Wah Win, Gelaw Asmare, Glass Deborah C, Sim Malcolm R, Hoy Ryan F, Berecki-Gisolf Janneke, Walker-Bone Karen
Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Healthy Working Lives Research Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
Int J Hyg Environ Health. 2025 Jan;263:114463. doi: 10.1016/j.ijheh.2024.114463. Epub 2024 Sep 26.
Wildfire smoke contains numerous hazardous air pollutants which pose serious health risks to humans. Despite this, there has been a limited focus on the assessment of the acute physiological and longer-term respiratory effects of wildfire exposure on firefighters and other emergency workers. Therefore, we undertook a systematic review of the evidence about the respiratory impacts of occupational wildfire smoke exposure among wildfire fighters (WFF).
Eligible studies from Medline, Embase and Scopus databases were included if they described the relationship between wildfire exposure and respiratory function, symptoms, measures and diseases amongst emergency personnel or firefighters who had responded to wildfires.
Twenty-six articles met the inclusion criteria. 24 out of 26 (22 out of 23 moderate/high quality) studies provided evidence of adverse respiratory effects, including reduced lung function, increased airway dysfunction and airway inflammation, upper and lower respiratory tract symptoms and increased asthma incidence related to wildfires or prescribed burns exposure among WFF and police responders. Fourteen out of 19 studies showed statistically significant declines in spirometry measures of lung function (mostly short-term studies). Two studies using complex lung function tests showed a significant effect on peripheral airway function.
This review found a convincing body of evidence that occupational exposure to wildfires or prescribed burns has both acute and possibly longer-term respiratory effects among WFFs and some other emergency personnel. Given that these events are increasing, more needs to be done to identify those most at risk and mitigate these risks.
野火烟雾含有多种有害空气污染物，对人类健康构成严重风险。尽管如此，对于野火暴露对消防员和其他应急人员的急性生理影响和长期呼吸影响的评估一直有限。因此，我们对有关野火消防员（WFF）职业性野火烟雾暴露的呼吸影响的证据进行了系统综述。
如果Medline、Embase和Scopus数据库中的合格研究描述了野火暴露与应对野火的应急人员或消防员的呼吸功能、症状、测量指标和疾病之间的关系，则将其纳入。
26篇文章符合纳入标准。26篇中的24篇（23篇中/高质量研究中的22篇）研究提供了不良呼吸影响的证据，包括肺功能下降、气道功能障碍和气道炎症增加、上呼吸道和下呼吸道症状以及与野火或规定燃烧暴露相关的WFF和警察应对人员中哮喘发病率增加。19篇研究中的14篇显示肺功能肺活量测定指标有统计学显著下降（大多为短期研究）。两项使用复杂肺功能测试的研究显示对外周气道功能有显著影响。
本综述发现了令人信服的证据，表明职业性暴露于野火或规定燃烧对WFF和其他一些应急人员有急性和可能的长期呼吸影响。鉴于这些事件正在增加，需要做更多工作来识别那些风险最高的人员并减轻这些风险。
