{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:54:10Z","timestamp":1790916850358,"version":"4.1.0"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T00:00:00Z","timestamp":1746576000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["RG94521"],"award-info":[{"award-number":["RG94521"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["RG94521"],"award-info":[{"award-number":["RG94521"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100014013","name":"UK Research and Innovation","doi-asserted-by":"publisher","award":["RG94521"],"award-info":[{"award-number":["RG94521"]}],"id":[{"id":"10.13039\/100014013","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>Firefighters are exposed to a diverse range of harmful substances, including polycyclic aromatic hydrocarbons, benzene, and other carcinogens. These toxic compounds induce DNA damage, often causing the formation of DNA adducts and other lesions that can contribute to the development of various diseases, including cancer. Recent advancements in molecular diagnostics have shown that circulating cell-free DNA (cfDNA) in plasma is a valuable biomarker for detecting DNA damage and disease states. In this study, we explored whether changes in the quantity and quality of plasma cfDNA might reveal DNA lesions or serve as early markers for diseases such as cancer in UK firefighters. Whilst there are few published epidemiological studies of risk of cancer in UK firefighters, there are none on molecular markers in this population. All the 685 firefighters who participated in the study were employed by the London Fire Brigade in 2017; many of them also attended the Grenfell Tower fire, the most devastating fire to occur in the UK in modern history. In this exploratory analysis, we sought to gain insights into the potential long-term health impacts of toxic smoke exposure on these first responders by analysing both the concentration of cfDNA present and specific genetic alterations in cfDNA. Using next-generation sequencing and a panel that detects pathogenic DNA variants linked to various cancers, we analysed a subset of 261 firefighters. Our findings revealed that 11 firefighters carried pathogenic DNA variants associated with cancer, but we found no association between fire smoke exposure and the presence of these variants.<\/jats:p>","DOI":"10.1038\/s41598-025-95991-y","type":"journal-article","created":{"date-parts":[[2025,5,7]],"date-time":"2025-05-07T09:02:15Z","timestamp":1746608535000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Assessment of cancer biomarkers in the Grenfell firefighter cohort study"],"prefix":"10.1038","volume":"15","author":[{"given":"Johanna","family":"Feary","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yizhou","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamanna","family":"Kabir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susie","family":"Schofield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian","family":"Bevan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victoria","family":"Askinyte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Honan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liza","family":"Emirali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Rubbi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne E.","family":"Willis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul","family":"Cullinan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shubha","family":"Anand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. Miguel","family":"Martins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,5,7]]},"reference":[{"key":"95991_CR1","doi-asserted-by":"publisher","first-page":"839","DOI":"10.1007\/s00420-020-01539-0","volume":"93","author":"S