1
|
Tucker S, Jonnalagadda S, Beseler C, Yoder A, Fruhling A. Exploring wearable technology use and importance of health monitoring in the hazardous occupations of first responders and professional drivers. J Occup Health 2024; 66:uiad002. [PMID: 38332724 PMCID: PMC11020306 DOI: 10.1093/joccuh/uiad002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 02/10/2024] Open
Abstract
OBJECTIVES Hazardous materials (HAZMAT) pose risks to the health and safety of professionals involved with transportation and emergency responses. Two distinct occupational groups that encounter HAZMAT events are first responders and professional drivers. Wearable technology is a tool that can assist with monitoring the health of professionals involved in HAZMAT events. The aim of this study was to compare and evaluate the perceptions of first responders and professional drivers on wearable technology and attitudes toward health monitoring. METHODS A survey was administered to first responders (n = 112) and professional drivers (n = 218). Statistical approaches included bivariate analysis, latent class analysis, logistic regression analysis, and path analysis for the variables of interest. RESULTS There were significant differences between the groups in perceptions of the benefits of monitoring certain health indicators. Professional drivers were more likely to have a history of wearable technology use compared with first responders (odds ratio [OR] = 10.1; 95% CI, 4.42-22.9), reported greater exposure to HAZMAT (OR = 4.32; 95% CI, 2.24-8.32), and were more willing to have their health data monitored by someone other than themselves (OR = 9.27; 95% CI, 3.67-23.4). A multinomial regression model revealed that occupation was not a significant predictor of class preference for acceptance of monitoring specific health indicators. CONCLUSIONS Occupation appeared to be important but further analysis uncovered that characteristics of individuals within the occupations were more salient to the use of wearable technology. HAZMAT exposure, someone else monitoring health data, and experience with wearable technology use were found to be important factors for perceptions about benefits of health monitoring with wearable technology.
Collapse
Affiliation(s)
- Sarah Tucker
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, United States
| | - Soundarya Jonnalagadda
- Information Systems and Quantitative Analysis, College of Information Science & Technology, University of Nebraska, Omaha, NE, 68182, United States
| | - Cheryl Beseler
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, United States
| | - Aaron Yoder
- Department of Environmental, Agricultural and Occupational Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, 68198, United States
| | - Ann Fruhling
- School of Interdisciplinary Informatics, College of Information Science & Technology, University of Nebraska, Omaha, NE, 68182, United States
| |
Collapse
|
2
|
Abramson MJ, Glass DC. Trajectories of lung function in urban firefighters. Respirology 2023; 28:208-209. [PMID: 36437525 DOI: 10.1111/resp.14418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022]
Affiliation(s)
- Michael J Abramson
- School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Deborah C Glass
- School of Public Health and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
3
|
Pendergrast C, Boyle T, Crockett AJ, Eston R, Johnston KN. Longitudinal lung function in urban firefighters: A group-based multi-trajectory modelling approach. Respirology 2023; 28:247-253. [PMID: 36180416 DOI: 10.1111/resp.14382] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Urban firefighters are routinely exposed to both physical and chemical hazards that can negatively impact lung health, but it is unclear if firefighters experience accelerated decline in spirometry parameters due to chronic exposure and acute insults. This study aimed to describe sub-groups of firefighters with differing spirometry trajectories and examine the relationship between the identified trajectories and demographic, lifestyle and occupational characteristics. METHODS Data from six waves of the Respiratory Function Measurement and Surveillance for South Australian Metropolitan Fire Service Study (2007-2019) were used to identify spirometry parameter z-score trajectories, using group-based multi-trajectory modelling (GBMTM). Analysis of variance and chi-square statistics were used to assess trajectory group differences in baseline self-reported demographic, lifestyle and occupational characteristics. RESULTS In the 669 included firefighters, we identified five trajectories for the combination of Forced Expiratory Volume in the first second z-score (FEV1 z), Forced Vital Capacity z-score (FVCz) and the ratio of FEV1 and FVC z-score (FEV1 /FVCz). There were three stable trajectories of low, average and very high lung function and two declining trajectories of average and high lung function. Analysis of subgroup characteristics revealed no significant differences between expected and actual group proportions for the occupational characteristics of years of service and respiratory protection use. Significant differences were seen in respiratory health and body mass index. CONCLUSION GBMTM defined distinct, plausible spirometry trajectory sub-groups. Firefighter longitudinal spirometry trajectory group membership was associated with BMI and respiratory disease or symptoms but not with self-reported smoking history or occupational factors.
Collapse
Affiliation(s)
- Catherine Pendergrast
- Innovation, Implementation and Clinical Translation in Health (IIMPACT) Research Concentration, University of South Australia, Adelaide, South Australia, Australia
| | - Terry Boyle
- Australian Centre for Precision Health, Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Alan J Crockett
- Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
| | - Roger Eston
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), University of South Australia, Adelaide, South Australia, Australia
| | - Kylie N Johnston
- Innovation, Implementation and Clinical Translation in Health (IIMPACT) Research Concentration, University of South Australia, Adelaide, South Australia, Australia
| |
Collapse
|
4
|
Jung AM, Beitel SC, Gutenkunst SL, Billheimer D, Jahnke SA, Littau SR, White M, Hoppe-Jones C, Cherrington NJ, Burgess JL. Excretion of polybrominated diphenyl ethers and AhR activation in breastmilk among firefighters. Toxicol Sci 2023; 192:kfad017. [PMID: 36856729 PMCID: PMC10109531 DOI: 10.1093/toxsci/kfad017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2023] Open
Abstract
Excretion of toxicants accumulated from firefighter exposures through breastmilk represents a potential hazard. We investigated if firefighting exposures could increase the concentration of polybrominated diphenyl ethers (PBDEs) and aryl hydrocarbon receptor (AhR) activation in excreted breastmilk. Firefighters and non-firefighters collected breastmilk samples prior to any firefighting responses (baseline) and at 2, 8, 24, 48, and 72 hours after a structural fire (firefighters only). Five PBDE analytes (BDEs 15, 28, 47, 99, and 153) detected in at least 90% of samples were summed for analyses. The AhR in vitro DR CALUX® bioassay assessed the mixture of dioxin-like compounds and toxicity from breastmilk extracts. Baseline PBDEs and AhR response were compared between firefighters and non-firefighters. Separate linear mixed models assessed changes in sum of PBDEs and AhR response among firefighters over time and effect modification by interior or exterior response was assessed. Baseline PBDE concentrations and AhR responses did not differ between the 21 firefighters and 10 non-firefighters. There were no significant changes in sum of PBDEs or AhR response among firefighters over time post-fire, and no variation by interior or exterior response. Plots of sum of PBDEs and AhR response over time demonstrated individual variation but no consistent pattern. Currently, our novel study results do not support forgoing breastfeeding after a fire exposure. However, given study limitations and the potential hazard of accumulated toxicants from firefighter exposures excreted via breastfeeding, future studies should consider additional contaminants and measures of toxicity by which firefighting may impact maternal and child health.
Collapse
Affiliation(s)
- Alesia M Jung
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Shawn C Beitel
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Shannon L Gutenkunst
- Statistics Consulting Lab, BIO5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Statistics Consulting Lab, BIO5 Institute, University of Arizona, Tucson, Arizona 85721, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
| | - Sara A Jahnke
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, Leawood, Kansas 66224, USA
| | - Sally R Littau
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | - Mandie White
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
| | | | - Nathan J Cherrington
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
- Department of Pharmacology and Toxicology, R. Ken Coit College of Pharmacy, University of Arizona, Tucson, Arizona 85721, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona 85724, USA
- Southwest Environmental Health Sciences Center, University of Arizona, Tucson, Arizona 85721, USA
| |
Collapse
|
5
|
Navarro KM, Butler CR, Fent K, Toennis C, Sammons D, Ramirez-Cardenas A, Clark KA, Byrne DC, Graydon PS, Hale CR, Wilkinson AF, Smith DL, Alexander-Scott MC, Pinkerton LE, Eisenberg J, Domitrovich JW. The Wildland Firefighter Exposure and Health Effect (WFFEHE) Study: Rationale, Design, and Methods of a Repeated-Measures Study. Ann Work Expo Health 2022; 66:714-727. [PMID: 34919119 PMCID: PMC9203592 DOI: 10.1093/annweh/wxab117] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 11/18/2021] [Accepted: 12/06/2021] [Indexed: 01/04/2023] Open
Abstract
The wildland firefighter exposure and health effect (WFFEHE) study was a 2-year repeated-measures study to investigate occupational exposures and acute and subacute health effects among wildland firefighters. This manuscript describes the study rationale, design, methods, limitations, challenges, and lessons learned. The WFFEHE cohort included fire personnel ages 18-57 from six federal wildland firefighting crews in Colorado and Idaho during the 2018 and 2019 fire seasons. All wildland firefighters employed by the recruited crews were invited to participate in the study at preseason and postseason study intervals. In 2019, one of the crews also participated in a 3-day midseason study interval where workplace exposures and pre/postshift measurements were collected while at a wildland fire incident. Study components assessed cardiovascular health, pulmonary function and inflammation, kidney function, workplace exposures, and noise-induced hearing loss. Measurements included self-reported risk factors and symptoms collected through questionnaires; serum and urine biomarkers of exposure, effect, and inflammation; pulmonary function; platelet function and arterial stiffness; and audiometric testing. Throughout the study, 154 wildland firefighters participated in at least one study interval, while 144 participated in two or more study interval. This study was completed by the Centers for Disease Control and Prevention's National Institute for Occupational Safety and Health through a collaborative effort with the U.S. Department of Agriculture Forest Service, Department of the Interior National Park Service, and Skidmore College. Conducting research in the wildfire environment came with many challenges including collecting study data with study participants with changing work schedules and conducting study protocols safely and operating laboratory equipment in remote field locations. Forthcoming WFFEHE study results will contribute to the scientific evidence regarding occupational risk factors and exposures that can impact wildland firefighter health over a season and across two wildland fire seasons. This research is anticipated to lead to the development of preventive measures and policies aimed at reducing risk for wildland firefighters and aid in identifying future research needs for the wildland fire community.
Collapse
Affiliation(s)
- Kathleen M. Navarro
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, Denver, CO, USA,Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH, USA,Author to whom correspondence should be addressed. Tel: +1-303-236-5953;
| | - Corey R. Butler
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, Denver, CO, USA,United States Department of the Interior, Denver, CO, USA
| | - Kenneth Fent
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH, USA
| | - Christine Toennis
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Cincinnati, OH, USA
| | - Deborah Sammons
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Cincinnati, OH, USA
| | - Alejandra Ramirez-Cardenas
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, Denver, CO, USA
| | - Kathleen A. Clark
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Respiratory Health Division, Morgantown, VA, USA
| | - David C. Byrne
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH, USA
| | - Pamela S. Graydon
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH, USA
| | - Christa R. Hale
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Western States Division, Denver, CO, USA
| | - Andrea F. Wilkinson
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH, USA,First Responder Health and Safety Laboratory, Skidmore College, Saratoga Springs, NY, USA
| | - Denise L. Smith
- First Responder Health and Safety Laboratory, Skidmore College, Saratoga Springs, NY, USA
| | - Marissa C. Alexander-Scott
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Effects Laboratory Division, Cincinnati, OH, USA
| | - Lynne E. Pinkerton
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH, USA,Maximus, Attain, Falls Church, VA, USA
| | - Judith Eisenberg
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Division of Field Studies and Engineering, Cincinnati, OH, USA
| | - Joseph W. Domitrovich
- United States Forest Service, National Technology and Development Program, Missoula, MT, USA
| |
Collapse
|
6
|
Davidson S, Jahnke S, Jung AM, Burgess JL, Jacobs ET, Billheimer D, Farland LV. Anti-Müllerian Hormone Levels among Female Firefighters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:5981. [PMID: 35627519 PMCID: PMC9141260 DOI: 10.3390/ijerph19105981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 02/04/2023]
Abstract
Female firefighters have occupational exposures which may negatively impact their reproductive health. Anti-müllerian hormone (AMH) is a clinical marker of ovarian reserve. We investigated whether AMH levels differed in female firefighters compared to non-firefighters and whether there was a dose-dependent relationship between years of firefighting and AMH levels. Female firefighters from a pre-existing cohort completed a cross-sectional survey regarding their occupational and health history and were asked to recruit a non-firefighter friend or relative. All participants provided a dried blood spot (DBS) for AMH analysis. Linear regression was used to assess the relationship between firefighting status and AMH levels. Among firefighters, the influence of firefighting-related exposures was evaluated. Firefighters (n = 106) and non-firefighters (n = 58) had similar age and BMI. Firefighters had a lower mean AMH compared to non-firefighters (2.93 ng/mL vs. 4.37 ng/mL). In multivariable adjusted models, firefighters had a 33% lower AMH value than non-firefighters (-33.38%∆ (95% CI: -54.97, -1.43)). Years of firefighting was not associated with a decrease in AMH. Firefighters in this study had lower AMH levels than non-firefighters. More research is needed to understand the mechanisms by which firefighting could reduce AMH and affect fertility.
