RESUMEN

Firefighters are occupationally exposed to chemicals that may affect fertility. To investigate this effect, firefighters were recruited to contribute blood, urine, breast milk or semen samples to (1) evaluate chemical concentrations and semen parameters against fertility standards and the general population; (2) assess correlations between chemical concentrations and demographics, fire exposure and reproductive history; and (3) consider how occupational exposures may affect reproduction. A total of 774 firefighters completed the online survey, and 97 firefighters produced 125 urine samples, 113 plasma samples, 46 breast milk samples and 23 semen samples. Blood, urine and breast milk samples were analysed for chemical concentrations (semivolatile organic compounds, volatile organic compounds, metals). Semen samples were analysed for quality (volume, count, motility, morphology). Firefighter semen parameters were below WHO reference values across multiple parameters. Self-reported rates of miscarriage were higher than the general population (22% vs. 12-15%) and in line with prior firefighter studies. Estimated daily intake for infants was above reference values for multiple chemicals in breast milk. More frequent fire incident exposure (more than once per fortnight), longer duration of employment (≥15 years) or not always using a breathing apparatus demonstrated significantly higher concentrations across a range of investigated chemicals. Findings of this study warrant further research surrounding the risk occupational exposure has on reproduction.

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Firefighters are occupationally exposed to heat intensities and chemical concentrations that may affect fertility. Twenty firefighters participated in an exploratory study assessing fertility of firefighters via an online survey and semen analysis. Data analysis included consideration of demographic characteristics, reproductive history and occupational exposures. Overall, firefighter semen parameters were below World Health Organisation reference values designating fertility in men. Firefighters younger than 45 years had a higher incidence of abnormal semen parameters (42%) than those aged 45 years or greater (9%). Increased rank and higher levels of occupational and/or personal hygiene were associated with improved semen quality. Increased frequency of fire exposure was associated with a reduction in normal forms, volume, sperm concentration and total sperm count. Sperm clumping was greater than 10% in 26% of samples, suggesting reduced semen quality. This exploratory study provides novel data that support the hypothesis of an association between semen quality and firefighter's occupational exposure to toxic environments.

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Firefighters are exposed to a wide variety of chemicals including polycyclic aromatic hydrocarbons (PAHs) while attending fire scenes. The objective of this study was to understand the exposure of firefighters to PAHs when attending simulated compartment fires that consisted of either a diesel pan or particleboard fire. Firefighters remained in the compartment fires for 15 min while using standard gear including self contained breathing apparatus (SCBA). Firefighters were able to remove firefighting clothing and shower within 10 min of leaving the burn. Air samples were collected from inside the compartment during the fire. Twenty-six (26) firefighters participated in the study providing urine and skin wipe samples collected from the wrist and neck before and after either one of the burn types. The concentrations of PAHs were measured in skin wipes and air samples, while concentrations of monohydroxy metabolites of PAHs (OH-PAHs) were measured in urine. The concentrations of all PAHs were significantly higher (p < 0.05) in the smoke layer of particleboard fires than in diesel pan fires. Correspondingly, the level of PAHs deposited on the wrists and necks of participants attending the particleboard fires was higher than those attending diesel pan fires. Urine samples from participants who attended diesel pan fires showed no significant difference (p > 0.05) in the concentration of all OH-PAHs between pre-burn and post-burn. Samples from participants who attended particleboard fires, showed no significant difference (p > 0.05) between 1-hydroxypyrene (1-OH-PYR) concentrations in urine pre- and post-burn. However, median concentrations of hydroxynaphthalenes (OH-NAPs), hydroxyfluorenes (OH-FLUs) and hydroxyphenanthrenes (OH-PHEs) increased significantly from 5.2, 0.44 and 0.88 µg g-1 creatinine pre-burn to 12, 1.4 and 1.2 µg g-1 creatinine post-burn, respectively. This suggests that in compartment burns with high concentrations of PAHs in the smoke layer, such as those created by the particleboard fires, exposure to PAHs can be observed though urinary OH-PAH metabolites. Overall, concentrations of urinary OH-PAHs were relatively low considering the potential exposure in these burns. This suggests protective equipment in combination with rapid removal of firefighting ensembles and showering are relatively effective in controlling exposure.

