U.S. Fire Administration - IAFF Main

1 fire AdministrationMission StatementAs an entity of the Department of Homeland Security s Federal Emergency Management Agency, the mission of the USFA is to reduce life and economic losses due to fire and related emergencies, through leadership, advocacy, coordination and support. We serve the Nation independently, in coordination with other Federal agencies, and in partnership with fire protection and emergency service communities. With a commitment to excellence, we provide public education, training, technology, and data project was developed through a Cooperative Agreement (Developing Materials on the Long-Term Health Effects of Occupational Respiratory Exposures on fire Fighters' Respiratory Health and the Ability of Exposure Reduction and Post-Exposure Mitigation Strategies to Improve Outcomes - EME-2003-CA-0342) between the Department of Homeland Security, United States fire Administration and the International Association of fire 2010 by the International Association of fire Fighters.

2 This publication is protected by copyright. The IAFF authorizes the reproduction of this document exactly and completely for the purpose of increasing distribution of the materials. None of the materials may be sold for a profit under the provisions of public domain. These materials have been copyrighted under the copyright laws of the United States. Permission to duplicate these materials is conditional upon meeting the above criteria and may be rescinded by the IAFF for failure to complyInternational Standard Book Number: 0-942920-51-1 Respiratory Diseases and the fire Servicei PREFACEThe United States fire Administration (USFA) is committed to using all means possible for reducing the incidence of occupational diseases, injuries and deaths to fire fighters. One of these means is to partner with fire service organizations who share this same admirable goal.

3 One such organization is the International Association of fire Fighters (IAFF). As a labor union, the IAFF has been deeply committed to improving the safety of their members and all fire fighters as a whole. This is why the USFA was pleased to work with the IAFF through a cooperative agreement to research and develop materials addressing the long-term effects from occupational respiratory exposures on fire fighter s health and the ability of exposure reduction and post-exposure mitigation strategies to improve health outcomes. The USFA gratefully acknowledges the following leaders of the IAFF for their willingness to partner on this project. General President General Secretary-Treasurer Harold A. Schaitberger Thomas H.

4 Miller Assistant to the General President Occupational Health, Safety & MedicineRichard M. Duffy Director of Occupational Health and SafetyJames E. BrinkleyInternational Association of fire Fighters, AFL-CIO, CLCD ivision of Occupational Health, Safety and Medicine1750 New York Avenue, NWWashington, DC 20006(202) 737-8484(202) 737-8418 (FAX) Diseases and the fire ServiceiiEDITORS: Richard Duffy, MScAssistant to the General PresidentOccupational Health, Safety and MedicineInternational Association of fire FightersWashington, DC Andrew Berman, MDProgram Director, Combined Training Program in Pulmonary and Critical Care MedicineAssociate Professor of Clinical MedicineAlbert Einstein College of MedicinePulmonary DivisionMontefiore Medical CenterBronx, NYDavid Prezant, MDProfessor of MedicineAlbert Einstein College of MedicinePulmonary Division Montefiore Medical CenterBronx, NYandChief Medical Officer, Office of Medical Affairs Co-Director of WTC Medical ProgramsFire Department City of New YorkBrooklyn, NYCONTRIBUTING AUTHORS:Amgad Abdu, MDPulmonary Fellow Albert Einstein College of MedicineMontefiore Medical CenterBronx, NYThomas K.

5 Aldrich, MDProfessor of MedicineAlbert Einstein College of MedicinePulmonary DivisionMontefiore Medical Center Bronx, NYDavid W. Appel, MDAssociate Professor of MedicineAlbert Einstein College of MedicineDirector of the Pulmonary Sleep LaboratoryPulmonary DivisionMontefiore Medical CenterBronx, NYMatthew P. Bars, MS, CTTS Director- FDNY Tobacco Cessation Program Director, IQuit Smoking Centers of ExcellenceProgram Director-Palisades Medical CenterMontvale, NJAndrew Berman, MDProgram Director, Combined Training Program in Pulmonary and Critical Care MedicineAssociate Professor of Clinical MedicineAlbert Einstein College of MedicinePulmonary DivisionMontefiore Medical CenterBronx, NYAlpana Chandra, MDAlbert Einstein College of MedicinePulmonary DivisionJacobi Medical CenterBronx, NYNaricha Chirakalwasan, MDPulmonary FellowAlbert Einstein College of MedicineMontefiore Medical CenterBronx, NYAsha Devereaux, MD, MPHP resident-California Thoracic SocietyPulmonary and Critical Care MedicineCoronado.

6 CAThe IAFF would also like to thank the following editors and authors for their contributions in addressing fire fighter respiratory diseases and the editors for their tireless efforts in developing and editing this manual so it is consistent, readable and understandable to this Nation s fire Diseases and the fire Serviceiii Peter V. Dicpinigaitis, MDProfessor of Clinical MedicineAlbert Einstein College of MedicineandDirector Cough CenterPulmonary DivisionMontefiore Medical CenterBronx, NYCarrie D. Dorsey, MD, MPHA ssistant ProfessorUniversity of Maryland School of MedicineOccupational Health ProgramBaltimore, MDRichard Duffy, MScAssistant to the General PresidentOccupational Health, Safety and MedicineInternational Association of fire FightersWashington, DCFelicia F.

