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Acute Upper and Lower Respiratory Effects in Wildland Firefighters

Gaughan, Denise M. MPH; Cox-Ganser, Jean M. PhD; Enright, Paul L. MD; Castellan, Robert M. MD, MPH; Wagner, Gregory R. MD; Hobbs, Gerald R. PhD; Bledsoe, Toni A. MS; Siegel, Paul D. PhD; Kreiss, Kathleen MD; Weissman, David N. MD

Journal of Occupational and Environmental Medicine: September 2008 - Volume 50 - Issue 9 - p 1019-1028
doi: 10.1097/JOM.0b013e3181754161
Original Articles

Objectives: To assess acute respiratory effects experienced by wildland firefighters.

Methods: We studied two Interagency Hotshot Crews with questionnaires, spirometry, and measurement of albumin, eosinophilic cationic protein (ECP), and myeloperoxidase (MPO) as indicators of inflammation in sputum and nasal lavage fluid. Assessments were made preseason, postfire, and postseason.

Results: Fifty-eight members of the two crews had at least two assessments. Mean upper and lower respiratory symptom scores were higher postfire compared to preseason (P < 0.001). The mean forced expiratory volume in 1 second was lower postfire compared to preseason (P < 0.001) and then recovered by postseason. Individual increases in sputum and nasal ECP and MPO from preseason to postfire were all significantly associated with postfire respiratory symptom scores.

Conclusions: Wildland firefighting was associated with upper and lower respiratory symptoms and reduced forced expiratory volume in 1 second. Within individuals, symptoms were associated with increased ECP and MPO in sputum and nasal lavage fluid. The long-term respiratory health impact of wildland firefighting, especially over multiple fire seasons, remains an important concern.

From the National Institute for Occupational Safety and Health (NIOSH) (Ms Gaughan, Dr Cox-Ganser, Dr Castellan, Dr Wagner, Ms Bledsoe, Dr Siegel, Dr Kreiss and Dr Weissman), Morgantown, WVa.; University of Arizona (Dr Enright), Tucson, Ariz.; West Virginia University (Dr Hobbs), Morgantown, WVa.

Address correspondence to: Denise M. Gaughan, MPH, NIOSH MS-H2800, 1095 Willowdale Road, Morgantown, WV 26505; E-mail:

©2008The American College of Occupational and Environmental Medicine