Reproductive hazards of fire fighting. I. Non-chemical hazards

Fire fighters are regularly exposed to chemical and non-chemical agents that have known or suspected adverse effects on reproductive health. Although chemical agents have received some attention, non-chemical hazards such as heat, noise, and physical exertion have only recently been examined for their reproductive effects. There is evidence that heat, noise, and physical exertion may affect various endpoints of reproductive health, including fertility, fetal loss, and growth parameters of the offspring. In particular, hyperthermia, a major fire fighting hazard, has been shown to impair male fertility and may also be teratogenic. Further study of the potential reproductive effects of this and other common non-chemical agents in the fire environment is needed to ensure the reproductive health of male and female fire fighters.     

Fire fighters' exposure to carbon monoxide during Australian bushfires

Fatal entrapments of Australian bushfire fighters have led to suggestions that carbon monoxide (CO) poisoning could have contributed to these accidents by impairing the fire fighters' judgement. Carboxyhemoglobin saturation (COHb%) levels were assessed from alveolar CO levels in 24 fire fighters working with handtools and in 12 accompanying scientific observers, before and after fire fighting (duration 37-187 min) on 15 experimental bushfires. Carboxyhemoglobin levels increased on average by 0.7% per hour in the fire fighters and by 0.3% per hour in the observers. Nonsmoking fire fighters had lower COHb% after fires than the smokers had before fires. Estimates of environmental CO concentrations (including cigarette smoke) during the fires averaged 31 parts per million (ppm) for the smokers, 17 ppm for the nonsmoking crew members, and 11 ppm for the observers, none of whom smoked. The highest estimates of environmental CO arising solely from bushfire smoke were 40 to 50 ppm. Smokers were exposed to as much CO from their cigarettes as from bushfire smoke. Carboxyhemoglobin levels at the end of 8-hr fire fighting shifts, predicted from these levels of environmental CO, averaged about 5% (maximum 11%) in smokers and about 3% (maximum 7%) in nonsmokers. Acute levels of COHb% of this degree are not considered to have significant effects on health or performance. These results indicate that bushfire fighters are generally unlikely to experience hazardous levels of CO exposure.     

Heart rates in fire fighters using light and heavy breathing equipment: similar near-maximal exertion in response to multiple work load conditions

Intense exertion is an occupational hazard inherent to fire fighting. This study was designed to look at the exertion levels that fire fighters attain during a fire fighting exercise when using (1) no self-contained breathing apparatus (SCBA), (2) light SCBA, and (3) heavy SCBA. Exertion levels were measured as a function of the heart rate increase relative to the maximum predicted heart rate determined by a standard treadmill exercise test. Five fire fighters wore electrocardiographic monitors during a routine fire fighting exercise. Heart rates increased rapidly to 70% to 80% of maximum within the first minute and then plateaued at 90% to 100% until the attack on the fire was completed. There was no significant difference between exertion levels when using no SCBA, light SCBA, and heavy SCBA (split-plot analysis of variance, p greater than .25). These results suggest that fire fighters attain an intense level of physical activity quickly and maintain that level as long as they are actively engaged in fighting fire. These results also suggest that regardless of the weight of the SCBA, if employed, fire fighters exert themselves from 85% to 100% of their maximum and adjust their work output to maintain that near-maximal level.     

Aging and the fitness of fire fighters: the complex issues involved in abolishing mandatory retirement ages.

This study presents an assessment of the cardiorespiratory health and physical fitness of fire fighters of different ages with the aim of addressing several questions currently being debated on a national level. These include how fire fighters differ across age groups in their health and physical fitness, and what would be the impact on the existing work force of implementing minimum fitness standards as an alternative to mandatory retirement ages. Fire fighters aged 20-65 years were found to be similar in their cardiorespiratory health and physical fitness to the sedentary segment of the general population of the same age. Particularly worrisome, however, is the low maximal aerobic capacity (31, 28, 26 ml/kg/min), high percent body fat (26, 29, 30), and high resting blood pressure (136/86, 140/90, 143/93 mm Hg) observed in the 40-45-, 50-55-, and 60-65-year-old fire fighters, respectively. In fact, 66%, 83%, and 93% of the fire fighters in these three age groups, respectively, fall below the lowest published recommendations for maximal aerobic capacity in this profession. These data underscore the need to establish minimum health and physical performance standards for fire fighters and demonstrate the profound impact such minimum standards will have on the existing work force.     

