Lung function and health status in metropolitan fire-fighters compared to general population controls
- 238 Downloads
To assess health status of South Australian (SA) metropolitan fire-fighters in terms of lung function and health-related quality of life, compare these with general population controls, and explore associations between fire-fighters’ self-reported occupational exposure and health status.
The study was a cross-sectional comparison of (respiratory) health indices between 501 fire-fighters and 1,324 general population controls taken from the North West Adelaide Health Study (NWAHS). All were men aged 21 to 61. Measurements included spirometry (i.e., forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), mid-expiratory flow (FEF25–75) and the Short Form 36 (SF-36) health-related quality of life questionnaire.
Health status in the fire-fighters was generally better than in NWAHS controls. Mean % predicted FEV1 and FVC were 103.4% [SD 12.1] versus 89.5% [13.7] and 110.0% [11.6] versus 88.5% [12.5] (both p < 0.001 in linear regression analysis, adjusted for age, smoking, BMI, and FEV1 % predicted). FEV1/FVC and FEF25–75 were significantly lower in the fire-fighters (p < 0.003). A total of 93 (18.6%) fire-fighters and 82 (6.2%) controls had an FEV1/FVC < 70% (p < 0.001). The SF-36 Mental Health scale was the only scale on which fire-fighters had a lower mean score (p = 0.009), but none of the SF-36 scales showed clinically meaningful differences between the cohorts. Fire-fighters exposed > 6 h/week to dust, smoke, and fire showed lower FEV1, FEV1 % predicted, and FVC values compared to those who were less exposed (p < 0.05).
Male metropolitan fire-fighters showed better general health, better lung health, and similar mental health compared to general population controls. The high rate of fire-fighters with FEV1/FVC values below the recommended cut-point for airflow obstruction illustrates the inappropriateness of this clinical cut-point for use in populations preselected on their physical fitness. The observed dose–effect relationship between self-reported occupational exposure and fire-fighters’ lung function warrants further investigation.
KeywordsFire-fighters Occupational health Population health Respiratory system Lung function Exposure Tobacco smoking
Acknowledgement is made of the generosity of the South Australian Metropolitan Fire Service (SAMFS) fire-fighters and North West Adelaide Health Study (NWAHS) participants in the giving of their time and effort, and of the contribution to the study by the SAMFS staff and the NWAHS research clinic and recruiting staff. The authors very much appreciate the preparatory work for the study performed by Guillaume Dujardin, and the support in the data collection, entry and processing by Daniel Blakeley.
Conflict of interest statement
The authors declare that they have no conflict of interest.
- American Thoracic Society. Standardization of spirometry—1987 update. Statement of the American Thoracic Society. Am Rev Respir Dis 136: 1285–1298Google Scholar
- Boxer PA, Wild D (1993) Psychological distress and alcohol use among fire fighters. Scand J Work Environ Health 19(2):121–125Google Scholar
- Global Initiative for Obstructive Lung Disease (GOLD) (2008) Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. Retrieved 22 May 2009. www.goldcopd.com
- Gore CJ, Crockett AJ, Pederson DG, Booth ML, Bauman A, Owen N (1995) Spirometric standards for healthy adult lifetime nonsmokers in Australia. Eur Respir J 8(5):773–782Google Scholar
- Grant JF, Chittleborough CR, Taylor AW, Del Grande E, Wilson DH, Phillips PJ, Adams RJ, Cheek J, Price K, Gill T, Ruffin RE (2006) The North West Adelaide Health Study: detailed methods and baseline segmentation of a cohort for selected chronic diseases. Epidemiol Perspect Innov 3:4CrossRefGoogle Scholar
- Liu D, Tager IB, Balmes JR, Harrison RJ (1992) The effect of smoke inhalation on lung function and airway responsiveness in wildland fire fighters. Am Rev Respir Dis 146(6):1469–1473Google Scholar
- Loke J, Abrams C, Virgulto J (1992) Lung function in fire fighters. Conn Med 56(4):179–183Google Scholar
- McFarlane AC (1986) Long-term psychiatric morbidity after a natural disaster. Implications for disaster planners and emergency services. Med J Aust 145(11–12):561–563Google Scholar
- Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CP, Gustafsson P, Jensen R, Johnson DC, MacIntyre N, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J (2005) Standardisation of spirometry. Eur Respir J 26(2):319–338CrossRefGoogle Scholar
- Sparrow D, Bosse R, Rosner B, Weiss ST (1982) The effect of occupational exposure on pulmonary function: a longitudinal evaluation of fire fighters and nonfire fighters. Am Rev Respir Dis 125(3):319–322Google Scholar
- Stellman JM, Smith RP, Katz CL, Sharma V, Charney DS, Herbert R, Moline J, Luft BJ, Markowitz S, Udasin I, Harrison D, Baron S, Landrigan PJ, Levin SM, Southwick S (2008) Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster. Environ Health Perspect 116(9):1248–1253CrossRefGoogle Scholar
- Witt M (2005) Fire fighters as a high-risk group of pathological changes in the respiratory tract. Przegl Lek 62(10):986–988Google Scholar