The long-term rate of change in lung function in urban professional firefighters: a systematic review
Abstract Background Despite the known occupational hazards, it is not yet clear whether long-term career firefighting leads to a greater rate of decline in lung function than would normally be expected, and how this rate of change is affected by firefighting exposures and other risk/protective facto...
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doaj-5c4edcac15b245be9bea6519a3a43c492020-11-25T00:57:30ZengBMCBMC Pulmonary Medicine1471-24662018-09-0118112010.1186/s12890-018-0711-8The long-term rate of change in lung function in urban professional firefighters: a systematic reviewFlynn Slattery0Kylie Johnston1Catherine Paquet2Hunter Bennett3Alan Crockett4Alliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, Universitiy of South AustraliaSchool of Health Sciences, Sansom Institute for Health Research, University of South AustraliaCentre for Population Health Research, Sansom Institute for Health Research, School of Health Sciences, University of South AustraliaAlliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, Universitiy of South AustraliaAlliance for Research in Exercise, Nutrition and Activity, Sansom Institute for Health Research, School of Health Sciences, Universitiy of South AustraliaAbstract Background Despite the known occupational hazards, it is not yet clear whether long-term career firefighting leads to a greater rate of decline in lung function than would normally be expected, and how this rate of change is affected by firefighting exposures and other risk/protective factors. Methods A systematic search of online electronic databases was conducted to identify longitudinal studies reporting on the rate of change in the forced expiratory volume in one second (FEV1) of forced vital capacity (FVC). Included studies were critically appraised to determine their risk of bias using the Research Triangle Institute Item Bank (RTI-IB) on Risk of Bias and Precision of Observational Studies. Results Twenty-two studies were identified for inclusion, from four different countries, published between 1974 and 2016. Examined separately, studies were categorised by the type of firefighting exposure. Firefighters experienced variable rates of decline in lung function, which were particularly influenced by cigarette smoking. The influence of routine firefighting exposures is unclear and limited by the methods of measurement, while firefighters exposed to ‘non-routine’ severe exposures unanimously experienced accelerated declines. Conclusions The data provided by longitudinal studies provide an unclear picture of how the rate of change in lung function of firefighters relates to routine exposures and how it compares to the rate of change expected in a working-age population. Non-smoking firefighters who routinely wear respiratory protection are more likely than otherwise to have a normal rate of decline in lung function. Exposure to catastrophic events significantly increases the rate of decline in firefighter lung function but there is limited evidence detailing the effect of routine firefighting. Future studies will benefit from more robust methods of measuring exposure. Trial registration International Prospective Register of Systematic Reviews (PROSPERO), registration number (CRD42017058499).http://link.springer.com/article/10.1186/s12890-018-0711-8FirefightersFirefightingSpirometryLung functionExposureLongitudinal |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Flynn Slattery Kylie Johnston Catherine Paquet Hunter Bennett Alan Crockett |
spellingShingle |
Flynn Slattery Kylie Johnston Catherine Paquet Hunter Bennett Alan Crockett The long-term rate of change in lung function in urban professional firefighters: a systematic review BMC Pulmonary Medicine Firefighters Firefighting Spirometry Lung function Exposure Longitudinal |
author_facet |
Flynn Slattery Kylie Johnston Catherine Paquet Hunter Bennett Alan Crockett |
author_sort |
Flynn Slattery |
title |
The long-term rate of change in lung function in urban professional firefighters: a systematic review |
title_short |
The long-term rate of change in lung function in urban professional firefighters: a systematic review |
title_full |
The long-term rate of change in lung function in urban professional firefighters: a systematic review |
title_fullStr |
The long-term rate of change in lung function in urban professional firefighters: a systematic review |
title_full_unstemmed |
The long-term rate of change in lung function in urban professional firefighters: a systematic review |
title_sort |
long-term rate of change in lung function in urban professional firefighters: a systematic review |
publisher |
BMC |
series |
BMC Pulmonary Medicine |
issn |
1471-2466 |
publishDate |
2018-09-01 |
description |
Abstract Background Despite the known occupational hazards, it is not yet clear whether long-term career firefighting leads to a greater rate of decline in lung function than would normally be expected, and how this rate of change is affected by firefighting exposures and other risk/protective factors. Methods A systematic search of online electronic databases was conducted to identify longitudinal studies reporting on the rate of change in the forced expiratory volume in one second (FEV1) of forced vital capacity (FVC). Included studies were critically appraised to determine their risk of bias using the Research Triangle Institute Item Bank (RTI-IB) on Risk of Bias and Precision of Observational Studies. Results Twenty-two studies were identified for inclusion, from four different countries, published between 1974 and 2016. Examined separately, studies were categorised by the type of firefighting exposure. Firefighters experienced variable rates of decline in lung function, which were particularly influenced by cigarette smoking. The influence of routine firefighting exposures is unclear and limited by the methods of measurement, while firefighters exposed to ‘non-routine’ severe exposures unanimously experienced accelerated declines. Conclusions The data provided by longitudinal studies provide an unclear picture of how the rate of change in lung function of firefighters relates to routine exposures and how it compares to the rate of change expected in a working-age population. Non-smoking firefighters who routinely wear respiratory protection are more likely than otherwise to have a normal rate of decline in lung function. Exposure to catastrophic events significantly increases the rate of decline in firefighter lung function but there is limited evidence detailing the effect of routine firefighting. Future studies will benefit from more robust methods of measuring exposure. Trial registration International Prospective Register of Systematic Reviews (PROSPERO), registration number (CRD42017058499). |
topic |
Firefighters Firefighting Spirometry Lung function Exposure Longitudinal |
url |
http://link.springer.com/article/10.1186/s12890-018-0711-8 |
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