Mortality of a municipal-worker cohort: IV. Fire fighters

Morbidity and mortality studies of fire fighters have produced varied and inconsistent findings regarding the potential chronic effects of fire fighting including respiratory disease, cardiovascular disease, and cancer. The mortality experience of 1,867 white male fire fighters who were employed for the City of Buffalo a minimum of five years with at least one year as a fire fighter was studied. Vital status was determined for 99% of the cohort, resulting in 470 observed deaths. The fire fighter cohort was characteristic of a healthy worker population. All-cause mortality was close to the expected standardized mortality ratio (SMR) = 95, and significantly lower than expected mortality was seen for all external causes (SMR = 67)--in particular, for suicide (SMR = 21) and respiratory diseases (SMR = 48). Significantly elevated SMRs were found for benign neoplasms (SMR = 417), cancer of the colon (SMR = 183), and cancer of the bladder (SMR = 286). Cause-specific mortality is presented by number of years employed, calendar year of death, year of hire, and latency. Cancer mortality was significantly higher in the long-term fire fighters, and risk of mortality from all malignant neoplasms tended to increase with increasing latency. Patterns in risk of mortality among fire fighters for cancers of the bladder, colon, and brain are intriguing. Additional follow-up of this cohort and initiation of cancer morbidity studies would be helpful in further clarifying the potential long-term effects of fire fighting on cancer risk.     

Which subgroups of fire fighters are more prone to work-related diminished health requirements?

Purpose

To determine whether certain subgroups of fire fighters are prone to work-related diminished health requirements.

Methods

The health requirements for fire-fighting were tested in a workers’ health surveillance (WHS) setting. These health requirements included psychological, physical and sense-related components as well as cardiovascular risk factors. The odds ratio (OR) and 95% confidence interval (95% CI) for the presence of the diminished health requirements were calculated for the subgroups of gender, professionalism and age.

Results

The prevalence of diminished psychological requirements was equivalent among the subgroups, and no significant high-risk group was identified. As compared to men fire fighters, women fire fighters were more likely to have diminished physical requirements (OR 28.5; 95% CI 12.1–66.9) and less likely to have cardiovascular risk factors (OR 0.3; 0.1–0.5). As compared to volunteer fire fighters, professionals were less likely to have diminished physical requirements (OR 0.5; 0.3–0.9), but professionals had a higher prevalence of cardiovascular risk factors with an odds ratio of 1.9 (1.1–3.2). As compared to the youngest fire fighters, the oldest fire fighters were more likely to have diminished sense-related requirements (OR 7.1; 3.4–15.2); a similar comparison could be made between oldest and middle-aged fire fighters (OR 5.1; 2.5–10.5). In addition, the oldest fire fighters were more likely to have cardiovascular risk factors when compared to the youngest (OR 4.4; 1.7–11.1) and to the middle-aged fire fighters (OR 3.1; 1.2–7.9).

Conclusions

Subgroups (gender, professionalism and age) of fire fighters are prone to at least one specific work-related diminished health requirement. Therefore, parts of the WHS could be applied with more attention to these high-risk groups.     

