Interstitial Lung Disease in Firefighters: An Emerging Occupational Hazard

Lee, Cathryn T.; Ventura, Iazsmin Bauer; Phillips, Emily; Leahy, A.; Jablonski, R.; Montner, Steven M.; Chung, Jonathan H.; Vij, Rekha; Adegunsoye, Ayodeji; Strek, Mary E.

doi:10.3389/fmed.2022.864658

Cited by 9 publications

(8 citation statements)

References 12 publications

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“…Interstitial pulmonary diseases are characterised by inflammation or scarring of lung tissue and include asbestosis, pulmonary fibrosis and sarcoidosis. Interstitial pulmonary diseases have been identified in firefighters at rates up to four times that of the general population [ 24 ]. Inhalation exposure to asbestos, silica and inorganic dust is thought to contribute to firefighters’ increased risk.…”

Section: Discussionmentioning

confidence: 99%

Scottish Firefighters Occupational Cancer and Disease Mortality Rates: 2000-2020

Stec

Robinson

Wolffe

et al. 2023

Occupational Medicine

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Background Increased mortality from cancers and other diseases has been reported in USA, Canadian, and Nordic firefighters. However, UK firefighters are understudied. Aims To determine whether UK firefighters suffer increased mortality from cancers and other diseases when compared with the general population. Methods Mortality from cancer and other diseases in Scottish male firefighters between 2000 and 2020 was compared with the general Scottish male population and expressed as standardized mortality ratios (SMRs) (with 95% confidence intervals, CI). Results Significant overall excess cancer mortality was found for Scottish firefighters compared with the general population (SMR 1.61, CI 1.42-1.81). Scottish firefighters were nearly three times more likely to die of malignant neoplasms (unspecified sites) (SMR 2.71, CI 1.71-4.00). Excess cancer mortality was also found for several site-specific cancers, including prostate (SMR 3.80, CI 2.56-5.29), myeloid leukaemia (SMR 3.17, CI 1.44-5.58), oesophagus (SMR 2.42, CI 1.69-3.29) and urinary system (kidney and bladder) (SMR 1.94, CI 1.16-2.91). Mortality from neoplasms of unknown behaviour was over six times greater in Scottish firefighters (SMR 6.37, CI 2.29-12.49). Additionally, significantly higher mortality was found for: acute ischaemic heart diseases (SMR 5.27, CI 1.90-10.33), stroke (SMR 2.69, CI 1.46-4.28), interstitial pulmonary diseases (SMR 3.04, CI 1.45-5.22), renal failure (SMR 3.28, CI 1.18-6.44) and musculoskeletal system diseases (SMR 5.64, CI 1.06-13.83). Conclusions UK firefighters suffer significant excess mortality from cancer and other diseases when compared with the general population. Preventative health monitoring and presumptive legislation are urgently required to protect UK firefighters’ health.

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Section: Discussionmentioning

confidence: 99%

Scottish Firefighters Occupational Cancer and Disease Mortality Rates: 2000-2020

Stec

Robinson

Wolffe

et al. 2023

Occupational Medicine

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“…Outside of the WTC disaster, most of the literature on inhalational injuries from natural disasters has focused on the wildland fires in Australia and Canada and acute inhalational exposures or obstructive lung diseases, rather than ILD. One US study showed that firefighters have a higher risk of ILD and IPF compared to the working population [92], but there is a major research gap to fully elucidate this relationship. Veterans are another occupational cohort with an elevated prevalence of IPF due to military exposure such as in Southeast and Southwest Asia [93].…”

Section: Conflict-related Disasters/inhalation Exposuresmentioning

confidence: 99%

Environmental Causes of Idiopathic Pulmonary Fibrosis

Gandhi,

Tonelli,

Murray

et al. 2023

IJMS

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Idiopathic pulmonary fibrosis (IPF), the most common and severe of the idiopathic interstitial pneumonias, is a chronic and relentlessly progressive disease, which occurs mostly in middle-aged and elderly males. Although IPF is by definition “idiopathic”, multiple factors have been reported to increase disease risk, aging being the most prominent one. Several occupational and environmental exposures, including metal dust, wood dust and air pollution, as well as various lifestyle variables, including smoking and diet, have also been associated with an increased risk of IPF, probably through interaction with genetic factors. Many of the predisposing factors appear to act also as trigger for acute exacerbations of the disease, which herald a poor prognosis. The more recent literature on inhalation injuries has focused on the first responders in the World Trade Center attacks and military exposure. In this review, we present an overview of the environmental and occupational causes of IPF and its pathogenesis. While our list is not comprehensive, we have selected specific exposures to highlight based on their overall disease burden.

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“…In a cohort study conducted at the University of Chicago with 76 firefighters, reductions in FVC and carbon monoxide diffusion volume were confirmed compared to the general population, and lung cancer and COPD were observed in firefighters and first responders who were active at the World Trade Center (WTC) terrorist scene. Asthma, chronic bronchitis, pulmonary fibrosis, and sarcoidosis were associated with firefighters responding to disasters [50]. Firefighters who experience extensive exposure to wildfire scenes were associated with non-resolving airway damage [51].…”

Section: Efforts and Implications For Prevention Of Occupational Resp...mentioning

confidence: 99%

Evaluation of Air Quality inside Self-Contained Breathing Apparatus Used by Firefighters

Kim,

Ham

2023

Fire

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(1) Background: When a fire breaks out, combustibles are burned and toxic substances such as carbon monoxide (CO), polycyclic aromatic hydrocarbons (PAH), benzene, and hydrogen cyanide are produced. The purpose of this study is to evaluate the air quality inside self-contained breathing apparatus (SCBA) by comparing it to that in the environment where the SCBA charger is installed. (2) Methods: The design of this study was a simulation-based case-control experiment study, and the experiment was conducted at two fire stations located on land and on water. When charging the SCBA, it was differentiated according to the presence or absence of exposure to harmful substances and the degree of exposure. The air quality inside the SCBA in the charging room installed in the fire station garages located on land and in the water, which were not completely isolated from harmful substances, was evaluated. CO, carbon dioxide (CO2), water, and oil mist were measured and analyzed to determine the air quality inside the SCBA. (3) Results: In the case of land firefighting stations, the mean CO among the SCBA internal air quality items was 20 times higher than the outside the SCBA, and higher than the safe range in the group with the highest exposure at the sites of firefighting buildings completely isolated from hazardous substances. The CO levels of all items of water were analyzed to be higher than the safe range in the floating fire station. (4) Conclusions: It was confirmed that the installation environment of an SCBA charging room can affect the safety of the charged internal air quality components. The results of this study can be actively used for the operation and management of SCBA charging room environments when building firefighting buildings in the future for the hygiene, safety, and health of firefighters.

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Interstitial Lung Disease in Firefighters: An Emerging Occupational Hazard

Cited by 9 publications

References 12 publications

Scottish Firefighters Occupational Cancer and Disease Mortality Rates: 2000-2020

Scottish Firefighters Occupational Cancer and Disease Mortality Rates: 2000-2020

Environmental Causes of Idiopathic Pulmonary Fibrosis

Evaluation of Air Quality inside Self-Contained Breathing Apparatus Used by Firefighters

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