Occupational and Environmental Lung Diseases Laboratory – Prof. Lizy Fireman >>

Occupational & Environmental Lung Diseases Laboratory


Our Vision

The Laboratory of Occupational and Environmental Lung Diseases, located in the Tel Aviv Medical Center and affiliated to the Tel Aviv University, is the sole facility of its kind in Israel for studying environmental and occupational exposures and their effects on human health and disease. Exposomics detect the overall effective dose that induces injury and disease, and the lab focuses upon exposomics by performing biological monitoring. We use sputum induction and exhaled breath condensate by means of noninvasive techniques to retrieve sputum and condensate from the middle airways, in order to monitor past and recent exposures. OUR GOAL AND VISION ARE TO TRANSLATE OUR FINDINGS INTO NEW STRATEGIES FOR PREVENTION AND TREATMENT OF PULMONARY DISEASES. In this context, we can bring the bench to the bedside to determine the causes of biological, environmental and occupational diseases.


Contact Us

Primary Investigators
General Contact
מור דחבש

Mor Dahbash, MSc, Lab Manager

03 - 6947378 mord@tlvmc.gov.il


Sammy Ofer Heart Building

Floor 10 Room 22



The use of bio-monitoring to assess and protect workers exposed to nano-scale materials

(A) Percentile of ultrafine particles (UFP) in induced sputum (IS) samples and artificial stone dust (ASD) in exposed workers and non-exposed subjects.
(B) Particle size distribution (PSD) of ASD compared with natural stone.
(C) Percentile of UFP in IS samples of exposed workers versus non-exposed subjects.
PSD was evaluated by a Donner Tech Innovative Particle Analyzer (DIPA) analyser, and UFP were evaluated by a NanoSight LM20 in the sputum specimens and in the dust collected from an artificial stone factory. The y-axis represents the frequency for each size. *P<0.05 was considered significant by Mann-Whitney test. The results are ±SE of at least six independent experiments.

In the present project, we use an interventional method (“fitting test”) to personalize the use of the masks. The biological testing of nano-scaled particles will be done before and after the workers have learned and implemented the fitting test to maximize its effect.

The correlation between particulate matter (PM) burden and health hazards in the Haifa Bay area (HBA) compared to Tel Aviv area (TA)

Our laboratory conducts research on biological monitoring by using biological samples (induced sputum and exhaled breath condensate) to measure particulate matter (PM) in the airways. The maps in the figure display completely different patterns when using data retrieved from biological monitoring vs environmental monitoring.
The goal of this project is to show the real pollution status in the Haifa Bay (compared to Tel Aviv metropolitan area), that can not be measured by environmental stations but rather by “human stations”.


Our Team

Current Staff
Past Staff

Resident MD Students

PhD Students

MSc Students

MD Students

Current funding


Highlight Publications

Quantitation of silica contents in lung explants of transplanted patients: artificial stone-induced silicosis vs. idiopathic pulmonary fibrosis.

Fireman E, Mahamed AE, Rosengarten D, Noach Ophir N and Kramer MR.

Int. J. Environ. Res. Public Health 2021, 18, 7237.

Association between elevated serum bilirubin levels with preserved lung function under conditions of exposure to air pollution.
Shapira U, Brezinski RY, Rogowski O, Zeltser D, Berliner S, Shapira I, Shenhar-Tsarfaty S, Fireman E. BMC Pulm Med 2021 Apr 13;21(1):119.

Eosinophil cell count in bronchoalveolar lavage fluid in early childhood wheezing: is it predictive of future asthma?

Gut G, Armoni Domany K, Sadot E, Soferman R, Fireman E, Sivan Y.Gut G, et al.  J Asthma. 2020 Apr;57(4):366-372.

More Publications >>

Ultrafine particles in airways: a novel marker of COPD exacerbation risk and inflammatory status.  

Fireman Klein E, Adir Y, Krencel A, Peri R, Vasserman B, Fireman E, Kessel A. Int J Chron Obstruct Pulmon Dis. 2019 Mar 1;14:557-56

Functional, inflammatory, and interstitial impairment due to artificial stone dust ultrafine particles exposure.

Ophir N, Bar Shai A, Korenstein R, Kramer MR, Fireman E. BMJ 2019 Dec;76(12):875-879.

Is induced sputum a useful noninvasive tool in the diagnosis of pulmonary sarcoidosis?

