COPD in Firefighters: A Specific Event-Related Condition Rather than a Common Occupational Respiratory Disorder
Armand RâjnoveanuRuxandra RâjnoveanuNicoleta Ștefania MotocParaschiva PostolacheGabriel GușetuMilena Adina Man
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Abstract:
Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Smoking remains the most important risk factor, but occupational exposures may play an essential role as well. Firefighters are among occupations regularly exposed to a variety of irritative inhalational products, and they may be expected to develop respiratory health problems because of such an occupational exposure. To better understand and characterize this relationship, we performed an extensive search of the scientific literature, and we identified two major research areas: firefighters exposed to wildland fire smoke and firefighters involved in the World Trade Centre disaster-related operations. Most of the studies did not report a significant increase in COPD diagnosis in firefighters. An accelerated rate of decline in lung function was seen, a short time after major exposure events. This is the reason for an increased rate of exacerbations observed in individuals already diagnosed with obstructive respiratory disorders. A limited number of studies not covering these specific circumstances of exposure were found. They reported long-term morbidity and mortality data, and the results are controversial. Major confounding factors for most of the studies were the "healthy worker effect" and the lack of useful data regarding smoking habits. Efforts should be made in the future to better characterize specific biomarkers for the progression of COPD; to establish exposure limits; and to implement preventive strategies like rotation of workers, smoking cessation programs, and long-term monitoring programs for respiratory disorders.Keywords:
Tobacco smoke
Tobacco use is one of the world's leading public health concerns. Globally and domestically, active and passive smoking are associated with an array of deleterious health outcomes. Environmental tobacco smoke (ETS), also referred to as passive smoke and second-hand smoke, exists in all countries and cultures and there is no level of exposure to ETS that is risk free [1]. Over 50 % of children worldwide are exposed to ETS in their homes while 60 % of US children between ages 3 and 11 years are exposed [1, 2].
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OBJECTIVES: This study evaluated the effectiveness of smoking restrictions. METHODS: We measured particulate concentrations in restaurants with different levels of allowable smoking. RESULTS: Mean particulate concentrations were 70% higher in establishments without smoking restrictions compared with those with partial smoking restrictions. Concentrations in nonsmoking restaurants were reduced by an additional 20% to 30%. Measurements of cadmium, an environmental tobacco smoke (ETS) marker, implicated ETS as the major source of particulate in restaurants that allowed smoking. CONCLUSIONS: Partial smoking restrictions substantially reduce, but do not eliminate, ETS exposure in restaurants. Occupants of nonsmoking restaurants avoid ETS exposure but may experience substantial particulate exposures from cooking emissions.
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Exposure to environmental tobacco smoke at workplaces, homes and other places was assessed.Exposure to environmental tobacco smoke was defined as occurring when a person reported inhaling, at least occasionally, tobacco smoke from other people's smoke. Some of the exposed were also smokers themselves. Questionnaire-based survey data and industrial hygiene measurements on environmental tobacco smoke were used to estimate the numbers of exposed persons by exposure level in Finland in January 2000.About 340,000 workers (16% of the employed population) were exposed to environmental tobacco smoke at work, of them 30,000 were exposed almost continuously (1.4% of the employed population). The mean level of exposure was 1 microg/m2 as measured by nicotine in workroom air. The nicotine concentration ranged from < 1 to > 100 microg/m3. Nearly 600,000 Finns (1% of the population) were exposed to environmental tobacco smoke at home. According measurements abroad, their mean nicotine exposure corresponded to about 4 microg/m3 at work. In addition, over 1 million Finns were exposed during leisure time to an unknown mean level of environmental tobacco smoke. Annual exposure of the Finnish population in January 2000 was estimated to originate mainly from smoking at home (48%) and leisure time in smoky restaurants (45%). Smoking was restricted at workplaces in 1995 and occupational exposure constituted 7% of the total population exposure in January 2000. New restrictions on smoking in restaurants should decrease the exposure of restaurant workers and customers even further.In spite of regulations, environmental tobacco smoke still remains the most common occupational exposure to chemical carcinogens in Finland.
