Firefighters have been shown to suffer chronic respiratory morbidity from their occupational exposures to smoke (T. L. Guidotti 1992). They routinely operate in harsh work environments with excessive heat and saturated smoke. Before recruitment (State of Connecticut), firefighters pass through a medical examination of The musculoskeletal; eyes and vision; nose, mouth, and throat and finally the respiratory tract (State 2015).
In an interview with theconverstion.com (Cassidy Jan 17, 2014) an experienced fire-fighter mentioned that his profession had made him develop the chronic obstructive pulmonary disease (COPD). COPD is the umbrella term for lung diseases including emphysema, chronic bronchitis, and chronic asthma. Cigarette smoke is the primary cause of the disease yet it has been seen to be very common in fire-fighters. According to a study by the International Association of Fire Fighters (IAFF) in 2000, one out of every 50 fighters were exposed to a respiratory communicable disease (Williams 2006).
During the decade beginning 1st January 1985, 887 full-time fire-fighters, all male, left the service of Strathclyde Fire Brigade (SFB). There were 17 deaths, compared to 64.4 expected in the Scottish under 50 male population, giving a standardized mortality ratio of 26 and 488 ill-health retirements (Occupational Medicine 48 (6), 381-388, 1998). All this can be retraced to the severe working conditions fire-fighters are exposed to. Almost 34% of retired firemen in the Republic of Chile suffer from chronic lung diseases making it the highest percentage in the world of post-working respiratory diseases. It is hence common that nearly a quarter of fire-fighters in the world, working and retired, suffer from chronic respiratory disorders.
Legally permissible limits. According to a report presented to The Committee On Education And The workforce Sub-committee On Workforce Protections, by David Michaels(2011); firemen adversely affected by smoke and other particles in the line of duty should be granted an earlier and compulsory retire at 40 years of age (MG Carey 2011).
In 1971, the National Safety Council (USA); approximated that 38 workers passed on in the course of their duty every day. 2 of which were firemen (United States Department of Labour, OSHA) .today, the number is 12 per day, with a workforce that is twice as large. Illnesses and injuries have also decreased; from 10.9/100 workers annually to as less as 4/10 in 2009. Affected individuals have always been compensated including fire-fighters.
Affected fire-fighters normally have a drooping curve health record (T. L. Guidotti 1927-1987). Their mortality rate has increased over the past decades and this has ensured an active topic of investigation (JA Difede 2007). Collateral toxicology evidence suggests that most deaths of aged firemen, who had former clear medical records while on duty, are closely linked to fire fighting. With common illnesses being:
- lung cancer
- heart diseases
- obstructive pulmonary diseases
(Black et al.. 1996) There has not been a vivid and consistent demonstration of excess risk due to occupational exposure for these outcomes.
There are certain other cancers that appear to be consistently elevated in relation to firemen including:
- Genitourinary, colon, and rectum
- Leukemia
- Lymphomas
- Myeloma
The American journal of industrial medicine (James J. Beaumont 1991), carried out a research to test the hypothesis that fire-fighter exposures may increase cancer risks. Mortality rates were calculated for fire-fighters in San Francisco (Sandra C Dorman 2014). It was found out that of the 3,066 employees between 1940 and 1970, 511 had respiratory infections. This is almost 1/6 of the total employees. The numbers have not shown any consistent trend of rising or falling but either-way, they are still alarming. (Nicholas Heyer 1990, 1945-1983).
The Wiley Online Library further established that there have been 383 deaths out of 2289 Seattle firefighters from 1945 to 1983. Excess mortality from leukemia (SMR=503, n=3) and multiple myeloma (SMR=989, n=2) was observed among fire-fighters with over 30 years of work experience. Lung cancer mortality was high (SMR=177, n=18) among firefighters over 65 years of age (RJ Butler 2017). Firemen at risk only after 30 years from first exposure were also analyzed and a trend of increasing risk with increase in exposure was observed for respiratory diseases. It was depicted from the analysis that fire-fighters with 30 years or more fire combat duty had a higher risk of getting infected compared to those with halfway their experience.
Implemented control Measures. Several control measures have been put forth by companies and governments to mainly and most importantly protect fire-fighters from exposure to harmful toxins while on duty. They include:
Abstaining from smoking. Smoking is strongly linked to chronic respiratory diseases. Firefighters, of all individuals, have a higher exposure to toxic smoke. They are hence advised not to smoke at all. Subsidiary programmes have been initiated to discourage smoking in fire-fighters and other workers that are highly exposed to toxic substances.
Training. Every member of the service is made knowledgeable of the risks awaiting in the environment. They are hence made to understand the physic-biological relations of their bodies and the environment.
Effective health and safety programs. Fire-fighters are subject to a regular lung-functioning test, commonly known as PFTs. This testing allows full documentation and monitoring of their health with respect to their professional exposure.
Using respiratory protective equipment. This is the most important control measure implemented. It is compulsory for every fire-fighter to be in full protective clothing when fighting the fire, the magnitude notwithstanding. The protective clothing includes: heat protection; reflective clothing; helmets; fine grip boots and a gas mask.
The implemented controls have been highly effective in reducing the numbers of fire-fighters exposed to toxic smoke (JE Kim 2018). This has in-turn cut-down the mortality rate of firefighters and has helped in boosting the lucrativeness of the profession. Some measures have however not been adhered to the latter. This includes abstaining from the smoke. A negligible percentage of firemen, especially in pre-modern societies in Africa, still smoke. I suggest the relevant authorities initiate more health and safety programs to curb this. On the positive side, the major control measure listed above have been effective in protecting the fire-fighters.
References
Black et al.., P Wang, PS Gartside. "Risk factors of firefighting." The American Journal, 1996.
Cassidy, Elizabeth. "Lung Infections." PLUS ONE, Jan 17, 2014.
Guidotti, Tee L. "Industrial Medicine." Mortality of Urban Firefighters in Alberta, 1927-1987: 921-940.
Guidotti, Tee L. "International Archives of Occupational and Environmental Health." Link Springer, 1992: 1-12.
JA Difede, J Cukor, N Jayasinghe, I Patt. "virtual reality exposure therapy." Journal of clinical, 2007.
James J. Beaumont, George ST Chu, Jeffery R Jones, Marc B Schenker, James A Singleton. "Epidemiologic Study of Cancer." The American Journal, 1991: 357-372.
JE Kim, SR Dager, HS Jeong, J Ma. "Results from a nationwide total population survey." Firefighters, Posttraumatic stress disorder, and barriers to treatment, 2018.
MG Carey, SS Al-Zaiti, GE Dean. "Quality of-of life in professional firefighting." The American journal, 2011.
Nicholas Heyer, Noel S Weiss, Paul Demers, Linda Rosenstock. "Cohort Mortality Study." The American Journal, 1990, 1945-1983: 493-504.
RJ Butler, P Upchurch, DB Norman, JC parish. "smoke exposure." The American journal, 2017.
Sandra C Dorman, Stacey A Ritz. "Smoke exposure." Journal of Respiratory Medicine, 2014.
State, Connecticut. "Medical Examination Guidance for Physician." NFPA 1582, 2015: 1-16.
Williams, Derek. "Communicable Disease and the Fire Service." Methicillin-Resistant Staphylococcus Aureus(MRSA), December 2006: 1-12.
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