Respiratory Diseases and the Fire Service - IAFF

2
Introduction
phase (fire is extinguished, clean-up begins and where respiratory protection
is not usually available) of structural fires indicates that short-term exposure
levels are exceeded for acrolein, benzene, carbon monoxide, formaldehyde,
glutaraldehyde, nitrogen dioxide and sulfur dioxide as well as soots and
particulates. They are often exposed in their fire stations to significant levels
of diesel particulate from the operation of the diesel fueled fire apparatus.
Fire fighters are routinely exposed to respirable particulate matter consisting
of liquids, hydrocarbons, soots, diesel fumes, dusts, acids from aerosols, and
smoke. Health effects are known to be produced not just by the particulates
themselves, but also by certain chemicals adsorbed onto the particulates.
Further, the mixture of hazardous chemicals is different at every fire and the
synergistic effects of these substances are largely unknown.
FIRE FIGHTER STUDIES
Although fire fighters have been shown in some studies to suffer chronic
respiratory morbidity from their occupational exposures, fire fighters are
probably at increased risk for dying from non-malignant respiratory diseases.
Such studies that address and link fire fighting with respiratory diseases fall
into three main groups—laboratory studies, field studies and epidemiological
studies. The first, involving animal laboratory experiments, have identified
exposure to certain chemicals, biological agents and particulate substances
and their contribution to the respiratory disease process. Such studies are
invaluable to the understanding of the effect such substances can have on
humans and they play a significant role in hazard identification for further
risk assessment.
The second group, field studies, documents the exposure of fire fighters
to these agents through industrial hygiene or biological and physiological
monitoring. Industrial hygiene data indicates that the fire environment contains
a number of potentially dangerous toxins. Due to the highly unpredictable
nature of the fire fighters’ environment, it is almost impossible to predict with
any certainty all of the exposures that could be encountered at any given fire.
However, these studies are important since they identify and characterize
fire fighter exposures during suppression and overhaul at fires as well as at
hazardous materials incidents or other special operations responses.
The third group, epidemiologic studies of fire fighters and other occupational
groups, is performed to determine if exposures actually result in elevated rates
of disease. For example, epidemiological studies have consistently shown
excesses of nonmalignant respiratory disease in fire fighters; acute and chronic
respiratory function impairment, acute increase in airway reactivity and
inflammatory changes in the lower airways of fire fighters. However, there
have also been a number of other epidemiologic studies that have not found
an increased morbidity or mortality or they provided conflicting information
on the health effects of fire fighting on the respiratory system. This is due to
a number of factors:
• Statistical constraints — the number of individuals studied may not be
sufficient to detect a difference.
• The studies rely on mortality, measuring only deaths from respiratory
disease. Differences in survivorship between an occupational group