Respiratory Diseases and the Fire Service

where the offending agents can be determined, avoidance is recommended.
If this cannot be practically achieved other options are considered and can be
described as those that either decrease the body’s exposure to the irritants,
or those that attenuate the bodies response to the irritants. Practical ways of
decreasing the body’s exposure to airway irritants would include a mask or
respirator designed to filter out the offending particles, or a nasal and sinus
saline rinse applied immediately after a large exposure or on a regular basis
in situations where the exposures are more persistent. (Table 2-1.2)
Steps for Minimizing Symptoms of Chronic Rhinosinusitis
• Avoidance of airway irritants such as smoke, dust, and toxic fumessometimes
by use of a mask or respirator
• Use of a saline nasal rinse to cleanse the nasal passages
• Room humidification (with a humidifier that is cleaned regularly)
• Allergy testing to learn of other possible triggers to avoid
• Ensure you are drinking plenty of fluids
• Avoid upper respiratory infections by washing your hands regularly
and after any contact with people you suspect of being sick
• Consultation with a physician to discuss medications which may
decrease your body’s sensitivity to nasal irritants
Table 2-1.2 Self-Care Steps for Minimizing Symptoms of Chronic Rhinosinusitis
There are a number of ways to alleviate the nasal response to airway irritants
both allergic and non-allergic. This would include topical and systemic
(usually taken by mouth) medications designed to minimize the inflammatory
response. A good example would be the use of an antihistamine pill for seasonal
allergies. Some medications and nose sprays are intended for symptomatic
relief, and some are intended to minimize the development of symptoms. This
distinction is very important, and should be clarified with your physician in
order to ensure proper use.
In situations where symptoms persist even with carefully considered
medical therapy, one must be evaluated for other factors. Certain defects of the
immune system, either innate or acquired, may be considered. There are also
anatomic factors that may warrant evaluation and possible treatment such as
obstructing polyps, major deformities of the nasal septum, or narrowing or
obstruction of the natural sinus openings. Benign and malignant tumors of
the nasal cavities, though rare, have many of the same signs and symptoms as
chronic rhinosinusitis, so evaluation is important if symptoms persist despite
what would otherwise be considered adequate treatment. Sometimes a surgical
procedure is helpful in addressing nasal obstructions or clearing the sinuses
in order for them to clear more effectively. It should be noted that surgery is
rarely if ever to be considered a cure for chronic sinusitis. It is simply one more
tool that specialists have available in their armament in order to relieve most
symptoms, and improve the body’s ability to be more resilient when exposed
to environmental allergens or irritants.
In cases where people tend to be much more symptomatic on one side, or
if these symptoms persist despite aggressive treatment, the possibility of a
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Chapter 2-1 • Disorders of the Upper Aerodigestive Tract