UTH

Texas Firefighter Cancer Study

Texas Firefighter Cancer Study

In response to growing evidence of elevated cancer risk among firefighters in Texas, and in recognition of the critical need for improved occupational exposure tracking and early detection, the Texas State Legislature appropriated funds through Senate Bill 1 89th Legislature in May 2025 to UTHealth Houston to establish the Texas Firefighter Cancer Study. This two-year initiative is designed to reduce the burden of firefighter-related cancers through three projects. While each project requires a distinct study protocol due to its methodological scope and data sources, they are unified by a shared scientific framework. The overarching protocol conceptualizes firefighter cancer risk as a multi-project process, beginning with exposure to carcinogens during firefighting activities, progressing through biological alterations, culminating in cancer diagnoses confirmed by registries, and clinical cancer screening promotion campaigns.

The three initial projects include: Project 1 Carcinogenic Exposure Assessment - Quantitative measurement of occupational exposure to fire-related carcinogens and analysis of exposure-associated molecular biomarkers in new recruits, active-duty firefighters, and retirees; Project 2 Occupational Cancer Epidemiology - Evaluation of cancer incidence through the linkage of occupational histories, demographic variables, and data from the Texas Cancer Registry; Project 3 Cancer Screening Promotion - Implementation of a firefighter-specific cancer screening initiative as part of the annual occupational medical examination, incorporating cancer-associated molecular tools for risk stratification and early detection.

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PUBLICATIONS

Multi-omics studies
  1. Jooyeon Hwang*, Jenny Gipson, Chao Xu, Timothy VanWagoner, Xin Xu, Robert J. Agnew, Willard M. Freeman Comparison of MicroRNA Profiling in the Skin and Serum of Volunteer and Career Firefighters, Environmental Research, 2025, Volume 285, Part 1, 122348, DOI: https://doi.org/10.1016/j.envres.2025.122348 
  2. Jooyeon Hwang*, Zongkai Peng, Fares Z Najar, Chao Xu, Robert J Agnew, Xin Xu, Zhibo Yang, Nagib Ahsan*, Urine proteome profile of firefighters with exposure to emergency fire-induced smoke: A pilot study to identify potential carcinogenic effects, Science of the Total Environment, 2024, 972, 172273, DOI: https://doi.org/10.1016/j.scitotenv.2024.172273
  3. Ting Zhu, Yuxiang Hu, Jooyeon Hwang, Dan Zhao, Libin Huang, Liang Qiao, Ankui Wei, Xin Xu. Urinary Proteomics of Simulated Firefighting Tasks and its Relation to Fitness Parameters, Int. J. Environ. Res. Public Health, 2021, Oct 11;18(20), 10618, PMID: 34682364 PMCID: PMC8536002. DOI: https://doi.org/10.3390/ijerph182010618
Carcinogens
  1. Mingze Zhu+, Jooyeon Hwang*, Chao Xu*. Meta-analysis identifies key genes and pathways implicated in Benzo[a]pyrene exposure response, Chemosphere, 2024, Volume 364, September 2024, 143121, https://doi.org/10.1016/j.chemosphere.2024.143121 
  2. Mingze Zhu+, Robert J. Agnew, Chao Xu, Timothy VanWagoner, Xin Xu, Jooyeon Hwang*. Residual Polycyclic Aromatic Hydrocarbons and Firefighters’ Hematological Profile, Frontiers in Environmental Health, Sec. Occupational Safety and Health Interventions, 2024, Volume 3 – 2024, https://doi.org/10.3389/fenvh.2024.1381159 
  3. Jooyeon Hwang, Chao Xu, Paul Grunsted, Robert J. Agnew, Tara R. Malone, Shari Clifton, Krista Thompson, Xin Xu. Urinary Metabolites of Polycyclic Aromatic Hydrocarbon in Firefighters: A Systematic Review and Meta-Analysis, Int. J. Environ. Res. Public Health, 2022, 19(14):8475, PMID: 35886320 PMCID: PMC9318785 DOI: https://doi.org/10.3390/ijerph19148475 
Exposure Assessment
  1. Jooyeon Hwang, Chao Xu, Robert J. Agnew, Shari Clifton, Tara R. Malone. Health Risk of Structural Firefighters from Exposure to Polycyclic Aromatic Hydrocarbons: A Systematic Review and Meta-Analysis, International Journal of Environmental Research and Public Health, 2021, 18(8), 4209, PMID: 33921138, PMCID: PMC8071552 DOI: https://doi.org/10.3390/ijerph18084209 
  2. Jooyeon Hwang, Ritchie Taylor, Charles Cann, Vijay Golla, Weylin Gilbert. Assessment of ambient air diesel particulates in fire departments using different exposure metrics: Pilot study, Fire Safety Journal, 2019, 106: 155-162, DOI: https://doi.org/10.1016/j.firesaf.2019.04.005 
  3. Jooyeon Hwang, Ritchie Taylor, Charles Cann, Pauline Norris, Vijay Golla. Evaluation of accumulated polycyclic aromatic hydrocarbons and asbestiform fibers on firefighter vehicles: Pilot Study, Fire Technology, 2019, 55(6): 2195-2213, DOI https://doi.org/10.1007/s10694-019-00851-7 
Turnout Gear
  1. Jake Mitchell, Jooyeon Hwang, Preston Larson, Sumit Mandal, Robert J. Agnew. Preliminary analyses of accumulation of carcinogenic contaminants on retired firefighter ensembles, Journal of Occupational and Environmental Hygiene, 2024, 21:4, 213-219 PMID: 38416517 DOI: https://doi.org/10.1080/15459624.2023.2296628 
  2. Gretchen Macy, Jooyeon Hwang, Ritchie Taylor, Vijay Golla, Charles Cann, Brittney Gates, Examining Behaviors Related to Retirement, Cleaning, and Storage of Turnout Gear Among Rural Firefighters, Workplace Health and Safety, 2019, 68 (3):129-138, PMID: 31735131 DOI: https://doi.org/10.1177/2165079919882951 
  3. Jooyeon Hwang, Ritchie Taylor, Gretchen Macy, Charles Cann, Vijay Golla. Comparison of Use, Storage, and Cleaning Practices for Personal Protective Equipment Between Career and Volunteer Firefighters in Northwestern Kentucky in the U.S, Journal of Environmental Health, 2019, 82(5), 8-15
Fire Service Communities
  1. Jooyeon Hwang, Ngee-Sing Chong, Mengliang Zhang, Robert J. Agnew, Chao Xu, Zhuangjie Li, Xin Xu. Face-to-face with Scorching Wildfire: Potential Toxicant Exposure and the Health Risks of Smoke for Wildland Firefighters at the Wildland-Urban Interface, Lancet Reg Health Am. 2023 Mar 26;21:100482. PMID: 37008196 PMCID: PMC10060103 DOI: https://doi.org/10.1016/j.lana.2023.100482  
  2. Ritchie Taylor, Gretchen Macy, Jooyeon Hwang, Vijay Golla, Charles Cann, Edrisa Sanyang, Using Collaborative Partnerships to Engage Firefighters in Rural Communities. Int. J. Environ. Res. Public Health, 2022, 19(4):2009. PMID: 35206197 PMCID: PMC8871703 DOI: https://doi.org/10.3390/ijerph19042009 

