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Changes in lung function and fractional exhaled nitric oxide across wildfire seasons in the wildland firefighter
Chieh-Ming Wu1, Kathleen Clark2, Olorunfemi Adetona1
1Division of Environmental Health Sciences, College of Public Health, The Ohio State University, Columbus, OH, USA.
Introduction:
Long-term pulmonary effects of wildland firefighting are unclear even though lung function declines have been observed following wildfire season and firefighting shift.
Methods:
Spirometry and airway inflammation indicated as fractional exhaled nitric oxide (FeNO) were measured among 152 wildland firefighters (WFFs) at the beginning (pre-season, April & May) and end (post-season, September & October) of the 2018 and/or 2019 wildfire seasons and among 19 WFFs at across 3 days of firefighting during a 2019 mid-season wildfire deployment.
Results:
Overall peak expiratory flow (PEF) and percent of predicted PEF (PEF%) significantly decreased across fire season when 2018 and 2019 measurements were combined (-0.15 ± 0.07 L/s, p = 0.04; -1.87 ± 0.71%, p = 0.01; respectively), more so due to 2018 declines. PEF% and percent of predicted forced vital capacity (FVC%) significantly improved between 2018 post-season and 2019 pre-season (i.e., off-season) (3.08 ± 1.26%, p = 0.02; 0.99 ± 0.41%, p = 0.02; respectively). FVC and FVC% significantly decreased across a firefighting shift on the first day of wildfire deployment (-0.12 ± 0.03 L, p < 0.01; -2.35 ± 0.64%, p < 0.01). FeNO significantly decreased across the 2018 and 2019 fire seasons (p < 0.01) and significantly increased during the off-season (p < 0.01). FeNO also showed statistically significant cross-shift decreases on the second day of wildfire deployment (-3.50 ± 0.95 ppm, p < 0.01).
Conclusions:
Seasonal wildland firefighting were associated with decreases in lung function and FeNO as well as increases in respiratory symptom score in this cohort. While lung function recovered during the off-season among the WFFs, the results suggest a need for longer-term studies to determine the impact of chronic wildland firefighting on pulmonary health.
