Changes in ventilation parameters in firefighters during a simulated intervention
Authors:
P. Klusáčková 1; L. Lischková 1; P. Kožený 2; T. Navrátil 1,3; B. Sedláčková 1; M. Nováková 4; J. Woronyczova 4; Z. Hon 2; D. Pelclová 1
Authors place of work:
Klinika pracovního lékařství, Všeobecná fakultní nemocnice v Praze, 1. lékařská fakulta Univerzity Karlovy, Praha, přednosta prof. MUDr. Sergej Zacharov, Ph. D.
1; Fakulta biomedicínského inženýrství, ČVUT v Praze, vedoucí prof. MUDr. Jozef Rosina, Ph. D., MBA
2; Ústav lékařské biochemie a laboratorní diagnostiky, 1. lékařská fakulta Univerzity Karlovy, Praha, vedoucí prof. MUDr. Tomáš Zima, DrSc., MBA
3; CASRI – Vědecké a servisní pracoviště tělesné výchovy a sportu, p. o., Praha, vedoucí Mgr. Libor Soumar, Ph. D.
4
Published in the journal:
Pracov. Lék., 75, 2023, No. 1-2, s. 13-18.
Category:
Original Papers
Summary
Introduction: The work of firefighters is one of the most risk in terms of potential health hazards. Firefighters are exposed to hazardous combustion products, which can have both acute and chronic effects. The aim of this project was to investigate what changes in ventilation parameters occur in firefighters early after a fire exposure.
Methodology: Twenty-four firefighters (mean age 37.1 years) participated in the project and were exposed to combustion products during training in a device simulating a real fire exposure (flashover container). Spirometry was performed before, immediately after and the next day. Before exposure, exhaled nitric oxide (FeNO) measurement was taken to assess possible allergic inflammation in the airways.
Results: The mean FeNO value in the subjects was 18.8 ppb (range 5–59). When measuring resting spirometry before the intervention, one person had a reduced FEV1 value (forced expiratory volume in 1 second), reduced values of peripheral airway obstruction (MEF-maximal expiratory flow rates at different levels of forced vital capacity) were found in 18 persons, increased values of airway resistance (Rocc) in 12 persons. The vital capacity (VC) of the lungs was normal in all persons. Immediately after the training intervention, the mean value of all the monitored ventilatory parameters improved in the group of subjects. The changes were significant in the parameters FEV1, MEF25 (maximum expiratory flow rate at 25 % of the forced vital capacity), AEX (area under the expiratory part of the curve) (p ≤ 0.001), FVC (forced vital capacity) and Rocc (p < 0.01). On the second day, there was a deterioration of the monitored ventilatory parameters, both with respect to the values immediately after the exposure and to the initial values. Changes on the second day after the exposure compared to pre-exposure values were significant for the VC parameter, Rocc (p < 0.001), FEV1 (p < 0.01).
Conclusion: The monitoring of ventilation parameters during the simulated fire incident showed that the deterioration occurred only after the second day, both in dynamic and static parameters. Thus, from the point of view of the recovery of the firefighters’ organism, recovery in the days following the intervention is very important.
Keywords:
Spirometry – exhaled nitric oxide – firefighters – combustion products
Zdroje
1. ATS/ERS ATS/ERS recommendations for standardized procedures for the online and offline measurement of exhaled lower respiratory nitric oxide and nasal nitric oxide 2005. Am J Respir Crit Care Med, 2005,171, P. 912–930.
2. Barbosa, J. V., Farraia, M., Branco, P. T. B. S., Alvim-Ferraz, M. C. M., Martins, F. G., Annesi-Maesano, I., Sousa, S. I. V. The Effect of Fire Smoke Exposure on Firefighters‘ Lung Function: A Meta-Analysis. Int J Environ Res Public Health, 2022, 19(24), p. 16799. doi: 10.3390/ijerph192416799. PMID: 36554677; PMCID: PMC9779288.
3. Barros, B., Oliveira, M., Morais, S. Firefighters‘ occupational exposure: Contribution from biomarkers of effect to assess health risks. Environ Int, 2021,156, p. 106704. doi: 10.1016/j.envint. 2021.106704. Epub 2021 Jun 20. PMID: 34161906.
4. Demers, P., DeMarini, D., Fent, K., Glass, D., Hansen, J., Adetona, O., et al. Carcinogenicity of occupational exposure as a firefighter. Lancet Oncol, 2022, 23(8), p. 985–986.
