By Stephanie Stevens, MA

Bob, an experienced firefighter and trainer started to experience chest pain, shortness of breath, and a cough with blood following a firefighter training that he set up and led. At the emergency room, the doctor ruled out a blood clot in his lungs. However, an x-ray did show Bob had small nodules in his lungs.

Bob’s doctor asked him to walk him through his activities the day his symptoms started. Bob explained some of the tasks involved with setting up and running the training. Concerned about the amount of smoke simulant Bob may have inhaled, his doctor asked, “do you know what that smoke is made of?” “It’s an oil-based smoke,” Bob said, “I’m pretty sure it isn’t hazardous.” The doctor had his answer.

Bob was exposed to mineral oil mist from the smoke simulant. Even short-term inhalation exposures to mineral oil mist, such as when Bob adjusted the supply nozzle or when he briefly opened the door to check on the progress of the smoke and fire, can cause an uncommon condition called lipoid pneumonia. Other health effects from acute exposure to mineral oil mists may include eye, skin, and upper respiratory tract infection, central nervous effects, and respiratory distress.

While rare, lipoid pneumonia is also known as “fire-eaters lung” because it has been documented in a small occupational group of performers (fire-eaters) who use liquid hydrocarbons for flame blowing.

Other occupations such as actors may also encounter oil- or glycol-based theatrical smoke, however, in a theater, the smoke is typically used sparingly to create effects without obscuring the scene, whereas in firefighter training, it is used liberally, creating high concentrations of particulate to create low to no visibility conditions. Thus, the health risk from simulated smoke used in firefighter training is expected to be…

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