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Firefighter uniforms protect firefighters from exposure to potentially harmful chemicals including a range of semi-volatile organic compounds (SVOCs). Contaminated uniforms can become a secondary source of firefighters' exposure to these chemicals. There is inconsistency on the removal efficiency of SVOCs during the cleaning, laundering and field decontamination of firefighting uniforms. Therefore, this study aims to assess how effective decontamination and laundering processes are in reducing firefighter uniforms as a vector for transport and exposure to SVOCs. Firefighters who had attended a controlled house fire and simulated container burns had their uniforms sampled pre- and post-laundering. Clean station wear was laundered with contaminated uniforms and after a load of contaminated uniforms to assess inter and intra load contamination. Surface wipes were collected from uniforms across 12 fire stations, after they had returned from a laundering provider. Concentrations of 13 polycyclic aromatic hydrocarbons (PAHs), six organophosphate flame retardants (OPFRs) and seven polybrominated diphenyl ethers (PBDEs) were measured in the collected samples. The concentrations of ∑13 PAHs in firefighters uniforms ranged between 0.063 and 43 µg g-1, while concentration of ∑6 OPFRs were between 0.061 and 90 µg g-1 with ∑7 PBDEs concentrations being measured between 0.00054 and 0.97 µg g-1.The highest concentrations of ∑13 PAHs were measured on the outer layers of gloves at an average of 19 µg g-1, with the highest ∑6 OPFRs concentrations being measured in the middle layers of gloves at an average of 31 µg g-1. The highest ∑7 PBDEs concentrations were measured on the shell layers of turnout jackets at 0.42 µg g-1. The significant reduction in ∑13 PAHs after laundering or decontamination was only found in 3 of the 16 sampled areas from firefighting uniforms. No significant differences were found in the between pre- and post-laundering concentrations of ∑6 OPFRs or ∑7 PBDEs in firefighting uniforms. The current laundering techniques do not appear to effectively remove PAHs, OPFRs and PBDEs at the measured concentrations from firefighters' uniforms. Further research is required to assess if chemical exposure though firefighting uniforms poses a health risk to firefighters and to develop methods for the removal of SVOCs from firefighting uniforms.

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Firefighters are exposed to a wide range of toxic chemicals due to combustion, with numerous biomonitoring studies completed that have assessed exposure. Many of these studies focus on individual classes of chemicals, with a few considering a broad range of systemic exposures. As yet, no review process has been undertaken to comprehensively examine these studies. The aims of this review are to: (1) ascertain whether biomonitoring studies pertaining to firefighters demonstrate occupational exposure to volatile organic compounds, semivolatile organic compounds, and metals; (2) determine and present results of biomonitoring studies; (3) provide any recommendations presented from the literature that may support exposure mitigation; and (4) suggest future study parameters that may assist in providing a greater understanding surrounding the occupational exposure of firefighters. A systematic review was undertaken with regards to firefighters and biomonitoring studies utilising the matrices of blood, urine, semen and breast milk. This yielded 5690 results. Following duplicate removal, inclusion and exclusion criteria screening and full text screening, 34 studies remained for review. Results of over 80% of studies analysed determined firefighters to experience occupational exposure. Results also show firefighters to be exposed to a wide range of toxic chemicals due to fire smoke; potentially exceeding the range of exposure of other occupations. As firefighters may face increased risk of health effects due to the additive, synergistic, and/or antagonistic effects of chemical exposure, all care must be taken to reduce exposure. This may be achieved by considering tactical decisions, increased personal hygiene, and thorough decontamination procedures. Future biomonitoring studies recognising and assessing the range of chemical exposure firefighters face would be beneficial.

