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Paiva AM, Barros B, Oliveira M, Alves S, Esteves F, Fernandes A, Vaz J, Slezáková K, Teixeira JP, Costa S, Morais S. Biomonitoring of polycyclic aromatic hydrocarbons exposure and short-time health effects in wildland firefighters during real-life fire events. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 926:171801. [PMID: 38508274 DOI: 10.1016/j.scitotenv.2024.171801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 02/27/2024] [Accepted: 03/16/2024] [Indexed: 03/22/2024]
Abstract
Human biomonitoring data retrieved from real-life wildland firefighting in Europe and, also, worldwide are scarce. Thus, in this study, 176 Portuguese firefighters were biomonitored pre- and post- unsimulated wildfire combating (average:12-13 h; maximum: 55 h) to evaluate the impact on the levels of urinary polycyclic aromatic hydrocarbons hydroxylated metabolites (OHPAH; quantified by high-performance liquid chromatography with fluorescence detection) and the associated short-term health effects (symptoms, and total and differentiated white blood cells). Correlations between these variables and data retrieved from the self-reported questionnaires were also investigated. Firefighters were organized into four groups according to their exposure to wildfire emissions and their smoking habits: non-smoking non-exposed (NSNExp), non-smoking exposed (NSExp), smoking non-exposed (SNExp), and smoking and exposed (SExp). The most abundant metabolites were 1-hydroxynaphthalene and 1-hydroxyacenaphthene (1OHNaph + 1OHAce) (98-99 %), followed by 2-hydroxyfluorene (2OHFlu) (0.2-1.1 %), 1-hydroxyphenanthrene (1OHPhen) (0.2-0.4 %), and 1-hydroxypyrene (1OHPy) (0.1-0.2 %); urinary 3-hydroxybenzo(a)pyrene was not detected. The exposure to wildfire emissions significantly elevated the median concentrations of each individual and total OHPAH compounds in all groups, but this effect was more pronounced in non-smoking (1.7-4.2 times; p ≤ 0.006) than in smoking firefighters (1.3-1.6 times; p ≤ 0.03). The greatest discriminant of exposure to wildfire emissions was 1OHNaph + 1OHAce (increase of 4.2 times), while for tobacco smoke it was 2OHFlu (increase of 10 times). Post-exposure, white blood cells count significantly increased ranging from 1.4 (smokers, p = 0.025) to 3.7-fold (non-smokers, p < 0.001), which was accompanied by stronger significant correlations (0.480 < r < 0.882; p < 0.04) between individual and total OHPAH and total white blood cells (and lymphocytes > monocytes > neutrophils in non-smokers), evidencing the impact of PAH released from wildfire on immune cells. This study identifies Portuguese firefighters with high levels of biomarkers of exposure to PAH and points out the importance of adopting biomonitoring schemes, that include multiple biomarkers of exposure and biomarkers of effect, and implementing mitigations strategies.
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Affiliation(s)
- Ana Margarida Paiva
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto, Portugal
| | - Bela Barros
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto, Portugal
| | - Marta Oliveira
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto, Portugal
| | - Sara Alves
- Instituto Politécnico de Bragança, UICISA: E, Unidade de Investigação em Ciências da Saúde: Enfermagem, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Filipa Esteves
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal; Department of Public Health and Forensic Sciences, Medical School, Faculty of Medicine, University of Porto, Rua Dr. Plácido da Costa, 4200-450 Porto, Portugal; EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Adília Fernandes
- Instituto Politécnico de Bragança, UICISA: E, Unidade de Investigação em Ciências da Saúde: Enfermagem, Campus de Santa Apolónia, 5300-253 Bragança, Portugal
| | - Josiana Vaz
- CIMO, Instituto Politécnico de Bragança, Centro de Investigação de Montanha, Campus Santa Apolónia, 5300-253 Bragança, Portugal; SusTEC, Instituto Politécnico de Bragança, Sustec - Associate Laboratory for Sustainability and Technology in Inland Regions, Campus Santa Apolónia, 5300-253 Bragança, Portugal
| | - Klára Slezáková
- LEPABE-ALiCE, Departamento de Engenharia Química, Faculdade de Engenharia, Rua Dr. Roberto Frias, 4200-465 Porto, Portugal
| | - João Paulo Teixeira
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal; EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Solange Costa
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Rua Alexandre Herculano 321, 4000-055 Porto, Portugal; EPIUnit, Instituto de Saúde Pública da Universidade do Porto, Rua das Taipas 135, 4050-600 Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, ISEP, Polytechnic of Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto, Portugal.
