Health Hazard Manual for Firefighters

[Excerpt] Firefighters, as well as victims, can be exposed to a variety of toxic substances during a fire. Some of these toxicants are particularly insidious because they are produced by thermal decomposition before smoke makes a fire evident

Unveiling Urinary Mutagenicity by the Ames Test for Occupational Risk Assessment: A Systematic Review

Occupational exposure may involve a variety of toxic compounds. A mutagenicity analysis using the Ames test can provide valuable information regarding the toxicity of absorbed xenobiotics. Through a search of relevant databases, this systematic review gathers and critically discusses the published papers (excluding other types of publications) from 2001–2021 that have assessed urinary mutagenicity (Ames test with Salmonella typhimurium) in an occupational exposure context. Due to the heterogeneity of the study methods, a meta-analysis could not be conducted. The characterized occupations were firefighters, traffic policemen, bus drivers, mail carriers, coke oven and charcoal workers, chemical laboratory staff, farmers, pharmacy workers, and professionals from several other industrial sectors. The genetically modified bacterial strains (histidine dependent) TA98, TA100, YG1041, YG1021, YG1024 and YG1042 have been used for the health risk assessment of individual (e.g., polycyclic aromatic hydrocarbons) and mixtures of compounds (e.g., diesel engine exhaust, fire smoke, industrial fumes/dyes) in different contexts. Although comparison of the data between studies is challenging, urinary mutagenicity can be very informative of possible associations between work-related exposure and the respective mutagenic potential. Careful interpretation of results and their direct use for occupational health risk assessment are crucial and yet complex; the use of several strains is highly recommended since individual and/or synergistic effects of complex exposure to xenobiotics can be overlooked. Future studies should improve the methods used to reach a standardized protocol for specific occupational environments to strengthen the applicability of the urinary mutagenicity assay and reduce inter- and intra-individual variability and exposure source confoundersThis work received financial support from the projects PCIF/SSO/0017/2018 and PCIF/SSO/0090/2019 of the Fundação para a Ciência e a Tecnologia (FCT), Ministério da Ciência, Tecnologia e Ensino Superior (MCTES) through national funds. This work received support from UIDB/50006/2020, UIDP/50006/2020 and LA/P/0008/2020. M. Oliveira and B. Barros were supported by the scientific contract CEEC Individual 2017 Program Contract CEECIND/03666/2017 and the Ph.D. grant 2020.07394.BD, respectively. These were supported by the FCT and the European Union through the Fundo Social Europeu (FSE) and Ministério da Ciência, Tecnologia e Ensino Superior, respectively.info:eu-repo/semantics/publishedVersio

Firefighters and acute myocardial infarction: understanding mechanisms and reducing risk