Casjens","year":"2020","unstructured":"Casjens, S., Bruning, T. & Taeger, D. Cancer risks of firefighters: a systematic review and meta-analysis of secular trends and region-specific differences. Int. Arch. Occup. Environ. Health 93, 839\u2013852. https:\/\/doi.org\/10.1007\/s00420-020-01539-0 (2020).","journal-title":"Int. Arch. Occup. Environ. Health"},{"key":"95991_CR2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18052519","author":"E Laroche","year":"2021","unstructured":"Laroche, E. & L\u2019Esperance, S. Cancer incidence and mortality among firefighters: An overview of epidemiologic systematic reviews. Int. J. Environ. Res. Public Health. https:\/\/doi.org\/10.3390\/ijerph18052519 (2021).","journal-title":"Int. J. Environ. Res. Public Health."},{"key":"95991_CR3","unstructured":"IARC. In Occupational Exposure as a Firefighter IARC Monographs on the Identification of Carcinogenic Hazards to Humans (2023)."},{"key":"95991_CR4","doi-asserted-by":"publisher","first-page":"2476","DOI":"10.1038\/s41598-018-20616-6","volume":"8","author":"AA Stec","year":"2018","unstructured":"Stec, A. A. et al. Occupational exposure to polycyclic aromatic hydrocarbons and elevated cancer incidence in firefighters. Sci. Rep. 8, 2476. https:\/\/doi.org\/10.1038\/s41598-018-20616-6 (2018).","journal-title":"Sci. Rep."},{"key":"95991_CR5","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1080\/15459624.2017.1334904","volume":"14","author":"KW Fent","year":"2017","unstructured":"Fent, K. W. et al. Contamination of firefighter personal protective equipment and skin and the effectiveness of decontamination procedures. J. Occup. Environ. Hyg. 14, 801\u2013814. https:\/\/doi.org\/10.1080\/15459624.2017.1334904 (2017).","journal-title":"J. Occup. Environ. Hyg."},{"key":"95991_CR6","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1016\/j.ijheh.2019.06.006","volume":"222","author":"KW Fent","year":"2019","unstructured":"Fent, K. W. et al. Firefighters\u2019 and instructors\u2019 absorption of PAHs and benzene during training exercises. Int. J. Hyg. Environ. Health 222, 991\u20131000. https:\/\/doi.org\/10.1016\/j.ijheh.2019.06.006 (2019).","journal-title":"Int. J. Hyg. Environ. Health"},{"key":"95991_CR7","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1093\/annweh\/wxx097","volume":"62","author":"H Wingfors","year":"2018","unstructured":"Wingfors, H., Nyholm, J. R., Magnusson, R. & Wijkmark, C. H. Impact of fire suit ensembles on firefighter PAH exposures as assessed by skin deposition and urinary biomarkers. Ann. Work Expo Health 62, 221\u2013231. https:\/\/doi.org\/10.1093\/annweh\/wxx097 (2018).","journal-title":"Ann. Work Expo Health"},{"key":"95991_CR8","doi-asserted-by":"publisher","first-page":"105","DOI":"10.1093\/mutage\/gex021","volume":"33","author":"MHG Andersen","year":"2018","unstructured":"Andersen, M. H. G. et al. Association between polycyclic aromatic hydrocarbon exposure and peripheral blood mononuclear cell DNA damage in human volunteers during fire extinction exercises. Mutagenesis 33, 105\u2013115. https:\/\/doi.org\/10.1093\/mutage\/gex021 (2018).","journal-title":"Mutagenesis"},{"key":"95991_CR9","doi-asserted-by":"publisher","first-page":"436","DOI":"10.1161\/CIRCGENETICS.116.001506","volume":"9","author":"R Joehanes","year":"2016","unstructured":"Joehanes, R. et al. Epigenetic signatures of cigarette smoking. Circ. Cardiovasc. Genet. 9, 436\u2013447. https:\/\/doi.org\/10.1161\/CIRCGENETICS.116.001506 (2016).","journal-title":"Circ. Cardiovasc. Genet."