Collapse
Affiliation(s)
- Samantha Davidson
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
| | - Sara Jahnke
- Center for Fire, Rescue & EMS Health Research, NDRI-USA, Inc., Leawood, KS 66224, USA;
| | - Alesia M. Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
| | - Jefferey L. Burgess
- Department of Community, Environment & Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA;
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Elizabeth T. Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
| | - Dean Billheimer
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
| | - Leslie V. Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ 85724, USA; (S.D.); (A.M.J.); (E.T.J.); (D.B.)
- Cancer Prevention and Control Program, University of Arizona Cancer Center, Tucson, AZ 85719, USA
- Department of Obstetrics and Gynecology, College of Medicine-Tucson, University of Arizona, Tucson, AZ 85724, USA
| |
Collapse
|
7
|
Abstract
Firefighters are the professional force at high risk of suffering potential health consequences due to their chronic exposure to numerous hazardous pollutants during firefighting activities. Unfortunately, determination of fire emission exposure is very challenging. As such, the identification and development of appropriate biomarkers is critical in meeting this need. This chapter presents a critical review of current information related with the use of different urinary biomarkers of effect and exposure in occupationally exposed firefighters over the last 25 years. Evidence suggests that urinary isoprostanes and mutagenicity testing are promising biomarkers of early oxidative stress. Data indicate that firefighters participating in firefighting activities present with increased urinary biomarkers of exposure. These include polycyclic aromatic hydrocarbons, heavy metals and metalloids, organo-chlorine and -phosphorus compounds, environmental phenols, phthalates, benzene and toluene. More studies are urgently needed to better evaluate firefighter occupational safety and health and to support the implementation of preventive measures and mitigation strategies to promote the protection of this chronically exposed group of workers.
Collapse
|
8
|
Jung AM, Jahnke SA, Dennis LK, Bell ML, Burgess JL, Jitnarin N, Kaipust CM, Farland LV. Occupational factors and miscarriages in the US fire service: a cross-sectional analysis of women firefighters. Environ Health 2021; 20:116. [PMID: 34749749 PMCID: PMC8573857 DOI: 10.1186/s12940-021-00800-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence from previous studies suggests that women firefighters have greater risk of some adverse reproductive outcomes. The purpose of this study was to investigate whether women firefighters had greater risk of miscarriage compared to non-firefighters and whether there were occupational factors associated with risk of miscarriage among firefighters. METHODS We studied pregnancies in the United States fire service using data from the Health and Wellness of Women Firefighters Study (n = 3181). We compared the prevalence of miscarriage among firefighters to published rates among non-firefighters using age-standardized prevalence ratios. We used generalized estimating equations to estimate relative risks (RRs) and 95% confidence intervals (CIs) between occupational factors (employment (career/volunteer), wildland firefighter status (wildland or wildland-urban-interface/structural), shift schedule, fire/rescue calls at pregnancy start) and risk of miscarriage, adjusted for age at pregnancy, education, gravidity, BMI, and smoking. We evaluated if associations varied by age at pregnancy or employment. RESULTS Among 1074 firefighters and 1864 total pregnancies, 404 pregnancies resulted in miscarriages (22%). Among most recent pregnancies, 138 resulted in miscarriage (13%). Compared to a study of US nurses, firefighters had 2.33 times greater age-standardized prevalence of miscarriage (95% CI 1.96-2.75). Overall, we observed that volunteer firefighters had an increased risk of miscarriage which varied by wildland status (interaction p-value< 0.01). Among structural firefighters, volunteer firefighters had 1.42 times the risk of miscarriage (95% CI 1.11-1.80) compared to career firefighters. Among wildland/wildland-urban-interface firefighters, volunteer firefighters had 2.53 times the risk of miscarriage (95% CI 1.35-4.78) compared to career firefighters. CONCLUSIONS Age-standardized miscarriage prevalence among firefighters may be greater than non-firefighters and there may be variation in risk of miscarriage by fire service role. Further research is needed to clarify these associations to inform policy and decision-making.
Collapse
Affiliation(s)
- Alesia M Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA.
| | - Sara A Jahnke
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, Leawood, KS, USA
| | - Leslie K Dennis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Melanie L Bell
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Nattinee Jitnarin
- Center for Fire, Rescue, & EMS Health Research, NDRI-USA, Leawood, KS, USA
| | | | - Leslie V Farland
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N Martin Ave, Tucson, AZ, 85724, USA
- Department of Obstetrics and Gynecology, College of Medicine-Tucson, University of Arizona, Tucson, AZ, USA
| |
Collapse
|
9
|
The Occupational Health Effects of Responding to a Natural Gas Pipeline Explosion Among Emergency First Responders - Lincoln County, Kentucky, 2019. Disaster Med Public Health Prep 2021; 16:1997-2004. [PMID: 34544524 DOI: 10.1017/dmp.2021.266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The aim of the study was to assess occupational health effects 1 month after responding to a natural gas pipeline explosion. METHODS First responders to a pipeline explosion in Kentucky were interviewed about pre- and post-response health symptoms, post-response health care, and physical exertion and personal protective equipment (PPE) use during the response. Logistic regression was used to examine associations between several risk factors and development of post-response symptoms. RESULTS Among 173 first responders involved, 105 (firefighters [58%], emergency medical services [19%], law enforcement [10%], and others [12%]) were interviewed. Half (53%) reported at least 1 new or worsening symptom, including upper respiratory symptoms (39%), headache (18%), eye irritation (17%), and lower respiratory symptoms (16%). The majority (79%) of symptomatic responders did not seek post-response care. Compared with light-exertion responders, hard-exertion responders (48%) had significantly greater odds of upper respiratory symptoms (aOR: 2.99, 95% CI: 1.25-7.50). Forty-four percent of responders and 77% of non-firefighter responders reported not using any PPE. CONCLUSIONS Upper respiratory symptoms were common among first responders of a natural gas pipeline explosion and associated with hard-exertion activity. Emergency managers should ensure responders are trained in, equipped with, and properly use PPE during these incidents and encourage responders to seek post-response health care when needed.
Collapse
|
10
|
Hoppe-Jones C, Griffin SC, Gulotta JJ, Wallentine DD, Moore PK, Beitel SC, Flahr LM, Zhai J, Zhou JJ, Littau SR, Dearmon-Moore D, Jung AM, Garavito F, Snyder SA, Burgess JL. Evaluation of fireground exposures using urinary PAH metabolites. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:913-922. [PMID: 33654270 PMCID: PMC8445814 DOI: 10.1038/s41370-021-00311-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 02/10/2021] [Accepted: 02/12/2021] [Indexed: 06/02/2023]
Abstract
BACKGROUND Firefighters have increased cancer incidence and mortality rates compared to the general population, and are exposed to multiple products of combustion including known and suspected carcinogens. OBJECTIVE The study objective was to quantify fire response exposures by role and self-reported exposure risks. METHODS Urinary hydroxylated metabolites of polycyclic aromatic hydrocarbons (PAH-OHs) were measured at baseline and 2-4 h after structural fires and post-fire surveys were collected. RESULTS Baseline urine samples were collected from 242 firefighters. Of these, 141 responded to at least one of 15 structural fires and provided a post-fire urine. Compared with baseline measurements, the mean fold change of post-fire urinary PAH-OHs increased similarly across roles, including captains (2.05 (95% CI 1.59-2.65)), engineers (2.10 (95% CI 1.47-3.05)), firefighters (2.83 (95% CI 2.14-3.71)), and paramedics (1.84 (95% CI 1.33-2.60)). Interior responses, smoke odor on skin, and lack of recent laundering or changing of hoods were significantly associated with increased post-fire urinary PAH-OHs. SIGNIFICANCE Ambient smoke from the fire represents an exposure hazard for all individuals on the fireground; engineers and paramedics in particular may not be aware of the extent of their exposure. Post-fire surveys identified specific risks associated with increased exposure.
Collapse
Affiliation(s)
- Christiane Hoppe-Jones
- Department of Chemical and Environmental Engineering, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Stephanie C Griffin
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | | | | | - Shawn C Beitel
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Leanne M Flahr
- Department of Chemical and Environmental Engineering, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Jing Zhai
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Jin J Zhou
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sally R Littau
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Devi Dearmon-Moore
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Alesia M Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Fernanda Garavito
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Shane A Snyder
- Department of Chemical and Environmental Engineering, College of Engineering, University of Arizona, Tucson, AZ, USA
| | - Jefferey L Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| |
Collapse
|
11
|
Jung AM, Zhou J, Beitel SC, Littau SR, Gulotta JJ, Wallentine DD, Moore PK, Burgess JL. Longitudinal evaluation of whole blood miRNA expression in firefighters. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2021; 31:900-912. [PMID: 33603099 PMCID: PMC8445815 DOI: 10.1038/s41370-021-00306-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Revised: 01/18/2021] [Accepted: 01/28/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Dysregulated microRNA (miRNA) expression could provide a mechanism linking firefighter exposure to increased cancer risk. OBJECTIVE To determine if changes in longitudinal miRNA expression in firefighters are associated with occupational exposures. METHODS Whole blood MiRNA was evaluated in 52 new recruits prior to live-fire training and 20-37 months later. Linear mixed effects models adjusted for age, ethnicity, BMI, and batch effects were used to determine associations separately for all fires and structure fires only between employment duration, cumulative fire-hours and fire-runs, and time since most recent fire with (1) nine a priori and (2) the full array of 799 miRNAs. RESULTS For multivariable models including all fires, two a priori miRNAs were associated with employment duration and four with time since most recent fire. For multivariable models restricted to structure fires, three a priori miRNAs were associated with employment duration and one with fire-runs. Additional miRNAs from the full array were associated with employment duration for all fires and/or structure fires. In general, tumor suppressive miRNAs decreased and oncogenic miRNAs increased with exposure. SIGNIFICANCE Changes in miRNAs may serve as biomarkers of exposure effects and a mechanism for increased cancer risk in firefighters.
Collapse
Affiliation(s)
- Alesia M Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Jin Zhou
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Shawn C Beitel
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Sally R Littau
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | | | | | - Jefferey L Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| |
Collapse
|
12
|
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.
Collapse
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
| |
Collapse
|
13
|
Abstract
To examine changes in pulmonary function over a 5-year period in US firefighters.
Collapse
|
14
|
Graham EL, Khaja S, Caban-Martinez AJ, Smith DL. Firefighters and COVID-19: An Occupational Health Perspective. J Occup Environ Med 2021; 63:e556-e563. [PMID: 34138822 PMCID: PMC8327761 DOI: 10.1097/jom.0000000000002297] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
| | - Saeed Khaja
- Advocate Lutheran General Hospital, Park Ridge, IL
- Hanover Park Fire Department, Hanover Park, IL
| | - Alberto J Caban-Martinez
- Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL
- Sylvester Comprehensive Cancer Center, Miami, FL
| | - Denise L Smith
- First Responder Health and Safety Laboratory, Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Springs, NY
| |
Collapse
|
15
|
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.