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SUMMARY In the recent years the exposure to environmental tobacco smoke (ETS) has been an important public health hazard, especially in Serbia, a country with too many smokers. A common component of tobacco smoke is particulate matter less than 10 μ m in aerodynamic diameter (PM10), which is considered to be the most dangerous air pollutant for health. The aim of this paper was to investigate the association between respiratory symptoms and illnesses in schoolchildren in relation to their environmental tobacco smoke exposure. We conducted an epidemiological study that included 708 participants (49.15 % male) aged 11-14 years from Niš, Serbia. The children were surveyed by original structured questionnaire, based on the instrument developed for similar investigations. Data about the prevalence of respiratory symptoms in the last 12-month period of life and lifetime prevalence of respiratory illnesses were obtained. The questionnaire also included items about other indoor environmental determinants. Tobacco smoke was the most prevalent source of indoor air pollution at children’s home (60.73%). We found a significant association between ETS exposure and increased prevalence of dyspnea, wheezing, bronchitis and asthma among children. It is necessary to inform parents in Serbia on the health effects of ETS exposure during childhood and to encourage them to change smoking habits in order to protect their children from ETS exposure at home.
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Worldwide tobacco smoking kills nearly 6 million people each year, including more than600,000 non-smokers who die from smoke exposure. Tobacco smoke is a toxic and carcinogenic mixture of more than 5,000 chemicals. Environmental Tobacco Smoke (ETS), or secondhand smoke, is the combination of side stream smoke, the smoke given off by a burning tobacco product and mainstream smoke, the smoke exhaled by smokers. Exposure to Environmental Tobacco Smoke is detrimental to health which may pose a health risks to nonsmokers. Epidemiological data suggest that exposure to ETS may increase the risk of developing lung cancer, stroke, heart disease, cardiovascular disease, intrauterine growth retardation, predisposition to chronic lung disease, sudden infant death syndrome and is a risk factor for childhood asthma. The human populations most at risk from ETS exposure appear to be neonates, young children, and possibly the fetus while in uterus. The effects of ETS on human health are well-known, passive smoking is harmful to those who breathe the toxins and it is a serious problem for public health. Therefore, the decrease in smoking prevalence could provide substantial health gains in humans. This article reviews information on environmental tobacco smoke (ETS) particles that are of potential interest to scientists and professionals involved in exposure or risk assessment, epidemiology, or tobacco policy and to compile effective ways of reducing exposure in order to contribute to the wellbeing of human.Keywords: Environmental Tobacco Smoke, side stream smoke, main Stream smoke, tobacco.
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Environmental tobacco smoke (ETS) exposure is an important health risk worldwide and one person dies every 10 seconds because of tobacco-related diseases. So we evaluate the effect of it in people over 15 years old in Bandar Abbas (Iran). This was a cross-sectional study conducted on 387 subjects( 172 male and 215 female) who were randomly selected by cluster sampling method. Data were collected using a customized questionnaire consisted of demographic characteristics and questions related to environmental tobacco smoke (ETS) exposure. The collected data were analyzed using the statistical package of SPSS (version 16). The results of the assessments showed that 98.4% and 93.5% of subjects had been exposed to cigarette and hookah smoke, respectively. Furthermore, 12.7% and 14.7% of the subjects were always and often exposed to cigarette smoke, respectively, whereas just 1.6% did not expose to cigarette smoke. About the place of the exposure, 52.2% and 31.3% of the subjects mentioned the public transportations and home, respectively. 93.4% of the subjects were exposed to hookah smoke at home. There was no significant difference between exposure of males and females regarding environmental tobacco smoke exposure. Findings of this study show that a high number of the studied population was exposed to environmental tobacco smoke. Therefore, preventive efforts and educational programs are necessary to make people aware about the harmful effects of the environmental tobacco smoke.
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Disease risk due to smoking is not limited to smokers only. Passive smoking, exposure to environmental tobacco smoke, is associated with adverse health effects, and it increases the risk of several diseases. This paper summarizes the cardiovascular effects of tobacco smoke and the current data on the effects of environmental tobacco smoke on the development of cardiovascular disease. According to the results of epidemiologic and experimental studies, environmental tobacco smoke has marked harmful effects on the cardiovascular system. It is estimated that it increases the risk of an acute event of coronary heart disease by 25-35%. Even though the number of studies conducted in the work environment is small, there is no reason to assume that the cardiovascular effects of environmental tobacco smoke differ markedly between the home and the workplace. Firm and timely actions are needed to protect people from exposure to environmental tobacco smoke, both in occupational and other environments.
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Exposure to environmental tobacco smoke(ETS)in public places and workplaces has become a major pubic and occupational health issue in recent years. This paper reviews the impacts of ETS on health,exposures of ETS in public places and workplaces,effects of smoking forbidden law to reduce the exposures of ETS and the exposed status in our country,as well as discusses the prospective research.
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