Association between lung function and exposure to smoke among firefighters at prescribed burns

Cross-shift changes in pulmonary function and occupational exposure to particulate matter among e-waste workers in Ghana

Introduction

Little is known on the association between cross-shift changes in pulmonary function and personal inhalation exposure to particulate matter (PM) among informal electronic-waste (e-waste) recovery workers who have substantial occupational exposure to airborne pollutants from burning e-waste.

Methods

Using a cross-shift design, pre- and post-shift pulmonary function assessments and accompanying personal inhalation exposure to PM (sizes <1, <2.5 μm, and the coarse fraction, 2.5-10 μm in aerodynamic diameter) were measured among e-waste workers (n = 142) at the Agbogbloshie e-waste site and a comparison population (n = 65) in Accra, Ghana during 2017 and 2018. Linear mixed models estimated associations between percent changes in pulmonary function and personal PM.

Results

Declines in forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) per hour were not significantly associated with increases in PM (all sizes) among either study population, despite breathing zone concentrations of PM (all sizes) that exceeded health-based guidelines in both populations. E-waste workers who worked "yesterday" did, however, have larger cross-shift declines in FVC [-2.4% (95%CI: -4.04%, -0.81%)] in comparison to those who did not work "yesterday," suggesting a possible role of cumulative exposure.

Discussion

Overall, short-term respiratory-related health effects related to PM exposure among e-waste workers were not seen in this sample. Selection bias due to the "healthy worker" effect, short shift duration, and inability to capture a true "pre-shift" pulmonary function test among workers who live at the worksite may explain results and suggest the need to adapt cross-shift studies for informal settings.

Assessment of phthalate exposure at a fire site in Korean firefighters

To determine phthalate exposure in 32 firefighters, the concentrations of urinary phthalate metabolites, immediately (exposure day) and three weeks (control day) after fire suppression, were compared. Mono-(2-ethyl-5-carboxypentyl) phthalate, mono-(2-ethyl-5-hydroxyhexyl) phthalate, mono-(2-ethyl-5-oxohexyl) phthalate, mono-n-butyl phthalate (MBP), mono-n-benzyl phthalate (MBzP), and total phthalates (∑phthalates) levels, and creatinine-adjusted levels of MBP, MBzP, and ∑phthalates were significantly higher on exposure day than on control day. Phthalate concentration was significantly higher in firefighters who performed the fire extinguishing tasks (geometric mean [GM], 149.9 μg/L) than in those who performed other tasks (GM 70.8 μg/L) (p = .012). The GM concentration of firefighters who were active ≤ 50 m from the fire was 119.0 μg/L, and 37.6 μg/L for those who were > 50 m away (p = .012). The GM concentration was significantly different (p = .039) in firefighters with subjective symptoms after fire suppression (151.9 μg/L) compared to those without symptoms (81.6 μg/L). This study showed that firefighters were exposed to phthalate.

Occupational exposure of firefighters to hazardous pollutants during prescribed fires in Portugal

Firefighters perform high-risk activities and during the course of their functions are highly exposed to a wide range of occupational hazards, including air pollution. Thus, this study aimed to assess the exposure of firefighters in prescribed wildland fires and their occupational exposure, as well as to identify and chemically characterise the particles collected during wildland firefighting and inside fire stations. Exposure to wildfire smoke was evaluated in 7 prescribed fires in Portugal, 2 in the north and 5 in the south of Viseu district. The concentrations of PM2.5, NO2, SO2, CO and VOCs were monitored and exceedances to occupational exposure limit values were identified. Moreover, the chemical composition of PM2.5 was analysed. The results showed that firefighters were exposed to high concentrations of these pollutants during prescribed fires and that, in some cases, exceeded occupational exposure limits, both for time-weighted average concentrations for an 8-h working day (a time-weighted average, TWA) of PM2.5, and for short-term exposure values (STEL) of NO2 and SO2. Despite being exposed to very high concentrations of CO, no exceedances to the occupational exposure values were observed. FT-IR and SEM-EDS allowed to chemically characterise the composition of the particles collected inside the fire stations and also during wildland fires, identifying mainly quartz, aluminium and magnesium silicates, characteristic of earth's crust constituents. and also, fibres that have undergone combustion. Concluding, firefighters' exposure to high concentrations of harmful pollutants, can lead to the degradation of their respiratory health. It is therefore extremely important to increase existing knowledge and conduct further studies, especially longitudinal ones, that can assess their lung function. This will allow an understanding of the impacts of smoke on firefighters' health and develop effective strategies to protect them during wildland firefighting operations.

Prescribed fires, smoke exposure, and hospital utilization among heart failure patients

BACKGROUND

Prescribed fires often have ecological benefits, but their environmental health risks have been infrequently studied. We investigated associations between residing near a prescribed fire, wildfire smoke exposure, and heart failure (HF) patients' hospital utilization.

METHODS

We used electronic health records from January 2014 to December 2016 in a North Carolina hospital-based cohort to determine HF diagnoses, primary residence, and hospital utilization. Using a cross-sectional study design, we associated the prescribed fire occurrences within 1, 2, and 5 km of the patients' primary residence with the number of hospital visits and 7- and 30-day readmissions. To compare prescribed fire associations with those observed for wildfire smoke, we also associated zip code-level smoke density data designed to capture wildfire smoke emissions with hospital utilization amongst HF patients. Quasi-Poisson regression models were used for the number of hospital visits, while zero-inflated Poisson regression models were used for readmissions. All models were adjusted for age, sex, race, and neighborhood socioeconomic status and included an offset for follow-up time. The results are the percent change and the 95% confidence interval (CI).

RESULTS

Associations between prescribed fire occurrences and hospital visits were generally null, with the few associations observed being with prescribed fires within 5 and 2 km of the primary residence in the negative direction but not the more restrictive 1 km radius. However, exposure to medium or heavy smoke (primarily from wildfires) at the zip code level was associated with both 7-day (8.5% increase; 95% CI = 1.5%, 16.0%) and 30-day readmissions (5.4%; 95% CI = 2.3%, 8.5%), and to a lesser degree, hospital visits (1.5%; 95% CI: 0.0%, 3.0%) matching previous studies.

CONCLUSIONS

Area-level smoke exposure driven by wildfires is positively associated with hospital utilization but not proximity to prescribed fires.

Development of a job-exposure matrix (JEM) for exposure to smoke particle mass among firefighters of the Fire Department of the City of New York (FDNY)

OBJECTIVES

A refined job exposure matrix (JEM) based on incident types and severities and response characteristics was developed for firefighters to estimate quantities of smoke particles emitted during structural and non-structural fire incidents from 2010 to 2021.

METHODS

The cohort included a subset of 3237 Fire Department of the City of New York firefighters who responded to at least one incident between 2010 and 2021, prior to retirement. Fire incident data included dates, type, severity (alarm level) and location. Response data included dates worked, firehouse, position titles and shift lengths for each firefighter. The quantity of smoke particle mass generated during structural and non-structural fires adjusted by individual firefighter engagement was computed using the United States Environmental Protection Agency AP-42 emissions framework. Correlations between years of employment, fire responses and career total particle mass concentration by firefighter were examined. Linear regression models were fit and corresponding R² values were calculated.

RESULTS

Firefighters responded to a median of 424.7 (IQR=202.3-620.0) annual incidents/person; 17.6% were fire incidents (median=77.1; IQR=40.4-114.0). Structural fires were the most common type of fire incident (72.5% of annual incidents/person; median=55.9; IQR=29.6-85.5). Incident severity (alarm level) and firefighter engagement (position title) appeared to differentiate between high and low exposure regimes (R²=0.43). Incident severity explained most of the variability of particle exposures (R²=0.90).

CONCLUSIONS

Using the JEM, job-related smoke particle concentrations were estimated to vary by incident type, incident severity and firefighter engagement, highlighting the importance of using refined measures, so that future studies can more accurately evaluate associations between firefighting and health outcomes.

