title: Chronic respiratory conditions in a cohort of metropolitan fire-fighters: associations with occupational exposure and quality of life.
abstract: OBJECTIVE
  To assess the prevalence of chronic respiratory conditions in metropolitan fire-fighters and to study associations between occupational exposure, use of respiratory protection and health-related quality of life (HRQoL) in fire-fighters with and without chronic respiratory conditions.
  
  
  METHODS
  Cross-sectional cohort analysis: Respiratory symptoms, medical conditions, occupational tasks and exposures and consistency of using respiratory protection were inquired by questionnaire. The SF12(®)V2 Health Survey was used to measure physical (PCS-12) and mental (MCS-12) HRQoL. Fire-fighters were categorised in subgroups: asthma; COPD/emphysema/chronic bronchitis; no chronic respiratory conditions; and as being 'not involved' or 'involved' in fire-fighting tasks, the latter further categorised as 'consistent' or 'inconsistent' use of respiratory protection. PCS-12 and MCS-12 scores were compared between subgroups and categories using linear regression.
  
  
  RESULTS
  Five hundred and seventy fire-fighters were analysed, 24 (4%) fulfilled the criteria for asthma, 39 (7%) for COPD/emphysema/chronic bronchitis. Fire-fighters with asthma were older than those in the other two subgroups and had been employed in the fire service longer. Respiratory subgroups did not differ in their involvement in fire-fighting tasks. Ninety-one percent of fire-fighters reported relevant occupational exposure in the past year. Mean PCS-12 scores for fire-fighters with no chronic respiratory conditions, asthma and COPD/emphysema/bronchitis were 52.0 (SD 6.9), 47.0 (8.5) and 48.1 (9.4). For PCS-12 (but not for MCS-12), interaction between having a chronic respiratory condition and inconsistent use of respiratory protection during fire knockdown was observed (p < 0.001).
  
  
  CONCLUSIONS
  Ten percent of metropolitan fire-fighters reported underlying chronic respiratory conditions. Presence of such a condition in combination with suboptimal protection from inhaled exposures may lead to poorer physical HRQoL.
authors.affiliation: Primary Care Respiratory Research Unit, Discipline of General Practice, School of Population Health, The University of Adelaide, Adelaide, SA, 5005, Australia, tjaarda.schermer@adelaide.edu.au.
authors.forename: Tjard R
authors.initials: TR
authors.lastname: Schermer
authors.forename: Winifred
authors.initials: W
authors.lastname: Malbon
authors.forename: Michael
authors.initials: M
authors.lastname: Morgan
authors.forename: Michael
authors.initials: M
authors.lastname: Smith
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Crockett
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D005260:Female; D061388:Firefighters / Q000523:psychology / Q000706:statistics & numerical data*; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects*; D011788:Quality of Life / Q000523:psychology*; D012140:Respiratory Tract Diseases / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires; D014505:Urban Population / Q000706:statistics & numerical data