7 Dworkin, MDDeputy Director Medical AffairsBureau of Tuberculosis ControlNew York City Department of Health and Mental HygieneNew York, NYAdrienne Flowers, MDUniversity of Maryland School of MedicineOccupational Health ProgramBaltimore, MDJames Geiling, MDAssociate Professor of MedicineDartmouth Medical SchoolHanover, NHandChief, Medical ServiceVA Medical CenterWhite River Junction, VTSubha Ghosh, MDAssistant Professor of RadiologyOhio State University Medical CenterDepartment of RadiologyColumbus, OHLinda B. Haramati, MD, MSProfessor of Clinical RadiologyAlbert Einstein College of MedicineDirector of Cardiothoracic ImagingDepartment of RadiologyMontefiore Medical CenterBronx, NYChrispin Kambili, MDAssistant Commissioner and Director, Bureau of Tuberculosis ControlNew York City Department of Health and Mental HygieneNew York, NYRobert Kaner, MDAssociate Professor of Clinical MedicineAssociate Professor of Genetic MedicineWeill Cornell Medical CollegePulmonary Division New York HospitalNew York, NYKerry J.

8 Kelly, MDChief Medical Officer, Bureau of Health Services and Co-Director of World Trade Center Medical ProgramsFire Department City of New YorkBrooklyn, NYAngeline A. Lazarus, MDProfessor of MedicineUniformed Services UniversityBethesda, MDStephen M. Levin, MDAssociate Professor of MedicineDepartment of Community and Preventive MedicineMount Sinai School of MedicineNew York, NYMichelle Macaraig, MPHA ssistant Director for Policy and Planning CoordinationBureau of Tuberculosis ControlNew York City Department of Health and Mental HygieneNew York, NYMelissa A. McDiarmid, MD, MPHP rofessor of Medicine and Director,University of Maryland Occupational Health ProgramBaltimore, MDLawrence C. Mohr, MDProfessor of Medicine, Biometry and EpidemiologyDirector, Environmental Biosciences ProgramMedical University of South CarolinaCharleston, South CarolinaDiana Nilsen, MD, RNDirector, Medical AffairsBureau of Tuberculosis ControlNew York City Department of Health and Mental HygieneNew York, NYDavid Ost, MD, MPHA ssociate Professor of MedicineNew York University School of MedicineNew York, NYRespiratory Diseases and the fire ServiceivDavid Prezant, MDProfessor of MedicineAlbert Einstein College of MedicinePulmonary Division Montefiore Medical CenterBronx, NYandChief Medical Officer, Office of Medical Affairs Co-Director of World Trade Center Medical ProgramsFire Department City of New YorkBrooklyn, NYJaswinderpal Sandhu.

9 MDPulmonary FellowAlbert Einstein College of MedicineMontefiore Medical CenterBronx, NYMichael R. Shohet, MDAssociate Clinical ProfessorOtolaryngology- Head and Neck SurgeryMount Sinai School of MedicineNew York, NYDorsett D Smith, MDClinical Professor of MedicineDivision of Pulmonary Diseases and Critical Care MedicineDepartment of MedicineUniversity of Washington Medical SchoolSeattle, WashingtonLeah Spinner, MDPulmonary Fellow Albert Einstein College of MedicineMontefiore Medical CenterBronx, NYMichael Weiden, MDAssociate Professor of MedicineNYU School of MedicineDivision of Pulmonary MedicineNew York, NYandMedical Officer, Bureau of Health Services World Trade Center Medical ProgramFire Department City of New YorkBrooklyn, NYIn concert with the United States fire Administration .

10 The IAFF sought independent review of this effort to provide us with technical and critical comments so as to ensure a complete and sound final product. The IAFF thanks the following organizations and individuals for their review of this TroupFire Program Specialist, Project ManagerUnited States fire AdministrationEmmitsburg, MDJames Melius, MD, DrPHChair, Medical Advisory BoardInternational Association of fire FightersAdministrator, New York State Laborers Health and Safety Trust FundAlbany, NYSandy Bogucki, MD, PhD, FACEP Associate Professor, Emergency Medicine, Yale UniversityAssociate EMS Medical Director and fire Surgeon, Branford fire Department New Haven, CTSara A. Pyle, PhDAssistant ProfessorPreventive Medicine & Family MedicineKansas City University of Medicine & BiosciencesKansas City, MOEd Nied Deputy Chief Tucson fire DepartmentDirector, IAFC Health, Safety and Survival SectionTucson, AZLu-Ann Beeckman-Wagner, PhDHealth ScientistDivision of Respiratory Disease StudiesNIOSHM organtown, WV Robert Castellan, MD, MPHE xpertDivision of Respiratory Disease StudiesNIOSHM organtown, WVChristopher Coffey, PhDChiefLaboratory Research BranchDivision of Respiratory Disease StudiesNIOSHM organtown, WVPaul Enright, MDExpert Consultant to NIOSHP rofessorUniversity of Arizona Tucson, ArizonaThomas Hales, MD, MPHS enior Medical EpidemiologistTeam Co-Leader, NIOSH fire Fighter Fatality Investigation and Prevention ProgramNIOSHC incinnati.