Collapse
|
16
|
Hwang J, Xu C, Agnew RJ, Clifton S, Malone TR. Health Risks of Structural Firefighters from Exposure to Polycyclic Aromatic Hydrocarbons: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4209. [PMID: 33921138 PMCID: PMC8071552 DOI: 10.3390/ijerph18084209] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 01/03/2023]
Abstract
Firefighters have an elevated risk of cancer, which is suspected to be caused by occupational and environmental exposure to fire smoke. Among many substances from fire smoke contaminants, one potential source of toxic exposure is polycyclic aromatic hydrocarbons (PAH). The goal of this paper is to identify the association between PAH exposure levels and contributing risk factors to derive best estimates of the effects of exposure on structural firefighters' working environment in fire. We surveyed four databases (Embase, Medline, Scopus, and Web of Science) for this systematic literature review. Generic inverse variance method for random effects meta-analysis was applied for two exposure routes-dermal and inhalation. In dermal, the neck showed the highest dermal exposure increased after the fire activity. In inhalation, the meta-regression confirmed statistically significant increases in PAH concentrations for longer durations. We also summarized the scientific knowledge on occupational exposures to PAH in fire suppression activities. More research into uncontrolled emergency fires is needed with regard to newer chemical classes of fire smoke retardant and occupational exposure pathways. Evidence-based PAH exposure assessments are critical for determining exposure-dose relationships in large epidemiological studies of occupational risk factors.
Collapse
Affiliation(s)
- Jooyeon Hwang
- Department of Occupational and Environmental Health, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Chao Xu
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA;
| | - Robert J. Agnew
- Fire Protection & Safety Engineering Technology Program, College of Engineering, Architecture and Technology, Oklahoma State University, Stillwater, OK 74078, USA;
| | - Shari Clifton
- Department of Health Sciences Library and Information Management, Graduate College, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.C.); (T.R.M.)
| | - Tara R. Malone
- Department of Health Sciences Library and Information Management, Graduate College, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; (S.C.); (T.R.M.)
| |
Collapse
|
17
|
Wang T, Wang Y, Xu M, Wang Z, Wu N, Qi F, Song J, Dai Y, Wang H, Sun X, Gao S, Wang W, Li Y, Chen R, Sun Z, Jia Q, Li X, Duan H, Liu Z. Polycyclic aromatic hydrocarbons in particulate matter and serum club cell secretory protein change among schoolchildren: A molecular epidemiology study. ENVIRONMENTAL RESEARCH 2021; 192:110300. [PMID: 33038368 DOI: 10.1016/j.envres.2020.110300] [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: 08/27/2020] [Revised: 09/30/2020] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
Airborne particulate matter (PM) is a complex mixture containing various kinds of harmful components. Exposure to air PM is associated with childhood respiratory disease, but epidemiological data are limited concerning the circulating respiratory injury protein on the etiology of childhood respiratory disease. Specifically, the role of PM toxic components or its biological effective dose (adduct) in respiratory injury remains unclear. To demonstrate the dose-response relationship and the main mechanism on circulating club cell secretory protein (CC16) from PM compositions among children, we enrolled 273 boarding schoolchildren in China, including 110 and 163 children of whom were in the low- and high-PM exposed areas, respectively. In this study, we measured the internal exposure levels, including serum polycyclic aromatic hydrocarbons (PAH) adduct, urinary metals, and AhR expression, and detected the serum CC16 level as a lung injury marker. Environmental tobacco exposure in children was assessed by urinary cotinine. We found that significantly higher levels of serum CC16, benzo[a]pyridin-7,8-dihydroglycol-9,10-epoxide (BPDE)-albumin adduct, urinary molybdenum, selenium, arsenic, cadmium and barium, and lower level of AhR expression in high-PM exposed group. There was a good association between serum BPDE-albumin adduct and CC16 (β = 0.222, P = 0.006). There was no association on urinary metals and serum CC16. BPDE-albumin adduct was directly associated with serum CC16 alternation [direct effect = 0.2044, 95% confidence interval (CI) = (0.0426, 0.36)]. PM could cause serum CC16 increased in children. PAH and its adduct might play a key role in lung injury during PM exposure.
Collapse
Affiliation(s)
- Ting Wang
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanhua Wang
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Mengmeng Xu
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhenjie Wang
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nan Wu
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fang Qi
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiayang Song
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yufei Dai
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huanqiang Wang
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xin Sun
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sheng Gao
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Wenrui Wang
- Inner Mongolia Center for Disease Control and Prevention, Hohhot, China
| | - Yanbo Li
- School of Public Health, Capital Medical University, Beijing, China
| | - Rui Chen
- School of Public Health, Capital Medical University, Beijing, China
| | - Zhiwei Sun
- School of Public Health, Capital Medical University, Beijing, China
| | - Qiang Jia
- Shandong Academy of Occupational Health and Occupational Medicine, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, China
| | - Xinwei Li
- Jinan Municipal Center for Disease Control and Prevention, Jinan, China
| | - Huawei Duan
- Key Laboratory of Chemical Safety and Health, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Zhong Liu
- Jinan Municipal Center for Disease Control and Prevention, Jinan, China.
| |
Collapse
|
18
|
Soteriades ES, Kim J, Christophi CA, Kales SN. Cancer Incidence and Mortality in Firefighters: A State-of-the-Art Review and Meta-َAnalysis. Asian Pac J Cancer Prev 2019; 20:3221-3231. [PMID: 31759344 PMCID: PMC7063017 DOI: 10.31557/apjcp.2019.20.11.3221] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: A systematic literature review and meta-analysis was conducted on the association between firefighting and cancer. Methods: A comprehensive literature search of databases including Medline, EMBASE, Biosis, NIOSHTIC2, Web of Science, Cancerlit, and HealthStar, for the period between 1966 to January 2007, was conducted. We also retrieved additional studies by manual searching. Results: A total of 49 studies were included in the meta-analysis. We found statistically significant associations between firefighting and cancers of bladder, brain and CNS, and colorectal cancers, consistent with several previous risk estimates. We also found statistically significant associations of firefighting with non-Hodgkin’s lymphoma, skin melanoma, prostate, and testicular cancer. For kidney, Hodgkin’s lymphoma, leukemia, lymphosarcoma and reticulosarcoma, multiple myeloma, and pancreatic cancer, we found some statistically significant but less consistent results. For all other cancers evaluated (esophageal, laryngeal, oral and pharyngeal, liver and gallbladder, lung, lymphatic and hematopoietic, non-melanoma skin cancer, stomach, and urinary cancer) we did not find any statistically significant associations. Conclusions: Although our meta-analysis showed statistically significant increased risks of either cancer incidence or mortality of certain cancers in association with firefighting, a number of important limitations of the underlying studies exist, which, precluded our ability to arrive at definitive conclusions regarding causation.
Collapse
Affiliation(s)
- Elpidoforos S Soteriades
- United Arab Emirates University, College of Medicine and Health Sciences, Institute of Public Health, Al Ain, United Arab Emirates.,Harvard T.H. Chan School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA
| | - Jaeyoung Kim
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA.,Keimyung University, College of Medicine, Department of Preventive Medicine, Daegu, Korea
| | - Costas A Christophi
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA.,Cyprus University of Technology, School of Health Sciences, Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Limassol, Cyprus.,The Biostatistics Center, The George Washington University, Rockville, MD, USA
| | - Stefanos N Kales
- Harvard T.H. Chan School of Public Health, Department of Environmental Health, Environmental and Occupational Medicine and Epidemiology (EOME), Boston, MA, USA.,Cambridge Health Alliance, Employee & Industrial Medicine, Cambridge, MA, USA
| |
Collapse
|
19
|
Remy LL, Clay T, Byers V, Rosenfeld PE. Hospital, health, and community burden after oil refinery fires, Richmond, California 2007 and 2012. Environ Health 2019; 18:48. [PMID: 31096983 PMCID: PMC6524223 DOI: 10.1186/s12940-019-0484-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/17/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Emergency Departments experience a significant census burst after disasters. The aim of this study is to describe patient presentations at Emergency Departments in Contra Costa County, California following chemical release incidents at an oil refinery in 2007 and 2012. Specific areas of focus include hospital and community burden with an emphasis on disease classes. METHODS Searching 4 weeks before through 4 weeks after each event, Emergency Department abstracts identified patients living in Contra Costa County and seeking care there or in neighboring Alameda County. City and ZIP-code of residence established proximity to the refinery. This provided the following contrast groups: Event (2007, 2012), time (before, after), location (bayside, rest of county), and within bayside, warned or not warned to shelter in place. Using the Multi-Level Clinical Classification Software, we classified primary health groups recorded 4 weeks before and after the events, then summarized the data, calculated rates, and made tables, graphs, and maps to highlight findings. RESULTS Number of visits meeting selection criteria totalled 105020 records. Visits increased modestly but statistically significantly after the 2007 incident. After the 2012 incident, two Emergency Departments took the brunt of the surge. Censuses increased from less than 600 a week each to respectively 5719 and 3072 the first week, with the greatest number 2 days post-event. It took 4 weeks for censuses to return to normal. The most common diagnosis groups that spiked were nervous/sensory, respiratory, circulatory, and injury. Bayside communities had statistically significant increases in residents seeking care. Specifically, visits of residents in warned communities nearest the refinery increased by a factor of 3.7 while visits of residents in other nearby un-warned communities increased by a factor of 1.5. CONCLUSIONS The 2012 Emergency Department census peaked in the first week and did not return to normal for 4 weeks. Diagnoses changed to reflect conditions associated with reactions to chemical exposures. Surrounding communities and nearby hospitals experienced significant emergent burdens. In addition to changes from such events in patient diagnoses and community burden, the discussion highlights the long-term implications of failures to require adequate monitoring and warning systems and failures of health planning.
Collapse
Affiliation(s)
- Linda L. Remy
- Family Health Outcomes Project, Family and Community Medicine, School of Medicine, University of California San Francisco, 500 Parnassus Ave. Room MU-337, San Francisco, CA 94143-0900 USA
| | - Ted Clay
- Family Health Outcomes Project, Family and Community Medicine, School of Medicine, University of California San Francisco, 500 Parnassus Ave. Room MU-337, San Francisco, CA 94143-0900 USA
| | - Vera Byers
- Immunology Inc, PO Box 4703, Incline Village, NV 89450 USA
| | - Paul E. Rosenfeld
- SWAPE, 2656 29th Street, Suite 201, Santa Monica, California 90405 USA
| |
Collapse
|
20
|
Zhou J, Jenkins TG, Jung AM, Jeong KS, Zhai J, Jacobs ET, Griffin SC, Dearmon-Moore D, Littau SR, Peate WF, Ellis NA, Lance P, Chen Y, Burgess JL. DNA methylation among firefighters. PLoS One 2019; 14:e0214282. [PMID: 30913233 PMCID: PMC6435149 DOI: 10.1371/journal.pone.0214282] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 03/11/2019] [Indexed: 01/09/2023] Open
Abstract
Firefighters are exposed to carcinogens and have elevated cancer rates. We hypothesized that occupational exposures in firefighters would lead to DNA methylation changes associated with activation of cancer pathways and increased cancer risk. To address this hypothesis, we collected peripheral blood samples from 45 incumbent and 41 new recruit non-smoking male firefighters and analyzed the samples for DNA methylation using an Illumina Methylation EPIC 850k chip. Adjusting for age and ethnicity, we performed: 1) genome-wide differential methylation analysis; 2) genome-wide prediction for firefighter status (incumbent or new recruit) and years of service; and 3) Ingenuity Pathway Analysis (IPA). Four CpGs, including three in the YIPF6, MPST, and PCED1B genes, demonstrated above 1.5-fold statistically significant differential methylation after Bonferroni correction. Genome-wide methylation predicted with high accuracy incumbent and new recruit status as well as years of service among incumbent firefighters. Using IPA, the top pathways with more than 5 gene members annotated from differentially methylated probes included Sirtuin signaling pathway, p53 signaling, and 5' AMP-activated protein kinase (AMPK) signaling. These DNA methylation findings suggest potential cellular mechanisms associated with increased cancer risk in firefighters.