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Barros B, Paiva AM, Oliveira M, Alves S, Esteves F, Fernandes A, Vaz J, Slezakova K, Costa S, Teixeira JP, Morais S. Baseline data and associations between urinary biomarkers of polycyclic aromatic hydrocarbons, blood pressure, hemogram, and lifestyle among wildland firefighters. Front Public Health 2024; 12:1338435. [PMID: 38510349 PMCID: PMC10950961 DOI: 10.3389/fpubh.2024.1338435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/23/2024] [Indexed: 03/22/2024] Open
Abstract
Introduction Available literature has found an association between firefighting and pathologic pathways leading to cardiorespiratory diseases, which have been linked with exposure to polycyclic aromatic hydrocarbons (PAHs). PAHs are highlighted as priority pollutants by the European Human Biomonitoring Initiative in occupational and non-occupational contexts. Methods This cross-sectional study is the first to simultaneously characterize six creatinine-adjusted PAHs metabolites (OHPAHs) in urine, blood pressure, cardiac frequency, and hemogram parameters among wildland firefighters without occupational exposure to fire emissions (> 7 days), while exploring several variables retrieved via questionnaires. Results Overall, baseline levels for total OHPAHs levels were 2 to 23-times superior to the general population, whereas individual metabolites remained below the general population median range (except for 1-hydroxynaphthalene+1-hydroxyacenaphtene). Exposure to gaseous pollutants and/or particulate matter during work-shift was associated with a 3.5-fold increase in total OHPAHs levels. Firefighters who smoke presented 3-times higher total concentration of OHPAHs than non-smokers (p < 0.001); non-smoker females presented 2-fold lower total OHPAHs (p = 0.049) than males. 1-hydroxypyrene was below the recommended occupational biological exposure value (2.5 μg/L), and the metabolite of carcinogenic PAH (benzo(a)pyrene) was not detected. Blood pressure was above 120/80 mmHg in 71% of subjects. Firefighters from the permanent intervention team presented significantly increased systolic pressure than those who performed other functions (p = 0.034). Tobacco consumption was significantly associated with higher basophils (p = 0.01-0.02) and hematocrit (p = 0.03). No association between OHPAHs and blood pressure was found. OHPAHs concentrations were positively correlated with monocyte, basophils, large immune cells, atypical lymphocytes, and mean corpuscular volume, which were stronger among smokers. Nevertheless, inverse associations were observed between fluorene and pyrene metabolites with neutrophils and eosinophils, respectively, in non-smokers. Hemogram was negatively affected by overworking and lower physical activity. Conclusion This study suggests possible associations between urinary PAHs metabolites and health parameters in firefighters, that should be further assessed in larger groups.
