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BMC Pulmonary Medicine

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Open Access 01-12-2018 | Research article

The long-term rate of change in lung function in urban professional firefighters: a systematic review

Authors: Flynn Slattery, Kylie Johnston, Catherine Paquet, Hunter Bennett, Alan Crockett

Published in: BMC Pulmonary Medicine | Issue 1/2018

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).

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Title: The long-term rate of change in lung function in urban professional firefighters: a systematic review
Authors: Flynn Slattery
Kylie Johnston
Catherine Paquet
Hunter Bennett
Alan Crockett
Publication date: 01-12-2018
Publisher: BioMed Central
Published in: BMC Pulmonary Medicine / Issue 1/2018
Electronic ISSN: 1471-2466
DOI: https://doi.org/10.1186/s12890-018-0711-8

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