Lung function in West Sussex firemen: a four year study.

Abstract

Although firefighting is a hazardous occupation, published evidence of long term lung damage in firemen is inconsistent. A group of 96 men from the West Sussex Fire Brigade, which covers a semi-rural, semi-urban area, were followed up for between one and four years. They included 31 non-smokers, 40 smokers, and 25 ex-smokers. After four years 12 firemen had been lost to the study. A control group of 69 volunteers, consisting of non-smoking men from various other occupations, were followed up in parallel. Lung function tests, covering a wider range than has been previously used in similar studies, were repeated six monthly for two years and annually for a further two years. The results were expressed in terms of the rate of change with time of the lung function variables. Many of the variables deteriorated in both firemen and controls, but the rate of deterioration was greater in the controls than the firemen for vital capacity, ratio of residual volume to total lung capacity, FEV,, FVC, peak expiratory flow (PEF), flow at 50% and 25% remaining vital capacity (V,o and V25 respectively), and airways resistance (Raw). With respect to PEF, V50, V25, and Raw the control subjects deteriorated more rapidly even than the smokers and ex-smokers among the firemen. Alveolar mixing efficiency (AME), a measure of small airways function, did not change significantly over the study period in any group. Non-smoking firemen had the highest mean value of AME, decreasing through ex-smokers, controls, and smokers. We conclude that these results show no evidence of chronic lung damage in West Sussex firemen; indeed, the firemen as a group show a lower rate of deterioration of lung function with age than do the control subjects. This is attributed to the selection of fit men for the service, continued All these previous studies have been carried out on city fire brigades and all but the Boston8 have been cross sectional. We report here a four year longitudinal study of the West Sussex Fire Brigade which covers an area half rural and half industrial in character. We used a larger range of lung function tests than have been used previously, including a newer test of gas mixing efficiency, in order to look for more subtle evidence of chronic lung damage. MethodsThe study was carried out with the full and active cooperation of the West Sussex Fire Brigade and their unions with an agreement that the information gained would be confidential.

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

“…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) . Our comparison between firefighters and NWAHS general population controls supports the latter finding and adds that this phenomenon may be mainly attributable to an increase in lung function over time in younger (i.e., <45 years) firefighters rather than a decelerated rate of decline across all age groups.…”

“…Although there is a body of literature showing that the respiratory system undergoes various anatomical and physiological changes with age and that after 20−25 years of age, aging is associated with progressive decline in lung function 27,28) , this may be different for firefighters. Possible explanations for this are the selection of healthy and very fit men for service ("healthy worker effect") 29,30) , the regular use of self-contained breathing apparatus systems 14) , the strenuous physical demands that come with the job or a combination of these (and other) factors. Moreover, firefighters are likely to realize that physical training and looking after their (respiratory) health are a year-round commitment if they are to successfully meet the demands of their job 31) -which seems to be reflected in the low smoking rate (~10%) in our firefighter cohort.…”

“…Studies looking at changes in firefighters' lung function over a prolonged period of time are scarce and have shown conflicting results, some indicating accelerated lung function decline 9) whereas others did not 10−12) . Only two previous studies have compared course of lung function between firefighters and general population controls 13,14) . Because both these studies were conducted well over fifteen years ago and firefighters' working conditions have changed considerably during the past decades, their applicability to present-day generations of firefighters is likely to be limited.…”

An epidemiologic study of cancer and other causes of mortality in San Francisco firefighters

“…Studies of acute pulmonary effects have shown decreased FEV,., and FVC [Shepard et al, 1986;Musk et al, 1979a;Musk et al, 1979b;Sidor and Peters, 1974al. Studies of chronic effects have been less consistent: some have shown long-term effects on pulmonary function Peters et al, 1974;Minty et al, 1985;Horsfield et al, 1988b;Loke et al, 1980;Chia et al, 1987;Sidor and Peters, 1974a,b], but other studies have shown no long-term effects [Horsfield et al, 1988a;Douglas et al, 1985;Musk et al, 1982;Young et al, 1980;Musk et al, 1977b;Tashkin et al, 19771.…”

Cytokine Genotype and Phenotype Effects on Lung Function Decline in Firefighters

“…8,41 Although longitudinal studies of firefighters from the 1970s and 1980s demonstrated an accelerated decline in lung function, most likely as a result of exposure to products of combustion, 42,43 more recent studies have reported mixed effects, with decrease in lung function attributed to a range of other factors including selection of and more pronounced respirator use. 44 In conclusion, we found that the TT genotype at IL-10 (Ϫ819) was significantly associated with an increased rate of decline in FEV 1 , and that the association between the T allele at IL-1RA (2018) and decline in lung function was of borderline significance. However, we failed to observe any significant functional effect of these SNPs on their respective concentrations of cytokine in the sputum.…”