},{"key":"95991_CR10","doi-asserted-by":"publisher","first-page":"599","DOI":"10.2217\/epi-2016-0001","volume":"8","author":"S Ambatipudi","year":"2016","unstructured":"Ambatipudi, S. et al. Tobacco smoking-associated genome-wide DNA methylation changes in the EPIC study. Epigenomics 8, 599\u2013618. https:\/\/doi.org\/10.2217\/epi-2016-0001 (2016).","journal-title":"Epigenomics"},{"key":"95991_CR11","doi-asserted-by":"publisher","first-page":"935","DOI":"10.1016\/j.envpol.2017.12.039","volume":"234","author":"NS Kuzmina","year":"2018","unstructured":"Kuzmina, N. S. et al. Gene hypermethylation in blood leukocytes in humans long term after radiation exposure\u2014Validation set. Environ. Pollut. 234, 935\u2013942. https:\/\/doi.org\/10.1016\/j.envpol.2017.12.039 (2018).","journal-title":"Environ. Pollut."},{"key":"95991_CR12","doi-asserted-by":"publisher","first-page":"5068","DOI":"10.1038\/s41467-018-07466-6","volume":"9","author":"J Moss","year":"2018","unstructured":"Moss, J. et al. Comprehensive human cell-type methylation atlas reveals origins of circulating cell-free DNA in health and disease. Nat. Commun. 9, 5068. https:\/\/doi.org\/10.1038\/s41467-018-07466-6 (2018).","journal-title":"Nat. Commun."},{"key":"95991_CR13","doi-asserted-by":"publisher","first-page":"1379","DOI":"10.1016\/j.clinbiochem.2016.09.009","volume":"49","author":"FC Wong","year":"2016","unstructured":"Wong, F. C. et al. Cell-free DNA in maternal plasma and serum: A comparison of quantity, quality and tissue origin using genomic and epigenomic approaches. Clin. Biochem. 49, 1379\u20131386. https:\/\/doi.org\/10.1016\/j.clinbiochem.2016.09.009 (2016).","journal-title":"Clin. Biochem."},{"key":"95991_CR14","doi-asserted-by":"publisher","DOI":"10.1111\/acel.12890","volume":"18","author":"YV Teo","year":"2019","unstructured":"Teo, Y. V. et al. Cell-free DNA as a biomarker of aging. Aging Cell 18, e12890. https:\/\/doi.org\/10.1111\/acel.12890 (2019).","journal-title":"Aging Cell"},{"key":"95991_CR15","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1007\/s00421-008-0827-2","volume":"104","author":"J Atamaniuk","year":"2008","unstructured":"Atamaniuk, J. et al. Effects of ultra-marathon on circulating DNA and mRNA expression of pro- and anti-apoptotic genes in mononuclear cells. Eur. J. Appl. Physiol. 104, 711\u2013717. https:\/\/doi.org\/10.1007\/s00421-008-0827-2 (2008).","journal-title":"Eur. J. Appl. Physiol."},{"key":"95991_CR16","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000014863","volume":"98","author":"Y Hayun","year":"2019","unstructured":"Hayun, Y. et al. Circulating cell-free DNA as a potential marker in smoke inhalation injury. Medicine (Baltimore) 98, e14863. https:\/\/doi.org\/10.1097\/MD.0000000000014863 (2019).","journal-title":"Medicine (Baltimore)"},{"key":"95991_CR17","doi-asserted-by":"publisher","first-page":"202","DOI":"10.1097\/CRD.0b013e318215c105","volume":"19","author":"ES Soteriades","year":"2011","unstructured":"Soteriades, E. S., Smith, D. L., Tsismenakis, A. J., Baur, D. M. & Kales, S. N. Cardiovascular disease in US firefighters: a systematic review. Cardiol. Rev. 19, 202\u2013215. https:\/\/doi.org\/10.1097\/CRD.0b013e318215c105 (2011).","journal-title":"Cardiol. Rev."},{"key":"95991_CR18","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1002\/em.21917","volume":"56","author":"A Borghini","year":"2015","unstructured":"Borghini, A. et al. Increased circulating cell-free DNA levels and mtDNA fragments in interventional cardiologists occupationally exposed to low levels of ionizing radiation. Environ. Mol. Mutagen 56, 293\u2013300. https:\/\/doi.org\/10.1002\/em.21917 (2015).","journal-title":"Environ. Mol. Mutagen"},{"key":"95991_CR19","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0064413","volume":"8","author":"LT Budnik","year":"2013","unstructured":"Budnik, L. T., Kloth, S., Baur, X., Preisser, A. M. & Schwarzenbach, H. Circulating mitochondrial DNA as biomarker linking