title: Lung function, bronchial hyperresponsiveness, and atopy among firefighters.
abstract: OBJECTIVE
  The aim of this study was to determine associations between lung function, bronchial hyperresponsiveness (BHR), and atopy with exposure to fire smoke among firefighters.
  
  
  METHODS
  The study was comprised of 402 firefighters, a randomly chosen subset of a previous survey among firefighters in the Netherlands. Subjects underwent spirometry and methacholine provocation, and blood samples were taken to assess atopy. Exposure to fire smoke was registered by a questionnaire.
  
  
  RESULTS
  Hyperresponsiveness expressed as dose-response slope (DRS) was positively and significantly associated with the number of fires fought in the last 12 months with and without adjustments for smoking, gender, atopy, age, and exposure in the main job held. Limiting the analysis to firefighters without exposure within 7 days of testing did not change any of the associations. The association between the number of fires and the DRS was stronger among atopics, and hyperresponsiveness expressed as PD (20)was also significantly associated, indicating that atopics are at higher risk of developing BHR as a result of smoke exposure. Respiratory protection devices were not optimally used.
  
  
  CONCLUSIONS
  It is recommended that awareness be heightened among firefighters to avoid exposure to all fire smoke and that management be sensitive to the adequate use of self-contained breathing apparatuses by their personnel.
authors.affiliation: Department of Environmental Health, Municipal Health Services, Hulpverleningsdienst, Groningen, PO Box 584, 9700 AN, Groningen, the Netherlands. f.greven@hvd.groningen.nl
authors.forename: Frans
authors.initials: F
authors.lastname: Greven
authors.forename: Esmeralda
authors.initials: E
authors.lastname: Krop
authors.forename: Jack
authors.initials: J
authors.lastname: Spithoven
authors.forename: Jos
authors.initials: J
authors.lastname: Rooyackers
authors.forename: Huib
authors.initials: H
authors.lastname: Kerstjens
authors.forename: Dick
authors.initials: D
authors.lastname: Heederik
mesh_terms: D000328:Adult; D016535:Bronchial Hyperreactivity / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D060731:Emergency Responders; D005260:Female; D061388:Firefighters; D005390:Fires; D006801:Humans; D019570:Inhalation Exposure; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009784:Occupational Diseases / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012129:Respiratory Function Tests / Q000379:methods; D012143:Respiratory Physiological Phenomena; D012906:Smoke / Q000009:adverse effects; D015208:Smoke Inhalation Injury / Q000209:etiology / Q000473:pathology / Q000503:physiopathology*; D055815:Young Adult
chemical_list: D012906:Smoke