10.1002/ajim.23205
PMID: 33283309
Ogunsina K, Koru-Sengul T, Rodriguez V, et al. A comparative analysis of histologic types of thyroid cancer between career firefighters and other occupational groups in Florida. BMC Endocr Disord. 2022;22(1):222. Published 2022 Sep 2. doi:10.1186/s12902-022-01104-5 PMID: 36056343
Ogunsina K, Koru-Sengul T, Rodriguez V, et al. Correlates of Positive Thyroid Peroxidase Antibodies Among Firefighters: A Cross-Sectional-Study. J Endocr Soc. 2022;6(10):bvac125. Published 2022 Aug 23. doi:10.1210/jendso/bvac125
PMID: 36111276
Environmental Sampling Program
“Warm Zone” Cases: Environmental Monitoring Immediately Outside the Fire Incident Response Arena | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
Hazardous work zones (i.e., hot, warm, and cold) are typically established during HAZMAT calls but less consistently for fire responses to segment personnel and response activities in the immediate geographic area around the fire. Despite available national guidelines, some studies have documented inconsistent use of respiratory protective equipment by firefighters at the fire scene. These published cases suggest firefighters should implement strategies for multi-gas detector use within the warm zone and include respiratory protection in the warm zone to provide adequate safety from noxious gasses and cancer-causing particulate.
Publications
Caban-Martinez AJ, Kropa B, Niemczyk N, et al. The "Warm Zone" Cases: Environmental Monitoring Immediately Outside the Fire Incident Response Arena by Firefighters. Saf Health Work. 2018;9(3):352-355. doi:10.1016/j.shaw.2017.12.003
PMID: 30370169
Evaluation of Urban Search and Response Personnel Exposures at the Surfside Condominium Collapse | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
In the early hours of June 24, 2021, the Champlain Towers South condominium complex collapsed in the town of Surfside, Florida. As part of rescue efforts, more than 80 Miami-Dade County and City of Miami fire rescue units were deployed at the scene of the collapse. Additionally, both domestic and international Urban Search and Response (USAR) teams were deployed to the site, working in alternating 12-hour shifts to search for survivors. The nature of this catastrophic collapse meant that significant amounts of suspended particulate matter and volatile organic compounds were present in the air, potentially exposing responders at the site. Passive sampling wristbands were deployed to determine first responders’ exposures. Data from this emergency initiative is pending the oversight of the State of Florida Fire Marshal.
Assessment of Fire Investigators’ Exposures during Post-Fire Scene Audits | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
Even after fires are extinguished, carcinogens continue to off-gas at post-fire scenes. This is a concern for fire investigators, who conduct in-depth forensic evaluations of post-fire scenes for prolonged periods of time. Compared to nearly 1.1 million firefighting personnel in the United States, the International Association of Arson Investigators (IAAI) estimates that there are approximately 7,000 to 9,000 fire investigators, making them a comparatively understudied portion of the overall firefighter population. This project aims to contribute evidence on the type and intensity of carcinogenic exposure sustained by fire investigators to help inform policy and improve fire investigators’ occupational hygiene.
Firefighter UV Safety Evaluation Study | Principal Investigator: Dr. Alberto Caban-Martinez | Completed
The occupational health and safety team is quantifying Ultraviolet (UV) exposure in firefighters through a wearable UV sensor to help characterize their environmental and occupational exposures.
Firefighter Stress and Immune Response | Co-Principal Investigator: Dr. Alberto Caban-Martinez and Dr. Firdaus Dhabhar | Completed
Firefighting is frequently reported as a highly stressful occupation. The job includes a wide range of physiological indicators (e.g., blood pressure, cortisol, skin conductance) of stress; however, relationships between stress exposure and immune response in firefighters remain understudied. In the present study, we use the firefighter training environment to evaluate stress exposure and the stress anticipation on firefighter immune system response.
Affiliated Projects
Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel (RECOVER) | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Damena Gallimore-Wilson
This project is a COVID-19 study funded by the Centers for Disease Control and Prevention (CDC) through a partnership with Abt Associates and various U.S. healthcare systems and academic institutions. This study seeks to determine the frequency of SARS-CoV-2 virus infection and re-infection and COVID-19 illness among healthcare personnel, first responders, and essential or frontline workers; and estimate the effectiveness of the COVID-19 vaccines.
