Adverse eye effects of smoke exposure at prescribed burns in wildland firefighters

Despite exposure to high concentrations of particulate matter (PM) and gases on the fire ground, little is known about the impact of wildfire smoke on the eye surface of wildland firefighters. This field study investigated the impact of smoke exposure at prescribed burns on the eye surface of Australian wildland firefighters.

Twenty-three firefighters (19-60 years, 78% male) were evaluated before and after four prescribed burns for eye symptoms and clinical signs of eye surface damage. Types of protective eyewear used were recorded and a subset of firefighters wore PM2.5 personal monitors.

Symptoms of eye discomfort, dryness and foreign body sensation increased after the burns, along with epithelial staining scores, eye surface redness and palpebral conjunctival roughness. Tear film stability reduced after the burns. Group mean PM2.5 exposure during the burns ranged from 130 to 480 µg/m³. All firefighters reported wearing sunglasses or goggles 40% to 100% of the time during the burns. Four firefighters (17%) wore no eye protection for 20% to 90% of the time.

Wildland firefighters experience increased eye irritation and display eye surface clinical changes consistent with eye surface damage. Evidence-based recommendations on how to prevent and manage eye surface complications in firefighters are urgently needed.