Occupational exposures and symptoms among firefighters and police during the carmel forest fire: the Carmel cohort study.

BACKGROUND: From 2 to 5 December 2010, Israel experienced the most severe forest fire In its history, resulting in the deaths of rescue workers. Little research exists on the health risks to emergency responders during forest fires, and there is no published research to date on occupational health among firefighters in Israel. OBJECTIVES: To describe the exposures experienced by emer gency responders to smoke, fire retardants and stress; the utilization of protective equipment; and the frequency of corresponding symptoms during and following the Carmel Forest fire. METHODS: A cohort of 204 firfighers and 68 police who took part in rescue and fire-abating activites during the Carmel Forest fire were recruited from a representative sample of participating stations throughout the country and interviewed regarding their activities during the fire and their coinciding symptoms. Unpaired two-sample t-test compared mean exposures and symptom frequency for firefighters and police. Chi-square estimates of OR and 95%CI are provided for odds of reporting symptoms, incurring injury or being hospitalied for various risk factors RESULTS: Of the study participants, 87% reported having at least one symptom during rescue work at the Carmel Forest fire,with eye irritation (77%) and fatigue (71%) being the most comon. Occupational stress was extremely high during the fire; the average length of time working without rest was 18.4 hours among firefighters. CONCLUSION: Firefighter and police were exposed to smoke and ocupational stress prolonged periods during the fire. Further research is needed on the residual health effects from exposure to forest fires among emergency responders, and to identify areas for improvement in health preparedness.

Urine arsenic concentration and obstructive pulmonary disease in the U.S. population.

Arsenic (As) is a known carcinogen commonly found in drinking water. An emerging body of evidence suggests that exposure to inorganic As may be associated with nonmalignant respiratory disease. The aim of this study was to determine whether there is an association between As exposure at levels seen in the United States and prevalence of asthma, emphysema, chronic bronchitis, and respiratory symptoms.Urinary As was collected from 5365 participants from the combined 2003-2006 National Health and Nutrition Examination Survey (NHANES) cohorts. Two methods to adjust for organic As component were incorporated into the statistical model. Linear and logistic regression models compared urinary As adjusted for organic As with diagnoses of obstructive pulmonary disease and respiratory symptoms.Geometric mean concentration of urinary As were not significantly different between participants with and those without asthma, chronic bronchitis,and emphysema. Odds of having asthma was 0.71 for participants with the highest quintile of urinary As (≥ 17.23 µg/dl) when compared to the lowest quintile (≤ 3.52 µg/dl). A significant association was found between increasing urinary As concentration and decreasing age, male gender, and non-"white" race.A significant association between urinary As and obstructive pulmonary disease and symptoms was not demonstrated in the U.S. population.

Mitigating pharmaceutical waste exposures: policy and program considerations.

Pharmaceutical disposal and the environmental fate of medication metabolites directly impacts the public's health in two significant ways: accidental medication ingestion of pharmaceuticals that were not disposed of properly results in inadvertent toxicity; and environmental health consequences of pharmaceuticals that were inappropriately disposed and which contaminate municipal water supply. In reviewing the effectiveness of medication disposal policy globally, it is crucial to not only determine which policies are effective but also to assess why they are effective. By assessing the root causes for a specific policy's effectiveness it can be determined if those successes could be translated to another country with a different health care system, unique culture and divergent policy ecosystem. Any intervention regarding pharmaceutical disposal would require a multifaceted approach beyond raising awareness and coordinating pharmaceutical disposal on a national level. While consumer participation is important, effective primary prevention would also include research on drug development that is designed to biodegrade in the environment as opposed to medications that persist and accumulate in the natural environment even when properly disposed. Countries that lack a nationalized disposal policy should leverage the resources and infrastructure already in place in the national health care system to implement a unified policy to address medication disposal in the short-term. In tandem, efforts should be made to recruit the biotechnology sector in high-tech and academia to develop new technologies in medication design and water filtration to decrease exposures in the long-term.

Contribution of nitrogen oxide and sulfur dioxide exposure from power plant emissions on respiratory symptom and disease prevalence.

This study investigates the association between exposure to ambient NOx and SO2 originating from power plant emissions and prevalence of obstructive pulmonary disease and related symptoms. The Orot Rabin coal-fired power plant is the largest power generating facility in the Eastern Mediterranean. Two novel methods assessing exposure to power plant-specific emissions were estimated for 2244 participants who completed the European Community Respiratory Health Survey. The "source approach" modeled emissions traced back to the power plant while the "event approach" identified peak exposures from power plant plume events. Respiratory symptoms, but not prevalence of asthma and COPD, were associated with estimates of power plant NOx emissions. The "source approach" yielded a better estimate of exposure to power plant emissions and showed a stronger dose-response relationship with outcomes. Calculating the portion of ambient pollution attributed to power plants emissions can be useful for air quality management purposes and targeted abatement programs.