The Effect of Fire Smoke Exposure on Firefighters' Lung Function: A Meta-Analysis

Firefighters are exposed to a range of harmful substances during firefighting. Exposure to fire smoke has been associated with a decrease in their lung function. However, the cause-effect relationship between those two factors is not yet demonstrated. This meta-analysis aimed to evaluate the potential associations between firefighters' occupational exposure and their lung function deterioration. Studies were identified from PubMed, Web of Science, Scopus and Science Direct databases (August 1990-March 2021). The studies were included when reporting the lung function values of Forced Expiratory Volume in 1 s (FEV₁) or Forced Vital Capacity (FVC). The meta-analyses were performed using the generic inverse variance in R software with a random-effects model. Subgroup analysis was used to determine if the lung function was influenced by a potential study effect or by the participants' characteristics. A total of 5562 participants from 24 studies were included. No significant difference was found between firefighters' predicted FEV₁ from wildland, 97.64% (95% CI: 91.45-103.82%; I² = 99%), and urban fires, 99.71% (95% CI: 96.75-102.67%; I² = 98%). Similar results were found for the predicted FVC. Nevertheless, the mean values of firefighters' predicted lung function varied significantly among studies, suggesting many confounders, such as trials' design, statistical methods, methodologies applied, firefighters' daily exposure and career length, hindering an appropriate comparison between the studies.

Cross-sectional and longitudinal associations of acrolein exposure with pulmonary function alteration: Assessing the potential roles of oxidative DNA damage, inflammation, and pulmonary epithelium injury in a general adult population

BACKGROUND

Acrolein is a significant high priority hazardous air pollutant with pulmonary toxicity and the leading cause of most noncancer adverse respiratory effects among air toxics that draws great attention. Whether and how acrolein exposure impacts pulmonary function remain inconclusive.

OBJECTIVES

To assess the association of acrolein exposure with pulmonary function and the underlying roles of oxidative DNA damage, inflammation, and pulmonary epithelium integrity.

METHODS

Among 3,279 Chinese adults from the Wuhan-Zhuhai cohort, associations of urinary acrolein metabolites (N-Acetyl-S-(2-carboxyethyl)-L-cysteine, CEMA; N-Acetyl-S-(3-hydroxypropyl)-L-cysteine, 3HPMA) as credible biomarkers of acrolein exposure with pulmonary function were analyzed by linear mixed models. Joint effects of biomarkers of oxidative DNA damage (8-hydroxy-deoxyguanosine), inflammation (C-reactive protein, CRP), and pulmonary epithelium integrity (Club cell secretory protein, CC16) with acrolein metabolites on pulmonary function and the mediating roles of these biomarkers were assessed. Besides, a subgroup (N = 138) was randomly recruited from the cohort to assess the stabilities of acrolein metabolites and their longitudinal associations with pulmonary function change in three years.

RESULTS

Significant inverse dose-response relationships between acrolein metabolites and pulmonary function were found. Each 10-fold increment in CEMA, 3HPMA, or ΣUACLM (CEMA + 3HPMA) was cross-sectionally related to a 68.56-, 40.98-, or 46.02-ml reduction in FVC and a 61.54-, 43.10-, or 50.14-ml reduction in FEV₁, respectively (P < 0.05). Furthermore, acrolein metabolites with fair to excellent stabilities were found to be longitudinally associated with pulmonary function decline in three years. Joint effects of acrolein metabolites with 8-hydroxy-deoxyguanosine, CRP, and CC16 on pulmonary function were identified. CRP significantly mediated 5.97% and 5.51% of CEMA-associated FVC and FEV₁ reductions, respectively. 8-hydroxy-deoxyguanosine significantly mediated 6.78%, 6.88%, and 7.61% of CEMA-, 3HPMA-, and ΣUACLM-associated FVC reductions, respectively.

CONCLUSIONS

Acrolein exposure of general adults was cross-sectionally and longitudinally related to pulmonary function decline, which was aggravated and/or partly mediated by oxidative DNA damage, inflammation, and pulmonary epithelium injury.

Microbial contamination in waste collection: Unveiling this Portuguese occupational exposure scenario

Previous studies anticipated that microorganisms and their metabolites in waste will increase as a consequence of a decreased collection frequency and due to differences in what kind of waste is bagged before collection leading to an increased exposure of workers handling the waste. This study aim was to investigate the microbial contamination present in the waste collection trucks (WCT) and in the support facilities (waste collection station - WCS). It was applied a multi-approach protocol using active (air sampling by impingement and impaction) and passive (surface swabs, electrostatic dust cloths and settled dust) sampling methods. The screening of azole-resistance, the investigation of mycotoxins and the assessment of the elicited biological responses in vitro were also carried out aiming recognizing the possible health effects of waste collection drivers. SARS-CoV-2 detection was also performed. In WCS only air samples had contamination in all the four sampling sites (canteen, operational removal core, operational removal center, and administrative service). Among all the analyzed matrices from the WCT a higher percentage of total bacterial counts and Gram-was detected in swabs (66.93%; 99.36%). In WCS the most common species were Penicillium sp. (43.98%) and Cladosporium sp. (24.68%), while on WCT Aspergillus sp. (4.18%) was also one of the most found. In the azole resistance screening Aspergillus genera was not observed in the azole-supplemented media. SARS-CoV-2 was not detected in any of the environmental samples collected, but Aspergillus section Fumigati was detected in 5 samples. Mycotoxins were not detected in EDC from WCS, while in WCT they were detected in filters (N = 1) and in settled dust samples (N = 16). In conclusion, our study reveals that a comprehensive sampling approach using active and passive sampling (e.g. settled dust sampling for a representative mycotoxin evaluation) and combined analytic methods (i.e., culture-based and molecular) is an important asset in microbial exposure assessments. Concerning the waste collection exposure scenario, the results of this study unveiled a complex exposure, particularly to fungi and their metabolites. Aspergillus section Fumigati highlight the significance of targeting this section in the waste management industry as an indicator of occupational health risk.

Potential impacts of Washington State's wildfire worker protection rule on construction workers

Driven by climate change, wildfires are increasing in frequency, duration, and intensity across the Western United States. Outdoor workers are being exposed to increasing wildfire-related particulate matter and smoke. Recognizing this emerging risk, Washington adopted an emergency rule and is presently engaged in creating a permanent rule to protect outdoor workers from wildfire smoke exposure. While there are growing bodies of literature on the exposure to and health effects of wildfire smoke in the general public and wildland firefighters, there is a gap in knowledge about wildfire smoke exposure among outdoor workers generally and construction workers specifically-a large category of outdoor workers in Washington totaling 200,000 people. Several data sources were linked in this study-including state-collected employment data and national ambient air quality data-to gain insight into the risk of PM2.5 exposure among construction workers and evaluate the impacts of different air quality thresholds that would have triggered a new Washington emergency wildfire smoke rule aimed at protecting workers from high PM2.5 exposure. Results indicate the number of poor air quality days has increased in August and September in recent years. Over the last decade, these months with the greatest potential for particulate matter exposure coincided with an annual peak in construction employment that was typically 9.4-42.7% larger across Washington counties (one county was 75.8%). Lastly, the 'encouraged' threshold of the Washington emergency rule (20.5 μg m-3) would have resulted in 5.5 times more days subject to the wildfire rule on average across all Washington counties compared to its 'required' threshold (55.5 μg m-3), and in 2020, the rule could have created demand for 1.35 million N-95 filtering facepiece respirators among construction workers. These results have important implications for both employers and policy makers as rules are developed. The potential policy implications of wildfire smoke exposure, exposure control strategies, and data gaps that would improve understanding of construction worker exposure to wildfire smoke are also discussed.

