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Staack SD, Griffin SC, Lee VST, Lutz EA, Burgess JL. Evaluation of CBRN Respirator Protection in Simulated Fire Overhaul Settings. Ann Work Expo Health 2021; 65:843-853. [PMID: 33787854 PMCID: PMC8340998 DOI: 10.1093/annweh/wxab004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 11/16/2020] [Accepted: 01/16/2021] [Indexed: 11/13/2022] Open
Abstract
Overhaul is the phase of firefighting after flames have been extinguished but when products of combustion are still being released. While positive pressure self-contained breathing apparatus (SCBA) provide the highest level of respiratory protection during overhaul, use of air-purifying respirators (APRs) with suitable filters could potentially provide a lower weight, longer duration option for first responders. The objective of this study was to assess whether an APR with a chemical, biological, radiological, and nuclear (CBRN) canister could be recommended as substitution for SCBA during overhaul. A total of 15 simulated standard overhaul environments were created by burning household materials. Sampling was conducted using mannequin heads fitted with full facepiece respirators with either a CBRN canister or SCBA. In-mask and personal samples were collected for aldehydes, polynuclear aromatic hydrocarbons, inorganic acids, aromatic hydrocarbons, nitrogen dioxide, and particulate matter. An additional six simulated high-exposure overhaul environments were created in a flashover chamber by continuously adding household materials to a smoldering fire. The sampling train was the same for both the standard and high-exposure environments; however, the facepiece was sealed to the mannequin head in the high-exposure environments. In the standard overhaul environment, the CBRN canister effectively reduced the level of exposure for most contaminants, while in the high-exposure overhaul exposure setting in-mask acetaldehyde and formaldehyde were detected. In both exposure settings, the SCBA prevented almost all exposure, and therefore remains the recommended respiratory protection during overhaul.
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Affiliation(s)
- Shawn D Staack
- Department of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, 1295 North Martin Ave., Tucson, AZ, USA
| | - Stephanie C Griffin
- Department of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, 1295 North Martin Ave., Tucson, AZ, USA
| | - Vivien S T Lee
- Department of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, 1295 North Martin Ave., Tucson, AZ, USA
| | - Eric A Lutz
- University of Arizona College of Engineering-Mining and Geological Engineering, 1235 James E. Rogers Way, Tucson, AZ, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, University of Arizona Mel and Enid Zuckerman College of Public Health, 1295 North Martin Ave., Tucson, AZ, 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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Fritschi L. OccIDEAS – occupational exposure assessment in community-based studies. Occup Med (Lond) 2019; 69:156-157. [DOI: 10.1093/occmed/kqy126] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Affiliation(s)
- Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
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Jalilian H, Ziaei M, Weiderpass E, Rueegg CS, Khosravi Y, Kjaerheim K. Cancer incidence and mortality among firefighters. Int J Cancer 2019; 145:2639-2646. [PMID: 30737784 DOI: 10.1002/ijc.32199] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/14/2019] [Accepted: 01/29/2019] [Indexed: 11/07/2022]
Abstract
Firefighters are exposed to both known and suspected carcinogens. This study aims to systematically review the literature on the association of firefighting occupation and cancer incidence and mortality, overall and for specific cancer sites. A systematic review using PubMed, Embase, and Web of Science was performed up to January 1, 2018. We extracted risk estimates of cancers and calculated summary incidence risk estimates (SIRE), summary mortality risk estimates (SMRE), and their 95% confidence intervals (CI). Publication bias and risk of bias in individual studies were assessed using Begg's and Egger's tests and the Newcastle-Ottawa scale (NOS), respectively. We included 50 papers in the review and 48 in the meta-analysis. We found significantly elevated SIREs for cancer of the colon (1.14; CI 1.06 to 1.21), rectum (1.09; CI 1.00 to 1.20), prostate (1.15; CI 1.05 to 1.27), testis (1.34; CI 1.08 to 1.68), bladder (1.12; CI 1.04 to 1.21), thyroid (1.22; CI 1.01 to 1.48), pleura (1.60; CI 1.09 to 2.34), and for malignant melanoma (1.21; CI 1.02 to 1.45). We found significant SMREs of 1.36 (1.18 to 1.57) and 1.42 (1.05 to 1.90) for rectal cancer and Non-Hodgkin's lymphoma, respectively. Considering the significantly elevated risk of some cancers in this occupational group, we suggest improving preventive measures and securing adequate and relevant medical attention for this group. Further studies with more accurate and in-depth exposure assessments are indicated.
