Respiratory effects in the aftermath of a major fire in a chemical waste depot.
OBJECTIVE
The aim of this study was to investigate respiratory effects among emergency services first responders and residents with exposure to combustion products in the aftermath of a chemical waste depot fire.


METHODS
The study population comprised 138 individuals who were present in the area downwind of an accidental fire. Identified by telephone interview six years later, subjects with persistent respiratory symptoms were suspected as having Reactive Airways Dysfunction Syndrome (RADS). Medical tests were performed. For bronchial responsiveness, a cut-off point of PD (20)<2.39 mg histamine was taken and a dose-response slope (DRS) was calculated. Suspected RADS cases were compared with healthy controls for exposure to combustion products, lung function, and bronchial responsiveness.


RESULTS
The 25 suspected RADS cases were more frequently exposed than the 99 controls; the crude odds ratio for high versus low exposure was 6.5 [95% confidence interval (95% CI) 2.4-18.0]. Suspected cases showed a lower ratio of forced expiratory volume in one second to forced vital capacity (FEV(1)/FVC; P=0.028). Overall, suspected cases had higher DRS than controls. The difference was significant for males only (P=0.006), and non-smoking males (P=0.014). Highly exposed subjects had higher DRS than low exposed subjects (P=0.056). These differences were significant when restricted to non-smokers (P=0.034) and to males (P=0.019). Differences between cases and controls were stronger when the population was restricted to current non-smokers.


CONCLUSIONS
Persistent respiratory symptoms and bronchial responsiveness were associated with exposure to combustion products of a chemical waste depot fire which occurred more than six years earlier. Authorities and emergency services are recommended to take this into consideration when managing incidents in order to limit possible exposure to airway irritants.
Greven
Frans
F
Department of Environmental Health, Municipal Health Services, Hulpverleningsdienst Groningen, PO Box 584, 9700 AN, Groningen, the Netherlands. f.greven@hvd.groningen.nl
Kerstjens
Huib A M
HA
Duijm
Frans
F
Eppinga
Pier
P
de Meer
Gea
G
Heederik
Dirk
D
D000393:Air Pollutants / Q000633:toxicity*; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005390:Fires; D015386:Hazardous Substances; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D016272:Occupational Health; D012129:Respiratory Function Tests; D012140:Respiratory Tract Diseases / Q000209:etiology*
D000393:Air Pollutants; D015386:Hazardous Substances