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Oh H, Kim S, Woo H, Ham S. Associations between Awareness of the Risk of Exposure to Pollutants Occurring at Fire Scenes and Health Beliefs among Metropolitan Firefighters in the Republic of Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148860. [PMID: 35886708 PMCID: PMC9318504 DOI: 10.3390/ijerph19148860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 02/06/2023]
Abstract
Firefighters are repeatedly exposed to various pollutants that occur at fire scenes. There are three levels of exposure: primary exposure to pollutants, secondary exposure to pollutants on personal protective equipment (PPE), and tertiary exposure to contaminated fire stations and fire engines due to pollutants on PPE. Therefore, it is important for firefighters to be aware of the risk of exposure to pollutants and to practice health behaviors such as appropriate PPE management. No clear association has been established in the existing literature between firefighters’ risk perception level and their health beliefs about the health impact of awareness of exposure to hazardous substances at fire scenes. This study aims to evaluate the relationship between awareness of the exposure risk to primary, secondary, and tertiary pollutants and health beliefs. It was designed as a cross-sectional study, in which a web-based survey was conducted from 13 May to 31 May 2021. The analysis was conducted in 1940 firefighters working in the Seoul metropolis who agreed to participate in the research. Participants who perceived susceptibility were likely to be aware of the primary (adjusted odds ratio (AOR) = 2.10, 95% confidence interval (CI) 1.16–3.80), secondary (AOR = 2.77, 95% CI 1.77–4.32), and tertiary (AOR = 2.73, 95% CI 1.85–4.03) exposure risks. Participants who perceived barriers were unlikely to be aware of the risk of exposure to primary (AOR = 0.67, 95% CI 0.49–0.91), secondary (AOR = 0.77, 95% CI 0.61–0.96), and tertiary (AOR = 0.75, 95% CI 0.62–0.91) pollutants. Educational intervention is recommended to improve perceived susceptibility and awareness of the risk of exposure to pollutants and reduce perceived barriers. Consequently, educational intervention is expected to positively impact firefighters’ management of appropriate PPE. We confirmed an association between occupational exposure risk and firefighters’ health beliefs. In the health belief model (HBM), health beliefs that affect health behavior also affect awareness of the exposure risk level. Therefore, an intervention for health beliefs can also be used to raise job-related exposure risk awareness. Regular training on the health impacts of fire scenes is necessary for both newcomers and incumbents to enable firefighters to better recognize the risks of each occupational exposure level. Additionally, laws and regulations are necessary for the removal of harmful substances that contaminate PPE, such as self-contained breathing apparatus (SCBA), during exposure to a fire scene. Our research can be used as a basis for improving fire policies and education programs in the future.
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Affiliation(s)
- Hyeeun Oh
- Department of Health Administration, Kongju National University, Gongju 32588, Korea;
| | - Soojin Kim
- Fire Science Research Center, Seoul Metropolitan Fire Service Academy, Seoul 03312, Korea;
| | - Hyekyung Woo
- Department of Health Administration, Kongju National University, Gongju 32588, Korea;
- Institute of Health and Environment, Kongju National University, Gongju 32588, Korea
- Correspondence: (H.W.); (S.H.)
| | - Seunghon Ham
- Department of Occupational and Environmental Medicine, Gil Medical Center, Gachon University College of Medicine, Incheon 21565, Korea
- Correspondence: (H.W.); (S.H.)
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Bakali U, Baum JLR, Killawala C, Kobetz EN, Solle NS, Deo SK, Caban-Martinez AJ, Bachas LG, Daunert S. Mapping carcinogen exposure across urban fire incident response arenas using passive silicone-based samplers. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2021; 228:112929. [PMID: 34768049 DOI: 10.1016/j.ecoenv.2021.112929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/05/2021] [Accepted: 10/19/2021] [Indexed: 06/13/2023]
Abstract
Carcinogens are emitted in significant quantities at fire scenes and are a major contributor in the increased cancer risk observed in firefighters when compared to the general population. A knowledge gap exists in the current understanding of the distribution of these toxic compounds within a localized fire incident response arena. Here, we employ stationary silicone-based passive samplers at controlled live fire trainings to evaluate the deposition behavior of polyaromatic hydrocarbons (PAHs) emitted by fires. Our findings indicate significantly greater total PAH exposure in fires fueled by biomass and wood compared to fires burning cleaner fuels, such as propane. A 22% increase in total PAH deposition and a 68% increase in high molecular weight PAH deposition was recorded for biomass fueled fires compared to propane fueled fires. Furthermore, we observe that heavier molecular weight PAHs exhibit a pronounced deposition front within a certain radius of the hot zone, whereas low molecular weight PAHs are more uniformly distributed throughout the area. These findings highlight that the warm zones and cold zones of fire situations yield elevated levels of carcinogen exposure to first responders within them. We anticipate that these findings will help inform decisions made by emergency personnel when evaluating risk for the hot zone, warm zone, and cold zone of urban fires helping ease the carcinogenic risk experienced.
