The Effect of Fire Smoke Exposure on Firefighters’ Lung Function: A Meta-Analysis

Abstract

Firefighters are exposed to a range of harmful substances during firefighting. Exposure to fire smoke has been associated with a decrease in their lung function. However, the cause–effect relationship between those two factors is not yet demonstrated. This meta-analysis aimed to evaluate the potential associations between firefighters’ occupational exposure and their lung function deterioration. Studies were identified from PubMed, Web of Science, Scopus and Science Direct databases (August 1990–March 2021). The studies were included when reporting the lung function values of Forced Expiratory Volume in 1 s (FEV1) or Forced Vital Capacity (FVC). The meta-analyses were performed using the generic inverse variance in R software with a random-effects model. Subgroup analysis was used to determine if the lung function was influenced by a potential study effect or by the participants’ characteristics. A total of 5562 participants from 24 studies were included. No significant difference was found between firefighters’ predicted FEV1 from wildland, 97.64% (95% CI: 91.45–103.82%; I2 = 99%), and urban fires, 99.71% (95% CI: 96.75–102.67%; I2 = 98%). Similar results were found for the predicted FVC. Nevertheless, the mean values of firefighters’ predicted lung function varied significantly among studies, suggesting many confounders, such as trials’ design, statistical methods, methodologies applied, firefighters’ daily exposure and career length, hindering an appropriate comparison between the studies.

Knowledge of Infection Prevention and Control and Practice Behaviors among Career and Volunteer Firefighters in Rural Communities

“…The indicators used to assess COVID-19 KP were based on lessons learned from similar studies in the context of infectious diseases (Table 1). 19. All these variables were factored in to determine the knowledge and practice behaviors of firefighters surveyed.…”

“…Career firefighters are expected to have received comprehensive training in emergency response including infection control and best practices. Previous studies have found that first responders are often faced with various challenges including working under an emerging threat environment, keeping up to date with growing information, the lack of available training and education, and changes in their daily work responsibilities [4,19,20]. Professional groups like firefighters need to have sustainable strategies to improve knowledge through continuing education that focuses on targeting emerging and reemerging infectious agents, while also including technologies with proven efficiency to protect patient and worker health.…”

“…Western Kentucky University (WKU) Center for Environmental and Workplace Health (CEWH) research team previously identified a concern for negative health outcomes with firefighter exposures to work-related toxic substances and behaviors on management of turnout gears (coats and pants) [13][14][15]. Overall, there is limited literature on firefighters' exposure to biological contaminants; most of the previous studies are limited to chemical exposures [14][15][16] and were conducted in urban areas [17][18][19]. Therefore, the purpose of this study was to compare career and volunteer firefighters' knowledge and practice behaviors on infection transmission in the dayroom and during emergency runs.…”

Occupational exposure and health of wildland firefighters: protocol for a systematic review

“…The health impacts closely related to forest fire emissions are mortality and morbidity from cardiorespiratory causes. Note that the emissions released increase influence the onset of asthma and chronic obstructive pulmonary disease (COPD) (Barbosa et al, 2022;Youssouf et al, 2014).…”