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Adverse Respiratory Effects Following Overhaul in Firefighters

Burgess, Jefferey L. MD, MPH; Nanson, Christopher J. MPH; Bolstad-Johnson, Dawn M. MPH; Gerkin, Richard MD; Hysong, Tracy A. BA; Lantz, R. Clark PhD; Sherrill, Duane L. PhD; Crutchfield, Clifton D. PhD; Quan, Stuart F. MD; Bernard, Alfred M. PhD; Witten, Mark L. PhD

Journal of Occupational and Environmental Medicine: May 2001 - Volume 43 - Issue 5 - p 467-473
Original Articles

Overhaul is the stage in which firefighters search for and extinguish possible sources of reignition. It is common practice not to wear respiratory protection during overhaul. Fifty-one firefighters in two groups, 25 without respiratory protection and 26 wearing cartridge respirators, were monitored for exposure to products of combustion and changes in spirometric measurements and lung permeability following overhaul of a structural fire. Testing at baseline and 1 hour after overhaul included forced vital capacity (FVC), forced expiratory volume in one second (FEV1), serum Clara cell protein (CC16), and serum surfactant-associated protein A (SP-A). Overhaul increased CC16 in both groups, indicating increased alveolar-capillary membrane permeability. Contrary to expectations, SP-A increased and FVC and FEV1 decreased in the firefighters wearing cartridge respirators. Changes in FEV1, CC16, and SP-A were associated with concentrations of specific products of combustion or carboxyhemoglobin levels. Firefighter exposures during overhaul have the potential to cause changes in spirometric measurements and lung permeability, and self-contained breathing apparatus should be worn during overhaul to prevent lung injury.

From the University of Arizona, Tucson (Dr Burgess, Dr Crutchfield, Dr Lantz, Dr Sherrill, Dr Quan, Dr Witten, Mr Nanson, Mrs Hysong); the City of Phoenix Fire Department Health Center (Ms Bolstad-Johnson, Dr Gerkin); and the Industrial Toxicology and Occupational Medicine Unit, Catholic University of Louvain, Brussels, Belgium (Dr Bernard).

Address correspondence to: Dr Jefferey L. Burgess, Environmental and Occupational Health, University of Arizona College of Public Health, 1435 North Fremont, Box 210468, Tucson, AZ 85719-4197; e-mail

The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the National Institute for Occupational Safety and Health.

Copyright © by American College of Occupational and Environmental Medicine

© 2001 Lippincott Williams & Wilkins, Inc.