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Affiliation(s)
- Umer Bakali
- Department of Biochemistry and Molecular Biology University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Jeramy L R Baum
- Department of Chemistry, University of Miami, Coral Gables, FL, USA
| | - Chitvan Killawala
- Department of Biochemistry and Molecular Biology University of Miami, Miller School of Medicine, Miami, FL, USA; Department of Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Erin N Kobetz
- Public Health Sciences and Sylvester Comprehensive Cancer Center, USA; Medicine and Sylvester Comprehensive Cancer Center, USA; Sylvester Comprehensive Cancer Center, USA
| | - Natasha Schaefer Solle
- Medicine and Sylvester Comprehensive Cancer Center, USA; Sylvester Comprehensive Cancer Center, USA
| | - Sapna K Deo
- Department of Biochemistry and Molecular Biology University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, USA
| | - Alberto J Caban-Martinez
- Public Health Sciences and Sylvester Comprehensive Cancer Center, USA; Sylvester Comprehensive Cancer Center, USA
| | | | - Sylvia Daunert
- Department of Biochemistry and Molecular Biology University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, USA.
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Abstract
OBJECTIVE Evaluate the effectiveness of firefighter exposure reduction interventions. METHODS Fireground interventions included use of self-contained breathing apparatus by engineers, entry team wash down, contaminated equipment isolation, and personnel showering and washing of gear upon return to station. Urinary polycyclic aromatic hydrocarbon metabolites (PAH-OHs) were measured after structural fire responses before and after intervention implementation. Separately, infrared sauna use following live-fire training was compared to standard postfire care in a randomized trial. RESULTS The fireground interventions significantly reduced mean total urinary postfire PAH-OHs in engineers (-40.4%, 95%CI -63.9%, -2.3%) and firefighters (-36.2%, 95%CI -56.7%, -6.0%) but not captains (-11.3% 95%CI -39.4%, 29.9%). Sauna treatment non-significantly reduced total mean PAH-OHs by -43.5% (95%CI -68.8%, 2.2%). CONCLUSIONS The selected fireground interventions reduced urinary PAH-OHs in engineers and firefighters. Further evaluation of infrared sauna treatment is needed.
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Baum JLR, Bakali U, Killawala C, Santiago KM, Dikici E, Kobetz EN, Solle NS, Deo S, Bachas L, Daunert S. Evaluation of silicone-based wristbands as passive sampling systems using PAHs as an exposure proxy for carcinogen monitoring in firefighters: Evidence from the firefighter cancer initiative. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2020; 205:111100. [PMID: 32911453 DOI: 10.1016/j.ecoenv.2020.111100] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 07/25/2020] [Accepted: 07/28/2020] [Indexed: 05/23/2023]
Abstract
Compared to the general population, firefighters are known to sustain greater levels of exposure to hazardous compounds, despite their personal protective equipment, also known as turnout gear. Among the most significant toxins that firefighters are chronically exposed to are polycyclic aromatic hydrocarbons (PAHs). Additionally, firefighters have also been noted to exhibit an increased incidence of certain types of cancer. Considering a probable link between exposure to PAHs and increased rates of cancer in the fire service, we aim to document ambient chemical concentrations in the firefighter work environment. Our strategy involves the use of silicone-based wristbands that have the capacity to passively sorb PAHs. To determine if wristbands can serve as an effective chemical monitoring device for the fire service, silicone wristbands were pilot-tested as personal sampling devices for work environment risk monitoring in active-duty firefighters. Recovered wristbands underwent multiple extraction steps, followed by GC-MS analysis to demonstrate their efficacy in monitoring PAHs in the firefighter environment. Initial findings from all wristband samples taken from firefighters showed multiple exposures to various PAHs of concern for the health of the firefighters when in a fire environment. In addition to PAH monitoring, we examined known and potential sources of PAH contamination in their work environment. To that end, profiles of elevated PAH concentrations were documented at various fire stations throughout South Florida, for individual firefighters both during station duties and active fire response.
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Affiliation(s)
- Jeramy L R Baum
- Chemistry, University of Miami, Coral Gables, FL, USA; Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Umer Bakali
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Chitvan Killawala
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA; Biomedical Engineering, University of Miami, Coral Gables, FL, USA
| | - Katerina M Santiago
- Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Emre Dikici
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Erin N Kobetz
- Public Health Sciences, University of Miami, Miller School of Medicine, Miami, FL, USA; Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Natasha Schaefer Solle
- Medicine, University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | - Sapna Deo
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, Miami, FL, USA
| | | | - Sylvia Daunert
- Biochemistry and Molecular Biology, University of Miami, Miller School of Medicine, Miami, FL, USA; Sylvester Comprehensive Cancer Center, Miami, FL, USA.
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Caban-Martinez AJ, Schaefer Solle N, Santiago KM, Lee DJ, Koru-Sengul T, Bator CG, Babinec FA, Halas J, Kobetz EN. Impact of Organizational-level Factors on Cancer Screening Activities in Fire Departments: A Cross-sectional Study from the Sylvester Firefighter Cancer Initiative. Cancer Prev Res (Phila) 2019; 12:335-342. [DOI: 10.1158/1940-6207.capr-18-0496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/22/2019] [Accepted: 03/08/2019] [Indexed: 11/16/2022]
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