Asbestos exposure and fire fighting

Our plain-English summary of Asbestos exposure and fire fighting, by S.B. Markowitz, K. Garibaldi, R. Lilis, et al (Annals of the New York Academy of Sciences, 1991).

The study

• Authors: S.B. Markowitz, K. Garibaldi, R. Lilis, P.J. Landrigan
• Journal: Annals of the New York Academy of Sciences
• Published: 1991;643:573-7
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 004485).

Summary of the article

The authors examined whether long-term New York City fire fighters showed radiographic signs of asbestos-related lung and pleural disease. They invited fire fighters who had been employed by the New York City Fire Department as of December 1963, had worked in a ladder company for at least five years during the 1960s, and had been assigned to firehouses in areas with large office buildings, factories and warehouses, or heavy fire activity. Of 550 invited, 212 (39%) took part. All were male, their mean age was 57, and 72% were still active. Evaluation included occupational, smoking and medical histories, a respiratory symptom questionnaire, physical examination, spirometry, and chest X-rays read by two readers using the 1980 ILO classification. Overall, 42 participants (20%) had pleural thickening and/or small irregular parenchymal opacities. Of 152 fire fighters reporting no asbestos exposure before fire fighting, 20 (13%) had abnormalities, including 13 (9%) with pleural thickening and 8 (6%) with parenchymal opacities. Of 60 with prior exposure, 22 (37%) had abnormalities, including 18 (30%) with pleural thickening and 7 (12%) with parenchymal opacities. The abnormalities were mild. The authors concluded that fire fighters are at risk of asbestos-induced pleural and pulmonary fibrosis independent of other exposure. They noted that 9% pleural thickening exceeded the roughly 2% reported in general population studies. They recommended reducing exposure, using respiratory protection throughout all phases of fires, and providing medical surveillance.

PubMed has no abstract for this study, and the article doesn't print one. We wrote this summary from the full article with the help of AI. It is not the authors' wording.

In plain English

This cross-sectional study examined long-term New York City fire fighters selected for likely asbestos exposure. They had worked in ladder companies in the 1960s in areas with large buildings, factories and warehouses, or heavy fire activity. Of 550 invited, 212 (39%) took part, all men. Two readers interpreted chest X-rays using the ILO classification. In all, 42 of 212 (20%) had pleural thickening and/or small irregular lung opacities. Among the 152 with no reported asbestos exposure before becoming fire fighters, 13 (9%) had pleural thickening and 8 (6%) had lung opacities. Among the 60 who reported earlier jobs that may have involved asbestos exposure, the figures were 18 (30%) and 7 (12%). The abnormalities were slight or limited in extent. The authors concluded that fire fighters are at risk of asbestos-induced lung and pleural fibrosis independent of other asbestos exposure. They judged the 9% pleural thickening rate well above general-population expectations. They cautioned that participants, mostly still working, might be regarded as generally healthy, that sicker fire fighters may not have taken part, and that the group may not be representative.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Cross-sectional study (medical examination including chest X-ray, read by two readers using the 1980 ILO classification)
• Who was studied: New York City fire fighters, active and retired, employed by the Fire Department as of December 1963, who had worked at least five years in a ladder company during the 1960s in high-risk areas. 550 were invited and 212 (39%) took part. All were male, mean age 57, and 72% were still active.
• Exposure: Asbestos exposure during fire fighting, which the authors considered most likely during the overhaul phase after a fire. No fiber type is named. 60 participants (28%) also reported earlier work in occupations that may have involved asbestos exposure, mostly construction or ship repair, averaging 3.9 years.
• Main results:
  • 42 (20%) of the 212 participating fire fighters had pleural thickening and/or parenchymal abnormalities (small irregular opacities)
  • Pleural or parenchymal abnormalities were found in 20 (13%) of fire fighters without reported prior asbestos exposure, compared with 22 (37%) of the 60 with reported prior exposure
  • Parenchymal (lung) opacities occurred in 8 (6%) of the 152 fire fighters without prior exposure and in 7 (12%) of the 60 with prior exposure
  • Typical asbestos-induced pleural thickening was seen in 13 (9%) fire fighters without prior exposure and in 18 (30%) of those with prior exposure
  • The parenchymal opacities were slight: 10 of the 15 were graded 1/0 on the ILO scale
  • Prior asbestos exposure was not associated with more severe pleural abnormalities
  • Among fire fighters without prior exposure, the prevalence of abnormalities did not increase with time since first exposure. Length of employment as a fire fighter had no impact on prevalence.
  • The authors judged that the 9% rate of pleural thickening among long-term fire fighters without prior exposure is well above what is expected in the general population
• The authors' conclusion: The authors concluded that fire fighters are at risk for asbestos-induced interstitial pulmonary fibrosis and pleural fibrosis independent of exposure outside fire fighting, and that earlier workplace asbestos exposure adds to this risk
• Limitations the authors state:
  • Three-quarters of participants were still active fire fighters, so the authors said they may be regarded as being in generally good health
  • Fire fighters with more severe asbestos-related disease may not have participated because of illness
  • Only fire fighters believed likely to have had asbestos exposure were included, so they may not represent fire fighters in general
  • Only 15 (7%) participants had worked fewer than 20 years as fire fighters, which limits the comparison by length of employment

Topics

The National Library of Medicine indexes this study under subjects our site covers: Pleural plaques and thickening.

Medical terms in this study, explained in our Lexicon: Asbestos Exposure, Spirometry, Chest X-Ray, ILO Classification, Pleural Thickening, Pulmonary Fibrosis, Respirator.

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