Fire fighter fatalities 1998-2001: overview with an emphasis on structure related traumatic fatalities.

Objective: To review the causes of all fire fighter line-of-duty-deaths from 1998 through 2001, and present recommendations for preventing fatalities within the specific subgroup of structure related events.

Methods: Fire fighter fatality data from the United States Fire Administration were reviewed and classified into three main categories of injury. Investigations conducted through the National Institute for Occupational Safety and Health (NIOSH) Fire Fighter Fatality Investigation and Prevention Program provided the basis for the recommendations presented in this paper.

Occupational burns from oxygen resuscitator fires: the hazard of aluminum regulators.

Background: There have been over 30 incidents of oxygen resuscitator fires over the last 6 years, causing severe burns to a number of fire fighters, emergency medical service personnel, health care workers, and patients. The National Institute for Occupational Safety and Health (NIOSH) was requested to investigate three such incidents.

Methods: NIOSH conducted site investigations of the incidents, and the requesters also sent the involved oxygen resuscitators to a forensic engineering company for a causal analysis.

Suspected hypersensitivity pneumonitis after exposure to a biologic forage inoculant.

A 44-year-old farmer had respiratory symptoms and bibasilar pulmonary infiltrates after three exposures to a new biologic forage inoculant. Open lung biopsy revealed chronic interstitial pneumonitis and bronchiolitis obliterans with organizing pneumonia. The patient responded to oral corticosteroids but acutely worsened after an inadvertent reexposure to the forage inoculant.

Evaluation of proposed methods to update human testing of self-contained breathing apparatus.

The current Man Test protocols used by the National Institute for Occupational Safety and Health for the certification testing of self-contained breathing apparatus (SCBA) do not provide continuous real-time information on the performance of these devices during actual use. In addition, current protocols do not test human subjects at the same absolute work rates but at rates that vary according to the subjects' body weights. This study was conducted to evaluate revised "Use Test" protocols proposed by the U.

Does regression analysis of lung function data obtained from occupational epidemiologic studies lead to misleading inferences regarding the true effect of smoking?

Exposure-response studies of the relationship between ventilatory function and dust exposure in workers are often quantified using linear regression methods. In coal miners, this technique has indicated that average effects of smoking and moderate dust exposure are roughly equivalent. However, the validity of direct comparison of the average effects of smoking and dust exposure has been questioned, the argument being that smoking causes severe effects in a minority, but leaves the remainder largely unaffected.

The role of respiratory protective devices in the control of tuberculosis.

In this comprehensive review, the authors describe various types of respirators and the major issues in their application to TB control, including the degree of protection they offer and cost. Recent recommendations regarding the use of respiratory protective devices also are discussed.

Pneumoconiosis: comparison of digitized and conventional radiographs.

The classification of pneumoconiosis on 108 paired radiographs obtained in coal miners was compared by using conventional radiograph film images and digitized images of those conventional film images. Conventional film images and digitized images were each independently read in a random order in two separate sessions by three radiologists certified as "B" readers. Overall, the digitized images were perceived as being of better quality than the conventional film images (radiograph quality grade 1, 48% [617 of 1,292 classifications] vs 37% [482 of 1,296], respectively; P < .

Injuries in the mining industry.

This chapter reviews the history, statistics, and epidemiology of mining injuries in the United States. Although injuries in mining have been drastically reduced since the start of this century, their rates have not changed substantially in the past decade, and mining injury rates remain among the highest of all US industries. The injuries are often severe, as indicated by both high fatality rates and the high average number of days lost from work for nonfatal injury.

Respiratory protection in the mining industry.

Because respirators may have adverse effects on an individual, it is important that the occupational physician understand these effects and appropriate respirator use in the mining industry. Few studies have been performed on the effects of respirator wear among workers who may have some physiologic impairment. This chapter reviews the relevant regulations, types of respirators used in the mining industry, and the various effects of their use, as well as provides reasonable guidelines for determining fitness to wear these devices.

Pulmonary function of U.S. coal miners related to dust exposure estimates.

This study of 7,139 U.S. coal miners used linear regression analysis to relate estimates of cumulative dust exposure to several pulmonary function variables measured during medical examinations undertaken between 1969 and 1971.

A comparison of radiographic interpretation of silica exposed workers using the 1963 and the 1986 Chinese roentgenodiagnostic criteria of pneumoconioses.

