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• W2054548892 abstract "This month's issue contains two reports which should be of interest to all physicians, particularly those involved in pulmonary, critical care, and industrial medicine. The first, by Genovesi et al (see page 441), is a study of a group of firemen in Los Angeles following their acute exposure to smoke and emphasizes the dangers of the asymptomatic and unexpected occurrence of hypoxemia and carboxyhemoglobinemia in individuals exposed to toxic products of combustion, particularly in fires involving materials made of polyvinyl chloride.1Dyer RF Esch VH Polyvinyl chloride toxicity in fires.JAMA. 1976; 235: 393-399Crossref PubMed Scopus (103) Google Scholar All physicians should be aware of these two potential problems when treating victims of fires, making sure that oxygen is routinely administered as soon as possible and that the patient is observed carefully for (1) cerebral complications of the inhalation of carbon monoxide2Zarem HA Rattenborg CC Harmel MH Carbon monoxide toxicity in human fire victims.Arch Surg. 1973; 107: 851-853Crossref PubMed Scopus (16) Google Scholar and (2) the respiratory insufficiency which may ensue after a deceptively tranquil interval.3Webster JR McCabe MM Karp M Recognition and management of smoke inhalation.JAMA. 1967; 201: 287-290Crossref PubMed Scopus (12) Google Scholar Cardiac, as well as pulmonary, systems are affected by the altered physiology which results from this toxic exposure, especially during early critical periods. This requires that the physicians involved know and be prepared to practice all of the techniques for evaluation and treatment of the adult respiratory distress syndrome, noncardiac pulmonary edema, cardiac failure, airway injury, sepsis, lactic acidosis due to carboxyhemoglobinemia with tissue hypoxia,4Buehler JH Berns AS Webster JR Lactic acidosis from carboxyhemoglobinemia after smoke inhalation.Ann Intern Med. 1975; 82: 803-805Crossref PubMed Scopus (33) Google Scholar and so forth. The second report, by Tashkin et al (see page 445), discusses the respiratory status of this group of firemen one month after their acute exposure. They concluded that there was no evidence of development of subsequent chronic respiratory impairment. These findings are somewhat at variance with the results from other investigators who have reported an increased prevalence of chronic nonspecific respiratory symptoms in firemen and have concluded that fighting fires is a risk factor for the development of chronic pulmonary problems.5Peters JM Theriault GP Fine LJ Chronic effect of fire fighting on pulmonary function.N Engl J Med. 1974; 291: 1320-1322Crossref PubMed Scopus (66) Google Scholar Welldesigned prospective studies should provide data for settling this issue, but it is encouraging to note that while fighting fires may be a high-risk job, it seems to have low morbidity. Final resolution of these differences may have implications for other occupational groups besides firemen. The increasing interest in and the importance of the effects of inhalation of the toxic products of combustion are appropriate to the hazards surrounding us in today's plastic and toxic environment. A final caveat: we, as physicians, must remember that the most dangerous smoke to which the majority of our patients are chronically exposed is from cigarettes and that this is the great challenge of preventive medicine in 1976." @default.
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• W2054548892 date "1977-04-01" @default.
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• W2054548892 title "Smoke and Fire—1977" @default.
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• W2054548892 doi "https://doi.org/10.1378/chest.71.4.438" @default.
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