Acute myocardial infarction is the commonest cause of death in firefighters, accounting for 45% of all deaths on duty. Compared with an average life expectancy of 77 years in the general population, the average age of cardiovascular death in firefighters is 50 years suggesting that occupational hazards are responsible for premature disease. The risk of acute myocardial infarction is increased 12- to 136-fold during rescue and firefighting duties, and is likely to reflect a combination of factors including strenuous physical exertion, mental stress, heat and pollutant exposure. Previous studies have established that the duties of a firefighter, in particular fire suppression, put inordinate strain on the cardiovascular system yet the exact mechanisms underlying the increased risk of myocardial infarction remain poorly defined. In a series of studies, I assessed the effect of occupation-specific risk factors on cardiovascular health in a combination of controlled and real-life studies in order to better define these mechanisms, hypothesising that exposure to high temperatures, strenuous physical exertion, psychological stress and air pollution either alone or in combination caused vascular dysfunction and thrombosis. In order to assess if firefighters had a greater cumulative risk of cardiovascular disease due to their occupation at baseline, I assessed the cardiovascular function of group of healthy, off-duty firefighters and compared this to a group of healthy age- and sex-matched off-duty police officers; an occupational group with similar responsibilities but a much lower risk of on-duty cardiovascular events. I was able to demonstrate that traditional cardiovascular risk factors, vascular endothelial function and thrombogenicity were similar in the two groups concluding that the excess of cardiovascular events and deaths in on-duty firefighters are due to the acute and transient effects of strenuous physical exertion, psychological stress, heat and exposure to air pollutants. Having established that off-duty firefighters had no apparent increased risk of cardiovascular events, I then went on to clarify the effects of combustion derived air pollution in the form of wood smoke on the cardiovascular system. The suppression of wildland or forest fires is globally the single most important duty of the fire service. Previous work within our institution has demonstrated the adverse effects of combustion derived air pollution, in the form of diesel exhaust, on the cardiovascular system. In a similar fashion, I assessed the effect of a wood smoke inhalation in a group of healthy off-duty firefighters by performing controlled exposures to wood smoke utilising a unique and well characterised facility. Interestingly, unlike diesel-exhaust, the exposure to wood smoke had no adverse effect on vascular endothelial function or thrombogenicity in this group concluding that cardiovascular events during wildland fire suppression may not be directly related to wood smoke inhalation but instead precipitated by other mechanisms such as strenuous physical exertion or dehydration. Latterly, I proceeded to evaluate the effects of strenuous physical exertion and heat exposure by comprehensively assessing a number of cardiovascular end points following controlled exposure to a fire simulation activity in a group of healthy, off-duty firefighters. I was able to demonstrate that exposure to extreme heat and physical exertion impaired vasomotor function and increased thrombus formation. Moreover, I demonstrated cardiac troponin concentrations increased suggesting that fire suppression activity may cause myocardial injury. These important findings suggest pathogenic mechanisms to explain the association between fire suppression activity and acute myocardial infarction. In the final phase of work, I endeavoured to assess the effects of real-life firefighter activities on the cardiovascular system. In an ambitious study, I attempted to undertake a comprehensive assessment of cardiovascular function in healthy firefighters following three periods of duty: fire suppression, alarm response and non-emergency activity. I was unable to complete enough studies to adequately power an analysis and draw any firm conclusions about the effect of these duties on cardiovascular health. Further work is required in a real-world setting to more clearly define the occupational risk factors underlying the increased risk of cardiovascular events associated with specific firefighter duties Understanding the biological mechanisms and environmental factors that predispose firefighters to cardiovascular events is essential if we are to develop effective methods for the prevention of acute myocardial infarction on-duty. This body of work has greatly improved the understanding of the mechanisms underlying the increased risk of cardiovascular events on duty and calls for the immediate evaluation of current practice in order to minimise risk to firefighters in the future. Examples of where improvements should be made include strategies to ensure adequate hydration and cooling following exposure to heat and physical exertion, change to working patterns to limit the duration of extreme exposures, and education, training and screening programmes to reduce the impact of traditional and occupational cardiovascular risk factors

Biomonitoring of firefighting forces: a review on biomarkers of exposure to health-relevant pollutants released from fires

Occupational exposure as a firefighter has recently been classified as a carcinogen to humans by International Agency for Research on Cancer (IARC). Biomonitoring has been increasingly used to characterize exposure of firefighting forces to contaminants. However, available data are dispersed and information on the most relevant and promising biomarkers in this context of firefighting is missing. This review presents a comprehensive summary and critical appraisal of existing biomar-kers of exposure including volatile organic compounds such as polycyclic aromatic hydrocarbons, several other persistent other organic pollutants as well as heavy metals and metalloids detected in biological fluids of firefighters attending different fire scenarios. Urine was the most characterized matrix, followed by blood. Firefighters exhaled breath and saliva were poorly evaluated. Overall, biological levels of compounds were predominantly increased in firefighters after participation in firefighting activities. Biomonitoring studies combining different biomarkers of exposure and of effect are currently limited but exploratory findings are of high interest. However, biomonitoring still has some unresolved major limitations since reference or recommended values are not yet established for most biomarkers. In addition, half-lives values for most of the biomarkers have thus far not been defined, which significantly hampers the design of studies. These limitations need to be tackled urgently to improve risk assessment and support implementation of better more effective preventive strategies.This work received support by UIDB/50006/2020, UIDP/ 50006/2020, LA/P/0008/2020, and through the project PCIF/ SSO/0090/2019 by the Fundação para a Ciência e a Tecnologia (FCT), Ministério da Ciência, Tecnologia e Ensino Superior (MCTES) through national funds. The authors would also like to thank to FCT and European Union through Fundo Social Europeu (FSE) which supported the scientific contract CEEC- Individual 2017 Program Contract CEECIND/03666/2017 and the PhD grant 2020.07394.BD, respectively.info:eu-repo/semantics/publishedVersio

