title: Lung function and health status in metropolitan fire-fighters compared to general population controls.
abstract: OBJECTIVE
  To assess health status of South Australian (SA) metropolitan fire-fighters in terms of lung function and health-related quality of life, compare these with general population controls, and explore associations between fire-fighters' self-reported occupational exposure and health status.
  
  
  METHODS
  The study was a cross-sectional comparison of (respiratory) health indices between 501 fire-fighters and 1,324 general population controls taken from the North West Adelaide Health Study (NWAHS). All were men aged 21 to 61. Measurements included spirometry (i.e., forced expiratory volume in 1 s (FEV(1)), forced vital capacity (FVC), mid-expiratory flow (FEF(25-75)) and the Short Form 36 (SF-36) health-related quality of life questionnaire.
  
  
  RESULTS
  Health status in the fire-fighters was generally better than in NWAHS controls. Mean % predicted FEV(1) and FVC were 103.4% [SD 12.1] versus 89.5% [13.7] and 110.0% [11.6] versus 88.5% [12.5] (both p < 0.001 in linear regression analysis, adjusted for age, smoking, BMI, and FEV(1) % predicted). FEV(1)/FVC and FEF(25-75) were significantly lower in the fire-fighters (p < 0.003). A total of 93 (18.6%) fire-fighters and 82 (6.2%) controls had an FEV(1)/FVC < 70% (p < 0.001). The SF-36 Mental Health scale was the only scale on which fire-fighters had a lower mean score (p = 0.009), but none of the SF-36 scales showed clinically meaningful differences between the cohorts. Fire-fighters exposed > 6 h/week to dust, smoke, and fire showed lower FEV(1), FEV(1) % predicted, and FVC values compared to those who were less exposed (p < 0.05).
  
  
  CONCLUSIONS
  Male metropolitan fire-fighters showed better general health, better lung health, and similar mental health compared to general population controls. The high rate of fire-fighters with FEV(1)/FVC values below the recommended cut-point for airflow obstruction illustrates the inappropriateness of this clinical cut-point for use in populations preselected on their physical fitness. The observed dose-effect relationship between self-reported occupational exposure and fire-fighters' lung function warrants further investigation.
authors.affiliation: Primary Care Respiratory Research Unit, Department of General Practice, School of Population Health & Clinical Practice, The University of Adelaide, Adelaide, SA 5005, Australia. tjaarda.schermer@adelaide.edu.au
authors.forename: Tjard
authors.initials: T
authors.lastname: Schermer
authors.forename: Trish
authors.initials: T
authors.lastname: Malbon
authors.forename: Michael
authors.initials: M
authors.lastname: Morgan
authors.forename: Nancy
authors.initials: N
authors.lastname: Briggs
authors.forename: Christine
authors.initials: C
authors.lastname: Holton
authors.forename: Sarah
authors.initials: S
authors.lastname: Appleton
authors.forename: Robbert
authors.initials: R
authors.lastname: Adams
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
authors.forename: Alan
authors.initials: A
authors.lastname: Crockett
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004391:Dust; D004651:Employment; D005390:Fires; D006304:Health Status; D015989:Healthy Worker Effect; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D016272:Occupational Health / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology; D012119:Respiration; D012129:Respiratory Function Tests / Q000706:statistics & numerical data*; D012906:Smoke; D013021:South Australia; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult
chemical_list: D004391:Dust; D012906:Smoke