Women Worker Biomonitoring Collaborative (WWBC)

Institution: University of California, Berkeley
Investigator(s): Rachel Morello-Frosch, Ph.D., M.P.H. - Heather Buren,  - Erin Carrera,  -
Award Cycle: 2017 (Cycle 23) Grant #: 23BB-1700 Award: $737,778
Award Type: CRC Full Research Award
Research Priorities
Etiology and Prevention>Etiology: the role of environment and lifestyle

This is a collaboration with: 23BB-1701 - 23BB-1702 -

Initial Award Abstract (2017)

Introduction: As first-responders and health care providers, women firefighters and nurses work on the front lines to protect community well-being, yet their exposures to chemicals, particularly potential breast carcinogens, are understudied. Nurses are exposed to complex mixtures of potentially carcinogenic agents including ionizing radiation, disinfectants, chemotherapeutic agents, and medications, but few studies have used biomonitoring to identify exposures and markers of effect. Breast cancer is elevated among nurses despite their expected lower risk based on alcohol consumption, smoking, and reproductive characteristics. Firefighters are also exposed to breast carcinogens. Our prior CBCRP-funded study applied innovative approaches to biomonitoring to compare exposures between firefighters and office workers. Results show elevated exposures among firefighters to highly fluorinated chemicals, thought to be from fire-fighting foams, and previously unstudied exposures to potential breast carcinogens using innovative, non-targeted biomonitoring methods. This proposal builds on our “exposome approach” to compare three female CA occupational cohorts (firefighters, nurses and office workers). Instead of choosing a priori which chemicals to measure, which may or may not be present in our study population, we now propose a discovery-driven method that first uses non-targeted analysis to derive candidate chemicals that can then be measured in human serum (collected from blood); this exposome approach can improve knowledge about occupational exposures to chemicals and identify important biological responses relevant to breast cancer.


  1. What are exposure profiles for potential breast carcinogens among women firefighters, nurses and office workers?
  2. How do occupational categories of nursing and job stressors related to fire events among firefighters affect exposures?
  3. How are exposures in firefighting and nursing associated with biological responses relevant to breast cancer?

General methodology: First, we will develop a large chemical database to which we can compare data generated by a non-targeted scan of serum collected from nurses, firefighters and office workers for potential breast carcinogens. Second, using a lab technique known as liquid chromatography-quadrupole time-of-flight mass spectrometry we will screen serum samples for multiple breast carcinogens and their associated hormone or inflammatory molecule levels. This chemical exposure and biological response screen will compare results between 60 nurses and 40 office workers. We will then measure the actual concentrations of 15 potential breast carcinogens that have not been previously studied. Third, we will also apply the same combination of chemical screening, followed by a targeted analysis to measure serum concentrations of 5 additional breast carcinogens in a longitudinal biomonitoring analysis of 10 women firefighters before and after a fire event. Results of this chemical exposure and biological response scan will be compared across time in serum taken from women firefighters before, 1 day after and 1 month after a fire event. Finally, we will report individual and aggregate results to study participants who want them, and translate research results into exposure reduction activities at the individual, workplace and policy levels.

Innovative elements: This project applies newly available technologies to more holistically profile among nurses, firefighters and office workers unique occupational chemical exposures and associated biological responses of relevance to breast cancer risk. Data from our study can be analyzed by other researchers who can query it in the future for newly emerging chemicals of concern.

Community involvement: The WWBC integrates two occupational groups who are eager to collaborate on research that addresses chemical exposures linked to breast cancer. Our firefighter and nurse collaborators are affiliated with unions and other organizations that are concerned about workplace chemical risks; both have been involved in developing the study aims, protocol design and will engage in recruitment, data collection, analysis, and dissemination of results. With support from Breast Cancer Prevention Partners, the community and scientist collaborators will implement an integrated strategy to report-back results to participants and translate the research for nursing and firefighter communities, health advocates and decision-makers.

Future Plans: Novel exposure data and archived serum and urine samples generated from the WWBC represent a timely and cost-effective investment that will also support future research on occupational exposures of women to breast carcinogens and their potential health risks.