Mortality and cancer incidence in stockholm fire fighters

Fire fighters are exposed to irritating, asphyxiating, and toxic gases and aerosols, to psychological stress, and to physically demanding work. Due to differences in fire fighting techniques, exposure conditions for fire fighters differ among different countries. The purpose of this investigation was to study cancer incidence and mortality in fire fighters who have been working with fire fighting methods used in Sweden from the beginning of this century onwards. All male fire fighters employed for at least 1 year in the City of Stockholm during 1931–1983 were traced, and an index of the number of fires fought was calculated for each individual. The mortality during 1951–1986 (among 1, 116 fire fighters) was lower than expected (SMR = 82; 95% confidence interval 72–91) compared with local mortality rates, with a low mortality in circulatory diseases, obstructive lung diseases, violent deaths, and suicides. The cancer incidence in 1958–1986 was equal to the expected (SMR = 100; 95% confidence interval 83–119). However, an excess of stomach cancer (18 observed vs. 9.37 expected: SMR = 192, 95% CI 114–304) was observed. There was also a tendency for higher incidence and mortality in stomach and brain cancer with increasing number of fires. There were four deaths from brain cancer compared to 0.8 expected (SMR = 496; 95% CI 135–1270) in the highest exposure category. Fire fighters are, however, not systematically exposed to known stomach or brain carcinogens, and the results need confirmation in further studies with extensive exposure evaluations. © 1994 Wiley-Liss, Inc.     

Occupational exposures in California wildland fire fighting.

Industrial hygiene measurement of exposures to wildland fire fighters was conducted in northern California during three consecutive fire seasons (1986-1989) in conjunction with three separate health effects studies. Chemicals that were monitored included carbon monoxide, total and respirable particulates, polyaromatic hydrocarbons (PAHs), crystalline silica, aldehydes, and benzene. Measurements were taken at both wildland fires and prescribed (planned) burns. A variety of collection methods were employed--colorimetric detector tubes and a CO monitor were used for direct-reading area measurements; colorimetric diffusion tubes, filter cassettes, sorbent tubes, and passive vapor monitors were used for determining personal time-weighted average exposures. A new screening method (National Institute for Occupational Safety and Health Method 2539) was used to identify the presence of specific aldehydes. Results show that wildland fire fighters may at times be exposed to concentrations of carbon monoxide, total or respirable particulates, or silica at levels near or higher than recommended occupational exposure limits, although group means were generally well below the limits. Time-weighted average formaldehyde levels, measured in a few instances above 0.37 mg/m3 (0.3 ppm), indicate a potential for formaldehyde-induced eye or respiratory irritation under these conditions. Certain characteristics of the work such as high altitude, temperature, and breathing rate; extended work shifts; and additional off-shift exposures suggest that adjustment of 8-hr exposure limits may be necessary to provide adequate protection. In part, because of the rigors of performing industrial hygiene measurements under fire fighting conditions, data are limited and could not be considered representative of the full range of exposures fire fighters may encounter.(ABSTRACT TRUNCATED AT 250 WORDS)     

The effects of a worksite health promotion program on the wives of fire fighters

One method of increasing the cost-effectiveness of worksite health promotion programs is to develop programs that also have an impact on risk factors of family members and friends of the employees. In this study, 41 wives of fire fighters were interviewed concerning changes the fire fighters and they had made in their health habits--exercise, weight, and consumption of fats, fruits/vegetables, and cereal/whole grain breads--in the previous year. Thirty-two were wives of fire fighters who had received a worksite health promotion program and nine were wives of fire fighters who had not yet received the program. Findings of our exploratory study strongly suggest that wives of fire fighters who received information were more aware of the program (93% vs 56%), had greater exposure to the written diet plan (72% vs 11%) and guide to high fat foods (72% vs 0%) than controls. Furthermore, the intervention led to changes in the fire fighters' health habits that were reported by the wives. No significant changes in the wives' health habits occurred as a result of the intervention, although the changes were in the predicted direction in every category; changes by the wives were, however, related to changes by fire fighters. Involvement of the fire fighters in the preparation of meals and sharing of information from the intervention program by the participant with the wife, were related to change in health habits of the wives.(ABSTRACT TRUNCATED AT 250 WORDS)     

Occupational noise exposure and hearing loss in fire fighters assigned to airport fire stations.

