Development Of Chronic Respiratory Symptoms Research Articles

Chronic respiratory symptoms and pulmonary function status in Ethiopian agricultural workers: a comparative study

BackgroundWork-related respiratory disorders are major contributors to the global burden of respiratory diseases. Agricultural workers are exposed to a number of dusts, which may contribute to the development of respiratory disorders. However, the knowledge about the prevalence of respiratory symptoms and pulmonary function status in African farmers was limited. This study was conducted to assess the prevalence of chronic respiratory symptoms and pulmonary function status of Ethiopian farmers exposed to farming activities.MethodsA community based comparative cross sectional study was conducted among 288 agricultural workers (farmers) aged 18 to 65 years and 288 control subjects (non-agricultural workers). Data were collected by interviewer administered structured questionnaires adopted from British Medical Research Council respiratory questionnaire and American Thoracic Society Division of Lung Diseases questionnaire. Moreover, all study participants underwent spirometry.ResultsThe prevalence of chronic respiratory symptoms was higher in farmers than in controls, with significant difference for cough (20.5% vs. 9.0%, p = 0.001) and phlegm (19.1% vs. 9.0%, p = 0.001). Chronic respiratory symptoms among farmers were significantly associated with duration of agricultural exposure (p = 0.014). The mean values of all spirometric parameters were lower in farmers than in controls with significant difference for FVC, FEV1, FEF25%, FEF50%, FEF25–75% and PEFR. Moreover, the mean values of all spirometric parameters of farmers have found to be decreased with increased duration of workplace exposure. Lung function test results also showed a higher prevalence of obstructive (15.6% vs. 10.8%, p = 0.085) and restrictive type (12.8% vs. 3.1%, p < 0.001) of pulmonary function impairment in farmers than in controls. However, the difference was not significant for obstructive type of impairment.ConclusionThis study indicated that farmers are at high risk for the development of chronic respiratory symptoms and reduced pulmonary function indices. Hence, a comprehensive occupational safety practices are important to maintain the respiratory health of farmers.

Prevalence of chronic respiratory symptoms in an urban population of North Kerala

Background: Chronic respiratory diseases are becoming a challenge to public health due to its high morbidity and mortality. Most of these diseases are preceded by variable periods of chronic respiratory symptoms. If chronic respiratory symptoms can be diagnosed and managed properly and timely, we can reduce the incidence and complication of chronic respiratory diseases.Methods: A community based cross sectional survey was conducted in 20 electoral wards of Calicut corporation of Northern Kerala among the adult resident population of 20-70 years to assess the prevalence of chronic respiratory symptoms such as chronic cough, phlegm, wheezing, breathlessness and nasal allergy and the factors associated with these chronic symptoms. The information was collected from 1384 eligible subjects selected by cluster sampling using British research council respiratory questionnaire.Results: About 9.2% (n=95) of study population had at-least one of the chronic respiratory symptoms. 1.8% (n=19) had all the chronic respiratory symptoms. Prevalence of various chronic respiratory symptoms was chronic cough (8.7%), Phlegm (14.3%), wheezing (8.5%), breathlessness (2.2%) and nasal allergy (14.5%). Advancing age, current smoking, family history and past history of various respiratory diseases are significantly associated with the development of chronic respiratory symptoms. Female gender, longer duration of stay in Calicut corporation and regular alcoholism were significantly associated with chronic phlegm in the study population. Wheezing, breathlessness and chronic nasal allergy was significantly higher among lower socio economic status.Conclusions: Prevalence of chronic respiratory symptoms is high among the urban population of Northern Kerala. Older age group, smoking, past and family history of respiratory diseases are the major risk factors associated with these respiratory symptoms.

Health Risk Survey for Domestic Waste Management Agency Workers: Case Study on Kota Bharu Municipal Council (MPKB), Kelantan, Malaysia

