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Original research
Association of firefighting exposures with lung function using a novel job exposure matrix (JEM)
  1. David G Goldfarb1,2,3,4,
  2. David J Prezant1,2,
  3. Rachel Zeig-Owens1,2,4,
  4. Charles B Hall4,
  5. Theresa Schwartz1,2,
  6. Yang Liu2,
  7. Ilias G Kavouras3
  1. 1 Department of Medicine, Montefiore Medical Center, Bronx, New York, USA
  2. 2 Bureau of Health Services, Fire Department of the City of New York, Brooklyn, New York, USA
  3. 3 Department of Environmental and Geospatial Health Sciences, City University of New York Graduate School of Public Health and Health Policy, New York city, New York, USA
  4. 4 Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
  1. Correspondence to Dr David G Goldfarb, Montefiore Medical Center, Bronx, New York, USA; david.goldfarb{at}


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 (FEV1). Models controlled for age, race/ethnicity, height, smoking and weight.

Results Every 1000 kg P was associated with 13 mL lower FEV1 (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 FEV1 (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.

  • occupational health
  • epidemiology
  • respiratory function tests

Data availability statement

Data are available upon reasonable request.

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Data availability statement

Data are available upon reasonable request.

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  • Contributors DGG contributed to the conceptualisation, analysis, investigation, methodology, validation, drafting and revising the manuscript. DJP contributed to the conceptualisation, investigation, methodology, resources, supervision and revising the manuscript. DJP also helped acquire funding and is responsible for the overall content as guarantor. RZ-O contributed to the methodology, supervision, validation and revisions of the manuscript. CBH contributed to the methodology and revisions of the manuscript. TS contributed to the data curation, validation and revisions of the manuscript. YL contributed to the data curation, methodology, validation and revisions of the manuscript. IGK contributed to the conceptualisation, investigation, methodology, supervision drafting and revising of the manuscript. All authors approve the final version of the manuscript.

  • Funding Funding was provided by the National Institute for Occupational Safety and Health, contracts: 75D301-22-R-72142 and 75D301-22-R-72244.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.