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Can you have Asthma and be a Firefighter?
Healthy Lungs...
One of the subjects researched was asthma which led to my discussing the topic in more detail. When I asked her if a firefighter could or could not do the job, she answered, and typically vague... that it depends...
It depends on how bad the asthma is. How much medication they have to take. Were they diagnosed with asthma at a young age or was it an adult onset. What are the triggers... Is it seasonal asthma connected with allergies? Have they been hospitalized before? Is a steroid used daily and have they had to use a rescue inhaler before. The list goes on and on... And if it's exercised induced asthma, then they are screwed...
For those never experiencing asthma, or a restricted airway issue, please allow me to share with you a teaching tool that is used to simulate the effects of an asthma attack. All you have to do is use a straw to breathe in and out. You now know what an asthmatic feels, which is complete fear because you cannot exchange air. Often it's not too difficult to inspire or breathe air in, it's just the getting air exhaled that is close to impossible, or at least that is how it is described by some. Hopefully, someone with more background can shed some light on the subject as well as share department policies or experiences with the ultimate goal of answering the question...
• Can you have Asthma and be a firefighter?
• Does your department permit asthmatics to work as firefighters?
• Have you responded to a serious asthmatic emergency?
• Do you know the mechanism of what causes or what 'triggers' asthma?
Note: Asthma PPT included for your review and use to help you answer the above questions.
Train often and when possible, let someone else do all the work... Enjoy!
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ASTHMA-1.ppt, 952 KB
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Replies to This Discussion
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Permalink Reply by Vic Silverfish on
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Mate, congratulations on the retirement!
I think asthma may keep you out of the fire service because the dry air in SCBA can trigger an attack. When I used to do SCUBA, they would not let anyone with even mild asthma do it.
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Permalink Reply by Mike Schlags (Captain Busy) Retd on
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Thanks for the congrats Vic. Retirement is actually keeping me very busy... pun intended!
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Permalink Reply by ashfire on
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I just seen something about a treatment that will be coming out that treats the lung to open them up to prevent asthma. It will be some sort or surgey to do it.
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Very interesting... Please share the source where you saw this... My simple mind tells me that an allergen, environmental or other trigger mechanism that results in bronchospasm, edema (swelling) and mucous production cannot be prevented by any type of surgery. But I could be very wrong here and I sure hope so.
What is was a complete surprise to me was the fact that Thunderstorms cause asthma... Check this out...
Link Between Thunderstorms and Asthma Attacks in the Atlanta Metro Area
Paige E. Tolbert, Ph.D.
Department of Environmental and Occupational Health
Emory University
NIEHS Grant R01ES011294
An in-depth, interdisciplinary study by medical researchers at Emory University and climatologists at the University of Georgia has discovered a link between asthma attacks and thunderstorm activity in the Atlanta metro area. The study was co-funded by NIEHS and the EPA and could have significant public health impacts.
While a relationship between thunderstorms and increased hospital visits for asthma attacks has been known and studied worldwide, this study is the first to combine epidemiology and climatology in a research effort in the American South.
The research team used a database of more than 10 million emergency room visits and found a 3 percent higher incidence of visits related to asthma on days following thunderstorms. While a 3 percent increase may seem modest, the researchers point out that it represents a significant number of hospital visits in an area of more than five million people and is likely a very conservative estimate because of the limitations in the research methodology.
A likely hypothesis offered by the research team for the increase in asthma is that pollen grains may rupture upon contact with rainwater releasing respirable-sized allergens and that gusty winds associated with the storm help to spread these particles. Exposure to certain pollen allergens is a known risk factor for asthma attacks.
During the 11-year period, there were 215,832 asthma emergency room visits and 28,350 of those occurred on days following thunderstorms. There were 564 thunderstorm days in the time period measured by total daily rainfall and wind speed. The research team will continue its work to better understand the mechanistic basis of thunderstorm-induced asthma in an effort to improve intervention strategies and improve planning for emergency room services. They point out that this is particularly important in the era of climate change especially considering severe thunderstorms are estimated to double in the Atlanta area in this century.
Citation: Grundstein A, Sarnat SE, Klein M, Shepherd M, Naeher L, Mote T, Tolbert P. Thunderstorm associated asthma in Atlanta, Georgia. Thorax. 2008 Jul;63(7):659-60.
