Fire research report Presented by: Michelle Engelsman

Firefighter Exposure Risks and Subsequent Reproductive Effects: A Preliminary Literature Review
Fire research report Presented by: Michelle Engelsman FRNSW Qualified Firefighter PhD Student, The University of Queensland

Introduction Why this research?
Although a multitude of recommended practices, training and equipment is provided by fire organisations to significantly increase firefighter safety, firefighters will always face risks This research is being undertaken by FRNSW to increase knowledge and determine how to further improve firefighter risk management practices

Introduction Why this research?
Tens of thousands of chemicals produced Many known toxic chemicals present Very small number of chemicals have been biomonitored Minimal consideration around reproductive health Risk of long term, repeated exposure may accelerate and/or exacerbate adverse health effects Three main mechanisms of exposure: inhalation, ingestion, dermal

Firefighter Exposure Mechanisms
Inhalation – Structure Fires and General Flame retardants (PBDEs) in blood serum: consistent SCBA usage compared to inconsistent (self-reporting) Wearing SCBA consistently during ventilation = 17% lower Wearing SCBA consistently during exterior fire suppression = 15% lower Wearing SCBA consistently during overhaul = 7% lower Gas monitors may not show true safety Arsenic found to exceed STEL US Research shows firefighters remove SCBA in visibly “clean air” 99+% particles during overhaul are less than 1 micron in diameter

Inhalation – Wildfire Wildfire smoke can contain: carbon monoxide (CO), nitrogen dioxide (NO2), benzene (C6H6), acrolein (C3H4O), formaldehyde (CH2O), respirable particles, polyaromatic hydrocarbons including benzo(a)pyrene, dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), polychlorinated dibenzodioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), polychlorinated biphenyl (PCBs), PBDEs, other. CO: 1 minute excursion windows of 629ppm measured, TWA found to be exceeded (30ppm) P2 does not filter out toxic gases US research shows firefighters may not wear any respiratory protection during wildfire suppression

Inhalation – Vehicle Fire Suppression Chemical groups present include: VOCs, PAHs, aldehydes, dioxins, furans, flame retardants, many more Many known, or reasonably assumed to be, human carcinogens. Not wearing SCBA in vehicle fire smoke can risk major short term exposure to the respiratory tract and eyes US research shows firefighters have reported not wearing SCBA at vehicle fires

Inhalation – Off-Gassing and Decontamination PPC/PPE off-gasses and contains residual dust/ash from fire environments Five-fold mean off-gas above background levels Inhalation risk while travelling in confined vehicles with off-gassing PPC/PPE, removing PPC/PPE (doffing), storage of PPC/PPE at the station

Ingestion US research indicated fire stations have much higher levels of brominated flame retardants in the dust compared with residences (~20x) Potentially caused by residual ash from fire scenes on PPC that is brought back to the station, and subsequently migrates to living quarters Station maintenance and cleaning, or removing PPC/PPE can cause risk of exposure through ingestion Regular hand washing whilst at the station = lower cadmium and certain PBDEs in blood

Dermal QFES (and others) have shown gas and particulates are able to reach the skin when wearing full PPC Further to this: many chemicals present in fire environments are lipophilic – can be absorbed through the skin Studies involving skin swatches, analysis of PPC in contact with skin, and biomonitoring post fire suppression with use of full respiratory protection all support dermal absorption Showering post fire suppression reduces exposure Regular hand washing reduces exposure

Dermal Permeability of the jaw line, scalp and forehead are among the highest on the human body (testicular skin is highest) Dermal absorption is likely to increase with increased body temperature and sweating Endocrine disrupting chemicals (EDCs) have been found on PPC/PPE post fire suppression activities, and can accumulate if not decontaminated Estrogens have been found on the inner and outer layer of new firefighting gloves and flash hoods, likely due to the presence of flame retardants Many other chemicals have been found on helmets, face guards, gloves and firefighting coats post fire suppression

Firefighter Exposure to Chemicals
Analysed Chemicals in Firefighters The following chemicals have been biomonitored in firefighters or are known to be present in fire environments Environmental phenols, organochlorine pesticides, polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans, polybrominated dibenzo-p-dioxins, polybrominated dibenzofurans, polybrominated diphenyl ethers, phthalates, polycyclic aromatic hydrocarbons, volatile organic compounds, perfluorochemicals, polychlorinated biphenyls, metals, others.