Collapse
Affiliation(s)
- Jin Zhou
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Timothy G. Jenkins
- Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Alesia M. Jung
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea
| | - Jing Zhai
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Elizabeth T. Jacobs
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
- University of Arizona Cancer Center, Tucson, Arizona, United States of America
| | - Stephanie C. Griffin
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Devi Dearmon-Moore
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | - Sally R. Littau
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| | | | - Nathan A. Ellis
- University of Arizona Cancer Center, Tucson, Arizona, United States of America
| | - Peter Lance
- University of Arizona Cancer Center, Tucson, Arizona, United States of America
| | - Yin Chen
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, Arizona, United States of America
| | - Jefferey L. Burgess
- Department of Community, Environment and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Arizona, United States of America
| |
Collapse
|
21
|
The "Warm Zone" Cases: Environmental Monitoring Immediately Outside the Fire Incident Response Arena by Firefighters. Saf Health Work 2018; 9:352-355. [PMID: 30370169 PMCID: PMC6130006 DOI: 10.1016/j.shaw.2017.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 12/06/2017] [Accepted: 12/13/2017] [Indexed: 11/24/2022] Open
Abstract
Hazardous work zones (i.e., hot, warm, and cold) are typically established by emergency response teams during hazardous materials (HAZMAT) calls but less consistently for fire responses to segment personnel and response activities in the immediate geographic area around the fire. Despite national guidelines, studies have documented the inconsistent use of respiratory protective equipment by firefighters at the fire scene. In this case-series report, we describe warm zone gas levels using multigas detectors across five independent fire incident responses all occurring in a large South Florida fire department. Multigas detector data collected at each fire response indicate the presence of sustained levels of volatile organic compounds in the “warm zone” of each fire event. These cases suggest that firefighters should not only implement strategies for multigas detector use within the warm zone but also include respiratory protection to provide adequate safety from toxic exposures in the warm zone.
Collapse
|
22
|
Slattery F, Johnston K, Paquet C, Bennett H, Crockett A. The long-term rate of change in lung function in urban professional firefighters: a systematic review. BMC Pulm Med 2018; 18:149. [PMID: 30189854 PMCID: PMC6128005 DOI: 10.1186/s12890-018-0711-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Accepted: 08/17/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Despite the known occupational hazards, it is not yet clear whether long-term career firefighting leads to a greater rate of decline in lung function than would normally be expected, and how this rate of change is affected by firefighting exposures and other risk/protective factors. METHODS A systematic search of online electronic databases was conducted to identify longitudinal studies reporting on the rate of change in the forced expiratory volume in one second (FEV1) of forced vital capacity (FVC). Included studies were critically appraised to determine their risk of bias using the Research Triangle Institute Item Bank (RTI-IB) on Risk of Bias and Precision of Observational Studies. RESULTS Twenty-two studies were identified for inclusion, from four different countries, published between 1974 and 2016. Examined separately, studies were categorised by the type of firefighting exposure. Firefighters experienced variable rates of decline in lung function, which were particularly influenced by cigarette smoking. The influence of routine firefighting exposures is unclear and limited by the methods of measurement, while firefighters exposed to 'non-routine' severe exposures unanimously experienced accelerated declines. CONCLUSIONS The data provided by longitudinal studies provide an unclear picture of how the rate of change in lung function of firefighters relates to routine exposures and how it compares to the rate of change expected in a working-age population. Non-smoking firefighters who routinely wear respiratory protection are more likely than otherwise to have a normal rate of decline in lung function. Exposure to catastrophic events significantly increases the rate of decline in firefighter lung function but there is limited evidence detailing the effect of routine firefighting. Future studies will benefit from more robust methods of measuring exposure. TRIAL REGISTRATION International Prospective Register of Systematic Reviews (PROSPERO), registration number ( CRD42017058499 ).
Collapse
Affiliation(s)
- Flynn Slattery
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, Universitiy of South Australia, Adelaide, Australia
| | - Kylie Johnston
- School of Health Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, Australia
| | - Catherine Paquet
- Centre for Population Health Research, Sansom Institute for Health Research, School of Health Sciences, University of South Australia, Adelaide, Australia
| | - Hunter Bennett
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, Universitiy of South Australia, Adelaide, Australia
| | - Alan Crockett
- Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, Universitiy of South Australia, Adelaide, Australia
| |
Collapse
|
23
|
Gainey SJ, Horn GP, Towers AE, Oelschlager ML, Tir VL, Drnevich J, Fent KW, Kerber S, Smith DL, Freund GG. Exposure to a firefighting overhaul environment without respiratory protection increases immune dysregulation and lung disease risk. PLoS One 2018; 13:e0201830. [PMID: 30130361 PMCID: PMC6103500 DOI: 10.1371/journal.pone.0201830] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Accepted: 07/23/2018] [Indexed: 01/29/2023] Open
Abstract
Firefighting activities appear to increase the risk of acute and chronic lung disease, including malignancy. While self-contained breathing apparatuses (SCBA) mitigate exposures to inhalable asphyxiates and carcinogens, firefighters frequently remove SCBA during overhaul when the firegrounds appear clear of visible smoke. Using a mouse model of overhaul without airway protection, the impact of fireground environment exposure on lung gene expression was assessed to identify transcripts potentially critical to firefighter-related chronic pulmonary illnesses. Lung tissue was collected 2 hrs post-overhaul and evaluated via whole genome transcriptomics by RNA-seq. Although gas metering showed that the fireground overhaul levels of carbon monoxide (CO), carbon dioxide (CO2), hydrogen cyanine (HCN), hydrogen sulfide (H2S) and oxygen (O2) were within NIOSH ceiling recommendations, 3852 lung genes were differentially expressed when mice exposed to overhaul were compared to mice on the fireground but outside the overhaul environment. Importantly, overhaul exposure was associated with an up/down-regulation of 86 genes with a fold change of 1.5 or greater (p<0.5) including the immunomodulatory-linked genes S100a8 and Tnfsf9 (downregulation) and the cancer-linked genes, Capn11 and Rorc (upregulation). Taken together these findings indicate that, without respiratory protection, exposure to the fireground overhaul environment is associated with transcriptional changes impacting proteins potentially related to inflammation-associated lung disease and cancer.
Collapse
Affiliation(s)
- Stephen J. Gainey
- Department of Animal Sciences, University of Illinois, Urbana, Illinois, United States of America
| | - Gavin P. Horn
- Illinois Fire Service Institute, Champaign, Illinois, United States of America
| | - Albert E. Towers
- Division of Nutritional Sciences, University of Illinois, Urbana, Illinois, United States of America
| | - Maci L. Oelschlager
- Department of Pathology, Program in Integrative Immunology and Behavior, University of Illinois College of Medicine, Urbana, Illinois, United States of America
| | - Vincent L. Tir
- Department of Pathology, Program in Integrative Immunology and Behavior, University of Illinois College of Medicine, Urbana, Illinois, United States of America
| | - Jenny Drnevich
- Roy J. Carver Biotechnology Center, University of Illinois, Urbana, Illinois, United States of America
| | - Kenneth W. Fent
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio, United States of America
| | - Stephen Kerber
- Director, UL Firefighter Safety Research Institute, Columbia, Maryland, United States of America
| | - Denise L. Smith
- Illinois Fire Service Institute, Champaign, Illinois, United States of America
- Department of Health and Human Physiological Sciences, Skidmore College, Saratoga Spring, New York, United States of America
| | - Gregory G. Freund
- Department of Animal Sciences, University of Illinois, Urbana, Illinois, United States of America
- Division of Nutritional Sciences, University of Illinois, Urbana, Illinois, United States of America
- Department of Pathology, Program in Integrative Immunology and Behavior, University of Illinois College of Medicine, Urbana, Illinois, United States of America
| |
Collapse
|
24
|
Leppänen M, Wu B, Corey J, Yermakov M, Grinshpun SA. Performance of a novel real-time respirator seal integrity monitor on firefighters: Simulated workplace pilot study. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2018; 15:607-615. [PMID: 29842832 DOI: 10.1080/15459624.2018.1479065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 05/02/2018] [Accepted: 05/15/2018] [Indexed: 06/08/2023]
Abstract
Millions of workers, including firefighters, use respiratory protective device. The key aspect in assuring the intended protection level of a respirator is its fit. However, even if the respirator originally fits well, the faceseal may be breached during its use. Until now, there have been no practically viable, inexpensive means to monitor the performance of a respirator during actual use. A novel Respirator Seal Integrity Monitor (ReSIM) was developed and recently evaluated on manikins by our team. The objective of this study was to evaluate the ReSIM effectiveness on respirator-wearing firefighters exposed to aerosols while performing simulated routine operational activities. Initially, 15 subjects were recruited for the study. Following a preliminary investigation that resulted in modifications in the ReSIM prototype and testing protocol, a subset of nine firefighters was chosen for a full-scale evaluation. The testing was conducted in a 24.3-m3 exposure chamber using NaCl as the challenge aerosol. Controlled faceseal leaks were established by opening a solenoid valve for 10, 15, or 20 sec. Leaks were also established as the tested firefighter slightly repositioned the respirator on his/her face. During the testing, the ReSIM measured particles inside a full-face elastomeric respirator with a 72.7% leak detection sensitivity (probability of correct leak identification) and an 84.2% specificity (probability of correct identification of the intervals which are absent of any leak). After adjusting for false negatives and persistent false positives, sensitivity and specificity increased to 83.6% and 92.2%, respectively. The factors causing minor limitations in leak detection sensitivity and specificity can be attributed to variability among subjects, moisture's effect on the particle sensor, and some in-mask sampling bias. In conclusion, the ReSIM can promptly detect the breach in a respirator faceseal with high sensitivity and specificity. Due to its capability to alert the wearer of possible overexposure to hazardous aerosols, the ReSIM concept has a remarkable potential to be applied in various working environments, where respirators are used.
Collapse
Affiliation(s)
- Maija Leppänen
- a Center for Health-Related Aerosol Studies, Department of Environmental Health, College of Medicine , University of Cincinnati , Cincinnati , Ohio
- b University of Eastern Finland , Department of Environmental and Biological Sciences , Kuopio , Finland
| | - Bingbing Wu
- a Center for Health-Related Aerosol Studies, Department of Environmental Health, College of Medicine , University of Cincinnati , Cincinnati , Ohio
| | - Jonathan Corey
- c Department of Civil and Architectural Engineering and Construction Management, College of Engineering and Applied Science , University of Cincinnati , Cincinnati , Ohio
| | - Michael Yermakov
- a Center for Health-Related Aerosol Studies, Department of Environmental Health, College of Medicine , University of Cincinnati , Cincinnati , Ohio
| | - Sergey A Grinshpun
- a Center for Health-Related Aerosol Studies, Department of Environmental Health, College of Medicine , University of Cincinnati , Cincinnati , Ohio
| |
Collapse
|
25
|
Wu B, Corey J, Yermakov M, Liu Y, Grinshpun SA. Laboratory Evaluation of a Novel Real-Time Respirator Seal Integrity Monitor. Ann Work Expo Health 2018; 62:742-753. [PMID: 29688252 DOI: 10.1093/annweh/wxy026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/06/2018] [Indexed: 11/14/2022] Open
Abstract
Background A low-cost real-time Respirator Seal Integrity Monitor (ReSIM) was recently developed to monitor a respirator's actual performance at a workplace. The objective of this study was to evaluate the capability of the new ReSIM prototype in manikin-based laboratory experiments to rapidly detect induced leakage of a half-mask elastomeric respirator. Methods Two phases of testing were conducted in this study. First, the accuracy of ReSIM measuring an aerosol concentration was assessed by comparing the outputs of ReSIM against a reference optical aerosol spectrometer (OAS) in a flow-through set-up. Second, the capability to detect a leak was tested using a manikin-based set-up to simulate leaks into a functional respirator. Results The regression curve of ReSIM versus OAS had an R2 of 0.936, indicating its high accuracy within the targeted particle size range of 0.5-2 µm. The ReSIM provided a leak detection sensitivity (probability of correctly identifying intervals with the true leak) of 98.4% when challenged with a combustion aerosol, compared to 71.8% when challenged with a NaCl aerosol. Its specificity (probability of identifying intervals without a leak) was 99.8% after adjusting for persistent false positives for both types of challenge aerosol. Conclusion The ReSIM prototype not only can estimate the particle concentration with high accuracy but also can rapidly detect respirator faceseal leakage in real time with sufficient sensitivity and specificity. In addition, it can trigger an alarm when the faceseal integrity is compromised.