Application of a Novel Collection of Exhaled Breath Condensate to Exercise Settings

The collection of exhaled breath condensate (EBC) is a non-invasive method for obtaining biosamples from the lower respiratory tract, an approach amenable to exercise, environmental, and work physiology applications. The purpose of this study was to develop a cost-effective, reproducible methodology for obtaining larger volume EBC samples. Participants (male: n = 10; female: n = 6; 26 ± 8 yrs.) completed a 10 min EBC collection using a novel device (N-EBC). After initial collection, a 45 min bout of cycling at 75% HRmax was performed, followed by another N-EBC collection. In a subset of individuals (n = 5), EBC was obtained using both the novel technique and a commercially available EBC collection device (R-EBC) in a randomized fashion. N-EBC volume—pre- and post-exercise (2.3 ± 0.8 and 2.6 ± 0.9 mL, respectively)—and pH (7.4 ± 0.5 and 7.4 ± 0.5, respectively) were not significantly different. When normalized for participant body height, device comparisons indicated N-EBC volumes were larger than R-EBC at pre-exercise (+12%) and post-exercise (+48%). Following moderate-intensity exercise, no changes in the pre- and post-trial values of Pentraxin 3 (0.25 ± 0.04 and 0.26 ± 0.06 pg/mL, respectively) and 8-Isoprostrane (0.43 ± 0.33 and 0.36 ± 0.24 pg/mL, respectively) concentrations were observed. In a cost-efficient fashion, the N-EBC method produced larger sample volumes, both pre- and post-exercise, facilitating more biomarker tests to be performed.

Health risks and mitigation strategies from occupational exposure to wildland fire: a scoping review

OBJECTIVES

Due to accelerating wildland fire activity, there is mounting urgency to understand, prevent, and mitigate the occupational health impacts associated with wildland fire suppression. The objectives of this review of academic and grey literature were to: 1. Identify the impact of occupational exposure to wildland fires on physical, mental, and emotional health; and 2. Examine the characteristics and effectiveness of prevention, mitigation, or management strategies studied to reduce negative health outcomes associated with occupational exposure to wildland fire.

METHODS

Following established scoping review methods, academic literature as well as government and industry reports were identified by searching seven academic databases and through a targeted grey literature search. 4679 articles were screened using pre-determined eligibility criteria. Data on study characteristics, health outcomes assessed, prevention or mitigation strategies studied, and main findings were extracted from each included document. The results of this scoping review are presented using descriptive tables and a narrative summary to organize key findings.

RESULTS

The final sample was comprised of 100 articles: 76 research articles and 24 grey literature reports. Grey literature focused on acute injuries and fatalities. Health outcomes reported in academic studies focused on respiratory health (n = 14), mental health (n = 16), and inflammation and oxidative stress (n = 12). The identified studies evaluated short-term outcomes measuring changes across a single shift or wildland fire season. Most research was conducted with wildland firefighters and excluded personnel such as aviation crews, contract crews, and incident management teams. Five articles reported direct study of mitigation strategies, focusing on the potential usage of masks, advanced hygiene protocols to reduce exposure, fluid intake to manage hydration and core temperature, and glutamine supplementation to reduce fatigue.

CONCLUSIONS

While broad in scope, the evidence base linking wildland fire exposure to any one health outcome is limited. The lack of long-term evidence on changes in health status or morbidity is a clear evidence gap and there is a need to prioritize research on the mental and physical health impact of occupational exposure to wildland fire.

Environmental and Occupational Short-Term Exposure to Airborne Particles and FEV1 and FVC in Healthy Adults: A Systematic Review and Meta-Analysis

Background: No study has compared the respiratory effects of environmental and occupational particulate exposure in healthy adults. Methods: We estimated, by a systematic review and meta-analysis, the associations between short term exposures to fine particles (PM_2.5 and PM₄) and certain parameters of lung function (FEV₁ and FVC) in healthy adults. Results: In total, 33 and 14 studies were included in the qualitative synthesis and meta-analyses, respectively. In environmental studies, a 10 µg/m³ increase in PM_2.5 was associated with an FEV₁ reduction of 7.63 mL (95% CI: −10.62 to −4.63 mL). In occupational studies, an increase of 10 µg/m³ in PM₄ was associated with an FEV₁ reduction of 0.87 mL (95% CI: −1.36 to −0.37 mL). Similar results were observed with FVC. Conclusions: Both occupational and environmental short-term exposures to fine particles are associated with reductions in FEV₁ and FVC in healthy adults.

Chronic Obstructive Pulmonary Disease in Adults Exposed to Fine Particles from a Coal Mine Fire

RATIONALE

In 2014 the Hazelwood open cut coal mine in south eastern Australia burned for six weeks, exposing nearby residents to high concentrations of fine particulate matter (PM_2.5). The long-term health consequences are unknown, and are being evaluated as part of the Hazelwood Health Study.

OBJECTIVES

To explore the association between PM_2.5 exposure and chronic obstructive pulmonary disease (COPD).

METHODS

A sample of 346 exposed, and 173 unexposed, adults participated in the longitudinal Respiratory Stream of the Hazelwood Health Study. Participants underwent spirometry and gas transfer measurements, and answered validated respiratory questionnaires 3.5-4 years after the fire. Individual-level mine fire-related PM_2.5 exposure was modelled. Multivariate linear regression and logistic models were fitted to analyse associations between mean and peak PM_2.5 exposure and clinical outcomes, stratified by smoking status.

RESULTS

A 10 μg/m³ increase in mean PM_2.5 exposure was associated with a 69% (95%CI: 11% to 158%) increase in odds of spirometry consistent with COPD amongst non-smokers and increased odds of chest tightness (odds ratio; OR 1.30, 95%CI 1.03 to 1.64) and chronic cough (OR 1.24, 95%CI 1.02 to 1.51) in the previous 12 months in all participants. For current smokers, increments in mean PM_2.5 exposure were associated with higher odds of chronic cough in the preceding 12 months (OR 2.13, 95%CI 1.24 to 3.65).

CONCLUSIONS

Almost four years after a six-week period of coal fire PM_2.5 exposure, we identified a dose-response association between exposure and COPD in non-smokers. With climate change a likely contributor to increased risk of landscape fires, the findings will inform policy decisions during future sustained smoke events.

2019–20 Australian Bushfires and Anomalies in Carbon Monoxide Surface and Column Measurements

In Australia, bushfires are a natural part of the country’s landscape and essential for the regeneration of plant species; however, the 2019–20 bushfires were unprecedented in their extent and intensity. This paper is focused on the 2019–20 Australian bushfires and the resulting surface and column atmospheric carbon monoxide (CO) anomalies around Wollongong. Column CO data from the ground-based Total Carbon Column Observing Network (TCCON) and Network for the Detection of Atmospheric Composition Change (NDACC) site in Wollongong are used together with surface in situ measurements. A systematic comparison was performed between the surface in situ and column measurements of CO to better understand whether column measurements can be used as an estimate of the surface concentrations. If so, satellite column measurements of CO could be used to estimate the exposure of humans to CO and other fire-related pollutants. We find that the enhancements in the column measurements are not always significantly evident in the corresponding surface measurements. Topographical features play a key role in determining the surface exposures from column abundance especially in a coastal city like Wollongong. The topography at Wollongong, combined with meteorological effects, potentially exacerbates differences in the column and surface. Hence, satellite column amounts are unlikely to provide an accurate reflection of exposure at the ground during major events like the 2019–2020 bushfires.

Characterization of occupational smoke exposure among wildland firefighters in the midwestern United States

Wildland firefighters are repeatedly exposed to elevated levels of wildland fire smoke (WFS) while protecting lives and properties from wildland fires. Studies reporting personal exposure concentrations of air pollutants in WFS during fire suppression or prescribed burn activities have been geographically limited to the western and southeastern United States. The objective of this study is to characterize exposure concentrations of air pollutants in WFS emissions among wildland firefighters who conducted prescribed burns in the Midwest. Between 2016 and 2019, a total of 35 firefighters (31 males and 4 females, age of 35.63 ± 9.31 years) were recruited to participate in this study. Personal particulate matter 2.5 (PM_2.5) and carbon monoxide (CO) exposure concentrations were measured during prescribed burns. The level of black carbon (BC) in WFS particulates was determined using the light transmission technique, while trace metal composition was analyzed using inductively coupled plasma mass spectrometry (ICP-MS). The results showed geometric means for PM_2.5, CO, and BC concentrations were 1.43 ± 0.13 mg/m³, 7.02 ± 0.69 ppm, and 58.79 ± 5.46 μg/m³, respectively. Although no occupational exposure limits (OELs) were exceeded by 8-h time-weighted average (TWA) exposure concentration observed in the firefighters, a total of 28 personal CO exposure concentrations were above the National Institute for Occupational Safety and Health (NIOSH) Recommended Exposure Limit (REL) Ceiling (200 ppm) for CO. PM_2.5 and CO concentrations were about 2-7 times higher in the Midwest than the other regions. Firefighters who performed holding had higher CO exposure concentrations compared to firefighters who performed lighting (p < 0.01), while lighters were exposed to higher level of BC in the smoke particulates (p < 0.01), possibly due to the domination of exposure by different combustion sources and stages. The levels of trace metals in WFS particulates were well below the corresponding OELs and no task-related difference was observed except for manganese. Our results suggest that wildland firefighters in the midwestern region have higher WFS exposures while working at prescribed burns compared to those western and southeastern United States.

