Carbon monoxide exposures in wildland firefighters in the United States and targets for exposure reduction

Background: Every year thousands of wildland firefighters (WFFs) work to suppress wildfires to protect public safety, health, and property. Although much effort has been put toward mitigating air pollutant exposures for the public and WFFs, the current burden in this worker population is unclear as are the most effective exposure reduction strategies. Objective: Quantify fireline carbon monoxide (CO) exposures in WFFs and identify predictors of exposures. Methods: We collected 1-min breathing zone CO measurements on 246 WFFs assigned to fires between 2015 and 2017. We used generalized estimating equations to evaluate predictors of CO exposure. Results: Approximately 5% of WFFs had fireline CO exposure means exceeding the National Wildfire Coordinating Group’s occupational exposure limit of 16 ppm. Relative to operational breaks, direct suppression-related job tasks were associated with 56% (95% CI: 47%, 65%) higher geometric mean CO concentrations, adjusted for incident type, crew type, and fire location. WFF perception of smoke exposure was a strong predictor of measured CO exposure. Significance: Specific job tasks related to direct suppression and WFF perceptions of smoke exposure are potential opportunities for targeted interventions aimed at minimizing exposure to smoke.