Short-term effects of air pollutant exposure on small airway dysfunction, spirometry, health-related quality of life, and inflammatory biomarkers in wildland firefighters: a pilot study

Niyatiwatchanchai, Nutchanok; Pothirat, Chaicharn; Chaiwong, Warawut; Liwsrisakun, Chalerm; Phetsuk, Nittaya; Duangjit, Pilaiporn; Choomuang, Woranoot

doi:10.1080/09603123.2022.2063263

Cited by 7 publications

(4 citation statements)

References 34 publications

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“…In a pilot prospective study, exposure to various air pollutants was associated with an increased risk of SAD. 31 However, given that the concentrations of various air pollutants changed annually, there have been uncertainties regarding the specific combined impacts of these changes on SAD. Our study provided evidence that the increased concentrations of multiple air pollutants may contribute to the pathogenesis of SAD.…”

Section: Discussionmentioning

confidence: 99%

“…Few studies have reported on the combined effects of different air pollutants on SAD. In a pilot prospective study, exposure to various air pollutants was associated with an increased risk of SAD 31 . However, given that the concentrations of various air pollutants changed annually, there have been uncertainties regarding the specific combined impacts of these changes on SAD.…”

Section: Discussionmentioning

confidence: 99%

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Combined effect of changes in NO₂, O₃, PM_2.5, SO₂ and CO concentrations on small airway dysfunction

Lee,

et al. 2024

Respirology

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Background and ObjectiveWhen multiple complex air pollutants are combined in real‐world settings, the reliability of estimating the effect of a single pollutant is questionable. This study aimed to investigate the combined effects of changes in air pollutants on small airway dysfunction (SAD).MethodsWe analysed Korea National Health and Nutrition Examination Survey (KNHANES) V–VIII database from 2010 to 2018 to elucidate the associations between annual changes in air pollutants over a previous 5‐year period and small airway function. We estimated the annual concentrations of five air pollutants: NO2, O3, PM2.5, SO2 and CO. Forced expiratory flow between 25% and 75% of vital capacity (FEF25%–75%) <65% was defined as SAD. Using the quantile generalized‐Computation (g‐Computation) model, the combined effect of the annual changes in different air pollutants was estimated.ResultsA total of 29,115 individuals were included. We found significant associations between SAD and the quartiles of annual changes in NO2 (OR = 1.10, 95% CI = 1.08–1.12), O3 (OR = 1.03, 95% CI = 1.00–1.05), PM2.5 (OR = 1.03, 95% CI = 1.00–1.05), SO2 (OR = 1.04, 95% CI = 1.02–1.08) and CO (OR = 1.16, 95% CI = 1.12–1.19). The combined effect of the air pollutant changes was significantly associated with SAD independent of smoking (OR = 1.31, 95% CI = 1.26–1.35, p‐value <0.001), and this trend was consistently observed across the entire study population and various subgroup populations. As the estimated risk of SAD, determined by individual‐specific combined effect models, increased and the log odds for SAD increased linearly.ConclusionThe combined effect of annual changes in multiple air pollutant concentrations were associated with an increased risk of SAD.image

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Combined effect of changes in NO₂, O₃, PM_2.5, SO₂ and CO concentrations on small airway dysfunction

Lee,

et al. 2024

Respirology

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“…FCV and FEV1 have been shown to decrease daily when compared to the prescribed burn period [ 17 ]. A previous study conducted in Chiang Mai reported that another group of firefighters had short-term effects on small airway dysfunction but no effect on spirometry [ 34 ]. This might differ from the participants in this study, as their average age was lower than that of the participants in this study.…”

Section: Discussionmentioning

confidence: 99%

The Urgent Need for Cardiopulmonary Fitness Evaluation among Wildland Firefighters in Thailand