Application of systematic evidence mapping to assess the impact of new research when updating health reference values: A case example using acrolein

BACKGROUND

The environmental health community needs transparent, methodologically rigorous, and rapid approaches for updating human health risk assessments. These assessments often contain reference values for cancer and/or noncancer effects. Increasingly, the use of systematic review methods are preferred when developing these assessments. Systematic evidence maps are a type of analysis that has the potential to be very helpful in the update process, especially when combined with machine-learning software advances designed to expedite the process of conducting a review.

OBJECTIVES

To evaluate the applicability of evidence mapping to determine whether new evidence is likely to result in a change to an existing health reference value, using inhalation exposure to the air pollutant acrolein as a case example.

METHODS

New literature published since the 2008 California Environmental Protection Agency's Office of Environmental Health Hazard Assessment (OEHHA) Reference Exposure Level (REL) for acrolein was assessed. Systematic review methods were used to search the literature and screening included the use of machine-learning software. The Populations, Exposures, Comparators and Outcomes (PECO) criteria were kept broad to identify studies that characterized acute and chronic exposure and could be informative for hazard characterization. Studies that met the PECO criteria after full-text review were briefly summarized before their suitability for chronic point of departure (POD) derivation and calculation of a reference value was considered. Studies considered potentially suitable underwent a targeted evaluation to determine their suitability for use in dose-response analysis.

RESULTS

Over 15,000 studies were identified from scientific databases. Both machine-learning and manual screening processes were used to identify 60 studies considered PECO-relevant after full-text review. Most of these PECO-relevant studies were short-term exposure animal studies (acute or less than 1 month of exposure) and considered less suitable for deriving a chronic reference value when compared to the subchronic study in rats used in the 2008 OEHHA assessment. Thirteen epidemiological studies were identified but had limitations in the exposure assessment that made them less suitable for dose-response compared to the subchronic rat study. Among the 13 studies, there were four controlled trial studies that have the potential to be informative for future acute reference value derivation. Thus, the 2008 subchronic rat study used by OEHHA appears to still be the most appropriate study for chronic reference value derivation. In addition, advances in dosimetric modeling for gases, including new evidence pertinent to acrolein, could be considered when updating existing acrolein toxicity values.

CONCLUSIONS

Evidence mapping is a very useful tool to assess the need for updating an assessment based on understanding the potential impact of new studies on revising an existing health reference value. In this case example, the focus was to identify studies suitable for chronic exposure dose-response analysis, while also identifying studies that may be important to consider for acute exposure scenarios, hazard identification, or for future research. This allows the evidence map to be a useful resource for a range of decision-making contexts. Specialized systematic review software increased the efficiency of the process in terms of human resources and time to conduct the analysis.

Assessing Forest Canopy Impacts on Smoke Concentrations Using a Coupled Numerical Model

The impact of a forest canopy on smoke concentration is assessed by applying a numerical weather prediction model coupled with a Lagrangian particle dispersion model to two low-intensity wildland (prescribed) fires in the New Jersey Pine Barrens. A comparison with observations indicates that the coupled numerical model can reproduce some of the observed variations in surface smoke concentrations and plume heights. Model sensitivity analyses highlight the effect of the forest canopy on simulated meteorological conditions, smoke concentrations, and plume heights. The forest canopy decreases near-surface wind speed, increases buoyancy, and increases turbulent mixing. Sensitivities to the time of day, plant area density profiles, and fire heat fluxes are documented. Analyses of temporal variations in smoke concentrations indicate that the effect of the transition from a daytime to a nocturnal planetary boundary layer is weaker when sensible heat fluxes from the fires are stronger. The results illustrate the challenges in simulating meteorological conditions and smoke concentrations at scales where interactions between the fire, fuels, and atmosphere are critically important. The study demonstrates the potential for predictive tools to be developed and implemented that could help fire and air-quality managers assess local air-quality impacts during low-intensity wildland fires in forested environments.

Fate of the inhaled smoke particles from fire scenes in the nasal airway of a realistic firefighter: A simulation study

Understanding the inhalation, transport and deposition of smoke particles during fire missions are important to evaluating the health risks for firefighters. In this study, measurements from Underwriters Laboratories' large-scale fire experiments on smoke particle size distribution and concentration in three residential fire scenes were incorporated into models to investigate the fate of inhaled toxic ultrafine particulates in a realistic firefighter nasal cavity model. Deposition equations were developed, and the actual particle dosimetry (in mass, number and surface area) was evaluated. A strong monotonic growth of nasal airway dosages of simulated smoke particles was identified for airflow rates and fire duration across all simulated residential fire scene conditions. Even though the "number" dosage of arsenic in the limited ventilation living room fire was similar to the "number" dosage of chromium in the living room, particle mass and surface area dosages simulated in the limited living room were 90-200 fold higher than that in the ventilated living room. These were also confirmed when comparing the dosimetry in the living room and the kitchen. This phenomenon implied that particles with larger size were the dominant factors in mass and surface area dosages. Firefighters should not remove the self-contained breathing apparatus (SCBA) during fire suppression and overhaul operations, especially in smoldering fires with limited ventilation.

Measuring acute pulmonary responses to occupational wildland fire smoke exposure using exhaled breath condensate

Wildland firefighters are directly exposed to elevated levels of wildland fire (WF) smoke. Although studies demonstrate WF smoke exposure is associated with lung function changes, few studies that use invasive sample collection methods have been conducted to investigate underlying biochemical changes. These methods are also either unrepresentative of the deeper airways or capable of inducing inflammation. In the present study, levels of biomarkers of oxidative stress (8-isoprostane) and pro-inflammatory response (interleukin-6 [IL-6], interleukin-8 [IL-8], C-reactive protein [CRP], and soluble intercellular adhesion molecule-1 [sICAM-1]) were determined in exhaled breath condensate (EBC) samples that were collected from firefighters before, after, and next morning following prescribed burn and regular work shifts. Results show only a marginal cross-shift increase in 8-isoprostane on burn days (.05 < p value < .1), suggesting WF smoke exposure causes mild pulmonary responses.

Acute effects of smoke exposure on airway and systemic inflammation in forest firefighters

Introduction

The aim of this study was to assess respiratory health and airway and systemic inflammation in professional forest firefighters post firefighting.

Methods

A total of 60 firefighters who participated in forest firefighting operations in Greece during 2008 were included in the study. A questionnaire consisting of symptoms and exposure, pulmonary function, atopy, bronchial hyperresponsiveness, and markers of inflammation in induced sputum, serum, and bronchoalveolar lavage (BAL) fluid was assessed.

Results

A measurable eosinophilic and neutrophilic inflammation was shown to be induced in the bronchial airways after acute exposure during forest firefighting. This was associated with increased respiratory symptoms from the upper and lower respiratory tract and pulmonary function impairment. Additionally, a measurable systemic inflammatory response was demonstrated. This study showed that acute exposure during forest firefighting significantly augments the intensity of airway and systemic inflammation in relation to the baseline inflammatory background due to chronic exposure.

Conclusion

The repeated acute exposures during firefighting augment the burden of chronic airway and systemic inflammation and may eventually lead to allergic sensitization of the airways and increased incidence of rhinitis and asthma after prolonged exposure.

