Acute effects of smoke exposure on airway and systemic inflammation in forest firefighters

Gianniou, Niki; Giannakopoulou, Charoula-Eleni; Dima, Efrossini; Kardara, Matina; Κatsaounou, Paraskevi; Tsakatikas, Alexandros; Roussos, Charis; Koulouris, Nikolaos; Rovina, Nikoletta

doi:10.2147/jaa.s136417

Cited by 21 publications

(15 citation statements)

References 43 publications

(66 reference statements)

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“…Twelve academic articles reported on inflammation and oxidative stress related outcomes [ 5 , 20 , 92 , 93 , 95 – 102 ]. Studies reported an increase in airway and systemic inflammation after acute exposure to wildland fire [ 96 ]. This includes increases in IL-6 and IL-8 in field [ 96 , 97 ] and at prescribed burn shifts [ 92 ], and decreases in IL-10 after 12 h (post-shift) of fire suppression [ 97 ].…”

Section: Resultsmentioning

confidence: 99%

“…Studies reported an increase in airway and systemic inflammation after acute exposure to wildland fire [ 96 ]. This includes increases in IL-6 and IL-8 in field [ 96 , 97 ] and at prescribed burn shifts [ 92 ], and decreases in IL-10 after 12 h (post-shift) of fire suppression [ 97 ]. At prescribed burns, there was no association between dose of PM 2.5 (based on fireline task exposure) and inflammatory biomarkers [ 92 ], although an exposure-response relationship was observed between a black carbon measure and inflammation [ 92 ].…”

Section: Resultsmentioning

confidence: 99%

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Health risks and mitigation strategies from occupational exposure to wildland fire: a scoping review

Koopmans

Cornish

Fyfe

et al. 2022

J Occup Med Toxicol

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Objectives Due to accelerating wildland fire activity, there is mounting urgency to understand, prevent, and mitigate the occupational health impacts associated with wildland fire suppression. The objectives of this review of academic and grey literature were to: Identify the impact of occupational exposure to wildland fires on physical, mental, and emotional health; and Examine the characteristics and effectiveness of prevention, mitigation, or management strategies studied to reduce negative health outcomes associated with occupational exposure to wildland fire. Methods Following established scoping review methods, academic literature as well as government and industry reports were identified by searching seven academic databases and through a targeted grey literature search. 4679 articles were screened using pre-determined eligibility criteria. Data on study characteristics, health outcomes assessed, prevention or mitigation strategies studied, and main findings were extracted from each included document. The results of this scoping review are presented using descriptive tables and a narrative summary to organize key findings. Results The final sample was comprised of 100 articles: 76 research articles and 24 grey literature reports. Grey literature focused on acute injuries and fatalities. Health outcomes reported in academic studies focused on respiratory health (n = 14), mental health (n = 16), and inflammation and oxidative stress (n = 12). The identified studies evaluated short-term outcomes measuring changes across a single shift or wildland fire season. Most research was conducted with wildland firefighters and excluded personnel such as aviation crews, contract crews, and incident management teams. Five articles reported direct study of mitigation strategies, focusing on the potential usage of masks, advanced hygiene protocols to reduce exposure, fluid intake to manage hydration and core temperature, and glutamine supplementation to reduce fatigue. Conclusions While broad in scope, the evidence base linking wildland fire exposure to any one health outcome is limited. The lack of long-term evidence on changes in health status or morbidity is a clear evidence gap and there is a need to prioritize research on the mental and physical health impact of occupational exposure to wildland fire.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Health risks and mitigation strategies from occupational exposure to wildland fire: a scoping review

Koopmans

Cornish

Fyfe

et al. 2022

J Occup Med Toxicol

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“…This analysis indicated that the post-fire period had a detectable statistically significant deficit in delta_PF and that the post-fire period, which was one-year after the wildfire event, could be impacted. This is conceivable as there are a number of reports in the literature that demonstrated that it may be possible for ambient air pollution, and wildfire smoke specifically, to act as an adjuvant to a delayed allergic sensitization of the respiratory system [22][23][24][25][26][27][28][29][30][31]. Therefore, the allergy patients attending this clinic may have become more susceptible and experienced more significant changes in peak flow associated with their allergic rhinitis and asthma as a result of their wildfire smoke exposure, and this was detected one year after the wildfire event.…”

Section: Discussionmentioning

confidence: 99%

Observations of Delayed Changes in Respiratory Function among Allergy Clinic Patients Exposed to Wildfire Smoke

Blando

Allen

Galadima

et al. 2022

IJERPH

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Wildfires have increased in frequency and magnitude and pose a significant public health challenge. The principal objective of this study was to assess the impact of wildfire smoke on respiratory peak flow performance of patients exposed to two different wildfire events. This longitudinal study utilized an observational approach and a cohort study design with a patient-level clinical dataset from a local outpatient allergy clinic (n = 842). Meteorological data from a local weather station served as a proxy for smoke exposure because air quality measurements were not available. This study found that there were decreases in respiratory peak flow among allergy clinic patients one year after each wildfire event. For every one percent increase in wind blowing from the fire towards the community, there was, on average, a 2.21 L per minute decrease in respiratory peak flow. This study observed an effect on respiratory peak flow performance among patients at a local allergy clinic one year after suspected exposure to wildfire smoke. There are likely multiple reasons for the observation of this relationship, including the possibility that wildfire smoke may enhance allergic sensitization to other allergens or that wildfire smoke itself may elicit a delayed immune response.

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“…Disaster Medicine and Public Health Preparedness smoke, ash, disturbed soil, and other chemical emissions from burning or smoldering structures, vehicles, and brush may also have contributed to respiratory irritation among these first responders. [17][18][19][20][21][22][23][24] Given the high proportion of responders reporting acute and ongoing post-response health symptoms and the potential for toxic exposures, responders should be encouraged to seek post-response medical care or evaluation. Barriers to seeking care should be identified and addressed to promote post-response health care.…”

Section: Discussionmentioning

confidence: 99%

The Occupational Health Effects of Responding to a Natural Gas Pipeline Explosion Among Emergency First Responders – Lincoln County, Kentucky, 2019

Bui

Kukielka

Blau

et al. 2021

Disaster med. public health prep.

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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.

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Acute effects of smoke exposure on airway and systemic inflammation in forest firefighters

Cited by 21 publications

References 43 publications

Health risks and mitigation strategies from occupational exposure to wildland fire: a scoping review

Health risks and mitigation strategies from occupational exposure to wildland fire: a scoping review

Observations of Delayed Changes in Respiratory Function among Allergy Clinic Patients Exposed to Wildfire Smoke

The Occupational Health Effects of Responding to a Natural Gas Pipeline Explosion Among Emergency First Responders – Lincoln County, Kentucky, 2019

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