Panumasvivat

Sirikul

Surawattanasakul

et al. 2023

IJERPH

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Wildland firefighting is a high-risk occupation. The level of cardiopulmonary fitness can indicate whether wildland firefighters are ready to perform their job duties. This study’s objective was to determine wildland firefighters’ cardiopulmonary fitness using practical methods. This cross-sectional descriptive study aimed to enroll all 610 active wildland firefighters in Chiang Mai. The participants’ cardiopulmonary fitness was assessed using an EKG, a chest X-ray, a spirometry test, a global physical activity questionnaire, and the Thai score-based cardiovascular risk assessment. The NFPA 1582 was used to determine “fitness” and “job restriction”. Fisher’s exact and Wilcoxon rank-sum tests were used to compare cardiopulmonary parameters. With a response rate of 10.16%, only eight wildland firefighters met the cardiopulmonary fitness requirements. Eighty-seven percent of participants were in the job-restriction group. An aerobic threshold of eight METs, an abnormal EKG, an intermediate CV risk, and an abnormal CXR were the causes of restriction. The job-restriction group had a higher 10-year CV risk and higher systolic blood pressure, although these differences were not statistically significant. The wildland firefighters were unfit for their task requirements and were more at risk of cardiovascular health compared to the estimated risk of the general Thai population. To improve the health and safety of wildland firefighters, pre-placement exams and health surveillance are urgently needed.

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“…The addition of oscillometry to spirometry increased the probability of detecting peripheral airway dysfunction from 0.12 to 0.19 [ 13 ]. Another study showed no short-term effects on small airway dysfunction in wildland firefighters from Thailand exposed to air pollution when using spirometry, whereas AX changes seen in IOS between non-pollution and pollution periods were significantly higher in firefighters than in controls [ 31 ]. As oscillometry cannot distinguish between obstructive and restrictive conditions and has limited ability to detect small airway dysfunction, these results suggest that the use of complementary methods with a focus on the small airways may aid detection of pulmonary pathology.…”

Section: Discussionmentioning

confidence: 99%

Airspace Dimension Assessment for early detection of lung function impairment in the peripheral airways of firefighters

et al. 2023

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IntroductionFirefighters have increased risk of chronic respiratory disease. Standard clinical techniques used in medical checkups may not detect the earliest microstructural changes in peripheral airways. A new technique called Airspace Dimension Assessment (AiDA) has been shown to enable early detection of emphysema in chronic obstructive pulmonary disease. This method may be useful in the occupational setting to detect early pulmonary changes and enable prevention.AimTo evaluate whether AiDA detects changes in the most peripheral airways of firefighters.MethodsAiDA, measuring the effective airspace radius (rAiDA) and zero-second recovery (R0), was used as a complement to other standardised lung function measures in 21 male firefighters and 16 age-matched male controls.ResultsThere were significant differences inrAiDAandR0between firefighters (meanrAiDA0.301 mm, standard deviation (sd) 0.024; meanR00.336 arbitrary units,sd0.116 and controls (meanrAiDA0.276 mm,sd0.044; meanR00.576 arbitrary units,sd0.168), p=0.03 and p<0.001, respectively. Higher forced vital capacity was found in firefighters (mean 101% of predicted) than in controls (mean 93% of predicted; p=0.03). No significant differences were found with regard to either the ratio between forced expiratory volume in 1 s and forced vital capacity or forced expiratory volume in 1 s. The majority of firefighters had diffusing capacity for carbon monoxide, oscillometry and single-breath nitrogen washout values within the normal ranges.ConclusionAiDA parameters can provide information on early pulmonary peripheral changes that may not be seen with standard techniques used in screening of pulmonary function.

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Short-term effects of air pollutant exposure on small airway dysfunction, spirometry, health-related quality of life, and inflammatory biomarkers in wildland firefighters: a pilot study

Cited by 7 publications

References 34 publications

Combined effect of changes in NO₂, O₃, PM_2.5, SO₂ and CO concentrations on small airway dysfunction

Combined effect of changes in NO₂, O₃, PM_2.5, SO₂ and CO concentrations on small airway dysfunction

The Urgent Need for Cardiopulmonary Fitness Evaluation among Wildland Firefighters in Thailand

Airspace Dimension Assessment for early detection of lung function impairment in the peripheral airways of firefighters

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Short-term effects of air pollutant exposure on small airway dysfunction, spirometry, health-related quality of life, and inflammatory biomarkers in wildland firefighters: a pilot study

Cited by 7 publications

References 34 publications

Combined effect of changes in NO2, O3, PM2.5, SO2 and CO concentrations on small airway dysfunction

Combined effect of changes in NO2, O3, PM2.5, SO2 and CO concentrations on small airway dysfunction

The Urgent Need for Cardiopulmonary Fitness Evaluation among Wildland Firefighters in Thailand

Airspace Dimension Assessment for early detection of lung function impairment in the peripheral airways of firefighters

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Product

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Combined effect of changes in NO₂, O₃, PM_2.5, SO₂ and CO concentrations on small airway dysfunction

Combined effect of changes in NO₂, O₃, PM_2.5, SO₂ and CO concentrations on small airway dysfunction