Waste collector workers are potentially exposed to a variety of health risk and health symptoms factors. Collection of the domestic waste is also a job which requires repeated heavy physical activity such as lifting, carrying, pulling, and pushing. The objectives of this study were to conduct a survey to identify potential health risk and health symptom and also to identify the workers practice on personal protective equipment (PPE) during work. The subjects were all current employees of Kota Bharu Municipal Council in Kota Bharu, Kelantan. The survey questionnaire was completed by 103 waste collector workers (n=103). The result of study indicates that waste collectors present a risk for the development of chronic respiratory symptoms (cough, phlegm, asphyxiate and wheezing) (75.0%), common work related hazards (biological, physical, ergonomic, psychosocial, and chemical) (62.3%), musculoskeletal symptoms (low back pain and elbow or wrist pain) (90.8%), dermatological symptoms (itchy and rashes) (70.3%) and gastrointestinal symptoms (nausea and diarrhea) (65.5%). Therefore, workers must alert and aware the potentials health risk and potentials health symptoms arising from their work. Index Terms--Health risk assessment, Kota Bharu Municipal Council, solid waste, workers. Language: en

Chronic lung disease of prematurity and early childhood wheezing: Is foetal inflammatory response syndrome to blame?

BackgroundLong-lasting respiratory symptoms have a huge impact on the quality of life in prematurely born children. AimsWe aimed to investigate the perinatal and maternal risk factors involved in the development of chronic respiratory morbidity in preterm infants, with an emphasis on the importance of Foetal Inflammatory Response Syndrome (FIRS). Study designProspective cohort study. SubjectsDemographic, antenatal, delivery and outcomes data were collected from 262 infants with less than 32 completed weeks of gestational age, over a 10-year period. Outcome measuresPresence of chronic lung disease of prematurity and early childhood wheezing. ResultsIn multivariate logistic regression analysis the presence of FIRS appears to be the most important risk factor for both, chronic lung disease of prematurity (OR 31.05, 95% CI 10.7–87.75, p<0.001) and early childhood wheezing (OR 5.63, 95% CI 2.42–13.05, p=0.01). In the alternative regression model for early childhood wheezing, with chronic lung disease included as a variable, the statistical significance of FIRS completely vanished (OR 1.15, 95% CI 0.39–3.34, p=0.79), whilst chronic lung disease became the most important risk factor (OR 23.45, 95% CI 8.5–63.25, p<0.001). ConclusionsPrenatal and early neonatal events are of utmost importance in the development of chronic respiratory symptoms in children. The influence of FIRS on the development of chronic respiratory symptoms goes far beyond its impact on gestational age and may be related to direct inflammation-mediated lung tissue damage. CLD appears to be an intermittent step on the way from FIRS to ECW.

A Study of Prevalance of Morbities in Door to Door Waste Collecting Workers of Surat City, Gujarat

Objective: In present work attempt has been made to study the prevalence of morbidities among door to door waste collecting workers. Study Area: Surat city workers working at Pal, Umarpada, Bhatar, Anjana, Vastadevdi and Pandesara transfer station were selected for study purpose. Method: A cross sectional study was carried out for 292 workers of Surat city who are involved in daily door to door waste collecting activity implemented under MSW 2000 rule. 93 workers who are working in office (not coming in touch of waste) were selected as non exposed group. Workers age, sex, social economic condition, habits and other relevant information for health survey were obtained separately. Respiratory symptoms data were collected using ATS- DLD standard questionnaires. Data were also collected for acute irritative symptoms, musculoskeletal symptoms and gastrointestinal symptoms. Result and Conclusion: The data were analyzed with reference to symptoms, habits. For comparison odds ratio was calculated. Results indicate that door to door waste collecting workers are having potential risk for the development of chronic respiratory symptoms (cough, phlegm, wheezing and chronic bronchitis). They are also having higher risk for musculoskeletal symptoms (low back pain, elbow/wrist pain) and injuries caused by sharp objects.

COMPARISON OF RESPIRATORY SYMPTOMS AMONG HUMAN IMMUNODEFICIENCY VIRUS-SEROPOSITIVE INDIVIDUALS IN THE PRE- AND POST-HIGHLY ACTIVE ANTIRETROVIRAL THERAPY ERAS

PURPOSE: Studies conducted prior to the widespread use of Highly Active Anti-Retroviral Therapy (HAART) demonstrated an increased risk for the development of chronic respiratory symptoms among HIV-seropositive individuals. Since HAART has dramatically decreased HIV-related pulmonary complications and has likely decreased chronic inflammatory changes in the lung, it is possible that the prevalence of respiratory symptoms among HIV-seropositive individuals has decreased in the HAART era. The purpose of the present study is to compare the prevalence of respiratory symptoms among HIV-seropositive subjects in the pre- and post-HAART eras.

