National Institute of Allergy and Infectious Diseases (NIAID)
Background: Exposure to smoke increases the risk of many diseases. People can be exposed to dangerous levels of smoke during wildfires. Also, smoke from fires that burn manmade materials may contain toxic chemicals. Researchers want to know more about how breathing smoke affects a person s airways (nose, sinuses, lungs) and immune system. Objective: To learn how exposure to smoke over time affects the health of people who work as firefighters. Eligibility: Healthy, nonsmoking people aged 18 to 65 years who work as firefighters. Some people older than 65 may also be included. Design: Participants will have study visits about every 6 months for up to 10 years. They will also have visits after a smoke exposure event. Some visits may be by telehealth. Each visit will include some or all of the following: Imaging scans of the sinuses or chest. Sample collection. These will include blood, nasal fluids, a skin swab, urine, and fluid coughed up from the lungs. Lung function test. Participants will blow air into a machine that measures the volume moving in and out of their lungs. Particles in exhaled air (PExA). Participants will breathe into a device that collects particles. Heart function test. Smell test. Participants will identify odors on scratch-and-sniff cards. Wearable air monitors. Participants may be asked to wear a device that measures particles and chemicals in the air around them for 1 to 20 days. International Public Safety Data Institute (IPSDI) reports. Participants will provide copies of these fire suppression event reports, if they are available. Participants who have exams of the airways as part of their routine health care may have extra tissue samples collected for research.
Study Description: This observational natural history study (FLARES) will define the acute and longterm airway, respiratory and immune consequences of anthropogenic smoke exposures that arise from urban and wildland urban interface (WUI) fires. Given their disproportionate exposure, firefighters will be used as a model. The protocol integrates (1) standardized clinical phenotyping, (2) detailed exposure assessment, and (3) multi-omic profiling to enable evidence-based management of smoke- and pollutant-related respiratory impairment. FLARES will enroll firefighter recruits and active-duty fi…
* INCLUSION CRITERIA: To be eligible to participate in this study, an individual must meet all of the following criteria: 1. Stated willingness to comply with all study procedures and availability for the duration of the study. 2. Aged 18 to 65 at time of enrollment. Firefighters over the age of 65 may be enrolled per investigator discretion. 3. In good general health as evidenced by medical history. 4. Have or are willing to obtain a non-NIH primary physician who will manage all health conditions and be responsive for emergency medical treatment, if required. 5. Able to provide informed con…