Wildfire smoke exposure and human health: Significant gaps in research for a growing public health issue

Understanding the effect of wildfire smoke exposure on human health represents a unique interdisciplinary challenge to the scientific community. Population health studies indicate that wildfire smoke is a risk to human health and increases the healthcare burden of smoke-impacted areas. However, wildfire smoke composition is complex and dynamic, making characterization and modeling difficult. Furthermore, current efforts to study the effect of wildfire smoke are limited by availability of air quality measures and inconsistent air quality reporting among researchers. To help address these issues, we conducted a substantive review of wildfire smoke effects on population health, wildfire smoke exposure in occupational health, and experimental wood smoke exposure. Our goal was to evaluate the current literature on wildfire smoke and highlight important gaps in research. In particular we emphasize long-term health effects of wildfire smoke, recovery following wildfire smoke exposure, and health consequences of exposure in children.

Lung function measures following simulated wildland firefighter exposures

Across the world, biomass smoke is a major source of air pollution and is linked with a variety of adverse health effects. This is particularly true in the western U.S. where wood smoke from wildland forest fires are a significant source of PM2.5. Wildland firefighters are impacted as they experience elevated PM2.5 concentrations over extended periods of time, often occurring during physical exertion. Various epidemiological studies have investigated wood smoke impacts on human health, including occupational field exposures experienced by wildland firefighters. As there are numerous challenges in carrying out these field studies, having the ability to research the potential health impacts to this occupational cohort in a controlled setting would provide important information that could be translated to the field setting. To this end, we have carried out a simulated wildland firefighter exposure study in a wood smoke inhalation facility. Utilizing a randomized crossover trial design, we exposed 10 participants once to clean filtered-air, 250 µg/m3, and 500 µg/m3 wood stove-generated wood smoke PM2.5. Participants exercised on a treadmill at an absolute intensity designed to simulate wildland firefighting for 1.5 hr. In addition to measured PM2.5 smoke concentrations, mean levels of CO2, CO, and % relative humidity were continuously monitored and recorded and were representative of occupational "real-world" exposures. Pulmonary function was measured at three time points: before, immediately after, and 1-hr post-exposure. Although there were some reductions in FVC, FEV1, and FVC:FEV1 measures, results of the spirometry testing did not show significant changes in lung function. The development of this wood smoke inhalational facility provides a platform to further address unique research questions related to wood smoke exposures and associated adverse health effects.

Wood smoke exposure of Portuguese wildland firefighters: DNA and oxidative damage evaluation

Portugal is among the European Union countries most devastated by forest fires each year. In the last three decades, more than 3.8 million hectares of forest were burned. Wildland firefighters are exposed to a variety of hazards, including many toxic combustion products that may lead to deleterious health effects. Epidemiological studies showed a positive association between firefighting and several chronic diseases, including cancer. Results from biomonitoring studies in firefighters, particularly concerning genotoxicity evaluation, constitute a valuable tool for investigating important occupational hazards. Thus, the aim of this study was to assess genotoxicity in a group of wildland firefighters using the comet assay for DNA damage and oxidative stress. Both parameters were increased in firefighters compared to controls, but significance was only found for basal DNA damage. No significant influence was found regarding major confounding variables on the genotoxic endpoints studied, with the exception of age. Data obtained provide preliminary information on human health effects of wildland firefighting exposure at genetic and molecular levels. These findings may also provide new important data to serve as public awareness to the potential adverse health risks involving wildland firefighting. Implementation of security and hygiene measures in this sector as well as good practices campaigns may be crucial to decrease risk.

The effect of artificial smoke compound on physiological responses, cognitive functions and work performance during firefighting activities in a smoke-diving room: an intervention study

This study investigated the combined effect of firefighting operations and exposure to smoke on physiological responses, cognitive functions and physical performance among firefighters. Each firefighter was engaged in two experimental conditions: (a) without artificial smoke, control (NS); (b) with artificial smoke (WS). The results of data analysis revealed that heart rate and body temperature increased significantly after the firefighting activities in the two conditions relative to baseline. In addition, reaction time (RT) and correct response (CR) decreased after the activity relative to baseline and there was a significant difference in RT and CR between the NS and WS conditions. There was also a significant difference in performance time between the NS and WS conditions. These findings demonstrated that a smoke compound has an insignificant effect on physiological responses during firefighting activity. On the contrary, the smoke compound has a detrimental influence on cognitive and physical performance.

Measured Pulmonary and Systemic Markers of Inflammation and Oxidative Stress Following Wildland Firefighter Simulations

OBJECTIVE

A controlled human exposure study was conducted to investigate the impact of inhalational exposures to wood smoke PM2.5 on measured concentrations of airway and systemic inflammatory biomarkers.

METHODS

Mimicking wildland firefighter activities, 10 participants were exposed to three doses of wood smoke PM2.5 (filtered-air, 250 μg/m, and 500 μg/m) while exercising on a treadmill. Exhaled breath condensate (EBC) and blood plasma samples were obtained pre-, immediately post-, and 1-hour postexposure. 8-isoprostane, pH, and myeloperoxidase were measured in EBC, while H2O2, surfactant protein D, and pentraxin-3 (PTX3) were measured in both EBC and plasma.

RESULTS

Only pH, 8-isoprostane, and PTX3 displayed significant changes when comparing pre- and postexposures.

CONCLUSIONS

Markers of inflammation and oxidative stress, including PTX3, pH, and 8-isoprostane in EBC and/or plasma, are sensitive to wood smoke inhalation, with further investigations warranted.

An Overview of Occupational Risks From Climate Change

Changes in atmosphere and temperature are affecting multiple environmental indicators from extreme heat events to global air quality. Workers will be uniquely affected by climate change, and the occupational impacts of major shifts in atmospheric and weather conditions need greater attention. Climate change-related exposures most likely to differentially affect workers in the USA and globally include heat, ozone, polycyclic aromatic hydrocarbons, other chemicals, pathogenic microorganisms, vector-borne diseases, violence, and wildfires. Epidemiologic evidence documents a U-, J-, or V-shaped relationship between temperature and mortality. Whereas heat-related morbidity and mortality risks are most evident in agriculture, many other outdoor occupational sectors are also at risk, including construction, transportation, landscaping, firefighting, and other emergency response operations. The toxicity of chemicals change under hyperthermic conditions, particularly for pesticides and ozone. Combined with climate-related changes in chemical transport and distribution, these interactions represent unique health risks specifically to workers. Links between heat and interpersonal conflict including violence require attention because they pose threats to the safety of emergency medicine, peacekeeping and humanitarian relief, and public safety professionals. Recommendations for anticipating how US workers will be most susceptible to climate change include formal monitoring systems for agricultural workers; modeling scenarios focusing on occupational impacts of extreme climate events including floods, wildfires, and chemical spills; and national research agenda setting focusing on control and mitigation of occupational susceptibility to climate change.

Review of the health effects of wildland fire smoke on wildland firefighters and the public

Each year, the general public and wildland firefighters in the US are exposed to smoke from wildland fires. As part of an effort to characterize health risks of breathing this smoke, a review of the literature was conducted using five major databases, including PubMed and MEDLINE Web of Knowledge, to identify smoke components that present the highest hazard potential, the mechanisms of toxicity, review epidemiological studies for health effects and identify the current gap in knowledge on the health impacts of wildland fire smoke exposure. Respiratory events measured in time series studies as incidences of disease-caused mortality, hospital admissions, emergency room visits and symptoms in asthma and chronic obstructive pulmonary disease patients are the health effects that are most commonly associated with community level exposure to wildland fire smoke. A few recent studies have also determined associations between acute wildland fire smoke exposure and cardiovascular health end-points. These cardiopulmonary effects were mostly observed in association with ambient air concentrations of fine particulate matter (PM2.5). However, research on the health effects of this mixture is currently limited. The health effects of acute exposures beyond susceptible populations and the effects of chronic exposures experienced by the wildland firefighter are largely unknown. Longitudinal studies of wildland firefighters during and/or after the firefighting career could help elucidate some of the unknown health impacts of cumulative exposure to wildland fire smoke, establish occupational exposure limits and help determine the types of exposure controls that may be applicable to the occupation.