Examining the Prevalence of Self-Reported Respiratory Symptoms and Respiratory Infection amongst Firefighters in the Presence or Absence of Asthma

BACKGROUND: Firefighters are exposed to numerous chemicals, fumes, and particulate matter on a regular basis. Current research shows a notable correlation between the number of years exposed to these chemicals, and the presence of respiratory related symptoms in firefighters. PURPOSE: The aim of this study was to determine if a significant positive correlation exists between the number of years in service as a firefighter and the development of respiratory symptoms. METHODS: An online survey utilizing the St. George’s Respiratory Survey was used to determine if there is a positive correlation between the number of years a fireman has served and the frequency of developed respiratory symptoms. Respiratory symptoms listed in the survey included coughing, shortness of breath, sputum production, and wheezing. Telephone, email, and Facebook were used to recruit fire departments within a large southern metropolitan area. Both active and retired firemen were included in the study. Inferential statistical tests included a Spearman’s correlation test and Whitney-Mann U test to determine if an association existed between years of service, respiratory symptoms, use of respirators and respiratory symptoms. RESULTS: A total of 43 surveys were completed and recorded. Among all respondents, 88% (N = 38) of were male, 4.7% (N = 2) were female, and 7.0% (N = 3) were unidentified. 48.8% (N = 21) of participants were between the ages of 45-54 years, 32.6% (N = 14) were 35-44 years, 4.7% (N = 2) were 25-34 years and 18-24 years, respectively, and 7.0% (N = 3) accounted for unidentified age. Spearman’s correlation test for a computed score of respiratory symptoms (M 2.74, STD ± 2.85) was p = 0.81, suggesting no significance in correlation for the presence of respiratory symptoms. In addition, a Spearman’s test was used to examen each of the symptoms individually, those results indicated no significant correlation between number of years in service and the presence and frequency of respiratory symptoms (coughing r = 0.014, p = 0.93, phlegm production r = 0.030, p = 0.856, shortness of breath r = 0.007, p = 0.97, and wheezing r = 0.099, p = 0.549). Wheezing showed the most significant results but had a weak positive correlation (r = 0.099 p = 0.549) with the number of years in service. This could suggest an existing correlation between certain respiratory symptoms and the line of work involved in a full-time fireman; however, more research is needed to support this conclusion. Examining the correlation between the use of respirators and respiratory symptoms, a Mann-Whitney U test was used to determine the prevalence in respiratory symptoms in those that used a respirator and those that did not (“YES” N = 28, “NO” N = 11, and N/A N = 4). Results showed no significant relationship between those that use and do not use a respirator and developed respiratory symptoms. CONCLUSION: The study findings support the conclusion that developed respiratory symptoms are idiopathic in nature. More research is needed to further determine the source of respiratory symptoms, particularly in those involved with fumes, chemicals, and particulate matter

Safety in Industrial and Occupational Settings

Safety procedures and standards in the workplace have adapted to encompass a large variety of different hazards and threats in the workplace. Psychological and physical hazards are sometimes difficult to detect but are essential to understanding and researching different protective methods for limiting bodily harm to an individual. Federal and state agencies have been established for the purpose of creating, testing, and regulating the new safety standards as well as revising old measure as new technology and research arise that provide better results. The main categories that are at high risk for causing harm are chemical, biological, fire, air quality, confined space, and fall hazards. Agencies develop standards for practices and equipment that are to be utilized in certain situations. The standards created are for preventing, containing, and managing hazards before and after they cause an accident. Employers and personnel are to be trained in dealing with these potential threats so as to not endanger the public or increase the risk to themselves

