Effect of Firefighting and On-Scene Rehabilitation on Hemostatsis

描述(由申请者提供)：消防已被国家职业研究议程(NRA)创伤伤害小组确定为创伤伤害的高危职业，因为消防员(FF)经常穿着沉重、狭窄的衣服，经常在炎热和恶劣的环境中执行艰苦的体力工作。单独来看，这些因素中的每一个都会给心血管系统带来巨大的压力。加在一起，它们导致了因心脏病发作而导致的职业性死亡率最高的FF。众所周知，心肌梗死(Mis)占FF因公死亡的近50%，但我们不知道心肌梗死发生的机制，也不了解现场干预在缓解热应激或心血管紧张方面的效果，这可能导致心肌梗死。这项研究将研究身体负担消防任务如何影响关键止血变量，以及现场康复(OSR)干预如何影响这些措施。具体地说，这项初步研究将调查消防对体温、血小板功能、促凝血、抗凝、纤溶原和抗纤溶标志物的影响，并将记录这些变量在2小时内恢复的程度。受试者将参加两个单独的试验，这两个试验将只在OSR成分上有所不同，从而允许研究人员检查OSR对体温、止血和心理生理变量以及随后的身体和心理表现的影响。这项研究将为消防对止血系统的影响提供重要的科学信息，并将为OSR在减轻危险的热应激条件、缓解CV应变和改善FF性能方面的有效性提供实用信息。OSR被广泛推荐，但到目前为止，还没有科学研究证明FF OSR的有效性或区分不同策略的有效性。由于消防人员经常被要求将公民从危险中解救出来，这一职业群体的健康和表现对公众健康具有重大影响。此外，根据这项初步研究和未来研究制定的康复干预措施可能对其他涉及在高热应激条件下工作的职业有用。对FF有效的干预措施将适用于其他面临高热压力或多种压力源的职业，就像为运动员设计的运动饮料被发现有利于建筑和采矿等职业一样。

DESCRIPTION (provided by applicant): Firefighting has been identified as a high-risk occupation for traumatic injuries by the National Occupational Research Agenda (NORA) Traumatic Injury Team as firefighters (FF) routinely performing physically strenuous work in heavy, constricting clothing and often in hot and hostile environments. Individually, each of these factors place great strain on the cardiovascular (CV) system. Combined, they contribute to FFs having the highest rate of occupational fatalities due to heart attacks. It is known that myocardial infarctions (MIs) account for nearly 50% of line of duty deaths in FF, but we do not know the mechanisms by which MIs occur nor do we understand the effect of on-scene interventions in mitigating heat stress or CV strain, which can lead to MIs. This study will examine how physically taxing firefighting tasks influence key hemostatic variables and how on scene rehabilitation (OSR) interventions impact these measures. Specifically, this initial study will investigate the effect of firefighting on body temperature, platelet function, procoagulatory, anticoagulatory, profibrinolytic, and antifibrinolytic markers, and will document the extent to which these variables recover within 2 hours. Subjects will participate in two separate trials that will differ only in the OSR component, thus permitting researchers to examine the effect of OSR on body temperature, hemostasis, and psycho-physiological variables as well as on subsequent physical and psychological performance. This study will provide important scientific information regarding the effect of firefighting on the hemostatic system and will provide practical information on the effectiveness of OSR to lessen dangerous heat stress conditions, mitigate CV strain, and improve FF performance. OSR is widely recommended, yet to date there is no scientific study that documents the efficacy of FF OSR or that differentiates the effectiveness of different strategies. As FFs are routinely called upon to rescue citizens from danger, the health and performance of this occupational group has a significant effect on public health. Additionally, rehabilitation interventions developed from this initial study and future studies may be useful for other occupations involving work in conditions of high heat stress. Interventions that are effective for FF will find application in other occupations that face high heat stress or multiple stressors in a manner similar to the way that sports drinks designed for athletes have been found to benefit occupations such as construction and mining.