Subsequent Reproductive Effects
Relatively minimal research on the potential for reproductive insult due to firefighter exposure Many chemicals are EDCs – they may produce adverse developmental, reproductive, immune and neurological effects Potential for insult to person or offspring depends on the timing and extent of the exposure Majority of chemicals tested for reproduction affect both genders Many of the chemicals in fire scenes are known to have mutagenic effects

Male Reproduction Epidemiological studies have shown male firefighters have increased risk of offspring with congenital heart defects/abnormalities, cleft lip, penis abnormalities, club foot Male germ cell mutagenesis can increase the chances of spontaneous abortion, physical malformations, behavioural alterations, increased incidence of certain diseases (incl. cancer) Chronic paternal exposure may not directly affect male fertility, but could affect fertility of his offspring. Sperm production takes ~75 days. Insult during that time could affect sperm viability until new sperm are fully matured

Male Reproduction - Hyperthermia Testes require local temperature 2-3C below normal core body temperature Up to four degree core body temperature elevation in firefighters Functional sperm count reduced up to 24 weeks in fertile males due to occupational exposure to high temps Sperm morphology and increased number of abnormal sperm shown to increase 30-60% within 6-8 months post exposure If conception occurs with abnormal sperm increased likelihood of spontaneous abortion and/or birth defects

Male Reproduction - Chemical Fire chemicals can affect sperm PAH exposure prior to conception linked to increased risk of brain tumours in children. Contribute to impaired testicular function and testosterone concentration Acrolein and formaldehyde can cause chromosomal point mutations or mutational changes in sperm morphology, impaired spermatogenesis, impaired ability to impregnate a female Benzene can increase pre-implantation mortality, carbon dioxide can decrease male fertility Dioxins and PCBs linked to reduced sperm count

Male Reproduction - Chemical Many toxic products of combustion are endocrine disrupting chemicals (EDCs) Human volunteers who had oestrogen levels reduced experienced: decreased sexual function and body mass increases EDCs in fire environments: phthalate diesters, VOCs, PFCs, PAHs, PCDD/Fs, PBDD/Fs, environmental phenols

Female Reproduction Limited research on female firefighters due to lower numbers No epidemiological studies on female firefighters and offspring General female reproduction analysis used, with overlay of fire scene exposure Reproductive insult: oocyte by means of genotoxic damage, pregnancy loss, decreased fertility or birth defects, menstruation, childbirth, offspring fertility, ongoing offspring growth and development

Female Reproduction - Chemical Benzene can cause abnormalities in menstruation in humans when exposed to high concentrations (15ppm or greater) Animal studies indicate acute exposure may cause post-implantation mortality EDCs in environment have potential to inhibit implantation and/or affect menstruation Some heavy metals can interfere to the binding of oestradiol decreased likelihood of embryonic implantation and reduced fertility

Pregnancy Cardiac output and blood volume increase placing additional strain on the body, firefighting heart rates of % maximum are usual Reduced capacity for heat stress Loud noises can lead to lower foetal weight and increased risk of foetal mortality 179 work cover claims resulting in deafness

Pregnancy - Hyperthermia Increased core body temperature above 38.9ºC linked with birth defects (neural system defects) Firefighter heat exposure can lead to significant increases in leukocyte and platelet counts for up to 24 hours post fire suppression activity 1.6% work cover claims due to heat incurring cost 2.1% NIIEMN claim due to heat 36% comments from female respondents to survey about PPC volunteered that they feel hot due to the turnout gear

Pregnancy - Chemical Intrauterine environment can lead to long term health impacts Pre-natal exposure to phthalates have resulted in DNA methylation changes and subsequent gene expression changes PBDEs cross the placenta with matched foetal and maternal blood concentrations Non-lethal maternal CO exposure associated with foetal loss and adverse neurological changes. Foetal blood concentrations 10-15% higher due to physiological responses of an unborn baby Animal studies linked stunted growth and developmental abnormalities after consistent formaldehyde exposure