The concentration of carbon monoxide in the breathing areas of workers during logging operations at the motor-manual level

OBJECTIVES

This article compares 2 variants of logging technologies at the motor-manual level: variant A - cutting and delimbing by means of a petrol chainsaw, skidding with the use of a cable winch mounted on a tractor (67-74 kW); variant B - cutting by means of a petrol chainsaw, skidding, debranching and cutting to length by means of a processor aggregated with a farm tractor (61 kW).

MATERIAL AND METHODS

Direct dosimetry and non-parametric (moving block bootstrap) methods were used in order to specify the characteristics of the collected sets.

RESULTS

Bootstrap average values show that the average CO concentration at a skidding tractor operator's station during early thinning was 2.54 mg×m(-3). At processor operator's station it amounted to 10.35 mg×m(-3). Such results allow to conclude that a higher CO concentration at the above-mentioned 2 work stations was observed during early thinning. In the case of a petrol chainsaw operator, it was observed that the permissible exposure limit (23 mg×m(-3)) was exceeded and the short-term permissible exposure limit (117 mg×m(-3)) was not. The average concentration value for a chainsaw operator working individually during late thinning interventions was substantially lower (15.01 mg×m(-3)), which results from the lack of technological pressure that can be observed while cooperating with a processor operator.

CONCLUSIONS

The risk increases along with conditions that generate the concentration of exhaust produced by 2-stroke petrol chainsaw engines.

Arterial stiffness, oxidative stress, and smoke exposure in wildland firefighters

OBJECTIVES

To assess the association between exposure, oxidative stress, symptoms, and cardiorespiratory function in wildland firefighters.

METHODS

We studied two Interagency Hotshot Crews with questionnaires, pulse wave analysis for arterial stiffness, spirometry, urinary 8-iso-prostaglandin F2α (8-isoprostane) and 8-hydroxy-2'-deoxyguanosine (8-OHdG), and the smoke exposure marker (urinary levoglucosan). Arterial stiffness was assessed by examining levels of the aortic augmentation index, expressed as a percentage. An oxidative stress score comprising the average of z-scores created for 8-OHdG and 8-isoprostane was calculated.

RESULTS

Mean augmentation index % was higher for participants with higher oxidative stress scores after adjusting for smoking status. Specifically for every one unit increase in oxidative stress score the augmentation index % increased 10.5% (95% CI: 2.5, 18.5%). Higher mean lower respiratory symptom score was associated with lower percent predicted forced expiratory volume in one second/forced vital capacity.

CONCLUSIONS

Biomarkers of oxidative stress may serve as indicators of arterial stiffness in wildland firefighters.

Exposures and cross-shift lung function declines in wildland firefighters

Respiratory problems are common among wildland firefighters. However, there are few studies directly linking occupational exposures to respiratory effects in this population. Our objective was to characterize wildland fire fighting occupational exposures and assess their associations with cross-shift changes in lung function. We studied 17 members of the Alpine Interagency Hotshot Crew with environmental sampling and pulmonary function testing during a large wildfire. We characterized particles by examining size distribution and mass concentration, and conducting elemental and morphological analyses. We examined associations between cross-shift lung function change and various analytes, including levoglucosan, an indicator of wood smoke from burning biomass. The levoglucosan component of the wildfire aerosol showed a predominantly bimodal size distribution: a coarse particle mode with a mass median aerodynamic diameter about 12 μm and a fine particle mode with a mass median aerodynamic diameter < 0.5 μm. Levoglucosan was found mainly in the respirable fraction and its concentration was higher for fire line construction operations than for mop-up operations. Larger cross-shift declines in forced expiratory volume in one second were associated with exposure to higher concentrations of respirable levoglucosan (p < 0.05). Paired analyses of real-time personal air sampling measurements indicated that higher carbon monoxide (CO) concentrations were correlated with higher particulate concentrations when examined by mean values, but not by individual data points. However, low CO concentrations did not provide reliable assurance of concomitantly low particulate concentrations. We conclude that inhalation of fine smoke particles is associated with acute lung function decline in some wildland firefighters. Based on short-term findings, it appears important to address possible long-term respiratory health issues for wildland firefighters. [Supplementary materials are available for this article. Go to the publisher's online edition of Journal of Occupational and Environmental Hygiene for the following free supplemental resources: a file containing additional information on historical studies of wildland fire exposures, a file containing the daily-exposure-severity questionnaire completed by wildland firefighter participants at the end of each day, and a file containing additional details of the investigation of correlations between carbon monoxide concentrations and other measured exposure factors in the current study.].

Personal carbon monoxide exposures among firefighters at prescribed forest burns in the Southeastern United States

Exposure to combustion products from wildland fires causes respiratory irritation and decreased lung function among firefighters. The authors evaluated carbon monoxide (CO) exposures of a group of wildland firefighters who conducted prescribed burns in the southeastern United States of America. A total of 149 person-days of samples were collected using data logging CO monitors. A questionnaire was administered to collect data on job tasks and self-reported smoke exposure. Overall, the highest exposures were seen amongst firefighters assigned to holding and mop-up tasks (geometric mean [GM]: 2.6 ppm), whereas the lowest were associated with lighting and jobs such as burn boss (GM: 1.6 and 0.3 ppm, respectively). The self-reported smoke exposure showed a significant linear trend with increasing CO exposure. The numbers of acres burned or burn duration, however, were not good predictors of exposure.

Acute respiratory effects in firefighters

BACKGROUND

Associations between acute respiratory inflammatory responses, changes in bronchial hyperresponsiveness, serum pneumoprotein levels, and exposure to fire smoke were studied.

METHODS

The study comprised 51 firefighters. Blood samples were taken within 24 hr following exposure to fire smoke, and after a week and 3 months. Sputum was induced within 5 days post-exposure and subjects underwent spirometry and methacholine provocation one week post-exposure. Exposure was registered by a questionnaire.

RESULTS

No changes were observed following smoke exposure in bronchial hyperresponsiveness and serum pneumoprotein levels. Nevertheless, in a sizable proportion of the firefighters (44%) elevated sputum neutrophil levels (≥60%) were found. Serum IL-8 concentrations were higher 24 hr post-exposure compared to pre-exposure. Elevated neutrophil levels in sputum were associated with elevated serum IL-8 (β = 0.010, P = 0.004) and TNFα (β = 0.005, P = 0.034) levels within 24 hr post-exposure and IL-8 elevation lasted up to 3 months.

CONCLUSIONS

Acute exposure to fire smoke induces acute neutrophilic airway and long-lasting systemic inflammation in healthy firefighters in the absence of bronchial hyperresponsiveness.

Respiratory symptoms in firefighters

BACKGROUND

The aim of the present study was to determine the prevalence and risk factors associated with respiratory symptoms in common firefighters in the Netherlands.

METHODS

A total of 1,330 firefighters from the municipal fire brigades of three provinces of the Netherlands were included in the study. All subjects were administered a Dutch web-based version of the European Community Respiratory Health Survey questionnaire.

RESULTS

General respiratory symptoms were associated with the number of fires fought in the last 12 months with odds ratios between 1.2 (95% CI 1.0-1.4) and 1.4 (95% CI 1.2-1.7) per 25 fires. A strong association was found between an inhalation incident and present respiratory symptoms with odds ratios between 1.7 (95% CI 1.1-2.7) and 3.0 (95% CI 1.9-4.7). Adjustments for smoking, sex, atopy, and age did not change any of the associations. After stratification, atopics showed elevated odds ratios.

CONCLUSIONS

It is recommended that firefighters are aware of these elevated healthcare risks associated with exposure to fire smoke and that they increase as much as possible the use of self-contained breathing apparatus.

Monitoring of firefighters exposure to smoke during fire experiments in Portugal

Forest fires represent a serious threat to public security in Europe due to the large burned area. Moreover, smoke pollution due to forest fire events is an important public health issue for the communities directly affected, and particularly for the personnel involved in firefighting operations. Aiming to contribute to the scientific knowledge concerning firefighters exposure to forest fires smoke, data of individual exposure to carbon monoxide, nitrogen dioxide, volatile organic compounds, and particulate matter were obtained during experimental field fires for a group of 10 firefighters equipped with portable "in continuum" measuring devices. Measured values are very high exceeding the Occupational Exposure Standard limits, in particular for peak limit thresholds. These are the first measurements and analysis of firefighter's individual exposure to toxic gases and particles in fire smoke experiments in Europe. However, they already indicate that urgent measures to avoid these levels of exposure are needed.