5. Dweik, R. A., Boggs, P. B., Erzurum, S. C., Irvin, C. G., Leigh, M. W., Lundberg J. O., Olin, A. C., Plummer, A. L., Taylor, D. R.; American Thoracic Society Committee on Interpretation of Exhaled Nitric Oxide Levels (FENO) for Clinical Applications. An official ATS clinical practice guideline: interpretation of exhaled nitric oxide levels (FENO) for clinical applications. Am J Respir Crit Care Med, 2011,184(5), p. 602–615.
6. Ferguson, M. D., Semmens, E. O., Weiler, E., Domitrovich, J., French, M., Migliaccio, C., Palmer, C., Dumke, C., Ward, T. Lung function measures following simulated wildland firefighter exposures. J Occup Environ Hyg, 2017,14(9), p. 739–748.
7. Gaughan, D. M., Piacitelli, C. A., Chen, B. T., Law, B. F., Virji, M. A., Edwards, N. T., Enright, P. L., Schwegler-Berry, D. E., Leonard, S. S., Wagner, G. R., Kobzik, L., Kales, S. N., Hughes, M. D., Christiani, D. C., Siegel, P. D., Cox-Ganser, J. M., Hoover, M. D. Exposures and cross-shift lung function declines in wildland firefighters. J Occup Environ Hyg, 2014, 11(9), p. 591–603.
8. Gianniou, N., Katsaounou, P., Dima, E., Giannakopoulou, C. E., Kardara, M., Saltagianni, V., Trigidou, R., Kokkini, A., Bakakos, P., Markozannes, E., Litsiou, E., Tsakatikas, A., Papadopoulos, C., Roussos, C., Koulouris, N., Rovina, N. Prolonged occupational exposure leads to allergic airway sensitization and chronic airway and systemic inflammation in professional firefighters. Respir Med, 2016,118, p. 7–14.
9. Greven, F., Krop, E., Spithoven, J., Rooyackers, J., Kerstjens, H., Heederik, D. Lung function, bronchial hyperresponsiveness, and atopy among firefighters. Scand J Work Environ Health, 2011, 37(4), p. 325–331.
10. Greven, F. E., Krop, E. J., Spithoven, J. J., Burger, N., Rooyackers, J. M., Kerstjens, H.A, van der Heide, S., Heederik, D. J. Acute respiratory effects in firefighters. Am J Ind Me, 2012, 55(1), p. 54–62.
11. Cherry, N., Barrie, J. R., Beach, J., Galarneau, J. M., Mhonde, T., Wong, E. Respiratory Outcomes of Firefighter Exposures in the Fort McMurray Fire: A Cohort Study From Alberta Canada. J Occup Environ Med, 2021, 63(9), p. 779–786.
12. Jacquin, L., Michelet, P., Brocq, F. X., Houel, J. G., Truchet, X., Auffray, J. P., Carpentier, J. P., Jammes, Y. Short-term spirometric changes in wildland firefighters. Am J Ind Med, 2011, 54(11), p. 819–825.
13. Kožený, P., Hon, Z. Vybraná zdravotní rizika v práci hasičů. The Science for Population protection, 2019, 2, p. 97–108.
14. Miller, M. R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., et al. Standardisation of spirometry. Eur Resp J, 2005, 26, p. 319–338. doi.org/10.1183/09031936.05.00034805.
15. Pedersen, J. E., Ugelvig Petersen, K., Ebbehøj, N. E., Bonde, J. P., Hansen, J. Risk of asthma and chronic obstructive pulmonary disease in a large historical cohort of Danish firefighters. Occup Environ Med, 2018, 75(12), p. 871–876.
16. Schermer, T., Malbon, W., Newbury, W., Holton, C., Smith, M., Morgan, M., Crockett, A. Spirometry and impulse oscillometry (IOS) for detection of respiratory abnormalities in metropolitan firefighters. Respirology, 2010, 15(6), p. 975–985.
17. Schermer, T., Malbon, T., Morgan, M., Briggs, N., Holton, C., Appleton, S., Adams, R., Smith, M., Crockett, A. Lung function and health status in metropolitan fire-fighters compared to general population controls. Int Arch Occup Environ Health, 2010, 83(7), p. 715–723.
18. Ramos, C., Minghelli, B. Prevalence and Factors Associated with Poor Respiratory Function among Firefighters Exposed to Wildfire Smoke. Int J Environ Res Public Health, 2022, 19(14), p. 8492. doi: 10.3390/ijerph19148492. PMID: 35886345; PMCID: PMC9323896..
Štítky
Hygiene and epidemiology Hyperbaric medicine Occupational medicineČlánok vyšiel v časopise
Occupational Medicine
2023 Číslo 1-2
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