Collapse
Affiliation(s)
- Bingbing Wu
- Center for Health-Related Aerosol Studies, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Jonathan Corey
- Department of Civil and Architectural Engineering and Construction Management, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
| | - Michael Yermakov
- Center for Health-Related Aerosol Studies, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Yan Liu
- Department of Civil and Architectural Engineering and Construction Management, College of Engineering and Applied Science, University of Cincinnati, Cincinnati, OH, USA
| | - Sergey A Grinshpun
- Center for Health-Related Aerosol Studies, Department of Environmental Health, College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| |
Collapse
|
26
|
Shen B, Whitehead TP, Gill R, Dhaliwal J, Brown FR, Petreas M, Patton S, Hammond SK. Organophosphate flame retardants in dust collected from United States fire stations. ENVIRONMENT INTERNATIONAL 2018; 112:41-48. [PMID: 29247842 DOI: 10.1016/j.envint.2017.12.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2017] [Revised: 12/05/2017] [Accepted: 12/06/2017] [Indexed: 05/12/2023]
Abstract
Firefighters are exposed to chemicals during fire events and we previously demonstrated that fire station dust has high levels of polybrominated diphenyl ethers (PBDEs). In conducting the Fire Station Dust Study, we sought to further characterize the chemicals to which firefighters could be exposed - measuring the emerging class of phosphorous-containing flame retardants (PFRs) in fire stations, for the first time, as well as PBDEs. Dust samples from 26 fire stations in five states were collected from vacuum-cleaner bags and analyzed for PFRs and PBDEs. PFR concentrations were found to be on the same order of magnitude as PBDE concentrations (maximum PFR: 218,000ng/g; maximum PBDE: 351,000ng/g). Median concentrations of tri-n-butyl phosphate (TNBP), tris (2-chloroisopropyl) phosphate (TCIPP), and tris(1,3-dichloroisopropyl)phosphate (TDCIPP) in dust from fire stations were higher than those previously reported in homes and other occupational settings around the world. Total PFR levels did not vary significantly among states. Levels of TDCIPP were higher in stations where vacuum cleaners were used to clean surfaces other than the floor. PBDE levels were comparable to those found in our previous study of 20 California fire stations and much higher than levels in California residences. PFR and PBDE levels in fire station dust are higher than in other occupational and residential settings, underscoring the need to identify and control sources of this contamination.
Collapse
Affiliation(s)
- Beverly Shen
- School of Public Health, University of California, 50 University Hall, Berkeley, CA, USA.
| | - Todd P Whitehead
- School of Public Health, University of California, 50 University Hall, Berkeley, CA, USA
| | - Ranjit Gill
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, 700 Heinz Avenue, Berkeley, CA, USA
| | - Joginder Dhaliwal
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, 700 Heinz Avenue, Berkeley, CA, USA
| | - F Reber Brown
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, 700 Heinz Avenue, Berkeley, CA, USA
| | - Myrto Petreas
- Environmental Chemistry Laboratory, California Department of Toxic Substances Control, 700 Heinz Avenue, Berkeley, CA, USA
| | - Sharyle Patton
- Biomonitoring Resource Center, Commonweal, 451 Mesa Road, Bolinas, CA, USA
| | - S Katharine Hammond
- School of Public Health, University of California, 50 University Hall, Berkeley, CA, USA
| |
Collapse
|
27
|
Keir JLA, Akhtar US, Matschke DMJ, Kirkham TL, Chan HM, Ayotte P, White PA, Blais JM. Elevated Exposures to Polycyclic Aromatic Hydrocarbons and Other Organic Mutagens in Ottawa Firefighters Participating in Emergency, On-Shift Fire Suppression. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2017; 51:12745-12755. [PMID: 29043785 DOI: 10.1021/acs.est.7b02850] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Occupational exposures to combustion emissions were examined in Ottawa Fire Service (OFS) firefighters. Paired urine and dermal wipe samples (i.e., pre- and post-event) as well as personal air samples and fire event questionnaires were collected from 27 male OFS firefighters. A total of 18 OFS office workers were used as additional controls. Exposures to polycyclic aromatic hydrocarbons (PAHs) and other organic mutagens were assessed by quantification of urinary PAH metabolite levels, levels of PAHs in dermal wipes and personal air samples, and urinary mutagenicity using the Salmonella mutagenicity assay (Ames test). Urinary Clara Cell 16 (CC16) and 15-isoprostane F2t (8-iso-PGF2α) levels were used to assess lung injury and overall oxidative stress, respectively. The results showed significant 2.9- to 5.3-fold increases in average post-event levels of urinary PAH metabolites, depending on the PAH metabolite (p < 0.0001). Average post-event levels of urinary mutagenicity showed a significant, event-related 4.3-fold increase (p < 0.0001). Urinary CC16 and 8-iso-PGF2α did not increase. PAH concentrations in personal air and on skin accounted for 54% of the variation in fold changes of urinary PAH metabolites (p < 0.002). The results indicate that emergency, on-shift fire suppression is associated with significantly elevated exposures to combustion emissions.
Collapse
Affiliation(s)
- Jennifer L A Keir
- Department of Biology, University of Ottawa , 30 Marie Curie, Ottawa, Ontario K1N 6N5, Canada
| | - Umme S Akhtar
- Department of Biology, University of Ottawa , 30 Marie Curie, Ottawa, Ontario K1N 6N5, Canada
| | - David M J Matschke
- Ottawa Fire Services , 1445 Carling Avenue, Ottawa, Ontario K1Z 7L9, Canada
| | - Tracy L Kirkham
- Dalla Lana School of Public Health, University of Toronto , 155 College Street, Toronto, Ontario M5T 3M7, Canada
| | - Hing Man Chan
- Department of Biology, University of Ottawa , 30 Marie Curie, Ottawa, Ontario K1N 6N5, Canada
| | - Pierre Ayotte
- Centre de toxicologie du Québec, Institut national de santé publique du Québec and Université Laval , 945 Avenue Wolfe, Québec City, Québec G1V 5B3, Canada
| | - Paul A White
- Department of Biology, University of Ottawa , 30 Marie Curie, Ottawa, Ontario K1N 6N5, Canada
- Environmental Health Science and Research Bureau, Health Canada , 50 Colombine Driveway, Ottawa, Ontario K1A 0K9, Canada
| | - Jules M Blais
- Department of Biology, University of Ottawa , 30 Marie Curie, Ottawa, Ontario K1N 6N5, Canada
| |
Collapse
|
28
|
Abstract
IntroductionFirst responders, including firefighters, police officers, emergency medical services, and company emergency response team members, have dangerous jobs that can bring them in contact with hazardous chemicals among other dangers. Limited information is available on responder injuries that occur during hazardous chemical incidents. METHODS We analyzed 2002-2012 data on acute chemical incidents with injured responders from 2 Agency for Toxic Substances and Disease Registry chemical incident surveillance programs. To learn more about such injuries, we performed descriptive analysis and looked for trends. RESULTS The percentage of responders among all injured people in chemical incidents has not changed over the years. Firefighters were the most frequently injured group of responders, followed by police officers. Respiratory system problems were the most often reported injury, and the respiratory irritants, ammonia, methamphetamine-related chemicals, and carbon monoxide were the chemicals more often associated with injuries. Most of the incidents with responder injuries were caused by human error or equipment failure. Firefighters wore personal protective equipment (PPE) most frequently and police officers did so rarely. Police officers' injuries were mostly associated with exposure to ammonia and methamphetamine-related chemicals. Most responders did not receive basic awareness-level hazardous material training. CONCLUSION All responders should have at least basic awareness-level hazardous material training to recognize and avoid exposure. Research on improving firefighter PPE should continue. (Disaster Med Public Health Preparedness. 2018;12:211-221).
Collapse
|
29
|
Wang C, Cai J, Chen R, Shi J, Yang C, Li H, Lin Z, Meng X, Liu C, Niu Y, Xia Y, Zhao Z, Li W, Kan H. Personal exposure to fine particulate matter, lung function and serum club cell secretory protein (Clara). ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2017; 225:450-455. [PMID: 28284549 DOI: 10.1016/j.envpol.2017.02.068] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 02/03/2017] [Accepted: 02/03/2017] [Indexed: 06/06/2023]
Abstract
BACKGROUND The underlying mechanisms about the association between ambient fine particulate matter (PM2.5) and lung function were unclear. Few epidemiological studies have evaluated the potential mediating effects of serum club cell secretory protein (Clara) (CC16), a biomarker of pulmonary epithelium integrity. OBJECTIVES To evaluate the short-term effect of personal PM2.5 exposure on lung function and to explore the potential mediating role of CC16 in this effect. METHODS We enrolled 36 healthy, nonsmoking college students for a panel study in Shanghai, China from December 17, 2014 to July 11, 2015. We measured personal and real-time exposure to PM2.5 for 72 h preceding each of four rounds of health examinations, including lung function test and serum CC16 measurement. We used linear mixed-effect models to examine the effects of PM2.5 on lung function and CC16 over various lag times. Furthermore, we analyzed the mediating effect of CC16 in the association between PM2.5 and lung function. RESULTS Average PM2.5 exposure ranged from 36 to 52 μg/m3 across different lag periods. PM2.5 exposure was negatively associated with lung function and positively associated with serum CC16 concentration. The effect of PM2.5 on CC16 occurred earlier than that on lung function. For instance, an interquartile range (IQR) increase in 0-2 h average exposure to PM2.5 was significantly associated with a 4.84% increase in serum CC16; and an IQR increase in 3-6 h average exposure to PM2.5 was significantly associated with a 1.08% decrease in 1-sec forced expiratory volume. These effects lasted up to 24 h after exposure. Increased serum CC16 contributed 3.9%-36.3% of the association between PM2.5 and impaired lung function. CONCLUSIONS Acute exposure to PM2.5 might induce an immediate decrease in lung function by virtue of the loss of pulmonary epithelium integrity.
Collapse
Affiliation(s)
- Cuicui Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China
| | - Jingjin Shi
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Changyuan Yang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Huichu Li
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Zhijing Lin
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Xia Meng
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Yue Niu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Yongjie Xia
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Zhuohui Zhao
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Weihua Li
- Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai 200030, China; Key Laboratory of Reproduction Regulation of NPFPC, SIPPR, IRD, Fudan University, Shanghai 200032, China.
| |
Collapse
|
30
|
Seyedmehdi SM, Attarchi M, Cherati AS, Hajsadeghi S, Tofighi R, Jamaati H. Relationship of aerobic fitness with cardiovascular risk factors in firefighters. Work 2016; 55:155-161. [PMID: 27612056 DOI: 10.3233/wor-162375] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Epidemiological studies on the general population have shown that increased physical activity and aerobic fitness (AF) significantly decrease the risk of coronary artery disease. Finding ways to decrease such risk factors can promote the health of firefighters. METHODS This study was conducted in a large industrial facility in Tehran. AF assessment and submaximal aerobic fitness testing of participants were performed according to the guidelines of the American College of Sports Medicine (ACSM). AF was determined using a bicycle ergometer. Other information was collected using a specifically designed questionnaire, physical examination and blood test. Data were analyzed using SPSS. Level of significance was set at P < 0.05. RESULTS A total of 157 male firefighters were evaluated in an industrial facility. The results of logistic regression analysis revealed that AF was significantly correlated with age, body mass index (BMI), cigarette smoking, physical activity, hemoglobin level, low-density lipoprotein (LDL) level, high-density lipoprotein (HDL) level, resting systolic blood pressure (RSBP), diastolic blood pressure (RDBP) and heart rate (RHR) (P < 0.05). CONCLUSIONS Firefighters with greater AF had lower cardiovascular disease (CVD) risk factors. Longitudinal studies are required to further confirm this finding. Increasing the AF may decrease CVD risk factors in firefighters.
