Prolonged occupational exposure leads to allergic airway sensitization and chronic airway and systemic inflammation in professional firefighters

• Published in: Respiratory medicine Vol. 118; pp. 7 - 14
• Main Authors: Gianniou, Niki, Katsaounou, Paraskevi, Dima, Efrossini, Giannakopoulou, Chariklia-Eleni, Kardara, Matina, Saltagianni, Vassiliki, Trigidou, Rodoula, Kokkini, Aggeliki, Bakakos, Petros, Markozannes, Evangelos, Litsiou, Eleni, Tsakatikas, Alexandros, Papadopoulos, Christos, Roussos, Charis, Koulouris, Nikolaos, Rovina, Nikoletta
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.09.2016; Elsevier Limited
• Subjects: Adult; Airway inflammation; Allergic sensitization; Biopsy; Bronchial Hyperreactivity - epidemiology; Bronchial Hyperreactivity - physiopathology; Bronchial Provocation Tests - methods; Bronchoalveolar Lavage Fluid - immunology; Chronic obstructive pulmonary disease; Cytokines; Dyspnea; Eosinophil Cationic Protein - metabolism; Eosinophils - immunology; Firefighters; Fires; Humans; Hypersensitivity - immunology; Hypersensitivity - pathology; Inflammation; Inflammation - metabolism; Inflammation - pathology; Interleukin-8 - blood; Lymphocytes; Male; Neutrophils; Occupational Exposure - adverse effects; Proteins; Pulmonary/Respiratory; Respiratory Function Tests - methods; Respiratory System - pathology; Respiratory System - physiopathology; Skin; Sputum - immunology; Systemic inflammation; Systemic Inflammatory Response Syndrome - physiopathology; Tumor Necrosis Factor-alpha - blood; Tumor necrosis factor-TNF; Vascular endothelial growth factor; Vascular Endothelial Growth Factor A - metabolism; Firefighters; Interleukin-4; provocative dose of methacholine producing a 20% fall in FEV 1; RV; forced vital capacity; TLC; Interleukin-8; tumor necrosis factor-alpha; CO transfer coefficient; PD20meth; residual volume; VEGF; Eosinophilic cationic protein; Interleukin-13; BALF; IL-4; IL-13; IL-8; FVC; FEV 1; ECP; Airway inflammation; total lung capacity; TNF-α; KCO; vascular endothelial growth factor; forced expiratory volume; bronchoalveolar lavage fluid; Systemic inflammation; Allergic sensitization; FEV1
• ISSN: 0954-6111; 1532-3064
• DOI: 10.1016/j.rmed.2016.07.006

Abstract Background and Objectives Little data exist on short- and long-term effects of occupational exposure on airway and systemic inflammation in professional firefighters. We aimed to characterize airway and systemic inflammation in training firefighters with a maximum occupational exposure of 1 year compared to the long-term exposure of professional firefighters. Methods A questionnaire for symptoms and exposure, pulmonary function, atopy, bronchial hyper-responsiveness, and markers of inflammation in induced sputum, serum, bronchoalveolar lavage (BAL) fluid and bronchial biopsies were assessed in a total of 92 firefighters (63 full-time professionals and 29 trainees). Results Professional firefighters showed allergic bronchial sensitization documented by the presence of atopy, and eosinophilia in induced sputum, BAL and bronchial biopsies. IL-8, ECP, VEGF, and TNF-α levels were statistically significantly higher in the sputum supernatants of professional firefighters compared to the trainees (p = 0.04, p = 0.02, p = 0.04, and p = 0.02, respectively). Serum IL-8 and TNF-α levels were also statistically significantly higher in the group of professional firefighters (p = 0.04, p = 0.03, respectively). Finally, there was a linear correlation between the duration of the occupation in Service and the degree of airway and systemic inflammation. Conclusions These results indicate a “dose-response” effect of chronic exposure to a polluted environment on bronchial and systemic inflammation in professional firefighters.