Pregnancy - Chemical Benzene crosses placenta. USA study that included chronic low level benzene exposure determined association with spina bifida. USA study on chronic exposure to CO, NO2, SO2, and particulates found weeks 2 and 5 to be heightened times of potential foetal exposure. Association found between NO2 or SO2 exposure and foetal heart defects. FRNSW studies show fire scenes have NO2 and SO2 present at several orders of magnitude higher than this USA study. NO2 has been implicated as potential cause of human spontaneous abortions in operating room personnel due to potential oxidation of anaesthetic nitrous oxide (NO).

Pregnancy - Chemical Human in-utero exposure to PFCs has shown increased prevalence of birth defects delays in growth and development delayed onset of menstruation in daughters (PFOA) increased prevalence of obesity and high waist circumference in daughters (PFOA) reduced sperm count and concentration and increased reproductive hormones in adult men exposure in-utero (PFOA) decreased birth weight (PFHxS) and increased birth weight (PFUnDA)

Lactating Firefighters Breastfeeding has been linked to reduced risks of infection and chronic diseases (allergies, asthma, arthritis, diabetes, obesity, cardiovascular disease, various cancers) WHO recommends breastfeeding in all but the most toxic environments two years Many chemicals firefighters are exposed to are persistent in the environment and have been measured in formula Formula has been found to be contaminated by toxic metals, bovine growth hormone, bacteria and other environmental toxins Breast milk can detoxify

Lactating Firefighters One pilot study on lactating firefighters Early findings recommend express milk and discard it for 72 hours following fire suppression activities Toxic fire chemicals can remain present in human systems for 15 days to 15 years depending on the chemical in question Maternal burden of chemicals can pass through to infants at a steady rate if no continued exposure

Lactating Firefighters Analysis firefighters vs general population shows the potential of nearly 30 toxic chemicals elevated in firefighter breast milk Many fire chemicals are lipophilic in nature Chemicals that are bound to human fats are found at higher levels in breast milk and cord blood than maternal serum These chemicals include: PCDDs/PCDFs, PBDEs, organochlorine pesticides, metals, PAHs, PFCs, PCBs

Child Health Effects Specific PBDEs have shown: preliminary evidence of male rat feminisation, female rat decreased sexual behaviour, altered development of the ultra-structrure of ovary cells and reduced sperm counts in adult rats, and neurochemical changes affecting motor activity and cognitive behaviour Early human evidence that PBDEs via breast milk could lead to cryptorchidism Research has shown that prenatal exposure to phthalates and bisphenols can lead to altered gene expression

Child Health Effects PFOS animal studies show significantly reduce maternal serum triglycerides and in-utero exposure can lead to defects (cleft palate, heart defects and cause both growth and development delays) PFOA human studies linked to reduced sperm concentration in adult men, delayed onset of menstruation in adult women, and increased obesity and waist circumference PAH human studies linked maternal exposure (first trimester and before conception) to gastroschisis, and/or small for gestational age offspring. Paternal exposure can increase risk of childhood brain tumours

Child Health Effects PCDDs/Fs found to risk foetal injury, congenital abnormalities, intrauterine growth retardation, altered psychomotor development in humans, animal studies have shown taratogenicity and increased risk of neurotoxicity Benzene has been linked to spina bifida, NO2 and/or SO2 exposure to congenital heart defects in humans

Conclusions Firefighter systems have been documented to have increased levels of toxic chemicals present, many of which are reproductive mutagens There is no safe or toxic level officially defined for many of these chemicals Levels for toxicity may vary between individuals For example children with a specific genotype are more evidently and adversely impacted by phthalates with regard to child cognitive tasks Definitive exposure levels for reproductive effects remain unknown

Conclusions Vigilant use of PPC/PPE and good hygiene mitigates exposure risks, but cannot completely eliminate them Showering ASAP post fire suppression activities, regular hand washing and PPC laundering to reduce dermal absorption Pregnant and lactating firefighters are in a unique category regarding exposure Education is key for all firefighters, male and female Reproductive health is not a female issue only More research is now needed in this area

