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Wildfires can negatively impact the health and well-being of wildland firefighters through a variety of exposure pathways. Many studies have measured acute health effects from occupational exposure to pollutants in wildfire smoke; however, research specifically examining cancer risks from exposure to carcinogens is limited. This review aimed to better understand cancer risk in this occupation by assessing the existing evidence of exposures and summarizing measured concentrations of carcinogens among wildland firefighters. A systematic search was conducted to identify scientific papers using the following databases: Medline(OVID), Embase(OVID), PsycINFO(OVID), Cochrane Library, CINAHL(EBSCOHost), EconLit(EBSCOHost), Scopus, Agricultural and Environmental Science Collect(ProQuest), and NIOSHTIC-2. Forty-nine papers were identified that met eligibility criteria. Across the papers, 31 carcinogens were identified and quantified using a variety of assessment methods. Papers measured particulate matter ( N  = 26), polycyclic aromatic hydrocarbons ( N  = 12), volatile organic compounds ( N  = 14), crystalline silica ( N  = 5), black carbon ( N  = 4), asbestos ( N  = 3), radionuclides ( N  = 7), and metals ( N  = 2). Most papers measured inhalation exposures through traditional air sampling methods, but a subset of exposures to polycyclic aromatic hydrocarbons ( N  = 8), as well as heavy metals ( N  = 1), were measured through urinary biomarkers and naphthalene was measured using dermal wipe samples ( N  = 2). Although the heterogeneity of exposure assessment methods made direct comparison of concentrations difficult, the papers provide consistent evidence that wildland firefighters are regularly exposed to carcinogens. All wildland fire personnel should continue to implement recommended mitigation strategies and support new mitigations to reduce exposure to carcinogens on the job.

Across the world, biomass smoke is a major source of air pollution and is linked with a variety of adverse health effects. This is particularly true in the western U.S. where wood smoke from wildland forest fires are a significant source of PM 2.5 . Wildland firefighters are impacted as they experience elevated PM 2.5 concentrations over extended periods of time, often occurring during physical exertion. Various epidemiological studies have investigated wood smoke impacts on human health, including occupational field exposures experienced by wildland firefighters. As there are numerous challenges in carrying out these field studies, having the ability to research the potential health impacts to this occupational cohort in a controlled setting would provide important information that could be translated to the field setting. To this end, we have carried out a simulated wildland firefighter exposure study in a wood smoke inhalation facility. Utilizing a randomized crossover trial design, we exposed 10 participants once to clean filtered-air, 250 µg/m 3 , and 500 µg/m 3 wood stove-generated wood smoke PM 2.5 . Participants exercised on a treadmill at an absolute intensity designed to simulate wildland firefighting for 1.5 hr. In addition to measured PM 2.5 smoke concentrations, mean levels of CO 2 , CO, and % relative humidity were continuously monitored and recorded and were representative of occupational "real-world" exposures. Pulmonary function was measured at three time points: before, immediately after, and 1-hr post-exposure. Although there were some reductions in FVC, FEV 1 , and FVC:FEV 1 measures, results of the spirometry testing did not show significant changes in lung function. The development of this wood smoke inhalational facility provides a platform to further address unique research questions related to wood smoke exposures and associated adverse health effects.

Background: Little is known regarding the impact of long-term wildland firefighting on health. Our objective was to investigate associations between duration of wildland firefighting experience and the prevalence of self-reported health outcomes., Methods: We ascertained employment, health, and demographic information on 499 current wildland firefighters (WLFFs) via questionnaire., Results: Relative to those with less than 10 years of experience as a WLFF, those with 10-19 years of experience had significantly greater odds of having ever been diagnosed with hypertension, as did those with 20 or more years of experience. Significant associations were observed for report of physician-diagnosed heart arrhythmia and previous knee surgery., Conclusions: We observed significant links between a greater number of years as a WLFF and self-report of two subclinical cardiovascular risk factors as well as markers of musculoskeletal health. Additional studies are needed to determine if findings can be generalized to all WLFFs., (© 2016 Wiley Periodicals, Inc.)

Each year, the general public and wildland firefighters in the US are exposed to smoke from wildland fires. As part of an effort to characterize health risks of breathing this smoke, a review of the literature was conducted using five major databases, including PubMed and MEDLINE Web of Knowledge, to identify smoke components that present the highest hazard potential, the mechanisms of toxicity, review epidemiological studies for health effects and identify the current gap in knowledge on the health impacts of wildland fire smoke exposure. Respiratory events measured in time series studies as incidences of disease-caused mortality, hospital admissions, emergency room visits and symptoms in asthma and chronic obstructive pulmonary disease patients are the health effects that are most commonly associated with community level exposure to wildland fire smoke. A few recent studies have also determined associations between acute wildland fire smoke exposure and cardiovascular health end-points. These cardiopulmonary effects were mostly observed in association with ambient air concentrations of fine particulate matter (PM2.5). However, research on the health effects of this mixture is currently limited. The health effects of acute exposures beyond susceptible populations and the effects of chronic exposures experienced by the wildland firefighter are largely unknown. Longitudinal studies of wildland firefighters during and/or after the firefighting career could help elucidate some of the unknown health impacts of cumulative exposure to wildland fire smoke, establish occupational exposure limits and help determine the types of exposure controls that may be applicable to the occupation.