Heavy metals, carbon monoxide and PBDE exposure among firefighters: a cross-sectional study

Firefighters are subject to significant risks to their health, including an increased risk for significant morbidities due to exposure to pollutants. The aim of this study was to examine the magnitude of firefighters' exposure to various hazardous substances in a large cross-sectional study. Detailed activity records of 108 firefighters, questionnaires blood and urine samples were collected and compared with 104 men with other occupations. Heavy metals, carboxyhemoglobin and PBDE levels were compared between firefighters and controls. Correlations were explored between pollutant levels and individual exposure frequencies to the total number of fire events, and by subtypes. Significant differences between firefighters and controls were observed in levels of Cr (0.41 ± 0.52 vs. 0.2 ± 0.14 µg/g creatinine, p-value = 0.006), Ni (0.55 ± 0.63 vs. 1.13 ± 0.59, p-value < 0.001) and Pb (0.26 ± 0.23 vs. 0.36 ± 0.21, p-value < 0.001). No significant difference was found in other metals, As (12.7 ± 10.7 vs. 11.8 ± 10.8), Cd (0.26 ± 0.14 vs. 0.23 ± 0.10), Hg (0.42 ± 0.43 vs. 0.59 ± 0.81), as well in COHb levels (2.80%±1.66 vs. 3.01%±1.58). Smokers exhibited significantly higher COHb levels. When adjusted for age and education, firefighters had significantly higher levels of As (p < 0.001) and lower levels of Ni (p < 0.001) vs. controls. We found low PBDEs levels, suggesting low exposure compared to firefighters from other countries. Exposure to fire events was not correlated with pollutant levels among firefighters. Israeli firefighters show low exposure to carbon monoxide, heavy metals, and PBDEs compared to international cohorts, though PBDEs levels exceed controls. No correlation exists between firefighting activities and pollutant levels, suggesting effective protective equipment use.