Recommendation Firefighting organisations offer support to research on the reproductive health by assisting in communicating/distributing surveys and information regarding blood/urine/breast milk collection analysis requests

Acknowledgements Thank you to the following for their invaluable support: Fire & Rescue NSW (FRNSW) FRNSW Fire Investigation and Research Unit FRNSW Health and Safety Unit The University of Queensland Queensland Alliance for Environmental Health Services Contact Details For further information please contact me via:

References Agnew, J., McDiarmid, M., Lees, P., & Duffy, R. (1991). Reproductive hazards of fire fighting. I. Non-chemical hazards. American Journal of Industrial Medicine, 19(4), 433—445. Alexander, B. M., & Baxter, C. S. (2014). Plasticizer contamination of firefighter personal protective clothing–a potential factor in increased health risks in firefighters. Journal of Occupational and Environmental Hygiene, 11(5), D43—8. Anstadt, G. (1990). Performance of pregnant firefighters. Journal of Occupational Medicine. : Official Publication of the Industrial Medical Association, 32(7), 571—572. Arcus-Arth, A., Krowech, G., & Zeise, L. (2005). Breast milk and lipid intake distributions for assessing cumulative exposure and risk. Journal of Exposure Analysis and Environmental Epidemiology, 15(4), 357—365. Aylward, L. L., Kirman, C. R., Schoeny, R., Portier, C. J., & Hays, S. M. (2013). Evaluation of biomonitoring data from the CDC National Exposure Report in a risk assessment context: perspectives across chemicals. Environmental Health Perspectives, 121(3), 287—294. Baird, P. (1992). Reproductive hazards and the workplace. CMAJ : Canadian Medical Association Journal = Journal de l’Association Medicale Canadienne, 147(2), 157—160. Biomonitoring California. (2010). Firefighter Occupational Exposures (FOX) Project - Data. Retrieved from Brown, F. R., Whitehead, T. P., Park, J.-S., Metayer, C., & Petreas, M. X. (2014). Levels of non-polybrominated diphenyl ether brominated flame retardants in residential house dust samples and fire station dust samples in California. Environmental Research, 135, 9—14. Burgess, J. L. (2015). Preliminary Unpublished Studies. The University of Arizona.

References Burgess, J. L., Duncan, M. D., Hu, C., Littau, S. R., Caseman, D., Kurzius-Spencer, M., … McDonagh, P. F. (2012). Acute cardiovascular effects of firefighting and active cooling during rehabilitation. Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine, 54(11), 1413— Callan, A., Rotander, A., Thompson, K., Heyworth, J., Mueller, J., Odland, J., & Hinwood, A. (2016). Maternal exposure to perfluoroalkyl acids measured in whole blood and birth outcomes in offspring. The Science of the Total Environment. Caux, C., O’Brien, C., & Viau, C. (2002). Determination of firefighter exposure to polycyclic aromatic hydrocarbons and benzene during fire fighting using measurement of biological indicators. Applied Occupational and Environmental Hygiene, 17(5), 379—386. Centers for Disease Control and Prevention. (2009). Fourth National Report on Human Exposure to Environmental Chemicals. Atlanta, GA, USA: Department of Health and Human Services, Centers for Disease Control and Prevention. Retrieved from Chen, Y., Wang, X., Li, Y., Toms, L.-M. L., Gallen, M., Hearn, L., … Mueller, J. F. (2015). Persistent organic pollutants in matched breast milk and infant faeces samples. Chemosphere, 118, 309—314. Chernyak, Y. I., Shelepchikov, A. A., Brodsky, E. S., & Grassman, J. A. (2012). PCDD, PCDF, and PCB exposure in current and former firefighters from Eastern Siberia. Toxicology Letters, 213(1), 9—14. Chia, S., & Shi, L. (2002). Review of recent epidemiological studies on paternal occupations and birth defects. Occupational and Environmental Medicine, 59(3), 149—155. Cordier, S., Monfort, C., Filippini, G., Preston-Martin, S., Lubin, F., Mueller, B., … Arslan, A. (2004). Parental exposure to polycyclic aromatic hydrocarbons and the risk of childhood brain tumors: The SEARCH International Childhood Brain Tumor Study. American Journal of Epidemiology, 159(12), 1109—

