title: Prevalence and risk of asthma symptoms among firefighters in São Paulo, Brazil: a population-based study.
abstract: The firefighters are at increased risk of respiratory disease as a result of exposure to smoke and dust. The aim of this study was to determine the prevalence and risk associated with respiratory symptoms among city firefighters in São Paulo, Brazil.
  
  
  METHODS
  A cross-sectional study utilizing the European Community Respiratory Health Survey (ECRHS) questionnaire was administered to firefighters and police officers, in order to evaluate their respiratory symptoms.
  
  
  RESULTS
  Complete respiratory data were obtained from 1,235 firefighters and 1,839 police officers. Among the firefighters, there were 55.5% never-smokers, 22.4% current smokers and 18.2% former smokers (P < 0.05). Among the police officers, there were 63.4%, 18.6%, and 9.6% who were never-smokers, current smokers and former smokers (P < 0.05), respectively. Compared to police, firefighters experienced an increase in wheezing [OR = 1.63 (95% CI: 1.43-1.87)], wheezing with breathlessness [OR = 1.34 (95% CI: 1.10-1.64)], wheezing without a cold [OR = 1.60 (95% CI: 1.32-1.95)], waking with tightness in the chest [OR = 1.20 (95% CI: 1.02-1.42)], and rhinitis [OR = 1.12 (95% CI: 1.03-1.22)]. The prevalence of adult-onset asthma in never-smokers was 9.3% and 6.7% for firefighters and police officers [OR = 1.23 (95% CI: 1.01-1.56)]. An independent association was observed between years employed, smoking, history of rhinitis, and work as a firefighter and respiratory and nasal symptoms. We observed a high prevalence of asthma-like symptoms in firefighters who presented respiratory symptoms beginning immediately after firefighting.
  
  
  CONCLUSIONS
  These results suggest that the prevalence of respiratory symptoms and asthma in firefighters is higher than those in police officers. Work-as a firefighter, rhinitis and years employed were risk factors for respiratory symptoms of asthma.
authors.affiliation: Occupational and Environmental Group, Pulmonary Division, Heart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil. marcospneumo@ig.com.br
authors.forename: Marcos
authors.initials: M
authors.lastname: Ribeiro
authors.forename: Ubiratan
authors.initials: U
authors.lastname: de Paula Santos
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Bussacos
authors.forename: Mario
authors.initials: M
authors.lastname: Terra-Filho
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational; D001249:Asthma / Q000453:epidemiology*; D001938:Brazil / Q000453:epidemiology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D005390:Fires / Q000706:statistics & numerical data*; D006801:Humans; D016015:Logistic Models; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology*; D016495:Police / Q000706:statistics & numerical data*; D011159:Population Surveillance; D015995:Prevalence; D012135:Respiratory Sounds; D012220:Rhinitis / Q000453:epidemiology; D012307:Risk Factors; D012736:Sex Education; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D011795:Surveys and Questionnaires
chemical_list: D000395:Air Pollutants, Occupational