Boycott research on firefighters that is not Open Access

Open Access logo

Open Access logo

We all hate paying for something and then not receiving what we paid for. That is what is happening now to taxpayers who pay for government-funded research and then have no access to the findings.

We have ranted about this before, and documented another example a few days ago when we discovered that it will cost us $41 to obtain a copy of the findings from research conducted by the University of Georgia. Associate Professor Luke Naeher and others found that  lung function decreases for firefighters who work on prescribed fires for multiple days and are exposed to smoke. Further, it showed that respiratory functions slowly declined over a 10-week season.

This is not the only research that has explored the effects of smoke on wildland firefighters, but it may significantly add to the limited body of knowledge we have on the topic. We won’t know, however, unless we pay a second time in order to see their conclusions.

Researchers at some organizations receive pay raises and promotions based partially on the “publish or perish” meme. A system that requires researchers to publish in journals that are not completely open to the public, is antiquated and has no place in 2011 when a paper can be published in seconds on the internet at little or no cost.

Some of the research that has been conducted on firefighters requires a great deal of cooperation from the firefighters, including for example, ingesting core temperature monitors, carrying a drinking water system that monitors every drink they take, and even lubricating and then inserting a rectal thermistor probe attached to wires.

The Boycott

There is no reason for firefighters to go to extreme lengths to help researchers advance the researcher’s career paths unless the firefighters can receive some benefits from the project. So, we are jumping on the idea proposed by Rileymon in a comment on the University of Georgia article:

Maybe it’s time to suggest that firefighter/research subjects boycott new research studies unless the findings are put into the Public Domain?

Here is what we are proposing:

  1. Firefighters, administrators, and land managers should not cooperate with researchers unless they can be assured that findings from the research will be available to the public at no charge immediately following the publication of the findings, or very shortly thereafter.
  2. Researchers should conform to the principles of Open Access.
  3. Scientists who assist in the peer review process for conferences or journals should pledge to only do so only if the accepted publications are made available to the public at no charge via the internet.

More information:

 

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Study: firefighters’ lung function decreases after exposure to smoke

A new study from the University of Georgia found that lung function decreases for firefighters who work on prescribed fires for multiple days and are exposed to smoke. Further, it showed that respiratory functions slowly declined over a 10-week season.

Unfortunately, even though the study was probably funded by taxpayers, you will have to pay a second time see the study’s results. It will cost you $41 to purchase the article that contains the detailed findings uncovered during the research. The University of Georgia decided to pay a private journal to publish the article, rather than placing it on the

Smoke, fire-N-of-Cascade-Rd-2006

Firefighter working in smoke, fire near Hot Springs, SD in 2006. Photo by Bill Gabbert

University’s web site for free. We have written previously about taxpayers not being able to access taxpayer-funded research. Why does the government continue to fund research, if the product of the research is not made available? A call to Luke Naeher, the senior author of the study, was not immediately returned.

Here is a summary of the report, which thankfully, is provided by the University of Georgia at no cost.

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December 5, 2011

After monitoring firefighters working at prescribed burns in the southeastern United States, University of Georgia researchers found that lung function decreased with successive days of exposure to smoke and other particulate matter.

“What we found suggested a decline in lung function across work seasons,” said Olorunfemi Adetona, a postdoctoral research associate and lead author of the study published recently in the journal Inhalation Toxicology.

Luke Naeher, senior author and associate professor in the UGA College of Public Health, explained that the study was designed to investigate whether the 26 firefighters experienced a decrease in lung function working at prescribed burns compared with days they spent away from the fires. Previously, researchers had looked only at changes in lung function of wildland firefighters on days with exposure to smoke.

“Over a 10-week season, these workers’ respiratory functions slowly declined,” Naeher said, adding that there is need to investigate the degree to which these declines returned to their baseline after the burn season. Although results of the study show that lung function at the start of two burn seasons in a limited number of nine firefighters in 2003 and 2004 did not vary significantly, more definitive answers relating to the issue of longer term effect of exposure on lung function would require a different study design.