Publications
Tyner HL, Burgess JL, Grant L, et al. Neutralizing Antibody Response to Pseudotype Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Differs Between mRNA-1273 and BNT162b2 Coronavirus Disease 2019 (COVID-19) Vaccines and by History of SARS-CoV-2 Infection. Clin Infect Dis. 2022;75(1):e827-e837. doi:10.1093/cid/ciab1038
PMID: 34928334
Caban-Martinez AJ, Gaglani M, Olsho LEW, et al. COVID-19 Vaccination Perspectives and Illnesses Among Law Enforcement Officers, Firefighters, and Other First Responders in the US, January to September 2021. JAMA Netw Open. 2022;5(7):e2222640. Published 2022 Jul 1. doi:10.1001/jamanetworkopen.2022.22640
PMID: 35852804
Naleway AL, Grant L, Caban-Martinez AJ, et al. Incidence of SARS-CoV-2 infection among COVID-19 vaccinated and unvaccinated healthcare personnel, first responders, and other essential and frontline workers: Eight US locations, January-September 2021. Influenza Other Respir Viruses. 2022;16(3):585-593. doi:10.1111/irv.12956
PMID: 35023288
Yoon SK, Hegmann KT, Thiese MS, et al. Protection with a Third Dose of mRNA Vaccine against SARS-CoV-2 Variants in Frontline Workers. N Engl J Med. 2022;386(19):1855-1857. doi:10.1056/NEJMc2201821
PMID: 35385628
Edwards LJ, Fowlkes AL, Wesley MG, et al. Research on the Epidemiology of SARS-CoV-2 in Essential Response Personnel (RECOVER): Protocol for a Multisite Longitudinal Cohort Study. JMIR Res Protoc. 2021;10(12):e31574. Published 2021 Dec 3. doi:10.2196/31574
PMID: 34662287
Thompson MG, Burgess JL, Naleway AL, et al. Prevention and Attenuation of Covid-19 with the BNT162b2 and mRNA-1273 Vaccines. N Engl J Med. 2021;385(4):320-329.kk doi:10.1056/NEJMoa2107058
PMID: 34192428
Thompson MG, Burgess JL, Naleway AL, et al. Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers - Eight U.S. Locations, December 2020-March 2021. MMWR Morb Mortal Wkly Rep. 2021;70(13):495-500. Published 2021 Apr 2. doi:10.15585/mmwr.mm7013e3
PMID: 33793460
Publications
Burgess JL, Fisher JM, Nematollahi A, et al. Serum per- and polyfluoroalkyl substance concentrations in four municipal US fire departments [published online ahead of print, 2022 Jul 21]. Am J Ind Med. 2022;10.1002/ajim.23413. doi:10.1002/ajim.23413
PMID: 35864570
Kadiwar P, Shah N, Black T, et al. Dietary Intake Among Members of a Volunteer Fire Department Compared With US Daily Dietary Recommendations. J Occup Environ Med. 2021;63(2):147-150. doi:10.1097/JOM.0000000000002102
PMID: 33273397
Solle NS, Santiago KM, Louzado Feliciano P, et al. Perceptions of Work-Related Health and Cancer Risks Among Women Firefighters: A Qualitative Study. J Occup Environ Med. 2021;63(12):e846-e852. doi:10.1097/JOM.0000000000002386
PMID: 34538836
Goodrich JM, Calkins MM, Caban-Martinez AJ, et al. Per- and polyfluoroalkyl substances, epigenetic age and DNA methylation: a cross-sectional study of firefighters. Epigenomics. 2021;13(20):1619-1636. doi:10.2217/epi-2021-0225
PMID: 34670402
Goodrich JM, Calkins MM, Caban-Martinez AJ, et al. Per- and polyfluoroalkyl substances, epigenetic age and DNA methylation: a cross-sectional study of firefighters. Epigenomics. 2021;13(20):1619-1636. doi:10.2217/epi-2021-0225
PMID: 34670402
Graber JM, Black TM, Shah NN, et al. Prevalence and Predictors of Per- and Polyfluoroalkyl Substances (PFAS) Serum Levels among Members of a Suburban US Volunteer Fire Department. Int J Environ Res Public Health. 2021;18(7):3730. Published 2021 Apr 2. doi:10.3390/ijerph18073730
PMID: 33918459
Goodrich JM, Furlong MA, Caban-Martinez AJ, et al. Differential DNA Methylation by Hispanic Ethnicity Among Firefighters in the United States. Epigenet Insights. 2021;14:25168657211006159. Published 2021 Mar 26. doi:10.1177/25168657211006159
PMID: 35036834
Upcoming Projects
National First Responder Per- or Polyfluoroalkyl Substances (PFAS) Registry | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Alexandra Cruz
The proposed study will include individuals who are in training to become firefighters or EMT/paramedics, as well as U.S active or retired firefighters or EMT/paramedics who have been exposed to PFAS. The purpose of the proposed study is to longitudinally measure and track U.S first responder PFAS exposures and levels.
PFAS Postal Mail Study | Principal Investigator: Dr. Alberto Caban-Martinez| Project Manager: Natalia Pacita Ongtengco
The purpose of the proposed study is to determine whether the at-home PFAS testing kits are a feasible and acceptable way to test PFAS levels in the blood of firefighters.
Dashboard, Analytics, and Data Coordinating Center | Principal Investigator: Dr. Alberto Caban-Martinez | Project Manager: Paola Louzado-Feliciano
Interactive web-based interface for disseminating firefighters’ cancer mortality and incidence rates to various stakeholders.
Additional Publications
Demers PA, DeMarini DM, Fent KW, et al. Carcinogenicity of occupational exposure as a firefighter. Lancet Oncol. 2022;23(8):985-986. doi:10.1016/S1470-2045(22)00390-4
PMID: 35780778
Louzado-Feliciano P, Santiago KM, Paule L, et al. Perceptions of Occupational Cancer Risk and Prevention Among Dominican Republic Firefighters: A Qualitative Study. J Occup Environ Med. 2022;64(3):e131-e135. doi:10.1097/JOM.0000000000002466
PMID: 35244089
Moore KJ, Koru-Sengul T, Alvarez A, et al. Safety Gear Decontamination Practices Among Florida Firefighters: Analysis of a Text-Based Survey Methodology. Workplace Health Saf. 2018;66(11):522-529. doi:10.1177/2165079918754331
PMID: 29480764