Baha A, Yıldırım F, Stark M, Kalkancı A, Fireman E, Köktürk N. Turk Thorac J. 2019 Aug 19;20(4):248-252.

Sputum anticitrullinated protein antibodies in patients with long-standing rheumatoid arthritis.

Polachek A, Vree Egberts W, Fireman E, Druckman I, Stark M, Paran D, Kaufman I, Wigler I, Levartovsky D, Caspi D, Pruijn GJM, Elkayam O. J Clin Rheumatol. 2018 Apr;24(3):122-126.

A novel combined score of biomarkers in sputum may be an indicator for lung cancer: A pilot study.

Bar-Shai A, Shenhar-Tsarfaty S, Ahimor A, Ophir N, Rotem M, Alcalay Y, Fireman E. Clin Chim Acta. 2018 Dec;487:139-144.2018.

Interstitial lung diseases associated with metal content in silicone breast implants: a case series.

Fireman E, Rosengarten D, Zelinger E, Kramer MR. Sarcoidosis Vasculitis and Diffuse Lung Diseases. 35: 381-389 2018.

Differential pattern of deposition of nanoparticles in the airways of exposed workers.

Fireman E, Edelheit R, Stark M, Bar Shai A. J Nanopart Res. 2017;19(2).

Identification of metal sensitization in sarcoid-like metal-exposed patients by the MELISA® lymphocyte proliferation test — a pilot study.

Fireman E, Alcalay Y, Ophir N,  Kivity S,  Stejskal V. Journal of Occupational Medicine and Toxicology. Mar 17, 2016 2: 00086.

Artificial stone dust-induced functional and inflammatory abnormalities in exposed workers monitored quantitatively by biometrics.

Ophir N., Bar Shai A, Alkalay Y,  Israeli S, Korenstein  R ,Krermer M,  Fireman E. ERJ Research March 17 2016 2:86

Mapping air pollution by biological monitoring in the Tel-Aviv metropolitan area.

Lavi A, Potchter O, Omer I, Fireman E. Int J Environ Health Res. 2015 Nov 24:1-15.

fingerprint of endogenous lung fluid ultra-fine-particles, a novel marker of acute lung inflammation.

Bar-Shai A, Alcalay Y, Adi Sagiv, A Rotem M , Alon R, Fireman E. Respirology. 2015 Jun 10.

Ultrafine particle content in exhaled breath condensate in airways of asthmatic children.

Benor  S, Alcalay Y, Armoni Domany K, Gut G, Soferman S, Kivity S, Fireman E. J Breath Res 2015 Apr 1;9(2).

An Official American Thoracic Society Statement: diagnosis and management of beryllium sensitivity and chronic beryllium disease.

Balmes JR, Abraham JL, Dweik RA, Fireman E, Fontenot AP, Maier LA, Muller-Quernheim J, Ostiguy G, Pepper LD, Saltini C, Schuler CR, Takaro TK, Wambach PF; ATS Ad Hoc Committee on Beryllium Sensitivity and Chronic Beryllium Disease .Am J Respir Crit Care Med. 2014 Nov 15;190(10(.

Biological monitoring of particulate matter accumulated in the lungs of urban asthmatic children in the Tel-Aviv area.

Fireman E, Bliznuk B, Schwarz Y, Soferman R,  Kivity S. International Archives of Occupational Environmental Health 2014 Aug 20.

A novel alternative to environmental monitoring to detect workers at risk for beryllium exposure-related health effects.

Fireman E, Lerman Y, Stark M, PardoA, Schwarz Y V. Van Dyke M, Jill Elliot J, Barkes B, Newman L, Maier L. Journal Occupational Environmental Hygiene 2014 Dec;11(12):809-18.

Biological exposure metrics of beryllium-exposed dental technicians.

Stark M, Lerman Y,  Kapel A, Pardo A, Schwartz Y, Newman L, Maier L,  Fireman E. Archives of Occupational Environmental Health 2014;69(2):89-99.

Chest wall shrapnel-induced chronic beryllium disease.

Fireman E,  Bar Shai A, Lerman Y,  Topilsky M, Blanc P,  Maier L, Li L, Chandra S, Abraham JM, Fomin I, Aviram G, Abraham JL. Sarcoidosis Vasc Diffuse Lung Dis. 2012 Oct;29(2):147-50.

Less Publications >>


From The Press

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