Baseline Pulmonary Function and Quality of Life 9 Years Later in a Middle-Aged Chinese Population

This research examined the association of baseline pulmonary function with future quality of life (QOL). We collected baseline pulmonary function data in 1993 and 1994, and assessed QOL using the Chinese 35-Item Quality of Life Instrument in 2002 in a cohort of 1,356 participants. We used Pearson correlation analysis, multivariate analysis of variance, and multivariate linear regression analysis to assess the relationship between pulmonary function and QOL. The baseline percentage of age- and height-predicted FEV1 (FEV1%) was significantly correlated with the resurvey total QOL score (r = 0.126, p < 0.001) and with QOL scores for the general (r = 0.074, p = 0.006), physical (r = 0.085, p = 0.002), independence (r = 0.178, p < 0.001), and psychological (r = 0.064, p = 0.018) domains but not with the social and environmental domains after adjusting for age and sex. These associations were weaker for the percentage of age- and height-predicted FVC. Multiple linear regression showed that the above associations were independent of baseline and resurvey smoking status. Inclusion of respiratory symptoms in the model reduced the regression coefficients from 0.82 to 0.41 for the total QOL score and from 1.43 to 0.94 for the independence domain score, for a 10% change in FEV1%. The age- and sex-adjusted mean total QOL scores were 78, 76, 76, and 69, respectively (p < 0.001), for the groups of normal, symptomatic only, impaired pulmonary function only, and both symptomatic and impaired pulmonary function. This trend was also significant for the general, physical, independence, and psychological domain scores. Impaired baseline pulmonary function has a significant negative impact on QOL in later life that is independent of age, sex, height, and smoking status and is largely mediated through the development of chronic respiratory symptoms.

Total and Specific Immunoglobulin E and Their Relationship to Respiratory Symptoms in Quebec Children and Adolescents

Respiratory disease is a major cause of morbidity in young people. It is now recognized that atopy plays an important role in the development of chronic respiratory symptoms in children. To examine the determinants and consequences of serum total and specific immunoglobulin E (IgE) in a general population sample of Québec children and adolescents. In 1999, 2349 children and adolescents (nine, 13 or 16 years of age) who had participated in a respiratory symptom and disease questionnaire had their total IgE measured. Of these participants, a subsample of 451 children and adolescents was analyzed to detect antibodies to eight specific allergens (ie, allergens of dust mites [Dermatophagoides farinae and Dermatophagoides pteronyssinus], cat, dog, ragweed, Timothy grass, mould [alternaria] and cockroach). The geometric mean of the total IgE was 44.4 U/mL among all participants. Concentrations were higher in boys and increased with age. More than 41% of the participants were sensitized to at least one specific allergen. Such sensitization was strongly associated with the occurrence of respiratory conditions and symptoms, namely asthma, wheezing and rhinitis. Family history, school location and ethnic origin had an impact on the prevalence of atopy and total IgE levels. Allergic sensitization is a major determinant in the development of asthma, wheezing and rhinitis in children and adolescents in the province of Québec.

Adverse Health Effects among Household Waste Collectors in Taiwan

Household waste collectors (HWCs) are potentially exposed to a variety of bioaerosols and toxic materials. Collection of household waste is also a job which requires repeated heavy physical activity such as lifting, carrying, pulling, and pushing. The object of this study was to assess whether there is an excess of adverse health outcomes among HWCs. The subjects were all current employees of the Household Waste Collection Department in the County of Kaohsiung, Taiwan. The survey questionnaire was completed by 533 HWCs and 320 office workers. Our data indicate that household waste collection presents a risk for the development of chronic respiratory symptoms (cough, phlegm, wheezing, and chronic bronchitis), musculoskeletal symptoms (low back pain and elbow/wrist pain), and injuries caused by sharp objects.

Airways responsiveness and development and remission of chronic respiratory symptoms in adults