The National Institute for Occupational Safety and Health (NIOSH) was requested to conduct a health hazard evaluation (HHE) at a large metropolitan fire department. The request concerned the hearing levels and noise exposures of fire fighters who were assigned to two fire stations serving the international airport. There was concern that these fire fighters were at a greater risk of accruing hearing loss than fire fighters located at other fire stations because of the addition of aircraft noise to their occupational noise exposures. The city also requested that NIOSH investigate other fire stations, not influenced by the airport, for noise exposures and hearing ability among a larger population of the fire fighters. NIOSH investigators conducted noise surveys at five fire stations and examined the hearing ability of 197 fire fighters. The noise surveys consisted of personal noise dosimetry on fire fighters assigned to the fire station for the entire 24-hr tour of duty over 2 consecutive days at each of the five stations. A NIOSH investigator accompanied the fire fighters on their vehicle to log response times and activities. The audiometric examinations were pure-tone, air conduction tests administered according to the Occupational Safety and Health Administration's (OSHA's) hearing conservation amendment. The noise dosimetry results revealed time-weighted averages (TWAs) that ranged from 60 to 82 dBA. However, the levels encountered during Code 3 responses (warning lights, sirens, and air horns) reached 109 dBA for a 1-min time period. The audiometric results showed that the average fire fighter exhibited a characteristic noise-induced permanent threshold shift.(ABSTRACT TRUNCATED AT 250 WORDS)     

Reproductive hazards in the work place.

Discusses the importance of addressing the potential toxic effects of harmful agents encountered through occupational exposure on the fetus and the male and female reproductive systems. Some employers in the United States have excluded females from job positions that may have the potential to interfere with normal reproductive function. This policy is contrary to the Equal Employment Opportunity Act of 1972 unless there is scientific evidence that a risk exists exclusively for women. The 2 major difficulties in determining the impact of occupational exposure are the extremely large number of chemical and physical agents to which workers may be exposed, and that the effects of these agents are multifactorial. Lists of possible adverse effects are provided; spontaneous abortion, low birth weight, malformation, and infertility are discussed at length. Adverse reproductive effects associated with various toxic agents are summarized in table form. Receiving special comments are anesthetic gases, lead and mercury, vinyl chloride, chloroprene, radiation, pesticides, hydrocarbons, solvents, and polychlorinated biphenyls. The authors declare a need for more research in this area, and a need for the establishment of a legal mechanism to enable industry to participate in reproductive outcome studies without being threatened by potential future litigation.     

Job stress and depressive symptoms among Japanese fire fighters

BACKGROUND: Associations between job stresses, as assessed by theoretical job stress model and depressive symptoms among fire fighters have not been fully investigated. The purpose of this study is to clarify the factors of job stress that influence the depressive symptoms in Japanese fire fighters. METHODS: The subjects involved 1,672 fire fighters from a local government. The questionnaire comprised age, gender, job type, job class, martial status, smoking, and drinking habit, the Center for Epidemiologic Studies Depression Scale (CES-D), and The National Institute for Occupational Safety and Health (NIOSH) generic job questionnaire. RESULTS: A group showing depressive symptoms (CES-D > or = 16) included 373 subjects (22.3%). In a multivariate logistic regression analysis, high variance in workload, high intergroup conflict, high role conflict, and low self-esteem had significantly higher odds ratio for depressive symptoms. CONCLUSIONS: High variance in workload, high intergroup conflict, high role conflict, and low self-esteem were significantly related to depressive symptoms among Japanese fire fighters. Further prospective studies are needed to clarify the influence of these stress factors on other health outcomes, and to elucidate whether alleviation of these stress factors improve the mental health among fire fighters.     

Carbon Monoxide: A Hazard to Fire Fighters

Carbon monoxide levels were measured in twenty-five fires in the city of Los Angeles to obtain information about fire fighters exposure to carbon monoxide. Levels as high as 3,000 ppm were observed for some fires. In general, when carbon monoxide levels were significantly elevated (> 100 ppm) the smoke was quite heavy and noxious, but in some cases the smoke was heavy and carbon monoxide levels were minimal. In two-story structures, the highest concentrations of carbon monoxide were found on the second-floor level and were usually (still elevated after the fire had been “knocked down” but was still smoldering. These data show that fire fighters are exposed to levels of carbon monoxide which could be a serious health hazard and may be related to the high incidence of heart disease in fire fighters.     

