title: Occupational exposures and symptoms among firefighters and police during the carmel forest fire: the Carmel cohort study.
abstract: BACKGROUND
  From 2 to 5 December 2010, Israel experienced the most severe forest fire In its history, resulting in the deaths of rescue workers. Little research exists on the health risks to emergency responders during forest fires, and there is no published research to date on occupational health among firefighters in Israel.
  
  
  OBJECTIVE
  To describe the exposures experienced by emer gency responders to smoke, fire retardants and stress; the utilization of protective equipment; and the frequency of corresponding symptoms during and following the Carmel Forest fire.
  
  
  METHODS
  A cohort of 204 firfighers and 68 police who took part in rescue and fire-abating activites during the Carmel Forest fire were recruited from a representative sample of participating stations throughout the country and interviewed regarding their activities during the fire and their coinciding symptoms. Unpaired two-sample t-test compared mean exposures and symptom frequency for firefighters and police. Chi-square estimates of OR and 95%CI are provided for odds of reporting symptoms, incurring injury or being hospitalied for various risk factors
  
  
  RESULTS
  Of the study participants, 87% reported having at least one symptom during rescue work at the Carmel Forest fire,with eye irritation (77%) and fatigue (71%) being the most comon. Occupational stress was extremely high during the fire; the average length of time working without rest was 18.4 hours among firefighters.
  
  
  CONCLUSIONS
  Firefighter and police were exposed to smoke and ocupational stress prolonged periods during the fire. Further research is needed on the residual health effects from exposure to forest fires among emergency responders, and to identify areas for improvement in health preparedness.
authors.affiliation: Department of Occupational and Environmental Health, University of Haifa, School of Public Health, Haifa, Israel. eamster@harvard.post.edu
authors.forename: Eric D
authors.initials: ED
authors.lastname: Amster
authors.forename: Shahar S
authors.initials: SS
authors.lastname: Fertig
authors.forename: Uri
authors.initials: U
authors.lastname: Baharal
authors.forename: Shai
authors.initials: S
authors.lastname: Linn
authors.forename: Manfred S
authors.initials: MS
authors.lastname: Green
authors.forename: Zvi
authors.initials: Z
authors.lastname: Lencovsky
authors.forename: Rafael S
authors.initials: RS
authors.lastname: Carel
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D061388:Firefighters / Q000706:statistics & numerical data*; D005390:Fires / Q000706:statistics & numerical data*; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects / Q000706:statistics & numerical data; D016272:Occupational Health; D016495:Police / Q000706:statistics & numerical data*; D018635:Rescue Work / Q000379:methods / Q000706:statistics & numerical data; D012134:Respiratory Protective Devices / Q000145:classification / Q000706:statistics & numerical data; D012307:Risk Factors; D012906:Smoke / Q000009:adverse effects / Q000032:analysis; D015208:Smoke Inhalation Injury / Q000209:etiology / Q000401:mortality / Q000503:physiopathology / Q000517:prevention & control; D014197:Trees
chemical_list: D012906:Smoke