Ultrafine Particle Exposure During Fire Suppression—Is It an Important Contributory Factor for Coronary Heart Disease in Firefighters?

Baxter, C. Stuart; Ross, Clara Sue; Fabian, Thomas; Borgerson, Jacob L.; Shawon, Jamila; Gandhi, Pravinray D.; Dalton, James M.; Lockey, James E.

doi:10.1097/jom.0b013e3181ed2c6e

Cited by 45 publications

(28 citation statements)

References 41 publications

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“…More than 70% of particles generated by combustion of wood and paper, and slightly more than 50% of particles generated by plastic combustion, were ultrafine, which is consistent with the earlier findings. (2) Half Mask Elastomeric Respirator with P-100 Filters 1. Respirator Donned on the Manikin (Unsealed) a.…”

Section: Particle Size Distribution Of Combustion Aerosolsmentioning

confidence: 99%

“…In a large-scale fire test laboratory study, ultrafine particles accounted for more than 70% of the total number concentration of particles during fire knockdown and overhaul. (2) Fine particle exposures at various workplace environments have been associated with impairment of cardiovascular function and other adverse health outcomes. (3)(4)(5) There are approximately 1.1 million firefighters in the United States (including 300,000 career firefighters).…”

Section: Introductionmentioning

confidence: 99%

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Manikin-Based Performance Evaluation of Elastomeric Respirators Against Combustion Particles

Yermakov

Reponen

et al. 2013

Journal of Occupational and Environmental Hygiene

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This study investigated the effects of faceseal leakage, breathing flow, and combustion material on the overall (non-size-selective) penetration of combustion particles into P-100 half and full facepiece elastomeric respirators used by firefighters. Respirators were tested on a breathing manikin exposed to aerosols produced by combustion of three materials (wood, paper, and plastic) in a room-size exposure chamber. Testing was performed using a single constant flow (inspiratory flow rate = 30 L/min) and three cyclic flows (mean inspiratory flow rates = 30, 85, and 135 L/min). Four sealing conditions (unsealed, nose-only sealed, nose and chin sealed, and fully sealed) were examined to evaluate the respirator faceseal leakage. Total aerosol concentration was measured inside (C(in)) and outside (C(out)) the respirator using a condensation particle counter. The total penetration through the respirator was determined as a ratio of the two (P = C(in) / C(out)). Faceseal leakage, breathing flow type and rate, and combustion material were all significant factors affecting the performance of the half mask and full facepiece respirators. The efficiency of P-100 respirator filters met the NIOSH certification criteria (penetration ≤0.03%); it was not significantly influenced by the challenge aerosol and flow type, which supports the current NIOSH testing procedure using a single challenge aerosol and a constant airflow. However, contrary to the NIOSH total inward leakage (TIL) test protocol assuming that the result is independent on the type of the tested aerosol, this study revealed that the challenge aerosol significantly affects the particle penetration through unsealed and partially sealed half mask respirators. Increasing leak size increased total particle penetration. The findings point to some limitations of the existing TIL test in predicting protection levels offered by half mask elastomeric respirators.

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Section: Particle Size Distribution Of Combustion Aerosolsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Manikin-Based Performance Evaluation of Elastomeric Respirators Against Combustion Particles

Yermakov

Reponen

et al. 2013

Journal of Occupational and Environmental Hygiene

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“…Reports in the peer-reviewed literature have examined the utility of standard health surveillance [23], advanced imaging [24–26], and the potential need for enhanced respiratory protection following fire suppression [27, 28] to mitigate the risk of cardiovascular disease among firefighters. However, few studies have examined the costs associated with these programs [24].…”

Section: Discussionmentioning

confidence: 99%

What Does It Cost to Prevent On-Duty Firefighter Cardiac Events? A Content Valid Method for Calculating Costs

