Is a Dry Eye Disorder in Firefighters an Occupational Disease?
DOI:
https://doi.org/10.23749/mdl.v114i2.13472Keywords:
Dry eye disorder, Firefighters, Fire smoke, Occupational disease, Ocular surface disease index, Tear break-up time, Schirmer testAbstract
Background: To examine firefighters (FFs) exposed to high levels of fire smoke and, as a result, to uncover risk factors for dry eye disorder (DED) compared to age-and gender-matched healthy individuals.
Methods: In this cross-sectional study, 51 FFs from the Afyonkarahisar Municipality Fire Department were chosen at random (group 1). A control group (group 2) included 51 age- and gender-matched healthy individuals. The Ocular Surface Disease Index (OSDI) questionnaire was administered after all participants were thoroughly explained the study's objectives and procedures. Then, using a portable hand biomicroscope, an ocular exam was performed on-site. DED was defined as a non-anesthetic Schirmer test result of <10 mm and/or a tear film break-up time (TBUT) of <5 seconds.
Results: Groups 1 and 2 had mean ages of 44.82±7.29 and 44.73±7.41 years, respectively (p=0.946). The median work duration in group 1 was 14 years (min-max: 1-27 years). TBUT test revealed a significantly increased DED prevalence in group 1 than group 2 (p=0.046). Despite the non-significant difference (p=0.276), Schirmer test revealed that group 1 had a higher DED prevalence than group 2. The OSDI score revealed that group 1 had more mild, moderate, and severe DED than group 2 (p=0.359). Longer work duration was associated with a higher DED prevalence (p=0.179).
Conclusions: Given the high prevalence of fire smoke-induced DED in FFs, preventive measures such as regular ocular exams, encouraging personal protective equipment usage, and health education programs can assist in avoiding complications and reducing the burden of ocular diseases.
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References
Kimani K, Lindfield R, Senyonjo L, et al. Prevalence and causes of ocular morbidity in Mbeere District, Kenya. Results of a population-based survey. PLoS One. 2013;8(8):e70009. doi:10.1371/journal.pone.0070009
The Health and Safety Executive. A Recipe for Safety: Occupational Health and Safety in Food and Drink Manufacture. 2nd ed. 2015, ISBN: 978 0 7176 6646 1; Series code: HSG252
Khurana A. Diseases of the Lens. Comprehensive Ophthalmology 4th ed. New Delhi: New Age International (p) Limited. 2007:170.
Pflugfelder SC. Prevalence, burden, and pharmacoeconomics of dry eye disease. Am J Manag Care. 2008;14(3 Suppl):S102-S106.
Kawashima M, Sano K, Takechi S, Tsubota K. Impact of lifestyle intervention on dry eye disease in office workers: a randomized controlled trial. J Occup Health. 2018;60(4):281-288. doi:10.1539/joh.2017-0191-OA.
Zhou Y, Murrough J, Yu Y, et al. Association Between Depression and Severity of Dry Eye Symptoms, Signs, and Inflammatory Markers in the DREAM Study. JAMA Ophthalmol. 2022;140(4):392-399. doi:10.1001/jamaophthalmol.2022.0140.
Miljanović B, Dana R, Sullivan DA, Schaumberg DA. Impact of dry eye syndrome on vision-related quality of life. Am J Ophthalmol. 2007;143(3):409-415. doi:10.1016/j.ajo.2006.11.060.
Guo OD LW, Akpek E. The negative effects of dry eye disease on quality of life and visual function. Turk J Med Sci. 2020;50(SI-2):1611-1615. doi:10.3906/sag-2002-143.
Gledhill N, Jamnik VK. Characterization of the physical demands of firefighting. Can J Sport Sci. 1992;17(3):207-213.
Oliveira M, Slezakova K, Alves MJ, et al. Firefighters' exposure biomonitoring: Impact of firefighting activities on levels of urinary monohydroxyl metabolites. Int J Hyg Environ Health. 2016;219(8):857-866. doi:10.1016/j.ijheh.2016.07.011.
Griffith GA, Jones NP. Eye injury and eye protection: a survey of the chemical industry. Occup Med (Lond). 1994;44(1):37-40. doi:10.1093/occmed/44.1.37.