As part of a larger study relating to silica exposure, silicosis, and lung cancer mortality in Chinese mine and factory workers, 1936 old posterior-anterior chest X-rays were re-interpreted according to the 1986 Chinese Roentgenodiagnostic Criteria of pneumoconioses. Each film was independently read by three individuals from a panel of eleven radiologists, and this reading was compared to the original one. Subsequent to the independent readings, a groups of three readers interpreted the films together, called the consensus readings.

Effects of thermal environment and chemical protective clothing on work tolerance, physiological responses, and subjective ratings.

This study examined the physiological and subjective responses of nine healthy men who performed work while wearing two types of protective ensembles in each of three thermal environments. The subjects, all experienced with the use of protective ensembles, each performed low intensity treadmill exercise (23% of VO2 max while not wearing a Self-Contained Breathing Apparatus [SCBA] or protective clothing) under six experimental conditions: two ensembles (SCBA--light work clothing and SCBA; and CHEM--a two-piece chemical protective ensemble with SCBA) during exposure to 'cool' (10.6 degrees C/water vapour pressure [Pw] 0.

A comparison of pneumoconiosis interpretation between Chinese and American readers and classifications.

As a preliminary step in joint Sino-American pneumoconiosis research efforts, a formal chest X-ray pneumoconiosis reading trial was conducted among Chinese and American radiologists. Twelve Chinese readers from different institutions located in south central China used the 1986 Chinese Roentgenodiagnostic Criteria of Pneumoconioses. Three American radiologists, centified as NIOSH "B" readers, used the International Labour Office Classification of Pneumoconioses.

Work tolerance and subjective responses to wearing protective clothing and respirators during physical work.

This study examined work tolerance and subjective responses while performing two levels of work and wearing four types of protective ensembles. Nine males (mean age = 24.8 years, weight = 75.

Workplace measurement of respirator effects using respiratory inductive plethysmography.

A useful system to study the cardiopulmonary effects of respirators in the workplace would be reliable, portable, and lightweight and would not encumber the nose or mouth or require modification to the respirator. Twenty men using such a system (which measured ventilatory parameters by respiratory inductive plethysmography [RIP]) were studied. The subjects all performed their usual jobs which involved some work with and some without a respirator.

Physiological and subjective responses to working in disposable protective coveralls and respirators commonly used by the asbestos abatement industry.

The physiological and subjective effects of working with different respirators while wearing lightweight disposable (Tyvek 1412 polyolefin) coveralls commonly used by the asbestos abatement industry were studied. Nine healthy men (mean age = 27.3 yr, weight = 76.

Physiological responses to the wearing of fire fighter's turnout gear with neoprene and GORE-TEX barrier liners.

This study examined the physiological effects of performing moderate and high intensity work while wearing fire fighter's turnout gear with either a neoprene or GORE-TEX barrier liner. Eight healthy men, experienced with the use of respirators and protective clothing, each performed moderate and high intensity treadmill exercise (44% and 71% of maximum work capacity) in a double-blind study at 27.6 degrees C (50% RH) while wearing complete fire fighter's turnout gear (weighing 23 kg) with either a neoprene or GORE-TEX barrier liner.

The use of inductive plethysmography in the study of the ventilatory effects of respirator wear.

The authors recently developed an ambulatory system, in which a self-contained respiratory inductive plethysmograph (RIP) was used, to measure noninvasively the volume and time components of breathing. Since it does not use nasal or oral devices, such a system is particularly suitable for use in studying the effects of respiratory protective masks on respiratory parameters. In order to validate this portable system, 22 healthy subjects were exercised on a treadmill; RIP and pneumotachographic minute ventilation measurements were compared.

Lung volume reference values for blue collar workers not exposed to occupational respiratory hazards.

Epidemiologic research into occupationally related lung disease often requires the comparison of a study group with an external nonexposed comparison group. In order to develop such an external comparison group, blue collar workers, who had no obvious adverse occupational pulmonary exposure, performed simple spirometry, were administered a standard questionnaire, and had standard posterior-anterior and lateral chest radiographs taken. Prediction equations were established for three indices of lung volume, namely total lung capacity, residual volume, and their ratio, for various combinations of race, sex, and smoking groups.

Reduced work tolerance associated with wearing protective clothing and respirators.

This study examined worker tolerance and physiological responses to two levels of work while subjects wore various types of protective clothing and respirators. Nine healthy men (mean age = 24.8 years, weight = 75.