Respiratory morbidity induced by occupational inhalation exposure to formaldehyde

The potential of formaldehyde to produce chronic respiratory tract disease remains a controversial issue. The main purpose of this study was to investigate the respiratory effects, if any, of long term occupational exposure to formaldehyde. This cross-sectional study was carried out at a local melamine-formaldehyde resin producing plant. The study population consisted of seventy exposed and 24 non-exposed (referent) employees. Using respiratory questionnaire, data on respiratory symptoms were gathered. Atmospheric concentrations of formaldehyde were measured at different contaminated areas of the plant. Similarly, the parameters of pulmonary function were measured at the beginning (preshift) and at the end (postshift) of the first working day of the week. The results showed that airborne concentrations of formaldehyde exceeded current permissible levels. Additionally, significant decrements in some preshift and postshift parameters of pulmonary function of exposed workers were noted. However, a relative recovery in lung functional capacity observed following temporary cessation of exposure (preshift values). Furthermore, exposed workers had higher prevalence rates of regular cough, wheezing, phlegm, shortness of breath, chest tightness and episodes of chest illness associated with cold. The findings of this study collectively indicate that exposure to formaldehyde may induce respiratory symptoms, acute partially reversible and chronic irreversible functional impairments of the lungs.

Respiratory irritants in Australian bushfire smoke: air toxics sampling in a smoke chamber and during prescribed burns

Bushfire smoke contains an array of organic and inorganic compounds, including respirable and inspirable particles, aldehydes, and carbon monoxide. These compounds have been found to be a health hazard for firefighters in the United States. Despite the high frequency of bushfires in Australia, analyses of bushfire smoke components are scarce. As part of an occupational health study investigating the respiratory health effects of bushfire smoke in firefighters, air toxics sampling was undertaken in a smoke chamber and during prescribed burns. Levels of formaldehyde and acrolein were demonstrated at respectively 60% and 80% of the Short Term Exposure Limit in the smoke chamber. Carbon monoxide levels exceeded the peak limit of 400 ppm significantly. Although concentrations were lower during the prescribed burns, the study shows that Australian bushfire smoke contains air toxics of concern and provides justification for further research into the levels of air toxics measured at bushfires and the associated health impacts.

Effect of protective filters on fire fighter respiratory health: field validation during prescribed burns

BACKGROUND

Bushfire smoke contains a range of air toxics. To prevent inhalation of these toxics, fire fighters use respiratory equipment. Yet, little is known about the effectiveness of the equipment on the fire ground. Experimental trials in a smoke chamber demonstrated that, the particulate/organic vapor/formaldehyde (POVF) filter performed best under simulated conditions. This article reports on the field validation trials during prescribed burns in Western Australia.

METHODS

Sixty-seven career fire fighters from the Fire and Emergency Services Authority of Western Australia were allocated one of the three types of filters. Spirometry, oximetry, self-reported symptom, and personal air sampling data were collected before, during and after exposure to bushfire smoke from prescribed burns.

RESULTS

Declines in FEV(1) and SaO(2) were demonstrated after 60 and 120 min exposure. A significant higher number of participants in the P filter group reported increases in respiratory symptoms after the exposure. Air sampling inside the respirators demonstrated formaldehyde levels significantly higher in the P filter group compared to the POV and the POVF filter group.

CONCLUSIONS

The field validation trials during prescribed burns supported the findings from the controlled exposure trials in the smoke chamber. Testing the effectiveness of three types of different filters under bushfire smoke conditions in the field for up to 2 hr demonstrated that the P filter is ineffective in filtering out respiratory irritants. The performance of the POV and the POVF filter appears to be equally effective after 2 hr bushfire smoke exposure in the field.

Health impacts of fire smoke inhalation

Most fatalities from fires are not due to burns, but are a result of inhalation of toxic gases produced during combustion. Fire produces a complex toxic environment involving flame, heat, oxygen depletion, smoke and toxic gases. As a wide variety of synthetic materials is used in buildings (insulation, furniture, carpeting, and decorative items) the potential for severe health impacts from inhalation of products of combustion during building fires is continuously increasing. In forest fires the burning of biomass leads to smoke emissions, the composition of which, as well as the relative health impacts from their inhalation, depends on the ecosystem's chemical and physical features and the local environmental parameters. In the present review, health problems that appear to people exposed to fire smoke and especially to firefighters are described and suggestions for fire management and prevention are made.

Occupational PAH exposures during prescribed pile burns

Wildland firefighters are exposed to particulate matter and gases containing polycyclic aromatic hydrocarbons (PAHs), many of which are known carcinogens. Our objective was to evaluate the extent of firefighter exposure to particulate and PAHs during prescribed pile burns of mainly ponderosa pine slash and determine whether these exposures were correlated with changes in urinary 1-hydroxypyrene (1-HP), a PAH metabolite. Personal and area sampling for particulate and PAH exposures were conducted on the White Mountain Apache Tribe reservation, working with 21 Bureau of Indian Affairs/Fort Apache Agency wildland firefighters during the fall of 2006. Urine samples were collected pre- and post-exposure and pulmonary function was measured. Personal PAH exposures were detectable for only 3 of 16 PAHs analyzed: naphthalene, phenanthrene, and fluorene, all of which were identified only in vapor-phase samples. Condensed-phase PAHs were detected in PM2.5 area samples (20 of 21 PAHs analyzed were detected, all but naphthalene) at concentrations below 1 microg m(-3). The total PAH/PM2.5 mass fractions were roughly a factor of two higher during smoldering (1.06 +/- 0.15) than ignition (0.55 +/- 0.04 microg mg(-1)). There were no significant changes in urinary 1-HP or pulmonary function following exposure to pile burning. In summary, PAH exposures were low in pile burns, and urinary testing for a PAH metabolite failed to show a significant difference between baseline and post-exposure measurements.

Nasal uptake of inhaled acrolein in rats

An improved understanding of the relationship between inspired concentration of the potent nasal toxicant acrolein and delivered dose is needed to support quantitative risk assessments. The uptake efficiency (UE) of 0.6, 1.8, or 3.6 ppm acrolein was measured in the isolated upper respiratory tract (URT) of anesthetized naive rats under constant-velocity unidirectional inspiratory flow rates of 100 or 300 ml/min for up to 80 min. An additional group of animals was exposed to 0.6 or 1.8 ppm acrolein, 6 h/day, 5 days/wk, for 14 days prior to performing nasal uptake studies (with 1.8 or 3.6 ppm acrolein) at a 100 ml/min airflow rate. Olfactory and respiratory glutathione (GSH) concentrations were also evaluated in naive and acrolein-preexposed rats. Acrolein UE in naive animals was dependent on the concentration of inspired acrolein, airflow rate, and duration of exposure, with increased UE occurring with lower acrolein exposure concentrations. A statistically significant decline in UE occurred during the exposures. Exposure to acrolein vapor resulted in reduced respiratory epithelial GSH concentrations. In acrolein-preexposed animals, URT acrolein UE was also dependent on the acrolein concentration used prior to the uptake exposure, with preexposed rats having higher UE than their naive counterparts. Despite having increased acrolein UE, GSH concentrations in the respiratory epithelium of acrolein preexposed rats were higher at the end of the 80 min acrolein uptake experiment than their in naive rat counterparts, suggesting that an adaptive response in GSH metabolism occurred following acrolein preexposure.