In recent years, the U.S. Forest Service has sought to better understand and improve its occupational exposure limits for firefighters across the country. Most studies have concentrated on burns in Western states where exposure to and composition of wood-smoke particulate matter may vary to some degree when compared with fires in the Southeast, including South Carolina, where the study was done.

Naeher said the study provides some preliminary information regarding the health effects of fine particulate matter exposure that is intermediate between two exposure extremes. On the low extreme lies ambient air levels typical for developed countries, while inhalation of particles by a smoker represents the opposite extreme. Much research in the field has focused on health effects at both extremes. However, the study of exposure at intermediate levels, like that experienced by wildland firefighters, and women and children exposed to indoor air pollution from cook stoves in developing countries is limited. Naeher’s research focuses on these two different populations, and he explains that the study of the body’s response tothese intermediate exposures may now be more urgent. For example, Naeher said, an initiative led by the United Nations Foundation aims to put clean-burning cooking stoves in 100 million homes in developing countries by 2020.

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Wildland firefighters: rhabdomyolysis or “rhabdo” can be extremely serious

Employee's left leg after 5 surgeries

From the FLA. Employee's left leg after 5 surgeries

I will have to admit that when the National Wildfire Coordinating Group’s Risk Management Committee distributed some information earlier this year about rhabdomyolysis, which is frequently referred to as “rhabdo”, I didn’t pay much attention. But today when the Wildfire Lessons Learned Center announced that a Facilitated Learning Analysis (FLA) for a severe case of rhabdo was available, I read it carefully and am now converted. The injury in the FLA occurred September 21, 2011 while a firefighter was taking the Work Capacity Test, or “pack test”. I have seen the light and realize how serious this condition can be.

Left untreated, or if not treated early enough, rhabdo can  lead to irreversible muscle damage, permanent disability, kidney failure possibly requiring lifelong dialysis, and even death. Up to 8% of cases of rhabdomyolysis are fatal according to a NIOSH report. And all of this can be the result of exercising hard or engaging in a strenuous fire assignment if other risk factors are also present.

Rhabdomyolysis is the breakdown of muscle fibers resulting in the release of muscle contents (myoglobin) into the bloodstream which are harmful to the kidneys and may lead to kidney failure.

The link between rhabdo and “compartment syndrome”, the condition that is emphasized in the FLA, is certain, but it is not clear to me, having much more fire training than medical training, if compartment syndrome leads to rhabdo or vice versa, and my research found conflicting information. But that is not really important, in that both conditions are similar in that they are caused by damaged muscle tissue. Compartment syndrome occurs when the damaged muscle is inside an enclosed compartment in a fibrous sheath with other muscles, as is found in the arms and legs. Rhabdo can occur with any muscles, but both can lead to the same outcome, including death.

I was disappointed that the recently released FLA did not state the cause of the injured employee’s compartment syndrome/rhabdo, nor did it provide much useful information about how to prevent a similar occurrence, other than to “prioritize staying physically fit”, and the “incorporation of healthy lifestyle choices and better nutrition”. So I attempted to gather some information here in one place that will hopefully be useful for wildland firefighters, to increase their chances of avoiding rhambdo, or diagnosing it if it occurs.
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The myth of drinking water

Firefighter on the Shep Canyon fire in South Dakota, September 6, 2011

Firefighter on the Shep Canyon fire in South Dakota, September 6, 2011. Photo: Bill Gabbert/Wildfire Today

After reading our excerpt and later the full document from the the Serious Accident Investigation Factual Report  for the hyperthemia fatality on the CR 337 fire in Texas, we heard from Dr. Brent Ruby, who has completed studies on this exact issue, even having studied wildland firefighters while they were working on fires. In one of his studies he was monitoring a wildland firefighter outfitted with a core temperature monitor, an ambient temperature sensor, and a special Camelback hydration system that monitored his water intake. This firefighter experienced a heat-related illness, heat exhaustion, and had to be evacuated off the fireline by a helicopter. That was a terrible thing to happen to a firefighter, and I’m sure the researchers thought the same thing, but it was probably a once in a lifetime cornucopia of incredibly useful data. Dr. Ruby sent us this message, reprinted here with his permission:
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9/11 health care bill does not cover firefighters’ cancer

