New study shows that constant exposure to smoke and toxic fumes may be taking a toll on firefighters' respiratory health. Image: Francesco Sommacal/Pexels

They are often the first to respond when fires and other emergencies strike, and while most have normal lung function, more than half of firefighters surveyed reported respiratory symptoms that may reflect the occupational hazards of repeated smoke exposure, a new study by the University of the Western Cape (UWC) has found.

The research, published in the International Journal of Environmental Research and Public Health, examined the lung health of 278 firefighters from the City of Cape Town Fire and Rescue Service. It found that more than half (53.6%) had experienced at least one respiratory symptom, highlighting the occupational health risks associated with firefighting.

The most common complaints were coughing, reported by 54.4% of participants, and nasal congestion, reported by almost 41%. Firefighters between the ages of 30 and 49 were more likely to experience respiratory symptoms than those in other age groups.

Coughing and nasal congestion were reported as the most common respiratory complaints among fire fighters. Image: Markus Spiske/Pexels

Led by Dr Jaron Ras, a senior lecturer in the Department of Sport, Recreation and Exercise Science, and co-authored by Prof Lloyd Leach and Jordan Sasha Kaylor, the study also found that firefighters with a higher body mass index (BMI), a greater percentage of body fat and more years of service tended to have poorer lung function.

The findings suggest that both long-term exposure to smoke and hazardous fumes, as well as physical health factors such as obesity, may contribute to declining respiratory health among firefighters.

Researchers used a lung function questionnaire to assess firefighters' respiratory symptoms. Participants answered questions about whether they had experienced wheezing or a whistling sound in their chest during the previous 12 months, whether they had episodes of shortness of breath accompanied by wheezing, and how much symptoms such as shortness of breath, wheezing, coughing or chest tightness had affected their daily activities and work during the four weeks before the study.

Firefighters also completed a validated electronic questionnaire that asked whether they had any current or previous lung conditions. In addition, the survey collected information on their age, sex, fire station, job role, and years of service, as well as their medical history, smoking habits and physical activity levels. To assess firefighters’ lung health, researchers also used spirometry tests – a non-invasive breathing test that measures how well the lungs function - as well as body composition assessments.

Researchers found that despite the high number of firefighters reporting respiratory symptoms, lung function tests showed that the vast majority (97.8%) had normal lung capacity. Only a small proportion showed signs of reduced lung function: 0.7% had borderline restriction, 1.1% had restricted lung function, and 0.4% had severe restriction. These rates are much lower than those reported in similar studies conducted in Nigeria and Portugal, where more than half of firefighters showed restrictive lung patterns.

Lead researcher Dr Jaron Ras. Image: supplied

However, the study found that smoking was linked to poorer lung function. Firefighters who smoked had significantly lower lung function than non-smokers, and those who smoked more cigarettes tended to have poorer breathing test results. These findings support previous research showing that smoking worsens lung health and increases the harmful effects of occupational smoke exposure.

Researchers said the findings highlight the occupational burden faced by firefighters, who are routinely exposed to smoke and other hazardous airborne substances while responding to fires and emergencies. To policymakers, they noted the results highlight the need for routine testing of pulmonary function among firefighters, including BMI monitoring and the supporting of smoking cessation and targeted fitness programmes.

“Regular exercise plays a critical role in mitigating the adverse effects of prolonged occupational exposure on pulmonary health. Therefore, comprehensive health programmes that promote physical activity, reduce body fat percentage, enhance muscle mass and address negative health behaviours are essential,” researchers noted.