References Costa, L. G., & Giordano, G. (2007). Developmental neurotoxicity of polybrominated diphenyl ether (PBDE) flame retardants. Neurotoxicology, 28(6), 1047— Dada, R., Gupta, N. P., & Kucheria, K. (2003). Spermatogenic arrest in men with testicular hyperthermia. Teratogenesis, Carcinogenesis, and Mutagenesis, Suppl 1, 235—243. De Vos, A. J. B. M., Reisen, F., Cook, A., Devine, B., & Weinstein, P. (2009). Respiratory irritants in Australian bushfire smoke: air toxics sampling in a smoke chamber and during prescribed burns. Archives of Environmental Contamination and Toxicology, 56(3), 380—388. Dobraca, D., Israel, L., McNeel, S., Voss, R., Wang, M., Gajek, R., … Das, R. (2015). Biomonitoring in California firefighters: metals and perfluorinated chemicals. Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine, 57(1), 88—97. Engelsman, M. (2015). Smoke Alarms in Homes: An Analysis (Fire Research Report) (p. 100). FRNSW. Evanoff, B., & Rosenstock, L. (1986). Reproductive hazards in the workplace: a case study of women firefighters. American Journal of Industrial Medicine, 9(6), 503—515. Fabian, T., Borgerson, J., L., Kerber, S. I., Gandhi, P., D. ., Baxter, C. S., Ross, C. S., … Dalton, J. M. (2010). Firefighter Exposure to Smoke Particulates (DHS AFG Grant #EMW-2007-FP Copyright 2010 Underwriters LAboratories Inc. Retrieved from Fabian, T., & Gandhi, P., D. . (2007). Smoke Characterization Report (Technical Report). The Fire Protection Research Foundation: Underwriters Laboratories Inc. Fent, K. (2013, February 7). Firefighters’ Unique Exposure Profiles. The InterAgency Board. Retrieved from

References Fent, K. W., Eisenberg, J., Snawder, J., Sammons, D., Pleil, J. D., Stiegel, M. A., … Dalton, J. (2014). Systemic Exposure to PAHs and Benzene in Firefighters Suppressing Controlled Structure Fires. Annals of Occupational Hygiene, 58(7), 830–845. Fent, K. W., & Evans, D. E. (2011). Assessing the risk to firefighters from chemical vapors and gases during vehicle fire suppression. J. Environ. Monit., 13(3), 536–543. Fent, K. W., Evans, D. E., Booher, D., Pleil, J. D., Stiegel, M. A., Horn, G. P., & Dalton, J. (2015). Volatile Organic Compounds Off-gassing from Firefighters’ Personal Protective Equipment Ensembles after Use. Journal of Occupational and Environmental Hygiene, 12(6), 404—414. Gyalpo, T., Toms, L.-M., Mueller, J. F., Harden, F. A., Scheringer, M., & Hungerbühler, K. (2015). Insights into PBDE Uptake, Body Burden, and Elimination Gained from Australian Age-Concentration Trends Observed Shortly after Peak Exposure. Environmental Health Perspectives, 123(10), 978—984. Halldorsson, T. I., Rytter, D., Haug, L. S., Bech, B. H., Danielsen, I., Becher, G., … Olsen, S. F. (2012). Prenatal exposure to perfluorooctanoate and risk of overweight at 20 years of age: a prospective cohort study. Environmental Health Perspectives, 120(5), 668—673. Hays, S., Becker, R., Leung, H., Aylward, L., & Pyatt, D. (2007). Biomonitoring equivalents: a screening approach for interpreting biomonitoring results from a public health risk perspective. Regulatory Toxicology and Pharmacology : RTP, 47(1), 96—109. Hsu, J.-F., Guo, H.-R., Wang, H. W., Liao, C.-K., & Liao, P.-C. (2011). An occupational exposure assessment of polychlorinated dibenzo-p-dioxin and dibenzofurans in firefighters. Chemosphere, 83(10), 1353— Jahnke, S. A., Poston, W. S. C., Haddock, C. K., Jitnarin, N., Hyder, M. L., & Horvath, C. (2012). The health of women in the US fire service. BMC Women’s Health, 12, 39.

