Lung Function Of Firefighters Research Articles

282 Food Intake REstriction for Health OUtcome Support and Education (FIREHOUSE): a Proof of Concept Randomized Clinical Trial

OBJECTIVES/GOALS: Particulate matter (PM) and metabolic syndrome (MetSyn) increase risk of World Trade Center-Lung Injury (WTC-LI). Mediterranean-type diets have also been found to improve lung function. Fire Department of New York 1st-responders with a high PM exposure at WTC and MetSyn may have improved lung function after a Mediterranean dietary intervention. METHODS/STUDY POPULATION: Food Intake REstriction for Health OUtcome Support and Education (FIREHOUSE) randomized clinical trial (RCT) assessed our hypothesis that a low-calorie Mediterranean (LoCalMed) intervention targeting clinically relevant disease modifiers will improve metabolic risk, subclinical indicators of cardiopulmonary disease, quality of life, and lung function in firefighters with WTC-LI. Primary-outcome targeted a LoCalMed loss of BMI(≥1kg/m2). Secondary-outcomes included lung function, quality of life, and cardiovascular health. Male firefighters with WTC-LI and a BMI>27kg/m2 were randomized to: 1. LoCalMed (n=46); or 2. Usual Care (UC; n=43). Clinicaltrials.gov:NCT03581006. RESULTS/ANTICIPATED RESULTS: LoCalMed’s estimated efficacy on BMI reduction crossed the pre-specified significance boundary on interim analysis compared to UC. In addition, improvements were observed in secondary-outcomes of lung health (FEV1 and FVC), inflammation (WBC), vascular disease (DBP), quality of life (SF-36, health perception) and dietary habits (less cholesterol, carbohydrates, fats, and sweets and increased protein) in the LoCalMed arm. DISCUSSION/SIGNIFICANCE: LoCalMed significantly decreased BMI and alleviated adverse health outcomes in our WTC-exposed first responders. A fully powered RCT is required to determine if this approach is efficacious for the treatment of WTC-associated pulmonary disease, as well as LoCalMed’s generalizability to PM associated disease.

Food Intake REstriction for Health OUtcome Support and Education (FIREHOUSE) Protocol: A Randomized Clinical Trial.

Fire Department of New York (FDNY) rescue and recovery workers exposed to World Trade Center (WTC) particulates suffered loss of forced expiratory volume in 1 s (FEV1). Metabolic Syndrome increased the risk of developing WTC-lung injury (WTC-LI). We aim to attenuate the deleterious effects of WTC exposure through a dietary intervention targeting these clinically relevant disease modifiers. We hypothesize that a calorie-restricted Mediterranean dietary intervention will improve metabolic risk, subclinical indicators of cardiopulmonary disease, quality of life, and lung function in firefighters with WTC-LI. To assess our hypothesis, we developed the Food Intake REstriction for Health OUtcome Support and Education (FIREHOUSE), a randomized controlled clinical trial (RCT). Male firefighters with WTC-LI and a BMI > 27 kg/m2 will be included. We will randomize subjects (1:1) to either: (1) Low Calorie Mediterranean (LoCalMed)—an integrative multifactorial, technology-supported approach focused on behavioral modification, nutritional education that will include a self-monitored diet with feedback, physical activity recommendations, and social cognitive theory-based group counseling sessions; or (2) Usual Care. Outcomes include reduction in body mass index (BMI) (primary), improvement in FEV1, fractional exhaled nitric oxide, pulse wave velocity, lipid profiles, targeted metabolic/clinical biomarkers, and quality of life measures (secondary). By implementing a technology-supported LoCalMed diet our FIREHOUSE RCT may help further the treatment of WTC associated pulmonary disease.

Related factors for preserving firefighter's pulmonary function.

BackgroundFirefighters are constantly exposed to harmful substances in the respiratory tract and require management measures. We comprehensively compared factors affecting the lung function of firefighters to identify management measures that can reduce the deterioration of lung function.MethodsA cross-sectional study was conducted in 1,108 male firefighters. Subjects were surveyed with self-written questionnaires that included a history of smoking, number of workouts per week, work department, and medical history, including diseases that could affect lung function. Body mass index was calculated using an automatic body measurement instrument and body fat, body fat percentage, muscle mass, and skeletal muscle mass were measured using Inbody 770. Based on the body weight obtained from body measurements, skeletal muscle mass height-adjusted skeletal muscle index (hSMI) compared to height was determined. For lung function, forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC, and peak expiratory flow (PEF) were measured using a spirometer HI-801. Analysis of variance and independent t-tests were performed for univariate analysis of factors that could affect lung function, and multiple regression analysis was performed for multivariate analysis.ResultsWhen the factors relating lung function were analyzed using regression analysis, FEV1 was negatively correlated with age, body fat percentage, and duty year, positively with height and hSMI. FVC increased with height and hSMI, decreased with age, body fat percentage, and duty year. FEV1/FVC was related with age, height, body fat percentage and working history. Height and muscle mass were analyzed as related factors on PEF. When the analysis was conducted on firefighters who exercised more than 3 times a week, working history had lower relation with FEV1 and body fat percentage had no relation with FEV1/FVC.ConclusionWe suggest management measures to reduce body fat percentage and increase skeletal muscle mass to maintain lung function in firefighters.

Longitudinal Decline in Lung Function: Evaluation of Interleukin-10 Genetic Polymorphisms in Firefighters

During annual medical monitoring, some firefighters are found to have rates of decline in forced expiratory volume in one second (FEV1) far exceeding their peers. Interleukin-10 (IL-10) suppresses inflammation, and single nucleotide polymorphisms (SNPs) in the IL-10 gene may confer variable susceptibility to more rapid decline in lung function. In 1204 firefighters with at least six annual FEV1 measurements, increased age and greater initial FEV1 were associated with more rapid decline in lung function. DNA collected from 379 of these firefighters was screened for IL-10 SNPs at -1117, -854, 919, 1668, and 1812. A statistically significant difference in decline in lung function was found based on genotyping at the 1668 SNP. Evaluation of gene polymorphisms regulating lung inflammation may help to explain some of the variation in rate of decline in lung function in firefighters.

Lung function in fire fighters, II: a five year follow-up fo retirees.

In a study of the chronic effects of fire fighting on lung function, 1,768 employees from the Boston Fire Department were examined in 1970. From this cohort, 109 firefighters who retired in the period 1970 to 1975 have been restudied with questionnaire and ventilatory function tests. The observed vulues for pulmonary function when expressed as a per cent of predicted are consistently slightly below 100 per cent. The expected effect of cigarett smoking on lung function was demonstrated. The results suggest thetirement) are important in reducing the effect of fire fighting on subjects who may be adversely affected by the inhalation of combustion products.

Lung function in fire fighters, I: a three year follow-up of active subjects.

From a cohort of 1,768 Boston fire fighters studied initially in 1970, pulmonary function measurements were repeated on 1, 146 active subjects in 1974. The mean time between examinations was 3.4 years. The data on 1,430 subjects after one year of follow-up had indicated excessive decrements in levels of forced vital capacity and one-second forced expiratory bolume which were related to the frequency of fire exposure. The annual decline over three years was less than that observed over one year and could not be related to the number of fires fought or to other indices of acute fire exposure. Selection factors within the fire department appear to be important in protecting fire fighter from continued loss ventilatory capacity.