title: Effect of wood smoke exposure on vascular function and thrombus formation in healthy fire fighters.
abstract: BACKGROUND
  Myocardial infarction is the leading cause of death in fire fighters and has been linked with exposure to air pollution and fire suppression duties. We therefore investigated the effects of wood smoke exposure on vascular vasomotor and fibrinolytic function, and thrombus formation in healthy fire fighters.
  
  
  METHODS
  In a double-blind randomized cross-over study, 16 healthy male fire fighters were exposed to wood smoke (~1 mg/m³ particulate matter concentration) or filtered air for one hour during intermittent exercise. Arterial pressure and stiffness were measured before and immediately after exposure, and forearm blood flow was measured during intra-brachial infusion of endothelium-dependent and -independent vasodilators 4-6 hours after exposure. Thrombus formation was assessed using the ex vivo Badimon chamber at 2 hours, and platelet activation was measured using flow cytometry for up to 24 hours after the exposure.
  
  
  RESULTS
  Compared to filtered air, exposure to wood smoke increased blood carboxyhaemoglobin concentrations (1.3% versus 0.8%; P < 0.001), but had no effect on arterial pressure, augmentation index or pulse wave velocity (P > 0.05 for all). Whilst there was a dose-dependent increase in forearm blood flow with each vasodilator (P < 0.01 for all), there were no differences in blood flow responses to acetylcholine, sodium nitroprusside or verapamil between exposures (P > 0.05 for all). Following exposure to wood smoke, vasodilatation to bradykinin increased (P = 0.003), but there was no effect on bradykinin-induced tissue-plasminogen activator release, thrombus area or markers of platelet activation (P > 0.05 for all).
  
  
  CONCLUSIONS
  Wood smoke exposure does not impair vascular vasomotor or fibrinolytic function, or increase thrombus formation in fire fighters. Acute cardiovascular events following fire suppression may be precipitated by exposure to other air pollutants or through other mechanisms, such as strenuous physical exertion and dehydration.
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. amanda.hunter@ed.ac.uk.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Hunter
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. jonunosson@gmail.com.
authors.forename: Jon
authors.initials: J
authors.lastname: Unosson
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. jenny.bosson@gmail.com.
authors.forename: Jenny A
authors.initials: JA
authors.lastname: Bosson
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. jeremy.langrish@ed.ac.uk.
authors.forename: Jeremy P
authors.initials: JP
authors.lastname: Langrish
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. jamshid.pourazar@lung.umu.se.
authors.forename: Jamshid
authors.initials: J
authors.lastname: Pourazar
authors.affiliation: ELEGI/Colt Laboratories, University of Edinburgh, Edinburgh, UK. jraftis@staffmail.ed.ac.uk.
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Raftis
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. Mark.Miller@ed.ac.uk.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Miller
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. andrewjohnlucking@gmail.com.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Lucking
authors.affiliation: Thermochemical Energy Conversion Laboratory, Umeå University, Umeå, Sweden. christoffer.boman@umu.se.
authors.forename: Christoffer
authors.initials: C
authors.lastname: Boman
authors.affiliation: Thermochemical Energy Conversion Laboratory, Umeå University, Umeå, Sweden. robin.nystrom@umu.se.
authors.forename: Robin
authors.initials: R
authors.lastname: Nyström
authors.affiliation: ELEGI/Colt Laboratories, University of Edinburgh, Edinburgh, UK. kdctox@hotmail.co.uk.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Donaldson
authors.affiliation: Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh, UK. Andrew.Flapan@nhslothian.scot.nhs.uk.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Flapan
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. Anoop.Shah@ed.ac.uk.
authors.forename: Anoop S V
authors.initials: AS
authors.lastname: Shah
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. louis.pung@gmail.com.
authors.forename: Louis
authors.initials: L
authors.lastname: Pung
authors.affiliation: Department of Analytical Chemistry, Stockholm University, Stockholm, Sweden. ioannis.sadiktsis@anchem.su.se.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Sadiktsis
authors.affiliation: Department of Analytical Chemistry, Stockholm University, Stockholm, Sweden. silvia.masala@anchem.su.se.
authors.forename: Silvia
authors.initials: S
authors.lastname: Masala
authors.affiliation: Department of Analytical Chemistry, Stockholm University, Stockholm, Sweden. roger.westerholm@anchem.su.se.
authors.forename: Roger
authors.initials: R
authors.lastname: Westerholm
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. thomas.sandstrom@lung.umu.se.
authors.forename: Thomas
authors.initials: T
authors.lastname: Sandström
authors.affiliation: Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden. anders.blomberg@lung.umu.se.
authors.forename: Anders
authors.initials: A
authors.lastname: Blomberg
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. D.E.Newby@ed.ac.uk.
authors.forename: David E
authors.initials: DE
authors.lastname: Newby
authors.affiliation: BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK. nick.mills@ed.ac.uk.
authors.forename: Nicholas L
authors.initials: NL
authors.lastname: Mills
mesh_terms: D000328:Adult; D001642:Bicycling; D015415:Biomarkers / Q000097:blood / Q000378:metabolism; D018592:Cross-Over Studies; D004311:Double-Blind Method; D004730:Endothelium, Vascular / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D061388:Firefighters; D006801:Humans; D008297:Male; D015539:Platelet Activation / Q000187:drug effects; D012306:Risk; D012606:Scotland / Q000453:epidemiology; D012906:Smoke / Q000009:adverse effects; D015208:Smoke Inhalation Injury / Q000097:blood / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology*; D013927:Thrombosis / Q000453:epidemiology / Q000209:etiology*; D014652:Vascular Diseases / Q000453:epidemiology / Q000209:etiology*; D059289:Vascular Stiffness / Q000187:drug effects; D014666:Vasomotor System / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism / Q000503:physiopathology; D014934:Wood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D012906:Smoke