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Affiliation(s)
- Hamed Jalilian
- Department of Occupational Health and Safety, Faculty of Health, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
| | - Mansour Ziaei
- School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.,Department of Research, Cancer Registry of Norway - Institute of Population-Based Cancer Research, Oslo, Norway.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Genetic Epidemiology Group, Folkhälsan Research Center, and Faculty of Medicine, Helsinki University, Helsinki, Finland
| | - Corina Silvia Rueegg
- Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital and Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Yahya Khosravi
- Department of Occupational Health and Safety, Research Center for Health, Safety and Environment, Alborz University of Medical Sciences, Karaj, Iran
| | - Kristina Kjaerheim
- Department of Research, Cancer Registry of Norway - Institute of Population-Based Cancer Research, Oslo, Norway
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Descatha A, Huynh Tuong A, Coninx P, Baer M, Loeb T, Despréaux T. Occupational Practitioner's Role in the Management of a Crisis: Lessons Learned from the Paris November 2015 Terrorist Attack. Front Public Health 2016; 4:203. [PMID: 27703965 PMCID: PMC5028718 DOI: 10.3389/fpubh.2016.00203] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2016] [Accepted: 09/05/2016] [Indexed: 11/13/2022] Open
Abstract
In massive catastrophic events, occupational health practitioners are more and more frequently involved in the management of such situations. We aim to describe the multiple aspects of the role that occupational health practitioners might play, by focusing on the recent example of the Paris terrorist attack of November 2015. During and after the Paris attack, occupational practitioners, in collaboration with emergency and security professionals, were involved in psychological care, assembling information, follow-up, return-to-work, and improving in-company safety plans. Based on this experience and other industrial disasters, we distinguish three phases: the critical phase, the post-critical phase, and the anticipation phase. In the critical phase, the occupational practitioner cares for patients before the emergency professionals take charge, initiates the psychological management, and may also play an organizational role for company health aspects. In the post-critical phase, he or she would be involved in monitoring those affected by the events and participate in preventing, to the extent possible, posttraumatic stress disorder, helping victims in the return-to-work process, and improving procedures and organizing drills. In addition to their usual work of primary prevention, occupational practitioners should endeavor to improve preparedness in the anticipation phase, by taking part in contingency planning, training in first aid, and defining immediately applicable protocols. In conclusion, recent events have highlighted the essential role of occupational health services in anticipation of a crisis, management during the crisis, and follow-up.
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Affiliation(s)
- Alexis Descatha
- AP-HP UVSQ, Occupational Health Unit, University Hospital of West Suburb of Paris, Garches, France; AP-HP, EMS (Samu92) University Hospital of West Suburb of Paris, Garches, France; UMR-S 1168, Versailles St-Quentin University UVSQ, Villejuif, France; U1168, INSERM, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France
| | - Alice Huynh Tuong
- AP-HP UVSQ, Occupational Health Unit, University Hospital of West Suburb of Paris, Garches, France; AP-HP, EMS (Samu92) University Hospital of West Suburb of Paris, Garches, France; UMR-S 1168, Versailles St-Quentin University UVSQ, Villejuif, France
| | | | - Pierre Coninx
- AP-HP, EMS (Samu92) University Hospital of West Suburb of Paris , Garches , France
| | - Michel Baer
- AP-HP, EMS (Samu92) University Hospital of West Suburb of Paris , Garches , France
| | - Thomas Loeb
- AP-HP, EMS (Samu92) University Hospital of West Suburb of Paris , Garches , France
| | - Thomas Despréaux
- AP-HP UVSQ, Occupational Health Unit, University Hospital of West Suburb of Paris, Garches, France; UMR-S 1168, Versailles St-Quentin University UVSQ, Villejuif, France; U1168, INSERM, VIMA: Aging and Chronic Diseases. Epidemiological and Public Health Approaches, Villejuif, France
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