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Affiliation(s)
- Bela Barros
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Ana Margarida Paiva
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Marta Oliveira
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
| | - Sara Alves
- Instituto Politécnico de Bragança, UICISA: E, Unidade de Investigação em Ciências da Saúde: Enfermagem, Instituto Politécnico de Bragança Campus de Santa Apolónia, Bragança, Portugal
| | - Filipa Esteves
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- Department of Public Health and Forensic Sciences, and Medical School, Faculty of Medicine, University of Porto, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Adília Fernandes
- Instituto Politécnico de Bragança, UICISA: E, Unidade de Investigação em Ciências da Saúde: Enfermagem, Instituto Politécnico de Bragança Campus de Santa Apolónia, Bragança, Portugal
| | - Josiana Vaz
- CIMO, Instituto Politécnico de Bragança, Bragança, Centro de Investigação de Montanha Campus Santa Apolónia, Bragança, Portugal
- SusTEC, Instituto Politécnico de Bragança, Bragança, Sustec – Associate Laboratory for Sustainability and Technology in Inland Regions – Campus Santa Apolónia, Bragança, Portugal
| | - Klara Slezakova
- LEPABE-ALiCE, Departamento de Engenharia Química, Faculdade de Engenharia, Rua Dr. Roberto Frias, Porto, Portugal
| | - Solange Costa
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - João Paulo Teixeira
- Environmental Health Department, National Institute of Health Dr. Ricardo Jorge, Porto, Portugal
- EPIUnit – Instituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Simone Morais
- REQUIMTE/LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Porto, Portugal
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Li J, Wang Y, Jiang R, Li J. Quantifying self-contained breathing apparatus on physiology and psychological responses during firefighting: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:77-89. [PMID: 34983320 DOI: 10.1080/10803548.2021.2024020] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Objectives. There is no consensus regarding the efficacy of self-contained breathing apparatus (SCBA) on firefighters' physiological and psychological stress responses. This study synthesized and quantified the psycho-physiological demands placed on firefighters wearing SCBA compared to a control group. Methods. Five databases were searched with English-language restrictions from inception to January 2021. As dependent variables, physiological (rectal temperature [Tre], mean skin temperature [T¯sk], heart rate [HR], maximal heart rate [HRmax], maximum oxygen uptake [VO2max], total sweat rate [TSR]) and psychological (rating of perceived exertion [RPE] and thermal sensation [TS]) responses were continuously collected. This study is registered with PROSPERO (CRD42021228363). Results. Nine eligible studies with 289 participants met the inclusion criteria. The pooled estimates for VO2max statistically significantly decreased, whereas T¯sk, HR, HRmax, TSR and RPE increased significantly. Additionally, the Tre and TS parameters were elevated but not significant. Subgroup analysis revealed that, except for VO2max and TSR, the SCBA weight did not differ significantly between groups on any outcome measure. Conclusions. Our meta-analysis indicates that wearing SCBA elicits thermoregulatory, metabolic and psychological stress. However, this is not primarily explained by the weight of SCBA, highlighting the value of ergonomic design and physiological monitoring.
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Affiliation(s)
- Jian Li
- College of Fashion and Design, Donghua University, People's Republic of China
| | - Yunyi Wang
- College of Fashion and Design, Donghua University, People's Republic of China.,Ministry of Education, Donghua University, People's Republic of China
| | - Rongfan Jiang
- College of Fashion and Design, Donghua University, People's Republic of China
| | - Jun Li
- College of Fashion and Design, Donghua University, People's Republic of China.,Ministry of Education, Donghua University, People's Republic of China
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D King G, Pan E, Millin MG. Wilderness First Responder Medical Clearance - A Scoping Review with Recommendations. PREHOSP EMERG CARE 2023; 28:50-75. [PMID: 36595615 DOI: 10.1080/10903127.2022.2162650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 12/13/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND AND PURPOSE Due to environmental extremes, as well as the nature of the work itself, wilderness first responders are at risk of incurring medical events in the line of duty. There currently do not exist standardized and scientifically supported methods to screen for a wilderness first responder's risk of incurring a medical event. METHODS We performed multiple scoping reviews using PubMed and CINAHL. The reviews covered six medical screening criteria based on previous recommendations from the National Fire Protection Association (NFPA) and the US Forest Service, and we grouped our reviews into two categories: articles that addressed objective screening criteria, and articles that addressed subjective findings with the first responder. RESULTS Of the objective criteria, our reviews identified 21 articles addressing the ability to screen for risk of incurring a medical event by evaluation of a first responder's heart rate, 12 by blood pressure assessment, and 56 by assessment of body temperature. Of the subjective criteria we identified 19 articles focused on self-assessment, 34 articles on the use of standardized tools to assess for fatigue and sleepiness, and two articles on assessment of a first responder's urine to determine level of dehydration. We also identified seven additional articles through a hand search. Overall, there were 151 articles identified in our scoping reviews. These articles were largely of low quality, consisting mostly of case series without comparison groups. CONCLUSION There is a dearth of high-quality research into the medical assessment of first responders. We recommend that this paper, and measures discussed within it, be used as a starting point in the development of an evidence-based assessment protocol for wilderness first responders. We also recommend the development of a national database of medical events incurred by wilderness first responders to facilitate higher-quality research of screening protocols in this community.