PRESENTATIONS

  1. Nasal Cavity Microbial Makeup and the Influence on Psychiatric Symptoms Following Acute Fire Exposure in Firefighters, American Society of Human Genetics, Boston, MA (Poster presenter: Paul Grunsted)
  2. Occupational Risk Factors for Mental Health Outcomes in Firefighters, GET PHIT Summit, Laredo, TX (Poster presenter: Kevin Dang)
  3. Effectiveness of Dermal Wipes in Removing PAHs From Urban Firefighters, UTHealth-CPRIT 2025 Summer Undergraduate Innovation in Cancer Prevention Research Program, Houston, TX (Poster presenter: Isabella Smetana)
  4. The role of decontamination wipes on polycyclic aromatic hydrocarbons (PAHs) removal and microbiome shifts in firefighter skin, AIHA Connect 2025 Student poster, Kansas City, MO (Poster presenter: Catherine Turlington)
  5. Fire Smoke Neurotoxicants: Occupational Exposure and Mental Health Implications for Firefighters, 2025 International Fire Service Cancer Symposium, Firefighter Cancer Initiative, Miami, FL (Poster presenter: Jooyeon Hwang)
  6. Impact of Exposure to Fire Smoke on miRNA Expression in Firefighters' Blood and Skin Samples, American Society of Human Genetics 2024 Annual Meeting, Denver, Colorado (Poster presenter: Paul Grunsted)
  7. Multi-Omics Profiling for Evaluating Carcinogenic Exposure and Health Effects in Firefighters During Emergency Fires, 36th annual US-Korea Conference (UKC 2023), Technical Group Symposium, Medical Science, Pharmaceutical Science, Veterinary Medicine, Physical Education (MPS), Dallas, Texas (Invited speaker: Jooyeon Hwang)

Researchers with UTHealth Houston School of Public Health awarded $5 million to study cancer risk among firefighters in Texas

The state of Texas awarded UTHealth Houston School of Public Health $5 million over two years for early detection and research, led by principal investigator Jooyeon Hwang, PhD, associate professor in the Department of Environmental and Occupational Health Sciences, on cancer risk among firefighters in Texas.

UTHealth Houston study links firefighter smoke exposure to biological changes that increase cancer risk

A new study published in Environmental Research by researchers at UTHealth Houston offers valuable insights into how firefighting can affect the body on a molecular level, potentially leading to long-term health risks such as cancer.

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