Spirometry and mannitol bronchial challenge test among firefighters in Bhuj district: a questionnaire based study

Kashyap Buch, Vinayak Chauhan


Background: Asthma is a common chronic lung disease that inflames and narrows the airways. It causes recurring period of wheezing, chest tightness, shortness of breath and coughing.

Methods: A questionnaire, spirometry, direct and indirect airway challenge tests, exhaled nitric oxide, and skin-prick tests were administered prospectively to 100 out of 120 firefighters employed in Bhuj district, Gujarat, India. Asthma was defined as the combination of respiratory symptoms with airway hyper responsiveness.

Results: Twenty out of 100 firefighters (12%) had physician-diagnosed asthma, which could be confirmed in 8 firefighters. In contrast, asthma was diagnosed in 28% (28 of 100 firefighters). Wheezing was the most sensitive symptom for the diagnosis of asthma (sensitivity, 88%; specificity, 90%).

Conclusions: Asthma was considerably under diagnosed in firefighters. The combination of a structured symptom questionnaire with a bronchial challenge test allows identifying patients with asthma and should routinely be used in the assessment of active firefighters and may be of help when evaluating candidates for this profession.


Asthma, Firefighters, Mannitol bronchial challenge test, Spirometry

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Kim KH, Jahan SA, Kabir E. A review on human health perspective of air pollution with respect to allergies and asthma. Environment International. 2013;59:41-52.

Plaut TF. One Minute Asthma: What you need to know: Pedipress, Inc., 2005. Available at

National Asthma Education, Prevention Program (National Heart, Lung, Blood Institute). Second Expert Panel on the Management of Asthma. Expert panel report 2: Guidelines for the diagnosis and management of asthma. DIANE Publishing; 1997. Available at

Berger WE. Asthma for Dummies: John Wiley and Sons, 2004.

Gagnon D, Morningstar A: Breathe Free: Nutritional and Herbal Care for Your Respiratory System: Lotus Press, 1991.

Oosterlee A, Drijver M, Lebret E, Brunekreef B. Chronic respiratory symptoms in children and adults living along streets with high traffic density. Occupational Environmental Med 1996;53:241-7.

Chan-Yeung M. Assessment of asthma in the workplace. Chest J. 1995;108:1084-117.

Miedinger D, Chhajed PN, Tamm M, Stolz D, Surber C, Leuppi D. Diagnostic tests for asthma in firefighters. Chest J. 2007;131:1760-7.

Aggarwal A, Chaudhry K, Chhabra S, Souza GD, Gupta D, Jindal S, et al. Prevalence and risk factors for bronchial asthma in Indian adults: a multicentre study. Indian J Chest Dis Allied Sci. 2006;48:13.

Camargo C, Richardson LD, Brenner B. Epidemiology of asthma. Clin Allergy Immunol. 1999;13:59-80.

Kelly YJ, Brabin BJ, Milligan P, Reid JA, Heaf D, Pearson M. Clinical significance of cough and wheeze in the diagnosis of asthma. Arch Dis Childhood. 1996;75:489-93.

Brisman J. Asthma and asthma-like symptoms in adults assessed by questionnaires. A literature revie.w. Chest J 1993;104:600-8.

Toren K, Brisman J, Jarvholm B. Asthma and asthma-like symptoms in adults assessed by questionnaires: a literature review. Chest. 1993;104:600-8.

Henderson ND, Berry MW, Matic T. Field measures of strength and fitness predict firefighter performance on physically demanding tasks. Personnel Psychol. 2007;60:431-73.