Collapse
Affiliation(s)
- Seyed Mohammad Seyedmehdi
- Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mirsaeed Attarchi
- Department of Forensic Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.,Department of Occupational Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Shokoufeh Hajsadeghi
- Department of Cardiology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Jamaati
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| |
Collapse
|
31
|
Beamer PI, Klimecki WT, Loh M, Van Horne YO, Sugeng AJ, Lothrop N, Billheimer D, Guerra S, Lantz RC, Canales RA, Martinez FD. Association of Children's Urinary CC16 Levels with Arsenic Concentrations in Multiple Environmental Media. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:E521. [PMID: 27223295 PMCID: PMC4881146 DOI: 10.3390/ijerph13050521] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Revised: 05/06/2016] [Accepted: 05/16/2016] [Indexed: 02/08/2023]
Abstract
Arsenic exposure has been associated with decreased club cell secretory protein (CC16) levels in adults. Further, both arsenic exposure and decreased levels of CC16 in childhood have been associated with decreased adult lung function. Our objective was to determine if urinary CC16 levels in children are associated with arsenic concentrations in environmental media collected from their homes. Yard soil, house dust, and tap water were taken from 34 homes. Urine and toenail samples were collected from 68 children. All concentrations were natural log-transformed prior to data analysis. There were associations between urinary CC16 and arsenic concentration in soil (b = -0.43, p = 0.001, R² = 0.08), water (b = -0.22, p = 0.07, R² = 0.03), house dust (b = -0.37, p = 0.07, R² = 0.04), and dust loading (b = -0.21, p = 0.04, R² = 0.04). In multiple analyses, only the concentration of arsenic in soil was associated with urinary CC16 levels (b = -0.42, p = 0.02, R² = 0.14 (full model)) after accounting for other factors. The association between urinary CC16 and soil arsenic may suggest that localized arsenic exposure in the lungs could damage the airway epithelium and predispose children for diminished lung function. Future work to assess this possible mechanism should examine potential associations between airborne arsenic exposures, CC16 levels, lung function, and other possible confounders in children in arsenic-impacted communities.
Collapse
Affiliation(s)
- Paloma I Beamer
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Chemical and Environmental Engineering, University of Arizona, 1133 E. James E. Rogers Way, Tucson, AZ 85721, USA.
| | - Walter T Klimecki
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, P.O. Box 210207, Tucson, AZ 85724, USA.
| | - Miranda Loh
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Institute of Occupational Medicine, Research Avenue North, Riccarton, Edinburgh EH14 4AP, UK.
| | - Yoshira Ornelas Van Horne
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Anastasia J Sugeng
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Nathan Lothrop
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Dean Billheimer
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Stefano Guerra
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
| | - Robert Clark Lantz
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
- Department of Cellular and Molecular Medicine, University of Arizona, P.O. Box 245044, Tucson, AZ 85724, USA.
| | - Robert A Canales
- Mel and Enid Zuckerman College of Public Health, University of Arizona, 1295 N. Martin Ave., Tucson, AZ 85724, USA.
| | - Fernando D Martinez
- Asthma and Airways Disease Research Center, University of Arizona, 1501 N. Campbell Ave., Tucson, AZ 85724, USA.
| |
Collapse
|
32
|
Freberg BI, Olsen R, Thorud S, Daae HL, Hersson M, Molander P, Barregard L, Ellingsen DG. Pulmonary function and serum pneumoproteins in professional ski waxers. Inhal Toxicol 2016; 28:7-13. [DOI: 10.3109/08958378.2015.1123333] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
|
33
|
Jones L, Burgess JL, Evans H, Lutz EA. Respiratory protection for firefighters--Evaluation of CBRN canisters for use during overhaul II: In mask analyte sampling with integrated dynamic breathing machine. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2016; 13:177-184. [PMID: 26554925 DOI: 10.1080/15459624.2015.1091964] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
According to the National Fire Protection Association there were 487,500 structural fires in the U.S. in 2013. After visible flames are extinguished firefighters begin the overhaul stage where remaining hot spots are identified and further extinguished. During overhaul, a significant amount of potentially hazardous chemicals can remain in the ambient environment. Previous research suggests that the use of air purifying respirators fitted with chemical, biological, radiological, and nuclear (CBRN) canisters may reduce occupational exposure. This study used large scale burns of representative structural materials to perform side-by-side, filtering, and service-life evaluations of commercially available CBRN filters using two head forms fitted with full-face respirators and a dynamic breathing machine. Three types of CBRN canisters and one non-CBRN cartridge were challenged in repetitive post-fire environments. Tests were conducted with two different breathing volumes and rates for two sampling durations (0-15 min and 0-60 min). Fifty-five different chemicals were selected for evaluation and results indicate that 10 of the 55 chemicals were present in the post-fire overhaul ambient environment. Acetaldehyde and formaldehyde were found to be the only two chemicals detected post filter but were effectively filtered to below ACGIH TLVs. Counter to our prior published work using continuous flow filter evaluation, this study indicates that, regardless of brand, CBRN filters were effective at reducing concentrations of post-fire ambient chemicals to below occupational exposure limits. However, caution should be applied when using CBRN filters as the ambient formaldehyde level in the current study was 8.9 times lower than during the previous work.
Collapse
Affiliation(s)
- Leaton Jones
- a Division of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona , Tucson , Arizona
| | - Jefferey L Burgess
- a Division of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona , Tucson , Arizona
| | - Heath Evans
- b Northwest Fire District, Training Battalion , Tucson , Arizona
| | - Eric A Lutz
- a Division of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health, University of Arizona , Tucson , Arizona
| |
Collapse
|
34
|
Evans DE, Fent KW. Ultrafine and respirable particle exposure during vehicle fire suppression. ENVIRONMENTAL SCIENCE. PROCESSES & IMPACTS 2015; 17:1749-59. [PMID: 26308547 PMCID: PMC4606867 DOI: 10.1039/c5em00233h] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Vehicle fires are a common occurrence, yet few studies have reported exposures associated with burning vehicles. This article presents an assessment of firefighters' potential for ultrafine and respirable particle exposure during vehicle fire suppression training. Fires were initiated within the engine compartment and passenger cabins of three salvaged vehicles, with subsequent water suppression by fire crews. Firefighter exposures were monitored with an array of direct reading particle and air quality instruments. A flexible metallic duct and blower drew contaminants to the instrument array, positioned at a safe distance from the burning vehicles, with the duct inlet positioned at the nozzle operator's shoulder. The instruments measured the particle number, active surface area, respirable particle mass, photoelectric response, aerodynamic particle size distributions, and air quality parameters. Although vehicle fires were suppressed quickly (<10 minutes), firefighters may be exposed to short duration, high particle concentration episodes during fire suppression, which are orders of magnitude greater than the ambient background concentration. A maximum transient particle concentration of 1.21 × 10(7) particles per cm(3), 170 mg m(-3) respirable particle mass, 4700 μm(2) cm(-3) active surface area and 1400 (arbitrary units) in photoelectric response were attained throughout the series of six fires. Expressed as fifteen minute time-weighted averages, engine compartment fires averaged 5.4 × 10(4) particles per cm(3), 0.36 mg m(-3) respirable particle mass, 92 μm(2) cm(-3) active particle surface area and 29 (arbitrary units) in photoelectric response. Similarly, passenger cabin fires averaged 2.04 × 10(5) particles per cm(3), 2.7 mg m(-3) respirable particle mass, 320 μm(2) cm(-3) active particle surface area, and 34 (arbitrary units) in photoelectric response. Passenger cabin fires were a greater potential source of exposure than engine compartment fires. The wind direction and the relative position of the fire crew to the stationary burning vehicle played a primary role in fire crews' potential for exposure. We recommend that firefighters wear self-contained breathing apparatus during all phases of the vehicle fire response to significantly reduce their potential for particulate, vapor, and gaseous exposures.
Collapse
Affiliation(s)
- Douglas E Evans
- Chemical Exposure and Monitoring Branch, Division of Applied Research and Technology, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, 1090 Tusculum Avenue, MS R-7, Cincinnati, Ohio, USA.
| | | |
Collapse
|
35
|
Ahn YS, Jeong KS. Mortality due to malignant and non-malignant diseases in Korean professional emergency responders. PLoS One 2015; 10:e0120305. [PMID: 25756281 PMCID: PMC4355623 DOI: 10.1371/journal.pone.0120305] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2014] [Accepted: 02/06/2015] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study was conducted to estimate the cause-specific mortality in male emergency responders (ER), compare with that of Korean men. Mortality was also compared between more experienced firefighters (i.e., firefighters employed ≥ 20 years and firefighters employed ≥ 10 to < 20 years) and less experienced firefighters and non-firefighters (i.e., firefighters employed < 10 years and non-firefighters) to investigate associations between mortality and exposure to occupational hazards. METHODS The cohort was comprised of 33,442 males who were employed as ERs between 1980 and 2007 and not deceased as of 1991. Work history was merged with the death registry from the National Statistical Office of Korea to follow-up on mortality between 1992 and 2007. Standardized mortality ratios (SMR) for ERs were calculated in reference to the Korean male population. Adjusted relative risks (ARRs) of mortalities for firefighters employed ≥ 20 years and ≥ 10 years to < 20 years were calculated in reference to non-firefighters and firefighters employed < 10 years. RESULTS Overall (SMR = 0.43, 95%CI = 0.39-0.47) and some kinds of cause-specific mortalities were significantly lower among ERs compared with the Korean male population. No significant increase in mortality was observed across the major ICD-10 classifications among ERs. Mortality due to exposure to smoke, fire, and flames (SMR = 3.11, 95% CI = 1.87-4.85), however, was significantly increased among ERs. All-cause mortality (ARR = 1.46, 95% CI=1.13-1.89), overall cancer mortality (ARR = 1.54, 95% CI = 1.02-2.31) and mortality of external injury, poisoning and external causes (ARR = 3.13, 95% CI = 1.80-5.46) were significantly increased among firefighters employed ≥ 20 years compared to those of non-firefighters and firefighters employed < 10 years. CONCLUSIONS An increase in mortality due to all cancer and external injury, poisoning, and external causes in firefighters employed ≥ 20 years compared with non-firefighters and firefighters employed < 10 years suggests occupational exposure.
Collapse
Affiliation(s)
- Yeon-Soon Ahn
- Department of Occupational and Environmental Medicine, Dongguk University, Dongguk University Ilsan Hospital, Goyang, the Republic of Korea
| | - Kyoung Sook Jeong
- Department of Occupational and Environmental Medicine, Dongguk University, Dongguk University Ilsan Hospital, Goyang, the Republic of Korea
| |
Collapse
|
36
|
Jones L, Lutz EA, Duncan M, Burgess JL. Respiratory protection for firefighters--evaluation of CBRN canisters for use during overhaul. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2015; 12:314-322. [PMID: 25738516 DOI: 10.1080/15459624.2014.989363] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
In the United States, there are approximately 366,600 structural fires each year. After visible flames are extinguished, firefighters begin the overhaul stage of firefighting to smother remaining hot spots and initiate investigations. Typically during overhaul significant ambient concentrations of chemical contaminants remain. However, previous research suggests that the use of air purifying respirators (APR) fitted with chemical, biological, radiological, and nuclear (CBRN) canisters may reduce occupational respiratory exposures. This pilot study used large-scale prescribed burns of representative structural materials to perform simultaneous, side-by-side, filtering and service-life evaluations of commercially available CBRN filters. Three types of CBRN canisters and one cartridge were challenged in repetitive post live-fire overhaul exposure tests using a sampling manifold apparatus. At a flow rate of 80 L/min, nine tests were conducted in the breathing zone for three different exposure durations (0-15 min, 0-30 min, and 0-60 min). Fifty different chemicals were identified for evaluation and results indicate that 21 of the 50 chemicals tested were in the air of the overhaul environment. Respirable particles and formaldehyde were consistently present above the American Conference of Governmental Industrial Hygienists (ACGIH®) recommended exposure level (REL) and threshold limit ceiling value (TLVc), respectively. Each filter effectively reduced concentrations for respirable particulates below the maximum recommended level. Formaldehyde was reduced, but not consistently filtered below the TLVc. These results were consistent across all exposure durations. This study indicates that, regardless of brand, CBRN filters provide protection from the vast majority of particle and gas-phase contaminants. However, due to formaldehyde breakthrough, CBRN filters do not provide complete protection during firefighter overhaul.