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Affiliation(s)
- Gregory D King
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| | - Erik Pan
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
| | - Michael G Millin
- Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Maryland and Mid-Atlantic Wilderness Rescue Squad, Inc./Austere Medical Professionals, Dayton, Maryland, USA
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Richardson A, Terrazzini N, Gage C, Lee BJ, Bradley R, Watt P, Watkins ER. Inflammatory and psychological consequences of chronic high exposure firefighting. J Therm Biol 2023; 111:103399. [PMID: 36585074 DOI: 10.1016/j.jtherbio.2022.103399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 10/20/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES This study aimed to examine the impact of extreme heat exposure frequency on inflammation and well-being in UK Fire Service personnel. METHODS 136 Fire personnel and 14 controls (CON) were recruited [92 Firefighters (FF), 44 Breathing Apparatus Instructors (BAI)]. BAI were split into low (LBAI; ≤15 exposures per month) and high (HBAI; ≥20 exposures per month) categories. Measures of inflammation, mood and fatigue were collected at 0, 3 and 6 month times points. These variables were analysed for differences between groups and association with frequency of exposure. RESULTS HBAI exhibited raised IL-1β, IL-6, IL-10, IgE and lower IgM (p < 0.05). In addition, IL-1β, IL-6, IL-10 and IgM were associated with monthly exposure number, with exposures accounting for 15.4% of the variance in IL-6, 11.8% of IL-1β and 25.2% of IL-10. No differences in mood or fatigue were reported (p > 0.05). CONCLUSION High exposure firefighting consistently causes systemic inflammation without perceptual recognition of potential health risks.
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Affiliation(s)
- Alan Richardson
- Environmental Extremes Group, University of Brighton, UK; Centre for Stress, Aging and Disease, University of Brighton, UK
| | - Nadia Terrazzini
- Centre for Stress, Aging and Disease, University of Brighton, UK
| | - Catherine Gage
- Environmental Extremes Group, University of Brighton, UK
| | - Ben James Lee
- Occupational and Environmental Research Group, Coventry University, UK
| | - Rebecca Bradley
- Centre for Stress, Aging and Disease, University of Brighton, UK
| | - Peter Watt
- Environmental Extremes Group, University of Brighton, UK
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Orysiak J, Młynarczyk M, Piec R, Jakubiak A. Lifestyle and environmental factors may induce airway and systemic inflammation in firefighters. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:73741-73768. [PMID: 36094704 PMCID: PMC9465149 DOI: 10.1007/s11356-022-22479-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/07/2022] [Indexed: 06/15/2023]
Abstract
Health status depends on multiple genetic and non-genetic factors. Nonheritable factors (such as lifestyle and environmental factors) have stronger impact on immune responses than genetic factors. Firefighters work is associated with exposure to air pollution and heat stress, as well as: extreme physical effort, mental stress, or a changed circadian rhythm, among others. All these factors can contribute to both, short-term and long-term impairment of the physical and mental health of firefighters. Increased levels of some inflammatory markers, such as pro-inflammatory cytokines or C-reactive protein (CRP) have been observed in firefighters, which can lead to local, acute inflammation that promotes a systemic inflammatory response. It is worth emphasizing that inflammation is one of the main hallmarks of cancer and also plays a key role in the development of cardiovascular and respiratory diseases. This article presents possible causes of the development of an inflammatory reaction in firefighters, with particular emphasis on airway inflammation caused by smoke exposure.
