Acute effects of smoke exposure on airway and systemic inflammation in forest firefighters

Abstract

Niki Gianniou,1 Charilena Giannakopoulou,2 Efrossini Dima,2 Matina Kardara,3 Paraskevi Katsaounou,1 Alexandros Tsakatikas,4 Charis Roussos,1–3 Nikolaos Koulouris,2 Nikoletta Rovina2 1Pulmonary and Critical Care Department, Evangelismos Hospital, 21st Department of Pulmonary Medicine, “Sotiria” Hospital; Athens Medical School, 3“M. Simos” Laboratories, Department of Critical Care and Pulmonary Services, National and Kapodistrian University of Athens, Athens, 4Medical Department, Hellenic Fireforce, Athens, Greece Introduction: The aim of this study was to assess respiratory health and airway and systemic inflammation in professional forest firefighters post firefighting. Methods: A total of 60 firefighters who participated in forest firefighting operations in Greece during 2008 were included in the study. A questionnaire consisting of symptoms and exposure, pulmonary function, atopy, bronchial hyperresponsiveness, and markers of inflammation in induced sputum, serum, and bronchoalveolar lavage (BAL) fluid was assessed. Results: A measurable eosinophilic and neutrophilic inflammation was shown to be induced in the bronchial airways after acute exposure during forest firefighting. This was associated with increased respiratory symptoms from the upper and lower respiratory tract and pulmonary function impairment. Additionally, a measurable systemic inflammatory response was demonstrated. This study showed that acute exposure during forest firefighting significantly augments the intensity of airway and systemic inflammation in relation to the baseline inflammatory background due to chronic exposure. Conclusion: The repeated acute exposures during firefighting augment the burden of chronic airway and systemic inflammation and may eventually lead to allergic sensitization of the airways and increased incidence of rhinitis and asthma after prolonged exposure.Keywords: firefighters, acute exposure, airway inflammation, systemic inflammation, allergic sensitization

Keywords

• Firefighters
• acute exposure
• airway inflammation
• systemic inflammation
• allergic sensitization