In addition to hazards such as explosive substances and the collapse of burning buildings, smoke inhalation and burns are two of the primary risks to all firefighters. Even though all fire engineers need to undergo a thorough medical evaluation before they can start working, it is necessary to make sure that their lungs are always in good shape, as they are exposed to smoke and chemical hazards more than any other profession.
Respiratory-Related Deaths
According to a joint report by the United States Fire Administration (USFA) and the International Association of Fire Fighters (IAFF), published in 2010, diseases linked to the respiratory system are third among the causes of disease-related deaths in North America alone. This means that one out of six disease-related deaths are because of respiratory disorders.
Fire engineers are highly susceptible to lung and airway disease because of the nature of their jobs, so it is important that they understand how to take care of their lungs and what to look for if they suspect any health issues.
Fire engineers need to be extremely fit, as not only do they have to carry equipment that can weigh anywhere up to 124 pounds but they also need to endure the harsh environments they are exposed to. Even though fire engineers are provided with masks and respirators, they are still at risk of exposure to dangerous fumes. As Dr. Monica Mishra of Riverview Medical Centre says, “The things we worry about in terms of lung health are related to what they are exposed to. Things like: respiratory toxins; asphyxiates like carbon monoxide; irritants such as ammonia; phenols; allergens; and, carcinogens such as asbestos. Smoke can also cause heart problems.” She adds, “Learning how to remove chemical residue from their protective clothing and skin is a must for individuals in the fire and safety industry.”
Respiratory Masks not the Answer
Declining lung function can manifest itself through shortness of breath, persistent coughing, wheezing, and weight loss. Firefighters need to be on the lookout for any of these symptoms, as well as any sleep disturbances. Chronic obstructive pulmonary disease, pulmonary hypertension, heart disease, interstitial lung disease, lung cancer, tuberculosis, and reactive airways dysfunction syndrome are just a few of the diseases they are susceptible to.
While respiratory masks do reduce exposure, they can’t totally eliminate it. A report by the USFA and the IAFF highlights a gradual decrease in expiratory volume among firefighters around the world. This means that their lung tissue is being affected, and the ability of the lungs to filter out harmful substances, such as carbon monoxide or benzene, is decreasing steadily.
Annual Medical Checkups
It is therefore necessary for firefighters to undergo a complete medical checkup every year. Although lungs are exposed, another cause of concern lies with the heart where, as Mishra highlights, “Believe it or not, heart disease is actually the number one killer in firefighters because of the amount of stress they undergo. It causes inflammation in the arteries and leads to early heart disease. They need to get a physical done every year, and that includes a blood count, cardio C-reactive protein, an EKG, and a stress test, although stress tests can be done once every five years, unless the person is symptomatic.” This is over and above the pulmonary function tests and chest x-rays that are necessary in the medical evaluation of a fire engineer.
Provocative challenge testing is another vital part of evaluating lung function. This test enlists the use of methacholine, cold air, and exercise to evaluate lung function and helps to determine the kind of disease, if any, that is present. Methacholine, administered as an aerosol mist, acts as an irritant to the respiratory system, causing the airways to contract involuntarily if there is a presence of asthma. If lung function drops by 20 percent, this is considered a positive result for the presence of asthma.
After the proactive challenge test, the doctor will give a bronchiodilator to bring lung function back to previous levels before the start of the test. Breathing in cold air is used as a test to check vital capacity and the flow of expired air from the lungs. If it drops significantly, then this indicates reduced lung function, and the doctor can provide further testing. For the exercise test, the doctor will ask the person being tested to run on a treadmill or use a stair-climbing machine and assess lung function before and after strenuous exercise, which will indicate the health of the lungs.
Maintaining Overall Fitness
In such jobs, where exposure to smoke and chemicals are a part of the job description, it becomes vital to maintain fitness. Physical therapist Bharti Verma describes the vital need to improve lung function. “Lung function is normally just at 50 percent of its potential, and it is important to enhance this to the maximum possible, especially when it comes to fire engineers. Fire engineers need to have a healthy exercise routine, which includes exercises specifically aimed at increasing lung function.”
To this end, deep breathing techniques and diaphragmatic breathing need to be incorporated into any exercise routine, and spirometers are also an effective way of giving the lungs a good workout. These are in addition to aerobic exercises, which go a long way in improving heart and lung function. Yoga can provide a variation in the exercise schedule. The core effect of yoga is based on breathing properly; it revitalizes the body and helps the lungs to cleanse themselves. Swimming is also a perfect way for increasing lung capacity; regular swimmers have a greater lung capacity than the average person, sometimes to the extent of three times as much.
“Although it may take years for a lung-related disease to develop, regularity in checkups is important,” explains Dr. Anshu Bais, internal medicine specialist at Mercy Hospital in the United States.
“And not just checkups, but in case any disease is detected, routine follow-ups need to be emphasized, and any change in symptoms need to be reported to the doctor. Apart from regularity in exercise, careful monitoring of the evolution of any other conditions is also important, as smoke inhalation can exacerbate these, especially when they involve the heart.”
Heart and Lung Care Go Hand-in-Hand
Fire engineers have highly stressful jobs, and this alone makes them more vulnerable to heart-related conditions. Lung care is doubly important, as the lungs and heart are interdependent, and too much pressure on one almost certainly affects the other. Fortunately, lung disease, when caught early, can be treated effectively.
Therefore, it is vital for firefighters and anyone who might regularly inhale smoke to not only be aware of the signs of lung disease but maintain their lung health via regular physical exercise. Indeed, for fire engineers, taking care of their lungs is a major step in maintaining their health and should be inculcated into their daily routine. It is, literally, as important as breathing itself.
