Effect of Firefighting and On-Scene Rehabilitation on Hemostatsis

描述（由申请人提供）：消防已被国家职业研究议程（NORA）外伤小组确定为创伤性损伤的高风险职业，因为消防员（FF）经常穿着笨重、狭窄的衣服，在炎热和恶劣的环境中进行体力艰苦的工作。单独来说，这些因素中的每一个都给心血管系统带来了很大的压力。综上所述，这些因素导致FFs因心脏病发作而导致的职业死亡率最高。众所周知，心肌梗死（MIs）占FF值勤死亡的近50%，但我们不知道心肌梗死发生的机制，也不了解现场干预对减轻可能导致心肌梗死的热应激或CV应变的影响。本研究将研究体力繁重的消防任务如何影响关键的止血变量，以及现场康复（OSR）干预措施如何影响这些措施。具体来说，这项初步研究将调查消防对体温、血小板功能、促凝、抗凝、纤溶和抗纤溶标志物的影响，并记录这些变量在2小时内恢复的程度。受试者将参加两个单独的试验，仅在OSR成分上有所不同，从而允许研究人员检查OSR对体温、止血、心理生理变量以及随后的生理和心理表现的影响。本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在减少危险热应激条件、减轻CV应变和提高FF性能方面的有效性提供实用信息。OSR被广泛推荐，但迄今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。由于医务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有重大影响。此外，从这项初步研究和未来的研究中发展出来的康复干预措施可能对其他涉及高热应激条件下工作的职业有用。对FF有效的干预措施将在其他面临高热应激或多种应激源的职业中得到应用，就像为运动员设计的运动饮料被发现有益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.