Background: Special police forces with extensive gunshot emissions in indoor shooting ranges suffered progressively from respiratory symptoms associated with their shooting practice. Therefore, we conducted an exploratory cross-sectional study to investigate clinical and functional parameters of respiratory health in police officers - the Berlin Shooting Range Study.

Methods: Clinical investigations, using records and questionaires, lung function tests and investigations of blood and urine samples for antimony, lead, manganese from Berlin police officers and controls were performed, who were divided into 3 groups based on exposure to gunshot emissions: high-exposure (n=53), low-exposure (n=94), and no exposure (n=76).

Results: Higher exposure was associated with more respiratory symptoms (64% vs. 21%, p<0.001) compared to the low-exposure group. Headache, cough, discoloured mucous and shortness of breath were also more common as were some other symptoms. The cough symptomatology of the high exposure group also persisted significantly longer (median: 0.67 days vs. 0.01 days, range: 0 to 5 days, p=0.029) compared to the low exposure group. They also showed a lower FEV1/FVC quotient (Tiffeneau Index, p=0.018 between the three groups, and p=0.005 for the high-exposure group), a possible marker of early, subclinical bronchial obstruction.

Conclusions: These first results suggest, that long-term exposure to gunshot emissions induces bronchitic reactions due to repeated irritation of the airways. Therefore, we recommend a reduction of exposure to gunshot emissions in order to decrease symptoms and avoid any - even small - deterioration in spirometry.