Respiratory symptoms, atopy and bronchial hyperreactivity in professional firefighters

Abstract

The aim of the present study was to assess respiratory health in professional firefighters.A total of 101 male professional firefighters from Basel, Switzerland, were included in the study. A control group consisting of 735 male subjects of the general population was composed of the Basel sample of the Swiss Study on Air Pollution and Lung Diseases in Adults. All subjects were administered a standardised questionnaire, spirometry, skin-prick tests and bronchial challenge testing to methacholine.Respiratory symptoms at work were more frequent in firefighters compared with the control group, including burning eyes (21 versus 3%), running nose (19 versus 2%), itchy throat (26 versus 3%), cough (28 versus 3%), dyspnoea (7 versus 2%) and headache (25 versus 3%), respectively. Atopy was present in 51% of firefighters compared with 32% in the control group. The odds ratio for hyperreactivity to methacholine was 2.24 (95% confidence interval 1.12-4.48) for firefighters compared with the control group.Firefighters reported more respiratory symptoms at work and suffered more often from atopy compared with the control group. Bronchial hyperreactivity was more pronounced in firefighters, but it was not related to acute exposure or duration of employment. It remains unclear whether these findings were present at recruitment or developed after joining the workforce.

Lung function, bronchial hyperresponsiveness, and atopy among firefighters

“…Studies that assessed BHR among firefighters were mostly confined to acute response (5,11) or the respiratory sequelae of the World Trade Center disaster (12, 13). Although Miedinger et al (6) found a higher prevalence of BHR in firefighters compared to a general Swiss population, a relation to length of employment as exposure estimate could not be demonstrated. However, in our study we found a positive relation between number of fires fought in the last 12 months and BHR (β=0.146, P=0.03) adjusted for smoking.…”

“…Previous studies have indicated that smoke exposure may result in acute lung function impairment (3,4) and acute increase of airway responsiveness (5). Furthermore, studies have suggested that firefighters are at risk of chronic respiratory symptoms and lung function impairment (6)(7)(8). On the other hand, some studies did not find associations between exposure and lung function impairment (9,10).…”

“…Bronchial hyperresponsiveness (BHR) among firefighters has mostly been assessed shortly following exposure to fire smoke in a small population (5,11) or following the World Trade Center disaster in New York, USA (12,13). Miedinger et al (6) found increased BHR in a population of 101 firefighters as compared to the Swiss general population. However, an association with levels of exposure was not demonstrated.…”

Respiratory symptoms in firefighters

“…Earlier studies have indicated that exposure of firefighters to smoke may result in acute lung function impairment [Musk et al, 1979; Brandt‐Rauf et al, 1989; Large et al, 1990], acute increase of airway responsiveness [Chia et al, 1990], and acute increase of respiratory symptoms [Betchley et al, 1997]. Furthermore, studies have suggested that firefighters are at risk of chronic respiratory symptoms and lung function impairment [Mustajbegovic et al, 2001; Miedinger et al, 2007; Ribeiro et al, 2009].…”

Evaluation of Pulmonary Function Tests in Working Firemen

“…Acute exposure induces acute neutrophilic inflammation and chronic systemic inflammation, and bronchial hyperreactivity develops (16). Atopy, asthma, and asthma attack prevalence significantly increase (12,17,18). Smoke exposure may result in acute bronchitis, chronic obstructive pulmonary disease, chronic interstitial pneumonia, pulmonary arterial hypertension, and interstitial lung disease (19)(20)(21).…”