Change in Lung Function over Time in Male Metropolitan Firefighters and General Population Controls: A 3‐year Follow‐up Study

Abstract

Change in Lung Function over Time in Male Metropolitan Firefighters and General Population Controls: A 3‐year Follow‐up Study: Tjard R. SCHERMER, et al. Discipline of General Practice, School of Population Health, The University of Adelaide, Australia Objective Previous studies in firefighters have been contradictory regarding their course of lung function over time. The aim of this ongoing study is to investigate how changes in lung function over time in male metropolitan firefighters compare with those in population controls, and to explore associations between firefighters� use of personal respiratory protection devices during occupational exposures and their risk of accelerated lung function decline. Methods A prospective comparison of FEV1 (forced expiratory volume in 1 second) and FVC (forced vital capacity) was performed between 281 firefighters and 933 population controls. Logistic regression models were used to compare changes from baseline of FEV1 and FVC after 3 years and risk of accelerated decline between the cohorts. Within the firefighter cohort, risk of accelerated decline was compared between subgroups based on use of respiratory protection devices. Results Controls showed similar mean annual declines for FEV1 and FVC across age categories, whereas firefighters aged <45 years showed increasing values over time (p=0.040). Firefighters had a lower odds of accelerated FEV1 decline compared with controls (OR=0.60, 95%CI 0.44; 0.83), but firefighters who never or rarely used respiratory protection during fire knockdown had a higher odds of accelerated FEV1 decline compared with those who used it often or frequently (OR=2.20, 95%CI 1.02; 4.74). Conclusions: Younger generations of firefighters showed an increase in lung function relative to older colleagues, while population controls consistently showed decline of lung function across all ages. Firefighters who reported to be incompliant in using respiratory protection showed an increased risk of accelerated FEV1 decline.

Predictors of pulmonary function in fire-fighters

“…It implies that as the years of service increases, the lung function parameters decreases proportionately. Our finding is similar to other previously published studies which have also shown a decline in lung function as duration of service increases [4,5,9,10] . Unger et al, demonstrated a trend towards an increased rate of volume loss in the FVC and FEV1 as years progressed, among the fire fighters [11].…”

“…The pioneering studies on lung function among firefighters were conducted in Boston in the 1970s [3]. Since then many studies have been conducted to assess the acute and chronic effects of smoke on lung function [4][5][6][7][8][9][10]. Acute effects on the lungs have well been documented in these studies.…”

The Global Lung Function Initiative 2012 Equations Are as Well-Suited as Local Population Derived Equations to a Sample of Healthy Professional Firefighters

“…A more valid means of examining lung function in a population like this is to examine the annual rate of change for each individual and compare this to an established limit of normal longitudinal decline [24]. This is the intention of our surveillance program, and preliminary results have previously been reported [15]. Longitudinal surveillance may also reduce the misclassification of those whose lung function lies close to the LLN or upper limit of normal, given that such classifications can change over follow-up [25].…”

“…Only never-smokers and firefighters with no history of doctor-diagnosed asthma or lung disease, based on questionnaire responses, were included in this analysis. Further details of procedures and equipment used in data collection have been previously described [11, 15, 16]. Calibration was performed on a daily basis using a three-litre syringe while zero flow was set immediately before each measurement.…”

The economics of firefighter injuries in the United States

“…15 Schermer et al (2010) compared the lung function and health of (501) firefighters of a South Australian metropolitan department to the (1324) general population and found better overall general health, lung health, and mental health in the firefighter sample. Schermer et al (2013) extended this work with a three-year follow-up and showed a decline in lung function in firefighters for those who reported incompliance of their respiratory protection. Baris et al (2001) evaluated the mortality of a cohort of 7789 Philadelphia firefighters, employed over 1925 to 1986.…”