A longitudinal study of pulmonary function in fire fighters

Abstract

Pulmonary function changes among fire fighters were evaluated by re-examining 632 Baltimore city fire fighters six to ten years after a baseline examination. Spirometry was used to determine forced expiratory volume in 1 second (FEV1). Information about exposures was obtained by questionnaire and by combining data from fire department records regarding the number of fires fought by fire fighting units with individual work histories. Men who never wore a mask while extinguishing fires experienced a 1.7 times greater rate of FEV1 decline than mask wearers. Men with ammonia exposure experienced a rate of decline 1.7 times greater than non-exposed men. Neither length of time spent in exposed jobs nor number of responses were associated with the rate of decline. Active fire fighters experienced a rate of decline 2.5 times greater than those who had retired or resigned. Some effects differed between men who were able to perform repeatable pulmonary function tests and those who were not.

Change in Lung Function over Time in Male Metropolitan Firefighters and General Population Controls: A 3‐year Follow‐up Study

“…But even by matching to more suitable controls, in the case of firefighters Often or frequently Some of the time Never or rarely the physical fitness and activity cannot be "isolated" from the other potential explanations for the unexpected increase in lung function (e.g., frequent use of breathing apparatus and performing strenuous physical activity while using this equipment). Our observation that a more frequent use of respiratory protection devices during fire knockdown and other potentially harmful tasks may prevent firefighters from having accelerated lung function decline is consistent with a report from the previously mentioned study in Baltimore firefighters, in which a correlation between the use of protective devices and rate of FEV 1 decline was found 9) . In contrast, analyses of longitudinal spirometry data of WTC rescue workers did not show an association between respirator use and FEV 1 or FVC decline 32) , which may be explained by the typical, very intense and enduring inhalation exposure of the rescue workers in the aftermath of the disaster 33) and the variety of respirator devices that were used 32) .…”

“…It has previously been shown that firefighters may be at increased risk of accelerated lung function decline, depending on their actual exposure to inhaled harmful substances during their professional duties 13,24,25) . Rapid decline of lung function over time has been reported in a study in Baltimore City firefighters 9) and in firefighters who presented for pulmonary evaluation after having been involved in the rescue work at the World Trade Center (WTC) disaster 26) . On the other hand, a follow-up study conducted in England showed that, as a group, male firefighters showed a lower rate of lung function decline over time than control subjects did 14) .…”

Short‐term spirometric changes in wildland firefighters

“…The same results were obtained for small sized airways [Loke et al, 1980;Sherman et al, 1989]. A persistence of this impairment in pulmonary function was also noted in almost every study regarding routine spirometry [Peters et al, 1974;Peters, 1974a, 1974b;Musk et al, 1977;Loke et al, 1980;Young et al, 1980;Douglas et al, 1985;Tepper et al, 1991;Loke et al, 1992;Mustajbegovic et al, 2001].…”

Smoke Exposure Has Transient Pulmonary and Systemic Effects in Wildland Firefighters

“…Although our observations suggest that the change in lung function resolves within a 2-week period after a single exposure to smoke, it is possible that repeated exposures over a longer period of time would result in a progressive decline in lung function. Indeed, the literature indicates that although acute exposure results in small decrements in spirometric measures that resolve, urban firefighters have been shown to experience an increased rate of lung function decline [18][19][20][21][22], and one study suggests that this is true in the case of wildland firefighters as well [23]. Additional studies examining decrements in lung function over time in forest firefighters compared to unexposed subjects would be necessary to establish whether there are chronic effects of occupational exposure to forest fire smoke on lung function.…”