Workplace hazards to women's reproductive health

Women make up nearly half of Minnesota's workforce. Thus, many women, including those of reproductive age, are exposed to workplace hazards. These hazards may be chemical-toxicants such as heavy metals, pesticides, and endocrine disruptors; physical--the result of activities or proximity to something in the environment; or biological-infectious agents. And they are of growing concern among scientists and the public. Although data on the effect of these hazards on the reproductive health of women is limited, there is evidence indicating they ought to be of concern to women and the physicians who treat them. Clinicians are encouraged to assess women for exposure to workplace hazards and to communicate with them about whether such exposure might increase their risk for problems such as infertility, miscarriage, and preterm birth. This article highlights selected job-related hazards and offers suggestions for caring for working women of reproductive age.     

A longitudinal study of pulmonary function in fire fighters

Pulmonary function changes among fire fighters were evaluated by re-examining 632 Baltimore city fire fighters six to ten years after a baseline examination. Spirometry was used to determine forced expiratory volume in 1 second (FEV1). Information about exposures was obtained by questionnaire and by combining data from fire department records regarding the number of fires fought by fire fighting units with individual work histories. Men who never wore a mask while extinguishing fires experienced a 1.7 times greater rate of FEV1 decline than mask wearers. Men with ammonia exposure experienced a rate of decline 1.7 times greater than non-exposed men. Neither length of time spent in exposed jobs nor number of responses were associated with the rate of decline. Active fire fighters experienced a rate of decline 2.5 times greater than those who had retired or resigned. Some effects differed between men who were able to perform repeatable pulmonary function tests and those who were not.     

Clinimetric quality of the fire fighting simulation test as part of the Dutch fire fighters Workers' Health Surveillance

Background  

Clinimetric data for the fire fighting simulation test (FFST), a new test proposed for the Workers' Health Surveillance (WHS) of Dutch fire fighters, were evaluated.     

Road to a smoke-free fire service for Florida: policies and progress

In 1986 the Professional Fire Fighters of Florida (PFFF), a labor organization of 11,000 members, passed an unprecedented resolution to create a "smoke-free fire service." The PFFF's commitment arose from its (i) concern for the health of fire fighters, (ii) need to address the issue of smoking to protect the fire fighters' "Heart and Lung Law," and (iii) attempt to avert criticism of its proposed presumptive "Cancer Bill." In 1987 the PFFF gained support for its resolution from a council representing chiefs, fire instructors and inspectors, and volunteer fire fighters. Prior to the "smoke-free" resolution, one fire department in Florida required that new fire fighters be non-smokers. Since the resolution passed, 14 departments added this requirement. In 1989 the PFFF succeeded in getting a landmark bill passed requiring that new fire fighters be non-users of tobacco for at least one year prior to application. Important implications of the PFFF's efforts to create a "smoke-free fire service" are also discussed.     

Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME)

The Promoting Healthy Lifestyles: Alternative Models' Effects (PHLAME) study evaluates the efficacy of two intervention strategies for improving nutrition and physical activity practices in fire fighters: a team-centered program and a one-on-one format targeting the individual. PHLAME compares these two behavior change models (the team-based versus the one-on-one approaches) against a usual-care control group. As a group, fire fighters have a concentration of the same harmful behaviors and health risks commonly afflicting the US population. Fire fighters have a unique work structure which is ideal for a team-centered model of behavior change. This strategy, based on Social Learning Theory, focuses on a team of fire fighters who work together on the same shift. If this team-centered model proves successful, it could provide a cost-effective method to impact behavior, and be disseminated among fire bureaus and in other team settings. The one-on-one intervention incorporates the Transtheoretical Model of behavior change, uses Motivational Interviewing for its counseling strategy and could be used in the more typical provider-client clinic setting. Findings from PHLAME will provide information about the process and outcomes of these models' ability to achieve health behavior change.