背景:尽管已知存在职业危害,目前尚不清楚长期的职业消防是否会导致肺功能下降的速度比通常预期的要大,以及这种变化率如何受到消防暴露和其他风险/保护因素的影响。
方法:对在线电子数据库进行系统搜索,以确定报告用力肺活量(FVC)一秒用力呼气量(FEV1)变化率的纵向研究。对纳入的研究进行了严格评估,以使用研究三角研究所项目库(RTI-IB)对偏倚风险和观察性研究的精度进行评估,以确定其偏倚风险。
结果:确定了22项纳入研究,来自四个不同的国家,1974年至2016年出版。单独检查,研究按消防暴露类型分类。消防员经历了不同的肺功能下降率,尤其受到吸烟的影响。常规消防暴露的影响尚不清楚,并且受到测量方法的限制,而暴露于“非常规”严重暴露的消防员一致经历了加速下降。
结论:纵向研究提供的数据提供了一个不清楚的图片,说明消防员肺功能的变化速率如何与常规暴露相关,以及它如何与工作年龄人群的预期变化速率进行比较。经常佩戴呼吸防护装置的非吸烟消防员比其他方式更有可能具有正常的肺功能下降率。暴露于灾难性事件会显着增加消防员肺功能下降的速度,但有限的证据详细说明了常规消防的效果。未来的研究将受益于更可靠的暴露测量方法。
背景:国际前瞻性系统审查注册(PROSPERO),注册号(CRD42017058499)。
BACKGROUND: Despite the known occupational hazards, it is not yet clear whether long-term career
firefighting leads to a greater rate of decline in lung function than would normally be expected, and how this rate of change is affected by
firefighting exposures and other risk/protective factors.
METHODS: A systematic search of online electronic databases was conducted to identify longitudinal studies reporting on the rate of change in the forced expiratory volume in one second (FEV1) of forced vital capacity (FVC). Included studies were critically appraised to determine their risk of bias using the Research Triangle Institute Item Bank (RTI-IB) on Risk of Bias and Precision of Observational Studies.
RESULTS: Twenty-two studies were identified for inclusion, from four different countries, published between 1974 and 2016. Examined separately, studies were categorised by the type of
firefighting exposure. Firefighters experienced variable rates of decline in lung function, which were particularly influenced by cigarette smoking. The influence of routine
firefighting exposures is unclear and limited by the methods of measurement, while firefighters exposed to \'non-routine\' severe exposures unanimously experienced accelerated declines.
CONCLUSIONS: The data provided by longitudinal studies provide an unclear picture of how the rate of change in lung function of firefighters relates to routine exposures and how it compares to the rate of change expected in a working-age population. Non-smoking firefighters who routinely wear respiratory protection are more likely than otherwise to have a normal rate of decline in lung function. Exposure to catastrophic events significantly increases the rate of decline in firefighter lung function but there is limited evidence detailing the effect of routine
firefighting. Future studies will benefit from more robust methods of measuring exposure.
BACKGROUND: International Prospective Register of Systematic Reviews (PROSPERO), registration number ( CRD42017058499 ).