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Permalink Reply by Roy Walker on
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Actually I do have asthma . It only developed when I moved to a farm and was exposed to the hay on a daily basis. Medication controlled it completely once I was diagnosed. Then I moved from the farm and it completely disappeared. Initially I stopped firefighting until diagnosed and trusted the medication. My chief at the time initially restricted my duties to exterior issues then my doctor said the asthma was well controlled and I began assuming full duties Since I left the farm I have stopped medication and have never had an attack. That was my experience and I think I was lucky it could easily have cost me a position as a ff, but not all cases are the same so as your wife said each case depends.
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• Did you ever experience an 'asthma attack'?
• Is the description 'breathing through a straw' come pretty close to describing how it feels?
How cool to first off be able to experience living and working in on a farm... Now that's living! However, it sucked that the allergens were the triggers for your asthma. The good news is that you get away from the 'triggers', then you have a good chance of remaining asymptomatic.
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Permalink Reply by Sparky3317 on
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Yes you can my brother is an ashmatic and has been in the fire service for 12 years and has never had one issue.
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Understanding that there are degrees of severity associated with asthma, coupled with your brother not having any issues, maybe it's like Roy's situation where it's an environmental issue where he simply separated himself from the allergens?
Does your brother require medication to control his asthma? If not, then luckily for him, it's not a severe form of asthma, making it possible for him to work as a firefighter.
Does his department have any written policies or standards other than a doctors note that approves your brother to work?
One of my goals here with this post is to identify departments that have already done the homework regarding department policy that gives direction and parameters for employees who are diagnosed as asthmatics.
Thanks for your input Joshua!
CBz
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Captain Busy, I never experienced an attack on the fire ground mine were mostly at the farm. The feeling was that when you inhaled you didn't get enough air and the harder you tried the less air you could move. Initially I would apply the same behaviors I had learned when breathing out the last of an SCBA supply. Stay calm . minimize efforts, go to help. Once I was diagnosed and had a rescue breather relief from an attack was almost immediate. I took an absence from my department because I didn't want to jeopardize any other firefighters. Before the department would let me back on the fire ground I was required to provide medical clearance and as I said it took awhile for the chief to feel confident enough to allow me to go interior. I hope this gives you some insight and answers your questions.
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Permalink Reply by Oldman on
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Good topic CB. Good ppt, too.
The short answer is; It depends.
COPD which includes Asthma, Emphysema, and Bronchitis are a Category B medical conditions under NFPA 1582. There are a whole host of causative agents which trigger and attack. Allergens including foods and additives, exercise, heartburn (usually related to gastric reflux disease), emotional stress, cold air, changes in temperature, and humidity and of course smoke and it's by products can trigger an attack.
Years ago, there were a few reactive medications to be used when an attack happened like; Alupent, Terbutiline, and Racemic Epinephrine. Modern medicine has begun to understand the disease processes better and now we have medications such as; Symbicort, Spiriva, and Flovent which can prevent attacks from occurring through a variety of different mechanisms.
The only one who can give a definitive answer of whether one could be a firefighter would be a pulmonary specialist, and after a battery of tests. Asthma attacks can be life threatening and I have witnessed a couple which didn't have a happy ending.
The IAFF has a decent page in this topic.
http://www.iaff.org/hs/Resi/asthmacopd.htm
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Brandon be careful with that being winded it';s a sign you might need to work out a bit since I assume you know the difference between that and an asthma attack. You need to keep your cardio up and your resp system at maximum efficiency so you don't end up with a dreaded Mi. Train hard brother we need you.
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What an outstanding resource for learning more about asthma. One of the key points I learned from the IAFF Occupational Medicine Website (http://www.iaff.org/hs/Resi/asthmacopd.htm) was the causative agents for occupational asthma.
Fire fighters that were not asthmatic before employment, but developed asthma in their work, should be evaluated for possible causes. Occupational asthma and other reactive airway diseases (RADS) may result from exposure to chemicals, hazardous spills, and combustion smoke. The contribution to the causation of asthma by irritant gases such as sulfur dioxide, nitrogen dioxide and ozone is still unclear, although it is known that these substances can certainly aggravate symptoms in those who are already asthmatic.
Causative agents for occupational asthma include:
• Isocyanates (e.g. in twin-pack spray paints)
• Hardening/curing agents e.g. anhydridess
• Rosin (colophony) fumes from soldering flux
• Dusts from various cereals (including flour)
• Animals such as mammals (rats, mice) but also arthropods (such as locusts)
• Wood dusts - various e.g. Canadian red cedar
• Aldehydes e.g. formaldehyde or glutaraldehyde
• Cyanoacrylates (as in "superglue")
• Antibiotics.
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