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Firefighters are exposed to a wide range of chemicals whilst on duty, including polycyclic aromatic hydrocarbons (PAHs), organophosphate flame-retardants (OPFRs), and polybrominated diphenyl ethers (PBDEs). These groups of chemicals are related to combustion emissions. PAHs are formed during combustion. OPFRs and PBDEs are flame-retardants and are inadvertently released during combustion. Exposure to these chemicals occurs when attending fire scenes, and firefighters can track these chemicals back into fire stations leading to further exposure. The objective of this study was to understand the concentrations of PAHs, OPFRs, and PBDEs in fire stations, to evaluate factors that affect chemical concentration, and to assess how air and dust could contribute to firefighters' relevant exposure risk. Concentrations of 13 PAHs, 9 OPFRs, and 8 PBDEs were quantified in fire station dust (n = 49) and air (n = 15) samples collected between November 2017 and February 2018. The median ∑13PAH concentration was 15 ng m-3 and 3.1 µg g-1 in air and dust, respectively, while the median ∑9 OPFR concentration was 56 ng m-3 in air and 84 µg g-1 in dust, and ∑8 PBDE had a median concentration of 0.78 ng m-3 in air and 26 µg g-1 in dust. The estimated daily intakes through dust and air for ∑13 PAHs, ∑9 OPFRs, and ∑8 PBDEs in firefighters were 3.6, 17, and 1.6 ng (kg body weight)-1 day-1, respectively. The worst-case estimated daily intakes were only 2% of the reference dose for individual chemicals. Pearson's correlations with chemical concentration for several PAHs, OPFRs, and PBDEs were found between the number of years since fire stations were last renovated, as well as the storage locations of firefighting ensembles. These results suggest chemicals are brought back to fire stations from fire scenes and that they are accumulating in fire stations. They also suggest soiled firefighting ensembles are a source of these chemicals in fire stations and that their proximity to the rest of the station determines the extent to which they contribute to chemical concentrations in fire stations.

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Firefighting is an occupation with exposure to a wide range of chemicals by means of inhalation, ingestion or dermal contact. Although advancements in personal protective clothing and equipment have reduced the risks for acute exposure during fire suppression operations, chronic exposure may still be present at elevated levels in fire stations. The aim of this study was to assess chemicals in air and on surfaces in fire stations, compare this with other indoor environments, and use this data to estimate firefighter exposure within the fire station. Fifteen Australian fire stations were selected for chemical exposure assessment by means of 135 active air monitors, 60 passive air monitors, and 918 wipe samples. These samples were collected from the interior and exterior of fire stations, from personal protective clothing and equipment, and from within the cabins of vehicles. Chemicals analysed included polycyclic aromatic hydrocarbons, volatile organic compounds, metals, and diesel particulate matter. Specific chemicals were detected from within each class of chemicals, with metals being most frequently detected. Statistical analysis by means of Pearson's Correlations and threshold tests were used to consider the source of exposure, and a collective addition risk quotient calculation was used to determine firefighter exposure. The presence of metals in fire stations was compared with findings from global indoor dust measurements. Concentrations across firefighter ensemble, inside vehicle cabins, and within fire stations for chromium (39.5-493 µg/m2), lead (46.7-619 µg/m2), copper (594-3440 µg/m2), zinc (11100-20900 µg/m2), nickel (28.6-2469 µg/m2) and manganese (73.0-997 µg/m2) were in most instances orders of magnitude higher when compared with concentrations measured in homes and offices. Our study suggests that the elevated concentrations are associated with the transfer of chemicals from fire suppression operations. Due to this elevated concentration of chemicals, firefighters may face increased exposure, and in turn increased risk of adverse health effects. Data suggest that exposure may be mitigated by means of increased laundering frequency and increased decontamination at the scene of the fire.

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