Patterson

Suyama

Reís

et al. 2013

Advances in Preventive Medicine

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Cardiac arrest is a leading cause of mortality among firefighters. We sought to develop a valid method for determining the costs of a workplace prevention program for firefighters. In 2012, we developed a draft framework using human resource accounting and in-depth interviews with experts in the firefighting and insurance industries. The interviews produced a draft cost model with 6 components and 26 subcomponents. In 2013, we randomly sampled 100 fire chiefs out of >7,400 affiliated with the International Association of Fire Chiefs. We used the Content Validity Index (CVI) to identify the content valid components of the draft cost model. This was accomplished by having fire chiefs rate the relevancy of cost components using a 4-point Likert scale (highly relevant to not relevant). We received complete survey data from 65 fire chiefs (65% response rate). We retained 5 components and 21 subcomponents based on CVI scores ≥0.70. The five main components include, (1) investment costs, (2) orientation and training costs, (3) medical and pharmaceutical costs, (4) education and continuing education costs, and (5) maintenance costs. Data from a diverse sample of fire chiefs has produced a content valid method for calculating the cost of a prevention program among firefighters.

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“…The ultrafine particles were found to account for >70% of airborne particles (by number) measured in a large-scale fire test laboratory study (Baxter et al , 2010). Exposure to ultrafine particles has been associated with impairment of cardiovascular function and other adverse health outcomes (Schwartz et al , 1996; Peters et al , 1997; Timonen et al , 2005; Schulte et al , 2008).…”

Section: Introductionmentioning

confidence: 99%

Effects of Breathing Frequency and Flow Rate on the Total Inward Leakage of an Elastomeric Half-Mask Donned on an Advanced Manikin Headform

Grinshpun

Reponen

et al. 2013

The Annals of Occupational Hygiene

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Objectives The objective of this study was to investigate the effects of breathing frequency and flow rate on the total inward leakage (TIL) of an elastomeric half-mask donned on an advanced manikin headform and challenged with combustion aerosols. Methods An elastomeric half-mask respirator equipped with P100 filters was donned on an advanced manikin headform covered with life-like soft skin and challenged with aerosols originated by burning three materials: wood, paper, and plastic (polyethylene). TIL was determined as the ratio of aerosol concentrations inside (Cin) and outside (Cout) of the respirator (Cin/Cout) measured with a nanoparticle spectrometer operating in the particle size range of 20–200 nm. The testing was performed under three cyclic breathing flows [mean inspiratory flow (MIF) of 30, 55, and 85 l/min] and five breathing frequencies (10, 15, 20, 25, and 30 breaths/min). A completely randomized factorial study design was chosen with four replicates for each combination of breathing flow rate and frequency. Results Particle size, MIF, and combustion material had significant (P < 0.001) effects on TIL regardless of breathing frequency. Increasing breathing flow decreased TIL. Testing with plastic aerosol produced higher mean TIL values than wood and paper aerosols. The effect of the breathing frequency was complex. When analyzed using all combustion aerosols and MIFs (pooled data), breathing frequency did not significantly (P = 0.08) affect TIL. However, once the data were stratified according to combustion aerosol and MIF, the effect of breathing frequency became significant (P < 0.05) for all MIFs challenged with wood and paper combustion aerosols, and for MIF = 30 l/min only when challenged with plastic combustion aerosol. Conclusions The effect of breathing frequency on TIL is less significant than the effects of combustion aerosol and breathing flow rate for the tested elastomeric half-mask respirator. The greatest TIL occurred when challenged with plastic aerosol at 30 l/min and at a breathing frequency of 30 breaths/min.

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Ultrafine Particle Exposure During Fire Suppression—Is It an Important Contributory Factor for Coronary Heart Disease in Firefighters?

Abstract: Exposure to ultrafine particles during fire suppression should be considered a potential contributing factor for CHD in firefighters. Of major significance is their predominance during overhaul, where firefighters frequently remove respiratory protection.

Cited by 45 publications

References 41 publications

Manikin-Based Performance Evaluation of Elastomeric Respirators Against Combustion Particles

Manikin-Based Performance Evaluation of Elastomeric Respirators Against Combustion Particles

What Does It Cost to Prevent On-Duty Firefighter Cardiac Events? A Content Valid Method for Calculating Costs

Effects of Breathing Frequency and Flow Rate on the Total Inward Leakage of an Elastomeric Half-Mask Donned on an Advanced Manikin Headform

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