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

Authors Gianniou N, Giannakopoulou C, Dima E, Kardara M, Katsaounou P, Tsakatikas A, Roussos C, Koulouris N, Rovina N

Received 8 March 2017

Accepted for publication 5 May 2017

Published 23 April 2018 Volume 2018:11 Pages 81—88

DOI https://doi.org/10.2147/JAA.S136417

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr Luis Garcia-Marcos


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

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