environmental chemical exposure to early preclinical lesions elevation of mtDNA in human serum after exposure to carcinogenic halo-alkane-based pesticides. PLoS ONE 8, e64413. https:\/\/doi.org\/10.1371\/journal.pone.0064413 (2013).","journal-title":"PLoS ONE"},{"key":"95991_CR20","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1177\/1947601911408889","volume":"2","author":"N Rivlin","year":"2011","unstructured":"Rivlin, N., Brosh, R., Oren, M. & Rotter, V. Mutations in the p53 tumor suppressor gene: Important milestones at the various steps of tumorigenesis. Genes Cancer 2, 466\u2013474. https:\/\/doi.org\/10.1177\/1947601911408889 (2011).","journal-title":"Genes Cancer"},{"key":"95991_CR21","unstructured":"Contributors, W. Grenfell Tower fire. https:\/\/en.wikipedia.org\/w\/index.php?title=Grenfell_Tower_fire&oldid=1277780100."},{"key":"95991_CR22","unstructured":"Feary, J. The Grenfell firefighters study; establishing a cohort. https:\/\/www.hra.nhs.uk\/planning-and-improving-research\/application-summaries\/research-summaries\/grenfell-firefighters-study\/ (2019)."},{"key":"95991_CR23","doi-asserted-by":"publisher","first-page":"87221","DOI":"10.18632\/oncotarget.20250","volume":"8","author":"P Adamo","year":"2017","unstructured":"Adamo, P. et al. Profiling tumour heterogeneity through circulating tumour DNA in patients with pancreatic cancer. Oncotarget 8, 87221\u201387233. https:\/\/doi.org\/10.18632\/oncotarget.20250 (2017).","journal-title":"Oncotarget"},{"key":"95991_CR24","doi-asserted-by":"publisher","first-page":"3099","DOI":"10.2147\/CMAR.S243320","volume":"12","author":"Y Zhong","year":"2020","unstructured":"Zhong, Y. et al. Plasma cfDNA as a potential biomarker to evaluate the efficacy of chemotherapy in gastric cancer. Cancer Manag. Res. 12, 3099\u20133106. https:\/\/doi.org\/10.2147\/CMAR.S243320 (2020).","journal-title":"Cancer Manag. Res."},{"key":"95991_CR25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0242145","volume":"15","author":"J Bu","year":"2020","unstructured":"Bu, J. et al. Enhanced detection of cell-free DNA (cfDNA) enables its use as a reliable biomarker for diagnosis and prognosis of gastric cancer. PLoS ONE 15, e0242145. https:\/\/doi.org\/10.1371\/journal.pone.0242145 (2020).","journal-title":"PLoS ONE"},{"key":"95991_CR26","doi-asserted-by":"publisher","DOI":"10.3390\/genes12081171","author":"K Thakur","year":"2021","unstructured":"Thakur, K. et al. Extracellular vesicle-derived DNA vs. CfDNA as a biomarker for the detection of colon cancer. Genes (Basel). https:\/\/doi.org\/10.3390\/genes12081171 (2021).","journal-title":"Genes (Basel)."},{"key":"95991_CR27","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1038\/s41586-023-05776-4","volume":"616","author":"C Abbosh","year":"2023","unstructured":"Abbosh, C. et al. Tracking early lung cancer metastatic dissemination in TRACERx using ctDNA. Nature 616, 553\u2013562. https:\/\/doi.org\/10.1038\/s41586-023-05776-4 (2023).","journal-title":"Nature"},{"key":"95991_CR28","doi-asserted-by":"publisher","first-page":"1055968","DOI":"10.3389\/fonc.2022.1055968","volume":"12","author":"HT Chan","year":"2022","unstructured":"Chan, H. T. et al. Tumor-informed or tumor-agnostic circulating tumor DNA as a biomarker for risk of recurrence in resected colorectal cancer patients. Front. Oncol. 12, 1055968. https:\/\/doi.org\/10.3389\/fonc.2022.1055968 (2022).","journal-title":"Front. Oncol."},{"key":"95991_CR29","doi-asserted-by":"publisher","first-page":"551","DOI":"10.21873\/cdp.10254","volume":"3","author":"MI Koukourakis","year":"2023","unstructured":"Koukourakis, M. I. et al. Circulating plasma cell-free DNA (cfDNA) as a predictive biomarker for radiotherapy: results from a prospective trial in head and neck cancer. Cancer Diagn. Progn. 