Application of physiological computational fluid dynamics models to predict interspecies nasal dosimetry of inhaled acrolein

Acrolein is a highly soluble and reactive aldehyde and is a potent upper-respiratory-tract irritant. Acrolein-induced nasal lesions in rodents include olfactory epithelial atrophy and inflammation, epithelial hyperplasia, and squamous metaplasia of the respiratory epithelium. Nasal uptake of inhaled acrolein in rats is moderate to high, and depends on inspiratory flow rate, exposure duration, and concentration. In this study, anatomically accurate three-dimensional computational fluid dynamics (CFD) models were used to simulate steady-state inspiratory airflow and to quantitatively predict acrolein tissue dose in rat and human nasal passages. A multilayered epithelial structure was included in the CFD models to incorporate clearance of inhaled acrolein by diffusion, blood flow, and first-order and saturable metabolic pathways. Kinetic parameters for these pathways were initially estimated by fitting a pharmacokinetic model with a similar epithelial structure to time-averaged acrolein nasal extraction data and were then further adjusted using the CFD model. Predicted air:tissue flux from the rat nasal CFD model compared well with the distribution of acrolein-induced nasal lesions from a subchronic acrolein inhalation study. These correlations were used to estimate a tissue dose-based no-observed-adverse-effect level (NOAEL) for inhaled acrolein. A human nasal CFD model was used to extrapolate effects in laboratory animals to human exposure conditions on the basis of localized tissue dose and tissue responses. Assuming that equivalent tissue dose will induce similar effects across species, a NOAEL human equivalent concentration for inhaled acrolein was estimated to be 8 ppb.

Integration of field chemical data in initial risk assessment of forest fire smoke

A risk assessment framework was used to assess the risks of forest fire smoke (ffs) to the exposed communities, critical infrastructures and the environment. The present work is focused on the planning and problem formulation phases of this risk assessment procedure. Specifically, as part of the problem formulation phase, integration of the available ffs chemical data was carried out by answering critical questions regarding the ffs. In this way, critical factors have been identified, which mostly define and characterize ffs as a cause of problems and possible symptoms. The integrated information can be used in order to determine assessment endpoints, conceptual models, and risk hypotheses, as presented in an indicative example referred to a simple risk scenario. This work, enhanced with additional risk scenarios, can be used for the next phases of the risk assessment procedure, such as risk analysis and risk characterization. Future research needs for adequate evaluation of ffs impacts on communities, infrastructures, and the environment are also discussed.

Woodsmoke health effects: a review

The sentiment that woodsmoke, being a natural substance, must be benign to humans is still sometimes heard. It is now well established, however, that wood-burning stoves and fireplaces as well as wildland and agricultural fires emit significant quantities of known health-damaging pollutants, including several carcinogenic compounds. Two of the principal gaseous pollutants in woodsmoke, CO and NOx, add to the atmospheric levels of these regulated gases emitted by other combustion sources. Health impacts of exposures to these gases and some of the other woodsmoke constituents (e.g., benzene) are well characterized in thousands of publications. As these gases are indistinguishable no matter where they come from, there is no urgent need to examine their particular health implications in woodsmoke. With this as the backdrop, this review approaches the issue of why woodsmoke may be a special case requiring separate health evaluation through two questions. The first question we address is whether woodsmoke should be regulated and/or managed separately, even though some of its separate constituents are already regulated in many jurisdictions. The second question we address is whether woodsmoke particles pose different levels of risk than other ambient particles of similar size. To address these two key questions, we examine several topics: the chemical and physical nature of woodsmoke; the exposures and epidemiology of smoke from wildland fires and agricultural burning, and related controlled human laboratory exposures to biomass smoke; the epidemiology of outdoor and indoor woodsmoke exposures from residential woodburning in developed countries; and the toxicology of woodsmoke, based on animal exposures and laboratory tests. In addition, a short summary of the exposures and health effects of biomass smoke in developing countries is provided as an additional line of evidence. In the concluding section, we return to the two key issues above to summarize (1) what is currently known about the health effects of inhaled woodsmoke at exposure levels experienced in developed countries, and (2) whether there exists sufficient reason to believe that woodsmoke particles are sufficiently different to warrant separate treatment from other regulated particles. In addition, we provide recommendations for additional woodsmoke research.

Effect of protective filters on fire fighter respiratory health during simulated bushfire smoke exposure

BACKGROUND

Bushfire fighters are potentially subject to risks from bushfire smoke. Although many different protective masks and filters are available, it is not clear which is the most effective from a health and safety perspective. The effect of protective filters on the respiratory health of Western Australian urban career fire fighters under controlled simulated conditions is investigated.

METHODS

Sixty-four healthy Fire and Emergency Services Authority of Western Australia (FESA) urban career fire fighters were subjected to controlled simulated bushfire smoke in an open smoke chamber for 15 min. The fire fighters were allocated one of the three types of protective filters: particulate only (P), particulate/organic vapor (POV), and a particulate/organic vapor/formaldehyde (POVF) filter using a double-blind randomized procedure. Personal air sampling inside the fire fighters' masks, spirometry, oximetry, and self-reported symptom data were collected at baseline and at two time intervals after the smoke exposure.

RESULTS

A significant decline in oxygen saturation was seen immediately after exposure, however, the decline was small and no significant relationships could be established between this and the type of filter used. A significantly higher number of participants in the P and POV filter groups self-reported an increase in coughing, wheezing, and shortness of breath compared to the POVF group. Air sampling demonstrated a significantly higher level of formaldehyde and acrolein inside the masks fitted with P filters compared to POV and POVF filters.

CONCLUSIONS

Testing the effectiveness of P, POV, and POVF filters under controlled conditions has demonstrated that the POVF filter provides statistically significant better protection for the fire fighters' airways in a simulated bushfire exposure chamber.

On-line monitoring of pine needles combustion emissions in the presence of fire retardant using a “thermogravimetry (TG)-bridge/mass spectrometry method”

In this work a new method called TG-bridge/mass spectrometry is presented, for the on-line monitoring of the pine needles combustion emissions in a common lab furnace. The TG-bridge (thermogravimetry-bridge) system has been developed in-house as a TG-MS (thermogravimetry-mass spectrometry) interface, for TG-MS analysis. In this work, TG-bridge was used for directly sampling of the combustion emissions from the inside of the furnace and transferring them into the mass spectrometer (MS), without disturbing the sub-pressure conditions inside the MS ion source. The effect of Fire-Trol 931 (a long-term fire retardant) on the emissions, produced during the combustion of pine needles, is tested in the lab for future application in the field. It was shown that in treated samples, increased evolution of ammonia and aromatic compounds took place, compared to untreated samples. Maximum concentrations of specific compounds, such as benzene and toluene, evolved during the combustion experiments in the furnace, were determined.

Real-time and time-integrated PM2.5 and CO from prescribed burns in chipped and non-chipped plots: firefighter and community exposure and health implications

In this study, smoke data were collected from two plots located on the Francis Marion National Forest in South Carolina during prescribed burns on 12 February 2003. One of the plots had been subjected to mechanical chipping, the other was not. This study is part of a larger investigation of fire behavior related to mechanical chipping, parts of which are presented elsewhere. The primary objective of the study reported herein was to measure PM(2.5) and CO exposures from prescribed burn smoke from a mechanically chipped vs. non-chipped site. Ground-level time-integrated PM(2.5) samplers (n=9/plot) were placed at a height of 1.5 m around the sampling plots on the downwind side separated by approximately 20 m. Elevated time-integrated PM(2.5) samplers (n=4/plot) were hung atop approximately 30 ft poles at positions within the interior of each of the plots. Real-time PM(2.5) and CO data were collected at downwind locations on the perimeter of each plot. Time-integrated perimeter 12-h PM(2.5) concentrations in the non-chipped plot (AVG 519.9 microg/m(3), SD 238.8 microg/m(3)) were significantly higher (1-tail P-value 0.01) than those at the chipped plot (AVG 198.1 microg/m(3), SD 71.6 microg/m(3)). Similarly, interior time-integrated 8-h PM(2.5) concentrations in the non-chipped plot (AVG 773.4 microg/m(3), SD 321.8 microg/m(3)) were moderately higher (1-tail P-value 0.06) than those at the chipped plot (AVG 460.3 microg/m(3), SD 147.3 microg/m(3)). Real-time PM(2.5) and CO data measured at a position in the chipped plot were uniformly lower than those observed at the same position in the non-chipped plot over the same time period. These results demonstrate that smoke exposures resulting from burned chipped plots are considerably lower than from burned non-chipped plots. These findings have potentially important implications for both firefighters working prescribed burnings at chipped vs. non-chipped sites, as well as nearby communities who may be impacted from smoke traveling downwind from these sights.