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Affiliation(s)
- Joanna Orysiak
- Central Institute for Labour Protection - National Research Institute, Czerniakowska St. 16, 00-701, Warsaw, Poland.
| | - Magdalena Młynarczyk
- Central Institute for Labour Protection - National Research Institute, Czerniakowska St. 16, 00-701, Warsaw, Poland
| | - Robert Piec
- Institute of Internal Security, The Main School of Fire Service, Słowackiego St. 52/54, 01-629, Warsaw, Poland
| | - Agnieszka Jakubiak
- Department of Heart Failure and Cardiac Rehabilitation, Medical University of Warsaw, Żwirki and Wigury St. 61, 02-091, Warsaw, Poland
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Review on the Effect of Exercise Training on Immune Function. BIOMED RESEARCH INTERNATIONAL 2022; 2022:9933387. [PMID: 35941982 PMCID: PMC9356886 DOI: 10.1155/2022/9933387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/12/2022] [Accepted: 07/21/2022] [Indexed: 11/17/2022]
Abstract
Exercise training is not only a necessary means to improve the level of exercise, but also an important means to improve the body's immunity. Different time, intensity, items, and forms of exercise training have different effects on the body's immune function. As a double-edged sword to improve the body's immune function, exercise training is a different reaction mechanism of different immune cells after exercise training. This paper combined with foreign scholars' studies on the immune function of the body of literature from different exercise intensity, different time, different sports, different movement forms, and different external environment such as angle of view for athletes body's immune cells and humoral immunity summarized the various indexes such as combing, in order to help academia, medicine, and sports. It provides enlightenment to the contemporary public on how to participate in sports training more healthily.
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Reid BO, Næss-Pleym LE, Bakkelund KE, Dale J, Uleberg O, Nordstrand AE. A cross-sectional study of mental health-, posttraumatic stress symptoms and post exposure changes in Norwegian ambulance personnel. Scand J Trauma Resusc Emerg Med 2022; 30:3. [PMID: 35016708 PMCID: PMC8749923 DOI: 10.1186/s13049-021-00991-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/29/2021] [Indexed: 11/11/2022] Open
Abstract
Background Posttraumatic stress disorder (PTSD) has been shown to be elevated among first responders (Emergency Medical Services, fire service, police force) compared to the general population. Examining the prevalence of mental health issues in a work force with an elevated occupational risk is fundamental towards ensuring their wellbeing and implementing safeguard measures. The goal of this study is therefore to report the prevalence of depression, anxiety, posttraumatic development, and PTSD in Norwegian ambulance personnel. Methods This study is a cross-sectional, anonymous, web-based survey (Questback®), performed among operative personnel employed in the Emergency Medical Services in the Regional Health Trust of Central Norway between 18. February and 9. April 2021. The study was sent to 1052 eligible participants. Questions reported demographic data, a traumatic events exposure index, Patient Health Questionnaire-9 (Depression), Generalized Anxiety Disorder-7 scale, Posttraumatic symptom scale (PTSD) and Posttraumatic change scale. Results The response rate in this study was 45.5% (n = 479/1052). The mean age of respondents was 37.1 years (std. 11.1) and 52.8% (n = 253) were male. Of the respondents, 80.6% (n = 386) were married or had a partner, and 91.6% (n = 439) reported having access to a peer support programme, with 34.9% (n = 167) reporting that they had utilized peer support. In this study, 5% (n = 24) showed a prevalence of manifest posttraumatic stress disorder symptoms, while 8.6% (n = 41) reported moderate to severe depression and 2.9% (n = 14) presented moderate to severe symptoms of general anxiety. Of the respondents, 77.2% (n = 370) reported personal growth because of their work experiences. Conclusions This study indicates that Norwegian ambulance personnel report a prevalence of posttraumatic stress symptoms and depression, which is slightly higher for men, and lower for the female proportion in this study, when compared to an adult Norwegian population. The vast majority of respondents reported personal growth because of their work experience, and both the degree of peer support and having a partner seem to influence levels of posttraumatic stress and -development. Supplementary Information The online version contains supplementary material available at 10.1186/s13049-021-00991-2.
