Acute respiratory effects in firefighters

• Published in: American journal of industrial medicine 2012-01, Vol.55 (1), p.54-62
• Main Authors: Greven, Frans E., Krop, Esmeralda J., Spithoven, Jack J., Burger, Nena, Rooyackers, Jos M., Kerstjens, Huib A., van der Heide, Sicco, Heederik, Dick J.
• Format: Article
• Language: English
• Subjects: Acute Disease; Adult; Biological and medical sciences; Bronchial Hyperreactivity - blood; Bronchial Hyperreactivity - physiopathology; bronchial hyperresponsiveness; Bronchial Provocation Tests; Chemical and industrial products toxicology. Toxic occupational diseases; Chronic obstructive pulmonary disease, asthma; Cross-Sectional Studies; cytokines; Cytokines - blood; Enzyme-Linked Immunosorbent Assay; Female; Firefighters; Humans; inflammation; Inorganic dusts (pneumoconiosises) and organic dusts (byssinosis etc.); Male; Medical sciences; Middle Aged; Netherlands; Neutrophils; Occupational Exposure - adverse effects; Pneumology; Regression Analysis; serum pneumoproteins; Smoke - adverse effects; Smoke Inhalation Injury - blood; Smoke Inhalation Injury - physiopathology; Spirometry; Sputum - chemistry; Surveys and Questionnaires; Toxicology; Uteroglobin - blood
• ISSN: 0271-3586; 1097-0274
• DOI: 10.1002/ajim.21012

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. Am. J. Ind. Med. 55:54–62, 2012. © 2011 Wiley Periodicals, Inc.