Many patients with chronic obstructive lung disease show increased airways responsiveness to histamine. We investigated the hypothesis that increased airways responsiveness predicts the development and remission of chronic respiratory symptoms. We used data from 24-year follow-up (1965-90) of 2684 participants in a cohort study in Vlagtwedde and Vlaardingen, Netherlands. Increased airways responsiveness was defined as a PC10 value (concentration of histamine for which challenge led to a 10% fall in forced expiratory volume in 1 s) of less than 8 mg/mL. Information on respiratory symptoms was collected by means of a standard questionnaire every 3 years. Logistic regression was used to control for age, area of residence, cigarette smoking status, and sex. Participants with increased airways responsiveness (1281 observations) were more likely than those without increased airways responsiveness (5801 observations) to develop the following symptoms during any 3-year follow-up interval: chronic cough (odds ratio 1.9 [95% CI 1.2-2.9]), chronic phlegm (2.0 [1.3-3.0]), dyspnoea (2.3 [1.5-3.5]), asthmatic attacks (3.7 [2.2-6.1]), and persistent wheeze (2.7 [1.7-4.4]). The estimate of the odds ratio for the development of any of the six symptoms was 1.7 (1.2-2.3). Participants with increased airways responsiveness were less likely than those without this characteristic to show remission of these respiratory symptoms. The estimate of the odds ratio for the remission of any of the six symptoms was 0.42 (0.28-0.61). These prospective analyses show that increased airways responsiveness is positively associated with the development of chronic respiratory symptoms and negatively associated with the remission of these symptoms in adults.

Respiratory symptoms and lung function in taxi drivers and manual workers

The aim of this study, was to determine the prevalence of some respiratory symptoms and possible diseases among taxi drivers and manual workers. This prospective study was performed on 165 Pakistani male drivers, (mean age: 34.5±7.8 years) and 165 Pakistani male manual workers not exposed to dust or fumes, without occupational exposure to driving employed in the Water and Electricity Department and recruited as controls (mean age: 34.6±7.6 years and mean height and weight 169.8±6.0 cm and 71.9±10.9 kg). The data on chronic respiratory symptoms showed that taxi drivers had higher prevalence of symptoms than manual workers, being significantly greater for asthma (RR=1.72; 95% CI=1.00–2.88,P=0.037); allergic rhinitis (RR=2.41; 95% CI=1.46–3.94,P=0.0006); dyspnea (RR=2.13; 95% CI=1.22–3.71,P=0.009); and nasal catarrh (RR=2.19; 95% CI=1.22–3.91,P=0.0106). Thirty percent of taxi drivers and 27% of manual workers were smokers, there was no significant differences in the prevalence of chronic respiratory symptoms between smokers and non-smokers. Lung function parameters in the taxi drivers were significantly lower than in manual workers group (P<0.0001) except PEF parameter. When comparing the measured mean values of lung function parameters in the drivers among smokers and nonsmokers, there was no significant differences between smokers and nonsmokers. Also, a comparison of ventilatory capacity of paired predicted values with measured normal values showed statistically significant differences between predicted and measured values for taxi drivers and manual workers for FVC, FEV1, FEF25–75 and PEF parameters except for FEV1/FVC test in manual workers. In conclusion, the results of the present study provide evidence regarding effects of such as carbon monoxide, nitrogen dioxide, sulfur dioxide and gases exposures on taxi drivers and long-term driving, which may be associated with the development of chronic respiratory symptoms and lung function impairment.

Respiratory symptoms and lung function in wool textile workers

Our study investigated a group of 216 wool textile workers (158 women and 58 men). Respiratory symptoms were assessed by questionnaire in wool textile workers and in 130 not exposed (control) workers. Ventilatory capacity was measured in wool workers by recording maximum expiratory flow-volume (MEFV) curves on Monday before and after the work shift. Forced vital capacity (FVC), 1-second forced expiratory volume (FEV1), and flow rates at 50% and the last 25% of the vital capacity (FEF50, FEF25) were measured on the MEFV curves. Analysis of the data demonstrated a significantly higher prevalence of all chronic respiratory symptoms in wool workers than in controls, being the highest in wool workers for nasal catarrh (M: 63.8%; F: 44.9%) and for sinusitis (M: 62.1%; F: 43.0%). A high prevalence of acute symptoms, associated with the work shift, was also noted in wool workers. Exposure to wool dust caused significant across-shift reductions of ventilatory capacity varying from 1.4% for FEV1 to 9.1% for FEF50. Textile workers exposed to wool for > 10 years in the workplace had similar across-shift reductions of ventilatory capacity tests as those with shorter exposures. In a large number of these wool workers, FEF50 and FEF25 were below 70% of predicted normal values. Smokers had acute and chronic lung function changes similar to those of nonsmokers, indicating that smoking did not account for all the respiratory effects seen in wool processing workers. Our data suggest that dust exposures in wool textile mills may be associated with the development of chronic respiratory symptoms and impaired lung function.