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Affiliation(s)
- Bjørn Ole Reid
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway. .,Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.
| | - Lars Eide Næss-Pleym
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU Norwegian University of Science and Technology, Trondheim, Norway.,Department of Research and Development, Norwegian Air Ambulance Foundation, Drøbak, Norway
| | - Karin Elvenes Bakkelund
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway
| | - Jostein Dale
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway
| | - Oddvar Uleberg
- Department of Emergency Medicine and Prehospital Services, St. Olav's Hospital, Prinsesse Kristinas gate 3, AHL, 7030, Trondheim, Norway.,Department of Circulation and Medical Imaging, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Espetvedt Nordstrand
- Joint Medical Services, Norwegian Armed Forces, Sessvollmoen, Norway.,Department of Psychology, NTNU Norwegian University of Science and Technology, Trondheim, Norway
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Park GJ, Kong SY, Shin DM, Lee DI, Ku BS, Oh JH, Kim SC. Acute Physiological Response of Live-Fire Simulation Activities Affecting Cardiovascular Health in Live-Fire Instructors: A Randomized Controlled Simulation Study. J Occup Environ Med 2022; 64:46-51. [PMID: 34310541 DOI: 10.1097/jom.0000000000002330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES This study aimed to assess acute physiological response of fire suppression simulation affecting cardiovascular health during repeated bouts of simulation. METHODS Fifteen live-fire instructors were randomly divided into three groups according to fire suppression simulation frequency. Vital signs, biomarkers, and heart rate variability (HRV) were measured before and after simulation. RESULTS Vital signs increased immediately after fire simulation and returned to the normal range after 2 h. Most biomarker levels were changed within the normal ranges 72 h after the simulation training. However, one of the HRV frequency domains, high frequency power, was severely suppressed after 1 h and tended to recover after 2 h of simulation (P < 0.05). CONCLUSIONS Vital signs and their biomarkers were changed within the normal range regardless of the number of bouts of fire suppression simulations. HRV could be used to assess the effects of fire suppression simulation on cardiovascular health.
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Affiliation(s)
- Gwan-Jin Park
- Department of Emergency Medicine, Chungbuk National University Hospital, 776, 1st Sunhwan-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do 28646, South Korea (Dr Park and Dr Kim); Strategic Research, Laerdal Medical Tanke Svilandsgate 30, 4002 Stavanger, Norway (Dr Kong); Department of Paramedic Science, Korea National University of Transportation, 61, Daehak-ro, Jeungpyeong-gun, Chungcheongbuk-do, 27909, South of Korea (Dr Shin); Division of Cardiology, Chungbuk National University Hospital, 776, 1st Sunhwan-ro, Seowon-gu, Cheongju-si, Chungcheongbuk-do 28646, South Korea (Dr Lee); Department of Fire Investigation and Analysis, Yongin Fire Station, 45, Myongji-ro, Cheoin-gu, Yongin-si, Gyeonggi-do, 17057, South Korea (Mr Ku); Icheon Fire Station, 2739, Gyeongchung-daero, Icheon-si, Gyeonggi-do, 17379, South Korea (Mr Oh); Department of Emergency Medicine, College of Medicine, Chungbuk National University, 1 Chungdae-ro, Seowongu, Cheongju-si, Chungcheongbuk-do 28646, South Korea (Dr Kim)
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Barros B, Oliveira M, Morais S. Firefighters' occupational exposure: Contribution from biomarkers of effect to assess health risks. ENVIRONMENT INTERNATIONAL 2021; 156:106704. [PMID: 34161906 DOI: 10.1016/j.envint.2021.106704] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 06/04/2021] [Accepted: 06/07/2021] [Indexed: 06/13/2023]
Abstract
Firefighting is physically and physiologically exhausting besides encompassing exposure to toxic fire emissions. Biomonitoring studies from the past five years have been significantly contributing to characterize the occupational-related health effects in this group of professionals and to improve risk assessment. Therefore, this study gathers and critically discusses the most characterized biomarkers of effect (oxidative stress, DNA and protein damage, stress hormones, inflammation, and vascular, lung, and liver injury), including those potentially more promising to be explored in future studies, and their relation with health outcomes. Various studies proved an association between exposures to fire emissions and/or heat and significantly altered values of biomarkers of inflammation (soluble adhesion molecules, tumor necrosis factor, interleukins, and leucocyte count), vascular damage and tissue injury (pentraxin-3, vascular endothelial growth factor, and cardiac troponin T) in firefighting forces. Moreover, preliminary data of DNA damage in blood, urinary mutagenicity and 8-isoprostaglandin in exhaled breath condensate suggest that these biomarkers of oxidative stress should be further explored. However, most of the reported studies are based on cross-sectional designs, which limit full identification and characterization of the risk factors and their association with development of work-related diseases. Broader studies based on longitudinal designs and strongly supported by the analysis of several types of biomarkers in different biological fluids are further required to gain deeper insights into the firefighters occupational related health hazards and contribute to implementation of new or improved surveillance programs.
