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Lung function and health status in metropolitan fire-fighters compared to general population controls

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Abstract

Purpose

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.

Methods

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.

Results

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).

Conclusions

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.

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Acknowledgements

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.

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Correspondence to Tjard Schermer.

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Ethical standards The studies reported in this paper have been approved by the appropriate ethics committees and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. All persons gave their informed consent prior to their inclusion in the studies.

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Schermer, T., Malbon, T., Morgan, M. et al. Lung function and health status in metropolitan fire-fighters compared to general population controls. Int Arch Occup Environ Health 83, 715–723 (2010). https://doi.org/10.1007/s00420-010-0528-0

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  • DOI: https://doi.org/10.1007/s00420-010-0528-0

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