References Jin, C., Sun, Y., Islam, A., Qian, Y., & Ducatman, A. (2011). Perfluoroalkyl acids including perfluorooctane sulfonate and perfluorohexane sulfonate in firefighters. Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine, 53(3), 324—328. Jones, K., Cocker, J., Dodd, L., & Fraser, I. (2003). Factors affecting the extent of dermal absorption of solvent vapours: a human volunteer study. The Annals of Occupational Hygiene, 47(2), 145—150. Kärrman, A., Ericson, I., van Bavel, B., Darnerud, P. O., Aune, M., Glynn, A., … Lindström, G. (2007). Exposure of perfluorinated chemicals through lactation: levels of matched human milk and serum and a temporal trend, , in Sweden. Environmental Health Perspectives, 115(2), 226—230. Kirk, K., M., Ridgeway, M., & Logan, M. B. (2011, August). Firefighter Exposures to Airborne Contaminants during Extinguishment of Simulated Residential Room Fires. The InterAgency Board. Retrieved from Kristensen, S., Ramlau-Hansen, C., Ernst, E., Olsen, S., Bonde, J., Vested, A., … Toft, G. (2013). Long-term effects of prenatal exposure to perfluoroalkyl substances on female reproduction. Human Reproduction (Oxford, England), 28(12), 3337— Laitinen, J. A., Koponen, J., Koikkalainen, J., & Kiviranta, H. (2014). Firefighters’ exposure to perfluoroalkyl acids and 2-butoxyethanol present in firefighting foams. Toxicology Letters, 231(2), 227—232. Landrigan, P. J., Sonawane, B., Mattison, D., McCally, M., & Garg, A. (2002). Chemical contaminants in breast milk and their impacts on children’s health: an overview. Environmental Health Perspectives, 110(6), A313—5. Langlois, P. H., Hoyt, A. T., Desrosiers, T. A., Lupo, P. J., Lawson, C. C., Waters, M. A., … National Birth Defects Prevention Study. (2014). Maternal occupational exposure to polycyclic aromatic hydrocarbons and small for gestational age offspring. Occupational and Environmental Medicine, 71(8), 529—535.

References Langlois, P. H., Hoyt, A. T., Lupo, P. J., Lawson, C. C., Waters, M. A., Desrosiers, T. A., … Lammer, E. J. (2013). Maternal occupational exposure to polycyclic aromatic hydrocarbons and risk of oral cleft-affected pregnancies. The Cleft Palate-Craniofacial Journal : Official Publication of the American Cleft Palate-Craniofacial Association, 50(3), 337—346. Lau, C., Thibodeaux, J. R., Hanson, R. G., Rogers, J. M., Grey, B. E., Stanton, M. E., … Stevenson, L. A. (2003). Exposure to perfluorooctane sulfonate during pregnancy in rat and mouse. II: postnatal evaluation. Toxicological Sciences : An Official Journal of the Society of Toxicology, 74(2), 382—392. Lin, S., Herdt-Losavio, M. L., Chapman, B. R., Munsie, J.-P., Olshan, A. F., Druschel, C. M., & National Birth Defects Prevention Study. (2013). Maternal occupation and the risk of major birth defects: a follow-up analysis from the National Birth Defects Prevention Study. International Journal of Hygiene and Environmental Health, 216(3), 317—323. Lönnermark, A., & Blomqvist, P. (2006). Emissions from an automobile fire. Chemosphere, 62(7), 1043— Lorber, M., Eaglesham, G., Hobson, P., Toms, L.-M. L., Mueller, J., & Thompson, J. (2015). The effect of ongoing blood loss on human serum concentrations of perfluorinated acids. Chemosphere, 118, 170—177. Lupo, P. J., Symanski, E., Waller, D. K., Chan, W., Langlois, P. H., Canfield, M. A., & Mitchell, L. E. (2011). Maternal exposure to ambient levels of benzene and neural tube defects among offspring: Texas, Environmental Health Perspectives, 119(3), 397—402. Madhavan, N., & Naidu, K. (1995). Polycyclic aromatic hydrocarbons in placenta, maternal blood, umbilical cord blood and milk of Indian women. Human & Experimental Toxicology, 14(6), 503—506. Main, K. M., Kiviranta, H., Virtanen, H. E., Sundqvist, E., Tuomisto, J. T., Tuomisto, J., … Toppari, J. (2007). Flame retardants in placenta and breast milk and cryptorchidism in newborn boys. Environmental Health Perspectives, 115(10), 1519—1526.