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Affiliation(s)
- Bela Barros
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto
| | - Marta Oliveira
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto
| | - Simone Morais
- REQUIMTE-LAQV, Instituto Superior de Engenharia do Porto, Instituto Politécnico do Porto, Rua Dr. António Bernardino de Almeida 431, 4249-015 Porto.
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Watkins ER, Hayes M, Watt P, Renshaw D, Richardson AJ. Extreme occupational heat exposure is associated with elevated haematological and inflammatory markers in Fire Service Instructors. Exp Physiol 2020; 106:233-243. [PMID: 32462715 DOI: 10.1113/ep088386] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/20/2020] [Indexed: 12/22/2022]
Abstract
NEW FINDINGS What is the central question of this study? Fire service instructors are frequently exposed to live fire scenarios, representing the most extreme chronic occupational heat exposure. These individuals report a series of unique health issues. We sought to identify whether the number of exposures completed was associated with inflammatory and immunological markers and symptoms of ill health. What is the main finding and its importance? Fire service instructors exhibit greater levels of inflammatory markers in comparison to firefighters. The number of exposures to fire is positively related to the prevalence of ill health and inflammation. Implementation of a proposed limit of nine exposures per month might be appropriate to minimize health issues. ABSTRACT Fire Service Instructors (FSIs) experience ∼10 times more fire exposures than firefighters (FFs), and the increased physiological stress from this potentially puts them at risk of ill health and future cardiac events. The aim of the study was to establish whether FSIs exhibit elevated biomarkers associated with cardiac event risk, identify whether FSIs experience systemic inflammation linked to the frequency of fire exposure and evaluate a proposed exposure limit of nine exposures per month. Blood samples were collected from 110 Fire Service personnel (mean ± SD, age,44 ± 7 years; height, 178.1 ± 7.1 cm; and body mass, 84.3 ± 12.0 kg; FSIs n = 53 and FFs n = 57) for biomarker analysis. Work history details were collected from all participants. Participants with biomarker concentrations above healthy reference ranges were classified as being 'at risk'. The neutrophil-to-lymphocyte ratio, platelet count, cardiac troponin T, interleukin (IL)-6, IL-1β, C-reactive protein and immunoglobulin G were greater in FSIs than in FFs (P < 0.05). Multiple regression analysis revealed that 18.8% of IL-6, 24.9% of IL-1β, 29.2% of C-reactive protein and 10.9% of immunoglobulin G variance could be explained by the number of exposures to heat per month. Odds ratios revealed that those FSIs above the nine per month exposure limit were six to 12 times more likely to be classified as 'at risk' and were 16 times more likely to experience symptoms of ill health. Increased cytokine levels suggest that FSIs experience systemic inflammation, which is related to symptoms of ill health. We propose that an exposure limit could reduce the prevalence of these biomarker risk factors and ill health.
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Affiliation(s)
- Emily R Watkins
- Department of Life Sciences, University of Roehampton, London, UK
| | - Mark Hayes
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
| | - Peter Watt
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
| | - Derek Renshaw
- Centre for Sport, Exercise & Life Sciences, Coventry University, Coventry, UK
| | - Alan J Richardson
- Environmental Extremes Laboratory, Welkin Laboratories, University of Brighton, Eastbourne, UK
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