Assessment of Pulmonary Function Tests among Firefighters in Jerusalem Longitudinal Study
Journal Title: Biomedical Journal of Scientific & Technical Research (BJSTR) - Year 2019, Vol 13, Issue 1
Abstract
Background: Firefighters are exposed to smoke and airborne toxins with known adverse effects. However, there is a lack of information regarding the respiratory risks they face. Pulmonary tests are not performed regularly on firefighters in Israel. In 2010 many Israeli firefighters were involved in a large-scale forest fire in the Carmel area where they were exposed to heavy smoke burden. Objectives: We sought to determine whether firefighters are at increased risk for obstructive pulmonary disorders and/or pulmonary function decline. Methods: We followed a cohort of 153 firefighters for two years. About half of the subjects were involved in the Carmel fire. We evaluated them annually with health questionnaires and spirometry. Results: We found a 3.9% prevalence of obstructive disorder. We did not find significant changes in FEV1 nor significant adverse effects of exposure to large forest fires. We found a significant decline in FVC and a 13.1% prevalence of a restrictive pattern. Smoking was highly prevalent and strongly associated with a decline in pulmonary function. Conclusion: Firefighters are generally healthy and do not seem to have an increased risk for obstructive disorders. Smoking among firefighters might be associated with accelerated pulmonary function decline. Our findings suggest an increased prevalence of a restrictive pattern; this should be confirmed in further studies.Firefighters are exposed to smoke and toxic Particulate Matter (PM) released during fire. Such exposure has adverse effects both acutely and chronically [1]. It is assumed that this population is at an increased risk for respiratory diseases and pulmonary function decline. Until recently, this assumption was not thoroughly studied. Research done after the collapse of the World Trade Center (WTC) shed light on this subject. Rescuers were exposed to high levels of PM and toxins which were released during the collapse [2,3]. Following this exposure several respiratory disorders have been described in rescue teams [4-7] and both acute and persistent changes in pulmonary functions were demonstrated [8-11]. However, longitudinal assessment of non-WTC firefighters compared to control subjects did not show greater pulmonary function decline [12]. There is a lack of evidence regarding the respiratory risk’s firefighters face. From December 2nd to 5th , 2010, Israel experienced the most severe forest fire in its history. The fire took place in the Carmel area and resulted in the deaths of 43 rescue workers and the hospitalization of others, mainly for acute smoke inhalation and traumatic injury. Consequently, many firefighters were exposed to smoke and other PM in a prolonged and mainly unprotected manner.Assessment of pulmonary function tests among firefighters in Israel is not regularly performed and therefore little is known about this population. In this research we sought to determine whether firefighters are at an increased risk for obstructive pulmonary disorders and pulmonary function decline. About half of the firefighters in Jerusalem were involved in the Carmel forest fire in 2010. We aimed to compare this group to the firefighters who did not participate in the rescue operations at the Carmel forest fire site.
Authors and Affiliations
Mitchnik Ilan, Rokach Ariel, Arish Nissim, Romem Ayal, Azulai Hava, Chen Chen Shuali, Kalak George, Izbicki Gabriel
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