Respiratory symptoms and immunological status in poultry food processing workers.

A group of 57 female workers employed in the processing of poultry food and 51 nonexposed control workers were studied to determine the possible relation between respiratory and immunological findings in poultry food workers. The prevalences of all chronic respiratory symptoms were significantly higher in exposed than in control workers (P < 0.01) except for occupational asthma. The highest prevalence of chronic respiratory symptoms in exposed workers was found for chronic cough (49.1%), followed by dyspnea (43.9%), rhinitis (38.6%), chronic phlegm (31.6%), and chronic bronchitis (26.3%). Occupational asthma was found in 5.3% of exposed workers. Exposed workers with a positive skin prick test to poultry food extract demonstrated higher prevalences of all chronic respiratory symptoms than those with negative skin tests, although the difference was statistically significant only for rhinitis (P < 0.05). The most frequent skin reactions were found for poultry food extract (exposed: 66.7%; control: 25.5%; P < 0.05). An increased IgE serum level was found in 19 (33.3%) of the exposed and in four (7.8%) of the control workers (P < 0.01). Three exposed workers with occupational asthma demonstrated an increased serum IgE level. Our data confirm previous results indicating that occupational exposure to poultry food dust may be associated with the development of chronic respiratory symptoms and immunological changes in exposed workers.

Respiratory symptoms and lung function in bus drivers and mechanics

Acute and chronic respiratory symptoms as well as ventilatory capacity were studied in 116 bus drivers and 119 mechanics. Bus drivers and mechanics demonstrated a significantly higher prevalence of most chronic respiratory symptoms when compared to control workers. In particular, lower airway symptoms of chest tightness and dyspnea and upper airway symptoms of nasal catarrh were significantly more prevalent among drivers and mechanics than among controls. Bus drivers and mechanics who were smokers had significantly higher prevalences of respiratory symptoms than nonsmoking bus drivers. Bus drivers and mechanics employed for more than 10 years also exhibited higher frequencies of respiratory symptoms than those exposed for 10 years or less. Many of the workers complained of acute symptoms during the work shift. The ventilatory capacity data demonstrated lower values for all parameters, particularly FEF25, compared to control worker values as well as to predicted normal values, for bus drivers and mechanics who were smokers. Our data indicate that long-term employment in the transport industry of bus drivers and mechanics, particularly in combination with smoking, may be associated with the development of chronic respiratory symptoms and lung function impairment.

Respiratory function and immunological reactions in jute workers.

A prospective study of respiratory function was performed in a group of 70 jute and 40 control workers. At the initial study there were consistently higher prevalences of all chronic respiratory symptoms in jute workers compared to control workers; however, the differences were statistically significant only for dyspnea (P < 0.05). At the follow-up study 19 out of the original 70 jute workers were examined 19 years later. There was a significant increase in the prevalence of almost all chronic respiratory symptoms among these workers. Similar across-shift reductions of forced vital capacity (FVC) and the 1-s forced expiratory volume (FEV1) were recorded on Monday and the following Thursday at the initial study. In the 19 jute workers followed prospectively there were similar across-shift reductions of FVC and FEV1 at the first and the follow-up study, the reduction being slightly larger for FEV1 than for FVC. Only one jute worker (5.3%) and two control workers (5.7%) responded to skin testing with specific textile extracts. Two workers developed symptoms of occupational asthma. One of these workers had a positive response to skin testing with jute extract. Our data suggest that exposure to jute dust may cause the development of chronic respiratory symptoms in some workers.

Respiratory symptoms and ventilatory capacity in workers in a vegetable pickling and mustard production facility

A group of 117 women occupationally exposed in a pickling factory were studied for the prevalence of acute and chronic respiratory symptoms and lung function changes. Workers were studied by task which included (1) pickling, (2) mustard making, and (3) packing. Similar prevalences for all respiratory symptoms were seen for the three workers groups, with all groups having significantly higher prevalences of chronic cough (P < 0.05), chest tightness, nasal catarrh, and sinusitis (P < 0.01) than a nonexposed control group from a bottling plant. Prevalences of acute symptoms were greater for pickling than for mustard or packing workers. Measured forced expiratory volume in 1 s and maximum flow rates at 50% and the last 25% of the control vital capacity were in general significantly lower than predicted values for the worker subgroups. Pickling workers exposed for more than 1 year in the industry had greater across-shift reductions for all spirometric parameters tested than those workers exposed for 1 year or less. Our data suggest that extended occupational exposure in the pickling industry results in acute exposure-related respiratory effects and ultimately may lead to the development of chronic respiratory symptoms and changes in baseline lung function.

