Where there's smoke, there's fire: focal points for risk communication.

Large fires involving hazardous materials are often characterized by failing crisis communication. In this study, we compared opinions of experts regarding the risks of major fires to lay beliefs using a mental models approach. Amongst lay people this revealed relevant knowledge gaps and beliefs in opposition to those held by experts. While, experts considered the chance of getting cancer from inhaling smoke from a chemical fire extremely small, most lay people thought that even at a great distance, the chance of getting cancer to be large. To improve crisis communication about risk in a case of large chemical fires, and reduce the potential for messages to be misunderstood, distrusted or dismissed, we recommend a clarification of cancer risk in communications about public health emergencies such as chemical fires, for which lay people equate even small exposures to carcinogenic chemicals make one more likely to get cancer later in life.

Acute respiratory effects in firefighters.

BACKGROUND: Associations between acute respiratory inflammatory responses, changes in bronchial hyperresponsiveness, serum pneumoprotein levels, and exposure to fire smoke were studied. METHODS: The study comprised 51 firefighters. Blood samples were taken within 24 hr following exposure to fire smoke, and after a week and 3 months. Sputum was induced within 5 days post-exposure and subjects underwent spirometry and methacholine provocation one week post-exposure. Exposure was registered by a questionnaire. RESULTS: No changes were observed following smoke exposure in bronchial hyperresponsiveness and serum pneumoprotein levels. Nevertheless, in a sizable proportion of the firefighters (44%) elevated sputum neutrophil levels (≥60%) were found. Serum IL-8 concentrations were higher 24 hr post-exposure compared to pre-exposure. Elevated neutrophil levels in sputum were associated with elevated serum IL-8 (ß = 0.010, P = 0.004) and TNFα (ß = 0.005, P = 0.034) levels within 24 hr post-exposure and IL-8 elevation lasted up to 3 months. CONCLUSIONS: Acute exposure to fire smoke induces acute neutrophilic airway and long-lasting systemic inflammation in healthy firefighters in the absence of bronchial hyperresponsiveness.

Respiratory symptoms in firefighters.

BACKGROUND: The aim of the present study was to determine the prevalence and risk factors associated with respiratory symptoms in common firefighters in the Netherlands. METHODS: A total of 1,330 firefighters from the municipal fire brigades of three provinces of the Netherlands were included in the study. All subjects were administered a Dutch web-based version of the European Community Respiratory Health Survey questionnaire. RESULTS: General respiratory symptoms were associated with the number of fires fought in the last 12 months with odds ratios between 1.2 (95% CI 1.0-1.4) and 1.4 (95% CI 1.2-1.7) per 25 fires. A strong association was found between an inhalation incident and present respiratory symptoms with odds ratios between 1.7 (95% CI 1.1-2.7) and 3.0 (95% CI 1.9-4.7). Adjustments for smoking, sex, atopy, and age did not change any of the associations. After stratification, atopics showed elevated odds ratios. CONCLUSIONS: It is recommended that firefighters are aware of these elevated healthcare risks associated with exposure to fire smoke and that they increase as much as possible the use of self-contained breathing apparatus.

Air pollution during New Year's fireworks and daily mortality in the Netherlands.

Short-term exposure to air pollution has been associated with cardiovascular and respiratory mortality and morbidity. Little is known about associations between air pollution caused by firework events and daily mortality. We investigated whether particulate matter from fireworks during New Year's celebrations was associated with daily mortality. We analyzed the celebrations of the years 1995-2012. PM10 concentrations increased dramatically during the firework events. Countrywide, the daily average PM10 concentrations from 27-30 December was 29 µg/m3 and increased during the first hour of the New Year by 277 µg/m3. In the more densely populated areas of the Netherlands the increase was even steeper, 598 µg/m3 in the first hour of the New Year. No consistent associations were found using linear regression models between PM10 concentrations during the first six hours of 1 January and daily mortality in the general population. Yet, using a case-crossover analysis firework-days and PM10 concentrations were associated with daily mortality. Therefore, in light of the contradictory results obtained with the different statistical analyses, we recommend further epidemiological research on the health effects of exposure to firework emissions.