Bhutia P, Sen S, Nath T, Shamshad MA. The effect of smoking on ocular surface and tear film based on clinical examination and optical coherence tomography. Indian J Ophthalmol. 2021;69(7):1693-1696. doi:10.4103/ijo.IJO_2840_20.
Li J, Zhang G, Nian S, et al. Dry eye induced by exposure to cigarette smoke pollution: An in vivo and in vitro study. Free Radic Biol Med. 2020;153:187-201. doi:10.1016/j.freeradbiomed.2020.04.007.
Soteriades ES, Smith DL, Tsismenakis AJ, Baur DM, Kales SN. Cardiovascular disease in US firefighters: a systematic review. Cardiol Rev. 2011;19(4):202-215. doi:10.1097/CRD.0b013e318215c105.
Dobson M, Choi B, Schnall PL, et al. Exploring occupational and health behavioral causes of firefighter obesity: a qualitative study. Am J Ind Med. 2013;56(7):776-790. doi:10.1002/ajim.22151.
Schiffman RM, Christianson MD, Jacobsen G, Hirsch JD, Reis BL. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol. 2000;118(5):615-621. doi:10.1001/archopht.118.5.615.
Pflugfelder SC, Tseng SC, Sanabria O, et al. Evaluation of subjective assessments and objective diagnostic tests for diagnosing tear-film disorders known to cause ocular irritation. Cornea. 1998;17(1):38-56. doi:10.1097/00003226-199801000-00007.
Paugh JR, Tse J, Nguyen T, et al. Efficacy of the Fluorescein Tear Breakup Time Test in Dry Eye. Cornea. 2020;39(1):92-98. doi:10.1097/ICO.0000000000002148.
Li K, Lipsey T, Leach HJ, Nelson TL. Cardiac health and fitness of Colorado male/female firefighters. Occup Med (Lond). 2017;67(4):268-273. doi:10.1093/occmed/kqx033.
Tavares Fde P, Fernandes RS, Bernardes TF, Bonfioli AA, Soares EJ. Dry eye disease. Semin Ophthalmol. 2010;25(3):84-93. doi:10.3109/08820538.2010.488568.
The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007;5(2):75-92. doi:10.1016/s1542-0124(12)70081-2.
Altinors DD, Akça S, Akova YA, et al. Smoking associated with damage to the lipid layer of the ocular surface. Am J Ophthalmol. 2006;141(6):1016-1021. doi:10.1016/j.ajo.2005.12.047.
Solberg Y, Rosner M, Belkin M. The association between cigarette smoking and ocular diseases. Surv Ophthalmol. 1998;42(6):535-547. doi:10.1016/s0039-6257(98)00002-2.
Thomas J, Jacob GP, Abraham L, Noushad B. The effect of smoking on the ocular surface and the precorneal tear film. Australas Med J. 2012;5(4):221-226. doi:10.4066/AMJ.2012.1035.
Matsumoto Y, Dogru M, Goto E, et al. Alterations of the tear film and ocular surface health in chronic smokers [published correction appears in Eye. 2008 Jul;22(7):983]. Eye (Lond). 2008;22(7):961-968. doi:10.1038/eye.2008.78.
Yoon KC, Song BY, Seo MS. Effects of smoking on tear film and ocular surface. Korean J Ophthalmol. 2005;19(1):18-22. doi:10.3341/kjo.2005.19.1.18.
Hashmani N, Mustafa FG, Tariq MA, et al. Distribution and Correlation of Ocular Surface Disease Index Scores in a Non-Clinical Population: The Karachi Ocular Surface Disease Study. Cureus. 2020;12(7):e9193. Published 2020 Jul 15. doi:10.7759/cureus.9193.
Fabian TZ GP. Smoke Characterization Project: Technical Report. Northbrook IL: Underwriters Laboratories, Inc. ; April 2007
Kumah DB, Mohammed AK, Ablordeppey RK, et al. Eye Conditions among Fire Officers in the Brong Ahafo Region, Ghana. Int J Open Access Ophthal. 2017;2(1):5. DOI: 10.15226/2474-9249/2/1/00118.
Harris CR, Jenkins M, Glaser D. Gender Differences in Risk Assessment: Why do Women Take Fewer Risks than Men? Judgment and Decision Making. 2006;1(1):48-63.
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