Remember the huge battles to get the bill passed to provide health care for the firefighters that were suffering from medical issues after working in the debris from the towers that fell during the 9/11 attacks? Most of us felt a huge relief when the “S. 1334: James Zadroga 9/11 Health and Compensation Act of 2009“ was finally passed. We wrote about it several times, with the latest being HERE.

It turns out that the bill, or at least the way the provisions are being interpreted, does not cover the treatment of cancer for the firefighters that worked on the debris pile. Cancer — you would think this would be close to the number one condition covered for the people that worked in that toxic environment.

John Howard, the World Trade Center Health Program administrator, said in a statement that cancer would not be covered because there is not adequate ”published scientific and medical findings” that a causal link exists between September 11 exposures and the occurrence of cancer in responders and survivors. So if we wait, and study the link for another, what, 20 or 30 years we can prove it then?

This is a disgrace.

Jon Stewart of the Daily Show, in a piece named “I Thought We Already Took Care of This S@#t”, expresses his opinion on the issue. The clip has profanity, but it is bleeped out.

NorthJersey.com has more details about this development.

Meanwhile, the Canadian government has a vastly different approach. For years the provinces of Alberta and Manitoba have had presumptive coverage for a list of conditions for firefighters. If they are diagnosed with one of the cancers on the list, it is considered an occupational disease and they may be eligible for workers compensation benefits. In fact, Alberta expanded their list in May to include prostate, breast, skin and multiple myeloma, bringing the total to 14 types covered under the Workers Compensation Board. Their government acknowledges that firefighters are at a greater risk of contracting cancer than the general public, and it can be difficult or impossible to prove that a particular case of cancer was caused by a specific incident or exposure, on or off the job.

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The future of wildland fire smoke research

JFSP smoke research planThe Joint Fire Science Program (JFSP) has released their plan for wildland fire smoke research. The 58-page document outlines their priorities for funding smoke research through 2015.

Much of the emphasis appears to be directed at how to deal with the public’s perception and tolerance of smoke. Smoke is becoming an increasingly sensitive subject to the population due to larger wildfires burning for longer periods of time, concern about the effects of wildfire smoke on global warming, and prescribed fires continuing to be an important tool for land managers.

One aspect of wildfire smoke that Wildfire Today has written about frequently is the short and long term effects of smoke on the health of firefighters. On April 23, 2010 we covered the study that NIOSH and the U.S. Fire Administration are conducting about cancer among structural firefighters. We called out the land management agencies and the firefighting associations:

There needs to be a concerted effort to conduct a similar study on wildland firefighters. It should be led by a physician/epidemiologist and should evaluate the long term health and occurrence of cancer and other diseases among wildland firefighters. There is a lot of grant money out there and it should be possible to get some of it pointed towards this overlooked niche of firefighting.

Followups to that article are HERE and HERE.

The JFSP five-year plan does mention research on the effects of smoke on wildland firefighters, but at times it seems like an afterthought. For example, the objective for one of four research themes, “Smoke and Populations”, sometimes includes the “impact of smoke on populations” (page 26), and in other places it is described as “impact of smoke on populations and fire fighters” (page 21).

However, the plan does list some specific “Smoke Science Foci” that may benefit firefighters:

  • 2011: (SSP T3 -2): Epidemiological research/literature review to determine human health risk from high PM loadings.
  • 2011 (SSP T3-4): Fire fighter smoke health hazards: trends in health and exposure.
  • 2012 (SSP T3-5): Review of epidemiological research to determine human health risk from high PM, high ozone and high aromatic hydrocarbon loadings with a focus on synergisms between pollutants.

We hope that the “foci” turns into actual research.

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