References Mannetje, A. ’t, Coakley, J., Mueller, J. F., Harden, F., Toms, L.-M., & Douwes, J. (2012). Partitioning of persistent organic pollutants (POPs) between human serum and breast milk: a literature review. Chemosphere, 89(8), 911—918. McDiarmid, M., & Agnew, J. (1995). Reproductive hazards and firefighters. Occupational Medicine (Philadelphia, Pa.), 10(4), 829—841. McDiarmid, M., Lees, P., Agnew, J., Midzenski, M., & Duffy, R. (1991). Reproductive hazards of fire fighting. II. Chemical hazards. American Journal of Industrial Medicine, 19(4), 447—472. Mead, M. N. (2008). Contaminants in human milk: weighing the risks against the benefits of breastfeeding. Environmental Health Perspectives, 116(10), A427—34. Meyer, C., P. ., Gras, J., L. ., Gillett, R., W. ., Selleck, P., Powell, J., Muller, J., … Tolhurst, K. (2008). Determination of the source and level of dioxin emissions from bushfires in Australia (No. JV07A) (p. 76). CSIRO. Retrieved from Neitzel, R., Naeher, L., Paulsen, M., Dunn, K., Stock, A., & Simpson, C. (2009). Biological monitoring of smoke exposure among wildland firefighters: a pilot study comparing urinary methoxyphenols with personal exposures to carbon monoxide, particular matter, and levoglucosan. Journal of Exposure Science & Environmental Epidemiology, 19(4), 349—358. Nickerson, K. (2006). Environmental contaminants in breast milk. Journal of Midwifery & Women’s Health, 51(1), 26—34. Olshan, A., Teschke, K., & Baird, P. (1990). Birth defects among offspring of firemen. American Journal of Epidemiology, 131(2), 312—321. Park, J.-S., Voss, R. W., McNeel, S., Wu, N., Guo, T., Wang, Y., … Petreas, M. (2015). High exposure of California firefighters to polybrominated diphenyl ethers. Environmental Science & Technology, 49(5), 2948— Paul, M., & Himmelstein, J. (1988). Reproductive hazards in the workplace: what the practitioner needs to know about chemical exposures. Obstetrics and Gynecology, 71(6 Pt 1), 921—938.

References Pleil, J. D., Stiegel, M. A., & Fent, K. W. (2014). Exploratory breath analyses for assessing toxic dermal exposures of firefighters during suppression of structural burns. Journal of Breath Research, 8(3), Ponsonby, A.-L., Symeonides, C., Vuillermin, P., Mueller, J., Sly, P. D., & Saffery, R. (2016). Epigenetic regulation of neurodevelopmental genes in response to in utero exposure to phthalate plastic chemicals: how can we delineate causal effects? Neurotoxicology. Public Health England. (2008). Polycyclic Aromatic Hydrocarbons (Benzo[a]pyrene) (General Information, Incident Management, Toxicological Overview). Public Health England, Prepared by the Toxicology Department CRCE, PHE. Retrieved from Reisen, F., Hansen, D., & Meyer, C. P. M. (2011). Exposure to bushfire smoke during prescribed burns and wildfires: firefighters’ exposure risks and options. Environment International, 37(2), 314—321. Ribas-Fitó, N., Cardo, E., Sala, M., Eulàlia de Muga, M., Mazón, C., Verdú, A., … Sunyer, J. (2003). Breastfeeding, exposure to organochlorine compounds, and neurodevelopment in infants. Pediatrics, 111(5 Pt 1), e580—5. Robaire, B., & Hales, B. (1993). Paternal exposure to chemicals before conception. BMJ (Clinical Research Ed.), 307(6900), 341—342. Rotander, A., Toms, L.-M. L., Aylward, L., Kay, M., & Mueller, J. F. (2015). Elevated levels of PFOS and PFHxS in firefighters exposed to aqueous film forming foam (AFFF). Environment International, 82, 28—34. Shaw, S. D., Berger, M. L., Harris, J. H., Yun, S. H., Wu, Q., Liao, C., … Kannan, K. (2013). Persistent organic pollutants including polychlorinated and polybrominated dibenzo-p-dioxins and dibenzofurans in firefighters from Northern California. Chemosphere, 91(10), 1386–