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CC999999/Intramural CDC HHS/United States2015-12-29T00:00:00Z23507352PMC469359

Shifting Public Perception: Climate Change Means Living with Fire and Smoke

The urgency to prepare for the climate crisis has never been greater. We are currently living in the sixth mass extinction and the effects are only going to accelerate. We will inherit more wildfires, larger wildfires, and more frequent wildfires. This piece is not meant to stoke fear in its readers or be depressing, but to shift public perception on what our future holds by evaluating the laws and science presented to us. This piece will look at regional and federal regulations and assess the increased rate of forest fires and the grave public health concerns from stagnant smoke specifically in the Pacific Northwest. It will analyze how Washington State is still reactive instead of proactive to fires, which in turn creates unhealthier forests and longer-lasting fires over a larger area, creating more and more smoke. Additionally, it will address and propose solutions to problems created by the Fire Funding Fix section of the 2018 Omnibus Bill. The Fire Funding Fix section of the Bill passed in March of 2018 attempted to alleviate pressure on agency and forest management funds; however, it does not remedy the issues of unhealthy forests and actually creates loopholes for environmental regulations. Among other things, Washington State should shift its policy towards more regulations and funding of projects that educate and prepare the public for climate change and its increasing impact from fires. This requires changing the public’s perception and expectations through scientific studies and policies that promote prescribed fires and proper preparation for smoke-filled skies to deter health concerns. The Fire Funding Fix Bill ought to be modified to both require people to take preventative measures around their homes and provide people with proper masks before larger smoke clouds set in for longer periods. These issues are particularly timely in the Pacific Northwest, a region home to more expansive and frequent forest fires

Diesel exhaust particulate induces pulmonary and systemic inflammation in rats without impairing endothelial function ex vivo or in vivo

<p>Abstract</p> <p>Background</p> <p>Inhalation of diesel exhaust impairs vascular function in man, by a mechanism that has yet to be fully established. We hypothesised that pulmonary exposure to diesel exhaust particles (DEP) would cause endothelial dysfunction in rats as a consequence of pulmonary and systemic inflammation.</p> <p>Methods</p> <p>Wistar rats were exposed to DEP (0.5 mg) or saline vehicle by intratracheal instillation and hind-limb blood flow, blood pressure and heart rate were monitored <it>in situ </it>6 or 24 h after exposure. Vascular function was tested by administration of the endothelium-dependent vasodilator acetylcholine (ACh) and the endothelium-independent vasodilator sodium nitroprusside (SNP) <it>in vivo </it>and <it>ex vivo </it>in isolated rings of thoracic aorta, femoral and mesenteric artery from DEP exposed rats. Bronchoalveolar lavage fluid (BALF) and blood plasma were collected to assess pulmonary (cell differentials, protein levels & interleukin-6 (IL-6)) and systemic (IL-6), tumour necrosis factor alpha (TNFα) and C-reactive protein (CRP)) inflammation, respectively.</p> <p>Results</p> <p>DEP instillation increased cell counts, total protein and IL-6 in BALF 6 h after exposure, while levels of IL-6 and TNFα were only raised in blood 24 h after DEP exposure. DEP had no effect on the increased hind-limb blood flow induced by ACh <it>in vivo </it>at 6 or 24 h. However, responses to SNP were impaired at both time points. In contrast, <it>ex vivo </it>responses to ACh and SNP were unaltered in arteries isolated from rats exposed to DEP.</p> <p>Conclusions</p> <p>Exposure of rats to DEP induces both pulmonary and systemic inflammation, but does not modify endothelium-dependent vasodilatation. Other mechanisms <it>in vivo </it>limit dilator responses to SNP and these require further investigation.</p