Collapse
Affiliation(s)
- Leaton Jones
- a Division of Community, Environment, and Policy, Mel and Enid Zuckerman College of Public Health , University of Arizona , Tucson , Arizona
| | | | | | | |
Collapse
|
37
|
Kirk KM, Logan MB. Firefighting instructors' exposures to polycyclic aromatic hydrocarbons during live fire training scenarios. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2015; 12:227-34. [PMID: 25679824 DOI: 10.1080/15459624.2014.955184] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Cumulative exposures of firefighting instructors to toxic contaminants generated from live-fire training potentially far exceed firefighter exposures arising from operational fires. This study measured the atmospheric concentrations of polycyclic aromatic hydrocarbons (PAHs) outside and inside the structural firefighting ensembles worn by instructors during five live fire training evolutions. In addition, the contamination of ensembles by deposition of PAHs was characterized. Concentrations of polycyclic aromatic hydrocarbons outside the instructors' structural firefighting ensembles during the training evolutions ranged from 430 μg/m(3) to 2700 μg/m(3), and inside the structural firefighting ensembles from 32 μg/m(3) to 355 μg/m(3). Naphthalene, phenanthrene and acenaphthylene dominated the PAHs generated in the live fire evolutions, but benzo[a]pyrene was the greatest contributor to the toxicity of the PAH mixture both inside and outside the structural firefighting ensembles. Deposition of PAHs onto the structural firefighting ensembles was measured at between 69 and 290 ng/cm(2), with phenanthrene, fluoranthene, pyrene, and benzo[a]anthracene detected on all samples. These findings suggest that firefighting instructor exposures to PAHs during a single live-fire training evolution are comparable with exposures occurring in industrial settings over a full shift. Further research is required to investigate the importance of various potential routes of exposure to PAHs as a result of ingress and deposition of PAHs in/on structural firefighting ensembles.
Collapse
Affiliation(s)
- Katherine M Kirk
- a Research and Scientific Branch , Queensland Fire and Emergency Services , Brisbane , Queensland , Australia
| | | |
Collapse
|
38
|
McCluskey JD, Harbison SC, Johnson GT, Xu P, Morris S, Wolfson J, Harbison RD. Occupational health surveillance: Pulmonary function testing in emergency responders. J Emerg Trauma Shock 2014; 7:180-5. [PMID: 25114428 PMCID: PMC4126118 DOI: 10.4103/0974-2700.136861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 09/02/2013] [Indexed: 11/17/2022] Open
Abstract
Emergency responders may be exposed to a variety of fumes, gases, and particulates during the course of their job that can affect pulmonary function (PF) and require the use of respiratory protection. This investigation used occupational health monitoring examination data to characterize PF in a population currently employed as emergency responders. PF tests for workers who required health examinations to ensure fitness for continued respirator use were compared to the National Health and Nutrition Examination Survey (NHANES) III Raw Spirometry database to determine if decreased PF was associated with employment as an emergency responder. The results of this research indicated that the emergency responders experienced a modest, but statistically significant, increase in forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) mean values over the NHANES III population in both total and stratified analyses, including stratification by age, gender, height, and smoking history. Results are likely due to a combination of effectively controlled exposures in the workplace, and the healthy worker effect among long-term workers. PF testing required by the Occupational and Safety Health Administration (OSHA) has substantial utility for conducting occupational surveillance at the population level. In this investigation, we were able to quickly evaluate if abnormal PF existed in an industrial sector known to have exposures that, when uncontrolled, can lead to PF impairment.
Collapse
Affiliation(s)
- James D McCluskey
- Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Stephen C Harbison
- Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Giffe T Johnson
- Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Ping Xu
- Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Steve Morris
- Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Jay Wolfson
- Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA
| | - Raymond D Harbison
- Center for Environmental and Occupational Risk Analysis and Management, College of Public Health, University of South Florida, Tampa, Florida, USA
| |
Collapse
|
39
|
Ide CW. Cancer incidence and mortality in serving whole-time Scottish firefighters 1984-2005. Occup Med (Lond) 2014; 64:421-7. [DOI: 10.1093/occmed/kqu080] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
40
|
Affiliation(s)
- Lin Fritschi
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Deborah C Glass
- Monash Centre for Occupational and Environmental Health, SPHPM, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
41
|
Gaughan DM, Siegel PD, Hughes MD, Chang CY, Law BF, Campbell CR, Richards JC, Kales SF, Chertok M, Kobzik L, Nguyen PS, O'Donnell CR, Kiefer M, Wagner GR, Christiani DC. Arterial stiffness, oxidative stress, and smoke exposure in wildland firefighters. Am J Ind Med 2014; 57:748-56. [PMID: 24909863 DOI: 10.1002/ajim.22331] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To assess the association between exposure, oxidative stress, symptoms, and cardiorespiratory function in wildland firefighters. METHODS We studied two Interagency Hotshot Crews with questionnaires, pulse wave analysis for arterial stiffness, spirometry, urinary 8-iso-prostaglandin F2α (8-isoprostane) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), and the smoke exposure marker (urinary levoglucosan). Arterial stiffness was assessed by examining levels of the aortic augmentation index, expressed as a percentage. An oxidative stress score comprising the average of z-scores created for 8-OHdG and 8-isoprostane was calculated. RESULTS Mean augmentation index % was higher for participants with higher oxidative stress scores after adjusting for smoking status. Specifically for every one unit increase in oxidative stress score the augmentation index % increased 10.5% (95% CI: 2.5, 18.5%). Higher mean lower respiratory symptom score was associated with lower percent predicted forced expiratory volume in one second/forced vital capacity. CONCLUSIONS Biomarkers of oxidative stress may serve as indicators of arterial stiffness in wildland firefighters.
Collapse
Affiliation(s)
- Denise M. Gaughan
- Department of Preventive Medicine and the Institute for Translational Epidemiology; Icahn School of Medicine at Mount Sinai; New York New York
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program); Harvard School of Public Health; Boston Massachusetts
| | - Paul D. Siegel
- Health Effects Laboratory Division; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Michael D. Hughes
- Department of Biostatistics; Harvard School of Public Health; Boston Massachusetts
| | - Chiung-Yu Chang
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program); Harvard School of Public Health; Boston Massachusetts
| | - Brandon F. Law
- Health Effects Laboratory Division; National Institute for Occupational Safety and Health; Morgantown West Virginia
| | - Corey R. Campbell
- Western States Office; National Institute for Occupational Safety and Health; Denver Colorado
| | - Jennifer C. Richards
- Department of Health and Exercise Science; Colorado State University; Fort Collins Colorado
| | - Stefanos F. Kales
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program); Harvard School of Public Health; Boston Massachusetts
| | - Marcia Chertok
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program); Harvard School of Public Health; Boston Massachusetts
| | - Lester Kobzik
- Department of Environmental Health (Molecular and Integrative Physiological Sciences); Harvard School of Public Health; Boston Massachusetts
| | - Phuong-son Nguyen
- Department of Environmental Health (Molecular and Integrative Physiological Sciences); Harvard School of Public Health; Boston Massachusetts
| | - Carl R. O'Donnell
- Beth Israel Deaconess Medical Center; Division of Pulmonary and Critical Care Medicine; Boston Massachusetts
| | - Max Kiefer
- Western States Office; National Institute for Occupational Safety and Health; Denver Colorado
| | - Gregory R. Wagner
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program); Harvard School of Public Health; Boston Massachusetts
| | - David C. Christiani
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program); Harvard School of Public Health; Boston Massachusetts
| |
Collapse
|
42
|
Schermer TR, Malbon W, Morgan M, Smith M, Crockett AJ. Chronic respiratory conditions in a cohort of metropolitan fire-fighters: associations with occupational exposure and quality of life. Int Arch Occup Environ Health 2014; 87:919-28. [PMID: 24570328 DOI: 10.1007/s00420-014-0935-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2013] [Accepted: 02/12/2014] [Indexed: 01/23/2023]
Abstract
OBJECTIVES To assess the prevalence of chronic respiratory conditions in metropolitan fire-fighters and to study associations between occupational exposure, use of respiratory protection and health-related quality of life (HRQoL) in fire-fighters with and without chronic respiratory conditions. METHODS Cross-sectional cohort analysis: Respiratory symptoms, medical conditions, occupational tasks and exposures and consistency of using respiratory protection were inquired by questionnaire. The SF12(®)V2 Health Survey was used to measure physical (PCS-12) and mental (MCS-12) HRQoL. Fire-fighters were categorised in subgroups: asthma; COPD/emphysema/chronic bronchitis; no chronic respiratory conditions; and as being 'not involved' or 'involved' in fire-fighting tasks, the latter further categorised as 'consistent' or 'inconsistent' use of respiratory protection. PCS-12 and MCS-12 scores were compared between subgroups and categories using linear regression. RESULTS Five hundred and seventy fire-fighters were analysed, 24 (4%) fulfilled the criteria for asthma, 39 (7%) for COPD/emphysema/chronic bronchitis. Fire-fighters with asthma were older than those in the other two subgroups and had been employed in the fire service longer. Respiratory subgroups did not differ in their involvement in fire-fighting tasks. Ninety-one percent of fire-fighters reported relevant occupational exposure in the past year. Mean PCS-12 scores for fire-fighters with no chronic respiratory conditions, asthma and COPD/emphysema/bronchitis were 52.0 (SD 6.9), 47.0 (8.5) and 48.1 (9.4). For PCS-12 (but not for MCS-12), interaction between having a chronic respiratory condition and inconsistent use of respiratory protection during fire knockdown was observed (p < 0.001). CONCLUSIONS Ten percent of metropolitan fire-fighters reported underlying chronic respiratory conditions. Presence of such a condition in combination with suboptimal protection from inhaled exposures may lead to poorer physical HRQoL.
Collapse
Affiliation(s)
- Tjard R Schermer
- Primary Care Respiratory Research Unit, Discipline of General Practice, School of Population Health, The University of Adelaide, Adelaide, SA, 5005, Australia,
| | | | | | | | | |
Collapse
|
43
|
Gaughan DM, Christiani DC, Hughes MD, Baur DM, Kobzik L, Wagner GR, Kales SN. High hsCRP is associated with reduced lung function in structural firefighters. Am J Ind Med 2014; 57:31-7. [PMID: 24115029 PMCID: PMC7786395 DOI: 10.1002/ajim.22260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2013] [Indexed: 11/07/2022]
Abstract
BACKGROUND To assess the association between markers of systemic inflammation and pulmonary function in a population of structural firefighters. METHODS We studied male career members of a large Midwestern fire department with questionnaires, spirometry, and high-sensitivity C-reactive protein (hsCRP) as a biomarker of systemic inflammation. We examined percent predicted forced expiratory volume in 1 s (FEV1 %-predicted) and forced vital capacity (FVC%-predicted). RESULTS Complete data were available for 401 firefighters. Higher hsCRP levels were associated with lower lung function values, after adjusting for confounding variables. Specifically, for every twofold increase in log10-hsCRP, FEV1 %-predicted decreased by a mean 1.5% (95% CI: 0.4, 2.6%) and FVC%-predicted decreased by a mean 1.4% (95% CI: 0.4, 2.3%). CONCLUSION hsCRP as a biomarker of systemic inflammation may indicate reduced lung function in structural firefighters.