3, 551\u2013557. https:\/\/doi.org\/10.21873\/cdp.10254 (2023).","journal-title":"Cancer Diagn. Progn."},{"key":"95991_CR30","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1016\/j.jmoldx.2016.10.002","volume":"19","author":"MM Li","year":"2017","unstructured":"Li, M. M. et al. Standards and guidelines for the interpretation and reporting of sequence variants in cancer: a joint consensus recommendation of the Association for Molecular Pathology, American Society of Clinical Oncology, and College of American Pathologists. J. Mol. Diagn. 19, 4\u201323. https:\/\/doi.org\/10.1016\/j.jmoldx.2016.10.002 (2017).","journal-title":"J. Mol. Diagn."},{"key":"95991_CR31","doi-asserted-by":"publisher","first-page":"801","DOI":"10.31557\/APJCP.2024.25.3.801","volume":"25","author":"SA Jahnke","year":"2024","unstructured":"Jahnke, S. A. et al. Meta-analysis of incidence and mortality of firefighter cancer: an update on emerging science. Asian Pac. J. Cancer Prev. 25, 801\u2013811. https:\/\/doi.org\/10.31557\/APJCP.2024.25.3.801 (2024).","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"95991_CR32","volume-title":"Study of Mortality and Cancer Incidence in Fire-fighters in Britain\u2014A Third Report 1965\u20131993","author":"S Donnan","year":"1996","unstructured":"Donnan, S. Study of Mortality and Cancer Incidence in Fire-fighters in Britain\u2014A Third Report 1965\u20131993 (Home Office Scientific Research and Development Branch, 1996)."},{"key":"95991_CR33","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1093\/occmed\/kqu080","volume":"64","author":"CW Ide","year":"2014","unstructured":"Ide, C. W. Cancer incidence and mortality in serving whole-time Scottish firefighters 1984\u20132005. Occup. Med. (Lond.) 64, 421\u2013427. https:\/\/doi.org\/10.1093\/occmed\/kqu080 (2014).","journal-title":"Occup. Med. (Lond.)"},{"key":"95991_CR34","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1093\/occmed\/kqac138","volume":"73","author":"AA Stec","year":"2023","unstructured":"Stec, A. A., Robinson, A., Wolffe, T. A. M. & Bagkeris, E. Scottish firefighters occupational cancer and disease mortality rates: 2000\u20132020. Occup. Med. (Lond.) 73, 42\u201348. https:\/\/doi.org\/10.1093\/occmed\/kqac138 (2023).","journal-title":"Occup. Med. (Lond.)"},{"key":"95991_CR35","doi-asserted-by":"publisher","first-page":"6606","DOI":"10.1200\/JCO.2022.40.16_suppl.TPS6606","volume":"40","author":"C Swanton","year":"2022","unstructured":"Swanton, C. et al. NHS-Galleri Trial Design: Equitable study recruitment tactics for targeted population-level screening with a multi-cancer early detection (MCED) test. J. Clin. Oncol. 40, 6606\u20136606. https:\/\/doi.org\/10.1200\/JCO.2022.40.16_suppl.TPS6606 (2022).","journal-title":"J. Clin. Oncol."},{"key":"95991_CR36","doi-asserted-by":"publisher","first-page":"534","DOI":"10.1038\/s41419-019-1770-3","volume":"10","author":"I Alborelli","year":"2019","unstructured":"Alborelli, I. et al. Cell-free DNA analysis in healthy individuals by next-generation sequencing: a proof of concept and technical validation study. Cell Death Dis. 10, 534. https:\/\/doi.org\/10.1038\/s41419-019-1770-3 (2019).","journal-title":"Cell Death Dis."},{"key":"95991_CR37","doi-asserted-by":"publisher","first-page":"231","DOI":"10.3389\/fphys.2017.00231","volume":"8","author":"BH Soon","year":"2017","unstructured":"Soon, B. H. et al. Mitochondrial DNA mutations in grade II and III glioma cell lines are associated with significant mitochondrial dysfunction and higher oxidative stress. Front. Physiol. 8, 231. https:\/\/doi.org\/10.3389\/fphys.2017.00231 (2017).","journal-title":"Front. Physiol."