Association of firefighting exposures with lung function using a novel job exposure matrix (JEM)
研究利用新型职业暴露矩阵估算消防员在非野火事故中的烟雾颗粒暴露量，发现每增加1000公斤颗粒物，肺功能指标FEV1长期下降13毫升，短期下降27毫升，且世贸中心高暴露者关联更强。
Objectives Characterisation of firefighters’ exposures to dangerous chemicals in smoke from non-wildfire incidents, directly through personal monitoring and indirectly from work-related records, is scarce. The aim of this study was to evaluate the association between smoke particle exposures (P) and pulmonary function. Methods The study period spanned from January 2010 through September 2021. Routine firefighting P were estimated using fire incident characteristics, response data and emission factors from a novel job exposure matrix. Linear mixed effects modelling was employed to estimate changes in pulmonary function as measured by forced expiratory volume in one second (FEV 1 ). Models controlled for age, race/ethnicity, height, smoking and weight. Results Every 1000 kg P was associated with 13 mL lower FEV 1 (β=−13.34; 95% CI=−13.98 to −12.70) over the entire 12-year follow-up period. When analysing exposures within 3 months before PFT measurements, 1000 kg P was associated with 27 mL lower FEV 1 (β=−26.87; 95% CI=−34.54 to −19.20). When evaluating P estimated within 3 months of a pulmonary function test (PFT), stronger associations were observed among those most highly exposed to the World Trade Center (WTC) disaster (β=−12.90; 95% CI=−22.70 to −2.89); the association of cumulative exposures was similar for both highly and less highly exposed individuals. Discussion Smoke particle exposures were observed to have modest short-term and long-term associations with pulmonary function, particularly in those who, previously, had high levels of WTC exposure. Future work examining the association between P and pulmonary function among non-WTC exposed firefighters will be essential for disentangling the effects of ageing, routine firefighting and WTC exposures.