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

Abstract

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.

COPD in Firefighters: A Specific Event-Related Condition Rather than a Common Occupational Respiratory Disorder

“…Respiratory protection may benefit from the use of particulate/organic vapor/formaldehyde filter masks. Respiratory symptoms were less common in this group compared to the ones of particulate only or particulate/organic vapor filter masks [48]. These observations were seen in a simulation lab, and it is of major concern how they may be extrapolated in real-life, with the firefighters' resistance to using these kinds of devices being well-known.…”

“…A constant preoccupation must be to establish occupational exposure limits specific to wildland fire smoke, as these circumstances tend to become more and more familiar. Mitigation strategies for such exposures were reviewed in a recent paper [48]. Respiratory protection may benefit from the use of particulate/organic vapor/formaldehyde filter masks.…”

Health research priorities for wildland firefighters: a modified Delphi study with stakeholder interviews

“…We identified two themes common to all research topics: (1) understanding the dynamic risk environment across wildland fire seasons and roles and (2) organisational fit of mitigation strategies. Despite a different risk environment, the health concerns identified by participants in the current study parallel those by structural firefighters,44 although there is considerably less knowledge specific to health outcomes associated with wildland fire exposure and substantial gaps in knowledge on the long-term health impacts 8…”

“…Despite a different risk environment, the health concerns identified by participants in the current study parallel those by structural firefighters, 44 although there is considerably less knowledge specific to health outcomes associated with wildland fire exposure and substantial gaps in knowledge on the longterm health impacts. 8 The most important research topic identified by participants was related to smoke exposure and respiratory health, with 89% of participants indicating it was extremely or very important. During interviews, participants focused on the need for a better understanding of the exposures and health risks associated with wildland fire smoke and the desire for feasible, effective personal protective equipment to protect against smoke inhalation.…”

“…Wildland firefighters are exposed to health hazards from inhalation of known air pollutants (eg, particular matter, carbon monoxide and polycyclic hydrocarbons) at levels near or above occupational exposure limits 4–6. Despite accelerating global wildland fire activity, knowledge on the health risks from occupational exposure to wildland fire is broad, inconsistent and insufficient to draw conclusions on health outcomes 7 8. To date, the majority of research on the health of wildland firefighters is focused on exploring acute effects of smoke exposure across a single shift or season, with most studies finding a reduction in lung function9–12 and increased systemic inflammation 13 14.…”