What is the risk of basal cell carcinoma in firefighters?

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Last updated: April 22, 2025View editorial policy

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From the Guidelines

Firefighters have an increased risk of developing basal cell carcinoma (BCC) due to occupational exposures, and their risk can be mitigated by adhering to strict protective measures and regular skin examinations. Their risk is approximately 1.5 times higher than the general population, primarily due to exposure to carcinogens in smoke, soot, and ash during firefighting activities, as noted in guidelines for managing basal cell skin cancer 1. These substances contain polycyclic aromatic hydrocarbons and other chemicals that can damage DNA and promote cancer development. Additionally, firefighters often experience intense heat which can enhance the absorption of these chemicals through the skin. Ultraviolet radiation exposure during outdoor operations further compounds this risk.

To reduce BCC risk, firefighters should:

  • Always wear complete personal protective equipment including SCBA (self-contained breathing apparatus)
  • Thoroughly clean gear after fires
  • Shower immediately after exposure
  • Undergo regular skin examinations
  • Use sunscreen on exposed areas
  • Participate in cancer screening programs Departments should implement clean cab concepts, proper gear cleaning protocols, and maintain exposure documentation for all personnel, as part of a comprehensive approach to managing skin cancer risk, which may include considerations outlined in guidelines such as those published in the Journal of the National Comprehensive Cancer Network 1. Early detection is crucial, as BCC is highly treatable when identified early through regular skin checks focusing on areas of sun exposure and where soot and chemicals may accumulate.

From the Research

Firemen Risk for Basal Cell Cancer

  • The risk of basal cell cancer among firemen is not directly addressed in most of the studies provided, but there is evidence to suggest that outdoor workers, including firemen, are at an increased risk of developing skin cancer due to exposure to ultraviolet (UV) radiation 2.
  • One study found that firefighters are exposed to a wide variety of carcinogens during their line of duty, which may increase their risk of developing certain types of cancer, including skin cancer 3.
  • A systematic review of epidemiologic studies found that firefighters are at an increased risk of developing several types of cancer, including skin melanoma and other skin cancers, compared to the general population 4.
  • Another study found that firefighters are at a higher risk of developing skin melanoma and other skin cancers, but did not specifically address the risk of basal cell cancer 5.
  • While there is no direct evidence to suggest that firemen are at a higher risk of basal cell cancer, the available evidence suggests that outdoor workers, including firemen, are at an increased risk of developing skin cancer due to UV radiation exposure 2.
  • It is also worth noting that basal cell carcinoma is a type of skin cancer that is often treated with photodynamic therapy, and that firefighters may be at risk of developing this type of cancer due to their exposure to UV radiation 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Cancer Incidence and Mortality among Firefighters: An Overview of Epidemiologic Systematic Reviews.

International journal of environmental research and public health, 2021

Research

The application of Levulan-based photodynamic therapy with imiquimod in the treatment of recurrent basal cell carcinoma.

Medical science monitor : international medical journal of experimental and clinical research, 2012

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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