DIETARY FACTORS AND THEIR RELATION TO RESPIRATORY SYMPTOMS

Dietary factors may influence inflammatory and antioxidant activity, and hence the development of chronic respiratory symptoms. To examine this hypothesis, the authors analyzed data from the Second National Health and Nutrition Examination Survey (NHANES II). NHANES II was conducted on a sample representative of the civilian, noninstitutionalized US population, which included 9,074 white and black adults aged 30 years or older. Dietary factors were derived from serum levels and from a 24-hour dietary recall questionnaire. The authors examined the relations of these dietary factors to the presence of currently active respiratory symptoms. The relation of serum vitamin C, dietary vitamin C intake, dietary fish intake, the ratio of dietary sodium to dietary potassium, and the ratio of serum zinc to serum copper to the respiratory symptoms of bronchitis and wheezing was assessed. Initially, nutrient-specific logistic regression analysis was performed, controlling for age, race, sex, calories, and pack-years of cigarette smoking. When multiple nutrients and total caloric intake were considered for each respiratory symptom outcome, bronchitis was negatively associated with serum vitamin C and with the serum zinc:copper ratio and was positively associated with the sodium:potassium ratio. Wheezing was negatively associated with serum vitamin C, niacin, and the serum zinc:copper ratio. Interactions between nutrients and smoking status were not significant. These data suggest that several dietary constituents may influence the occurrence of respiratory symptoms in adults, independently of cigarette smoking.

Effects of Exposure to Diesel Emissions Among Coal Miners: A Prospective Evaluation

Abstract This paper reports results from a prospective design employed to test the hypothesis that exposure to diesel emissions leads to chronic respiratory effects amongst underground coal miners. Changes in respiratory function and development of chronic respiratory symptoms were measured over a 5-year study period in diesel exposed and control miners from Eastern and Western U.S. underground coal mines. Spirometric measures of respiratory function included Forced Expiratory Volume in one second (FEV1). Forced Vital Capacity (FVC), and Forced Expiratory Flow Rate at 50 per cent of FVC (FEF50). Chronic respiratory symptoms, which included persistent cough, persistent phlegm, and breathlessness, were obtained by questionnaire as were smoking status and occupational history. The pattern of evidence does not support the tested hypothesis when comparing the data on diesel vs. non-diesel exposed miners.

Chronic respiratory effects of exposure to diesel emissions in coal mines.

A 5-yr prospective design was employed to test the hypothesis that exposure to diesel emissions leads to chronic respiratory effects among underground coal miners. Changes in respiratory function and development of chronic respiratory symptoms were measured during a 5-yr study period (i.e., 1977 to 1982) in 280 diesel-exposed and 838 control miners from Eastern and Western United States underground coal mines. Spirometry measures of respiratory function included forced expiratory volume in 1 sec (FEV1.0), forced vital capacity (FVC), and forced expiratory flow rate at 50% of FVC (FEF50). Chronic respiratory symptom measures, which included chronic cough, chronic phlegm, and breathlessness, were obtained by questionnaires, as were smoking status and occupational history. Based upon these data, the pattern of evidence did not support the hypothesis either in an age-adjusted comparison of diesel vs. nondiesel miners or in an internal analysis by cumulative years of diesel exposure.

Respiratory Status of Los Angeles Firemen: One-Month Follow-Up after Inhalation of Dense Smoke

A standardized respiratory questionnaire and detailed pulmonary function tests were administered to 21 Los Angeles firemen one month following exposure to the combustion products of polyvinylchloride, which had produced transient hypoxemia in 19 of the firemen. The results of these studies were compared with those obtained in a sample of nonfiremen residing in the Los Angeles area who were matched by computer with the firemen for anthropomorphic characteristics and smoking status. The frequency of respiratory symptoms, the results of spirometric and plethysmographic studies, and the single-breath nitrogen washout were similar in the firemen, compared with the matched sample, whereas closing volume was higher in the matched controls. These findings suggest that although fighting fires may result in acute pulmonary injury secondary to discrete episodes of inhalation of smoke, it does not appear to predispose to the development of chronic respiratory symptoms or chronic functional respiratory impairment.