Collapse
Affiliation(s)
- Denise M. Gaughan
- Department of Preventive Medicine, Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts
| | - David C. Christiani
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts
| | - Michael D. Hughes
- Department of Biostatistics, Harvard School of Public Health, Boston, Massachusetts
| | - Dorothee M. Baur
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts
| | - Lester Kobzik
- Department of Environmental Health (Molecular and Integrative Physiological Sciences),Harvard School of Public Health, Boston, Massachusetts
| | - Gregory R. Wagner
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts
| | - Stefanos N. Kales
- Department of Environmental Health (Environmental and Occupational Medicine and Epidemiology Program), Harvard School of Public Health, Boston, Massachusetts
| |
Collapse
|
44
|
Patterson PD, Suyama J, Reis SE, Weaver MD, Hostler D. What does it cost to prevent on-duty firefighter cardiac events? A content valid method for calculating costs. Adv Prev Med 2013; 2013:972724. [PMID: 24455288 PMCID: PMC3881339 DOI: 10.1155/2013/972724] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Accepted: 10/29/2013] [Indexed: 11/17/2022] Open
Abstract
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.
Collapse
Affiliation(s)
- P. Daniel Patterson
- University of Pittsburgh School of Medicine, Department of Emergency Medicine, 3600 Forbes Avenue, Suite 400A, Pittsburgh, PA 15261, USA
| | - Joe Suyama
- University of Pittsburgh School of Medicine, Department of Emergency Medicine, 3600 Forbes Avenue, Suite 400A, Pittsburgh, PA 15261, USA
| | - Steven E. Reis
- University of Pittsburgh School of Medicine, Department of Emergency Medicine, 3600 Forbes Avenue, Suite 400A, Pittsburgh, PA 15261, USA
| | - Matthew D. Weaver
- University of Pittsburgh School of Medicine, Department of Emergency Medicine, 3600 Forbes Avenue, Suite 400A, Pittsburgh, PA 15261, USA
| | - David Hostler
- University of Pittsburgh School of Medicine, Department of Emergency Medicine, 3600 Forbes Avenue, Suite 400A, Pittsburgh, PA 15261, USA
| |
Collapse
|
45
|
He X, Grinshpun SA, Reponen T, Yermakov M, McKay R, Haruta H, Kimura K. Laboratory evaluation of the particle size effect on the performance of an elastomeric half-mask respirator against ultrafine combustion particles. ACTA ACUST UNITED AC 2013; 57:884-97. [PMID: 23609115 DOI: 10.1093/annhyg/met014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVES This study quantified the particle size effect on the performance of elastomeric half-mask respirators, which are widely used by firefighters and first responders exposed to combustion aerosols. METHODS One type of elastomeric half-mask respirator equipped with two P-100 filters was donned on a breathing manikin while challenged with three combustion aerosols (originated by burning wood, paper, and plastic). Testing was conducted with respirators that were fully sealed, partially sealed (nose area only), or unsealed to the face of a breathing manikin to simulate different faceseal leakages. Three cyclic flows with mean inspiratory flow (MIF) rates of 30, 85, and 135 L/min were tested for each combination of sealing condition and combustion material. Additional testing was performed with plastic combustion particles at other cyclic and constant flows. Particle penetration was determined by measuring particle number concentrations inside and outside the respirator with size ranges from 20 to 200 nm. RESULTS Breathing flow rate, particle size, and combustion material all had significant effects on the performance of the respirator. For the partially sealed and unsealed respirators, the penetration through the faceseal leakage reached maximum at particle sizes >100 nm when challenged with plastic aerosol, whereas no clear peaks were observed for wood and paper aerosols. The particles aerosolized by burning plastic penetrated more readily into the unsealed half-mask than those aerosolized by the combustion of wood and paper. The difference may be attributed to the fact that plastic combustion particles differ from wood and paper particles by physical characteristics such as charge, shape, and density. For the partially sealed respirator, the highest penetration values were obtained at MIF = 85 L/min. The unsealed respirator had approximately 10-fold greater penetration than the one partially sealed around the bridge of the nose, which indicates that the nose area was the primary leak site.
Collapse
Affiliation(s)
- Xinjian He
- Center for Health-Related Aerosol Studies, Department of Environmental Health, University of Cincinnati, OH 45267-0056, USA
| | | | | | | | | | | | | |
Collapse
|
46
|
He X, Yermakov M, Reponen T, McKay RT, James K, Grinshpun SA. Manikin-based performance evaluation of elastomeric respirators against combustion particles. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2013; 10:203-12. [PMID: 23442086 PMCID: PMC6758539 DOI: 10.1080/15459624.2012.760063] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
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.
Collapse
Affiliation(s)
- Xinjian He
- Center for Health-Related Aerosol Studies, Department of Environmental Health, University of Cincinnati, Cincinnati, OH
| | - Michael Yermakov
- Center for Health-Related Aerosol Studies, Department of Environmental Health, University of Cincinnati, Cincinnati, OH
| | - Tiina Reponen
- Center for Health-Related Aerosol Studies, Department of Environmental Health, University of Cincinnati, Cincinnati, OH
| | - Roy T. McKay
- Center for Health-Related Aerosol Studies, Department of Environmental Health, University of Cincinnati, Cincinnati, OH
| | - Kelley James
- Department of Mechanical Engineering, University of Cincinnati, Cincinnati, OH
| | - Sergey A. Grinshpun
- Center for Health-Related Aerosol Studies, Department of Environmental Health, University of Cincinnati, Cincinnati, OH
| |
Collapse
|
47
|
Burgess JL, Duncan MD, Hu C, Littau SR, Caseman D, Kurzius-Spencer M, Davis-Gorman G, McDonagh PF. Acute cardiovascular effects of firefighting and active cooling during rehabilitation. J Occup Environ Med 2012; 54:1413-20. [PMID: 23090161 PMCID: PMC3493856 DOI: 10.1097/jom.0b013e3182619018] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVES To determine the cardiovascular and hemostatic effects of fire suppression and postexposure active cooling. METHODS Forty-four firefighters were evaluated before and after a 12-minute live-fire drill. Next, 50 firefighters performing the same drill were randomized to undergo postfire forearm immersion in 10 °C water or standard rehabilitation. RESULTS In the first study, heart rate and core body temperature increased and serum C-reactive protein decreased but there were no significant changes in fibrinogen, sE-selectin, or sL-selectin. The second study demonstrated an increase in blood coagulability, leukocyte count, factors VIII and X, cortisol, and glucose, and a decrease in plasminogen and sP-selectin. Active cooling reduced mean core temperature, heart rate, and leukocyte count. CONCLUSIONS Live-fire exposure increased core temperature, heart rate, coagulability, and leukocyte count; all except coagulability were reduced by active cooling.
Collapse
Affiliation(s)
- Jefferey L Burgess
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, Ariz 85724, USA.
| | | | | | | | | | | | | | | |
Collapse
|
48
|
Ahn YS, Jeong KS, Kim KS. Cancer morbidity of professional emergency responders in Korea. Am J Ind Med 2012; 55:768-78. [PMID: 22628010 DOI: 10.1002/ajim.22068] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2012] [Indexed: 12/25/2022]
Abstract
BACKGROUND Many professional emergency responders (ERs) who belong to the Korean National Emergency Management Agency (NEMA) have been cross-trained and serve multiple roles. As such, firefighters and other ERs in Korea are exposed to similar occupational hazards. This study was conducted to estimate cancer morbidity in male ERs and compare that with Korean men. METHODS The cohort was comprised of 33,416 male ERs working between 1980 and 2007, who were alive on December 31, 1995. Work histories were merged with the Korea National Central Cancer Registry (KNCCR) to assess cancer morbidity between 1996 and 2007. Standardized incidence ratios (SIRs) with reference to Korean men were analyzed. RESULTS SIRs with reference to national cancer rates were not significantly decreased for overall cancer (SIR = 0.97, 95% CI = 0.90-1.08) in all ERs. However, colorectal (SIR = 1.35, 95% CI = 1.07-1.67), kidney (SIR = 1.59, 95% CI = 1.00-2.41), and bladder (SIR = 1.77, 95% CI = 1.08-2.73) cancer, and non-Hodgkin's lymphoma (SIR = 1.81, 95% CI = 1.12-2.76) morbidities were significantly increased among all ERs. In firefighters, significantly increased cancer types were as same as those of all ERs. In non-firefighter ERs, colorectal (SIR = 2.51, 95% CI = 1.20-4.61) and bone and articular cartilage cancers (SIR = 9.53, 95% CI = 1.07-34.41) were significantly higher than those of Korean men. CONCLUSIONS Korean firefighters showed excess morbidity in several cancer types, including colorectal and urologic cancers, and non-Hodgkin's lymphoma, demonstrating similar trends to previous studies for firefighters conducted in other countries. Increased incidence in these cancer types suggests occupational exposure to carcinogens and shift work.
Collapse
Affiliation(s)
- Yeon-Soon Ahn
- Department of Occupational and Environmental Medicine, Dongguk University, Ilsan Hospital, Goyang, Republic of Korea.
| | | | | |
Collapse
|
49
|
Van Miert E, Sardella A, Nickmilder M, Bernard A. Respiratory effects associated with wood fuel use: a cross-sectional biomarker study among adolescents. Pediatr Pulmonol 2012; 47:358-66. [PMID: 21901861 DOI: 10.1002/ppul.21554] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2011] [Accepted: 06/26/2011] [Indexed: 12/30/2022]
Abstract
The use of wood as heating and cooking fuel can result in elevated levels of indoor air pollution, but to what extent this is related to respiratory diseases and allergies is still inconclusive. Here, we report a cross-sectional study among 744 school adolescents (median age 15 years) using as main outcomes respiratory symptoms and diseases, exhaled nitric oxide, total and aeroallergen-specific IgE in serum, and two epithelial biomarkers in nasal lavage fluid (NALF) or serum, that is, Clara cell protein (CC16) and surfactant-associated protein D (SPD). Information about the wood fuel use and potential confounders was collected via a personal interview of the adolescent and a questionnaire filled out by the parents. Two approaches were used to limit the possible influence of confounders, that is, multivariate analysis using the complete study population or pairwise analysis of matched sub-populations obtained using an automated procedure. Wood fuel use was associated with a decrease of CC16 and an increase of SPD in serum, which resulted in a decreased serum CC16/SPD ratio (median -9%, P = 0.001). No consistent differences were observed for the biomarkers measured in exhaled breath or NALF. Wood fuel use was also associated with increased odds for asthma [odds ratio (OR) 2.2, 95% CI: 1.1-4.4, P = 0.02], hay fever (OR = 2.4, 95% CI: 1.4-4.3, P = 0.002), and sensitization against pollen allergens (OR = 2.1, 95% CI: 1.3-3.4, P = 0.002). The risks of respiratory tract infections, self-reported symptoms, and sensitization against house-dust mite were not increased by wood fuel use. The increased risks of asthma, hay fever and aeroallergen sensitization, and the changes of lung-specific biomarkers consistently pointed towards respiratory effects associated with the use of wood fuel.
Collapse
Affiliation(s)
- Erik Van Miert
- Louvain Centre for Toxicology and Applied Pharmacology, Faculty of Medicine, Catholic University of Louvain, Brussels, Belgium
| | | | | | | |
Collapse
|
50
|
Cardiorespiratory fitness predicts cardiovascular risk profiles in career firefighters. J Occup Environ Med 2012; 53:1155-60. [PMID: 21915073 DOI: 10.1097/jom.0b013e31822c9e47] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Evaluate the association between cardiovascular disease (CVD) risk factors and cardiorespiratory fitness (CRF) in firefighters. METHODS Cross-sectional study of 968 male career firefighters. Cardiorespiratory fitness was measured by maximal exercise tolerance tests. Cardiovascular disease risk parameters included body composition, resting vital signs, and metabolic profiles. Group comparisons were performed using χ test, analysis of variance, and general linear regression with/without adjustment for age and body mass index (BMI). RESULTS Higher metabolic equivalents categories were significantly associated with lower diastolic blood pressure, body fat, triglycerides, low-density lipoprotein cholesterol and total/high-density cholesterol ratio, and higher high-density lipoprotein (P ≤ 0.0272, age and BMI adjusted). CONCLUSIONS Increasing CRF has beneficial independent effects on CVD risk factor profiles among firefighters. Higher CRF was beneficial regardless of BMI; nevertheless, increasing BMI had strong independent unfavorable effects. Firefighters should be encouraged to increase their CRF to decrease their future risk of CVD.
Collapse
|