},{"key":"95991_CR38","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1007\/BF02913333","volume":"22","author":"MS Naidu","year":"2007","unstructured":"Naidu, M. S., Suryakar, A. N., Swami, S. C., Katkam, R. V. & Kumbar, K. M. Oxidative stress and antioxidant status in cervical cancer patients. Indian J. Clin. Biochem. 22, 140\u2013144. https:\/\/doi.org\/10.1007\/BF02913333 (2007).","journal-title":"Indian J. Clin. Biochem."},{"key":"95991_CR39","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1080\/19312450701641375","volume":"1","author":"DJ O'Keefe","year":"2007","unstructured":"O\u2019Keefe, D. J. Brief report: Post hoc power, observed power, a priori power, retrospective power, prospective power, achieved power: Sorting out appropriate uses of statistical power analyses. Commun. Methods Meas. 1, 291\u2013299. https:\/\/doi.org\/10.1080\/19312450701641375 (2007).","journal-title":"Commun. Methods Meas."},{"key":"95991_CR40","doi-asserted-by":"publisher","first-page":"19","DOI":"10.1198\/000313001300339897","volume":"55","author":"JM Hoenig","year":"2001","unstructured":"Hoenig, J. M. & Heisey, D. M. The abuse of power. Am. Stat. 55, 19\u201324. https:\/\/doi.org\/10.1198\/000313001300339897 (2001).","journal-title":"Am. Stat."},{"key":"95991_CR41","doi-asserted-by":"publisher","first-page":"A3","DOI":"10.1016\/j.jss.2019.10.049","volume":"259","author":"AD Althouse","year":"2021","unstructured":"Althouse, A. D. Post hoc power: Not empowering, just misleading. J. Surg. Res. 259, A3\u2013A6. https:\/\/doi.org\/10.1016\/j.jss.2019.10.049 (2021).","journal-title":"J. Surg. Res."},{"key":"95991_CR42","unstructured":"Mobbs, A. London Data Store. https:\/\/data.london.gov.uk\/dataset\/lfb-fires-in-london-1966-2019---fire-facts (2021)."},{"key":"95991_CR43","doi-asserted-by":"publisher","first-page":"985","DOI":"10.1016\/S1470-2045(22)00390-4","volume":"23","author":"PA Demers","year":"2022","unstructured":"Demers, P. A. et al. Carcinogenicity of occupational exposure as a firefighter. Lancet Oncol. 23, 985\u2013986. https:\/\/doi.org\/10.1016\/S1470-2045(22)00390-4 (2022).","journal-title":"Lancet Oncol."},{"key":"95991_CR44","unstructured":"Wickham, H., Fran\u00e7ois, R., Henry, L. & M\u00fcller, K. https:\/\/github.com\/tidyverse\/dplyr (2022)."},{"key":"95991_CR45","doi-asserted-by":"publisher","first-page":"986","DOI":"10.1016\/j.gim.2022.01.001","volume":"24","author":"P Horak","year":"2022","unstructured":"Horak, P. et al. Standards for the classification of pathogenicity of somatic variants in cancer (oncogenicity): Joint recommendations of Clinical Genome Resource (ClinGen), Cancer Genomics Consortium (CGC), and Variant Interpretation for Cancer Consortium (VICC). Genet. Med. 24, 986\u2013998. https:\/\/doi.org\/10.1016\/j.gim.2022.01.001 (2022).","journal-title":"Genet. Med."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-95991-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-95991-y","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-95991-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T14:09:35Z","timestamp":1746713375000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-95991-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,7]]},"references-count":45,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["95991"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-95991-y","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,7]]},"assertion":[{"value":"17 December 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 March 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"7 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"Approval for the Grenfell Firefighters Study was granted by the North West London Ethics Committee (19\/LO\/1847).","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics"}}],"article-number":"15784"}}