References Siddiqi, M. A., Laessig, R. H., & Reed, K. D. (2003). Polybrominated diphenyl ethers (PBDEs): new pollutants-old diseases. Clinical Medicine & Research, 1(4), 281—290. Sjodin, A., Papke, O., Focant, J.-F., Jones, R. S., Pless-Mulloli, T., Leontjew Toms, L.-M., … Patterson, Jr, D. G. (2006). Concentration of Polybrominated Diphenyl Ethers (PBDEs) in Household Dust from Various Countries - Is Dust a Major Source of Human Exposure? In DIOXIN 2006 OSLO 26th International Symposium on Halogenated Persistent Organic Pollutants (pp. 2181–2185). Oslo: Norwegian Institute of Public Health. Stefanidou, M., Athanaselis, S., & Spiliopoulou, C. (2008). Health impacts of fire smoke inhalation. Inhalation Toxicology, 20(8), 761—766. Stevenson, M., Alexander, B., Baxter, C. S., & Leung, Y.-K. (2015). Evaluating Endocrine Disruption Activity of Deposits on Firefighting Gear Using a Sensitive and High Throughput Screening Method. Journal of Occupational and Environmental Medicine / American College of Occupational and Environmental Medicine, 57(12), e153—7. Stingone, J. A., Luben, T. J., Daniels, J. L., Fuentes, M., Richardson, D. B., Aylsworth, A. S., … National Birth Defects Prevention Study. (2014). Maternal exposure to criteria air pollutants and congenital heart defects in offspring: results from the national birth defects prevention study. Environmental Health Perspectives, 122(8), 863—872. Thibodeaux, J. R., Hanson, R. G., Rogers, J. M., Grey, B. E., Barbee, B. D., Richards, J. H., … Lau, C. (2003). Exposure to perfluorooctane sulfonate during pregnancy in rat and mouse. I: maternal and prenatal evaluations. Toxicological Sciences : An Official Journal of the Society of Toxicology, 74(2), 369—381.

References Thuresson, K., Höglund, P., Hagmar, L., Sjödin, A., Bergman, A., & Jakobsson, K. (2006). Apparent half-lives of hepta- to decabrominated diphenyl ethers in human serum as determined in occupationally exposed workers. Environmental Health Perspectives, 114(2), 176—181. Toms, L.-M. L., Mazaheri, M., Brommer, S., Clifford, S., Drage, D., Mueller, J. F., … Harden, F. A. (2015). Polybrominated diphenyl ethers (PBDEs) in dust from primary schools in South East Queensland, Australia. Environmental Research, 142, 135—140. Verhofstad, N. (2010). Paternal exposure to benzo(a)pyrene a genetic risk in offspring? (Thesis). Vested, A., Ramlau-Hansen, C. H., Olsen, S. F., Bonde, J. P., Kristensen, S. L., Halldorsson, T. I., … Toft, G. (2013). Associations of in utero exposure to perfluorinated alkyl acids with human semen quality and reproductive hormones in adult men.

Fire research report Presented by: Michelle Engelsman

Similar presentations

Presentation on theme: "Fire research report Presented by: Michelle Engelsman"— Presentation transcript:

Similar presentations

About project

Feedback

Log in

Auth with social network:

Fire research report Presented by: Michelle Engelsman

Similar presentations

Presentation on theme: "Fire research report Presented by: Michelle Engelsman"— Presentation transcript:

Similar presentations

About project

Feedback