Grant To Assess Heat Stress In Firefighters And Establish Fire And EMS Rehabilitation Protocols.

Main Category: Cardiovascular / Cardiology
Also Included In: Public Health;  Rehabilitation / Physical Therapy
Article Date: 26 Aug 2007 - 3:00 PDT

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Researchers at the University of Pittsburgh School of Medicine's department of emergency medicine, in collaboration with the Allegheny County Fire Academy, have received a Federal Emergency Management Agency (FEMA) Fire Prevention and Safety grant to conduct a study designed to develop optimal methods of reducing acute cardiovascular risk resulting from exposure to heat stress during fire suppression.

According to a July 2007 National Institute for Occupational Safety and Health (NIOSH) report, sudden cardiac death represents the most common cause of line-of-duty deaths among firefighters, killing approximately 45 each year. It is suspected that many of these deaths are triggered by heat stress, which can be caused by exposure to the fire and the use of personal protective garments.

The report also found that, for firefighters, coronary artery disease and sudden cardiac death involve a combination of personal and work-related factors. Personal factors can include age, gender, family history, diabetes, hypertension, smoking, high cholesterol, obesity and lack of exercise. Work-related factors can include exposure to fire smoke, heavy physical exertion, heat stress and other physical stresses.

"The Allegheny County Department of Emergency Services through the County Fire Training Academy is pleased to work with the University of Pittsburgh's department of emergency medicine to enhance fire safety and reduce the amount of line-of-duty deaths among fire and rescue workers," said Robert A. Full, Chief of Emergency Services and Fire Marshal, Allegheny County. "What an advantage it is to have the resources of a world-class health organization available to us in order to perform our jobs to the best of our ability."

The two-year study, known as the Fire ground Rehab Evaluation (FIRE) Trial, will assess the best methods for maintaining the health and safety of firefighters while in the line of duty, called fire ground rehabilitation.

Currently, fire ground rehabilitation is inconsistent across the profession due to size and scope of each organization. Changing behavior can be difficult especially in the fire and rescue community, where taking a break can be viewed as a sign of weakness.

"During the FIRE trial, we will be looking for the right threshold at which fire ground rehabilitation should be administered and investigating the efficacy of different methods of rehabilitation that can be administered at fire scenes. The study is designed to improve firefighter health and safety by providing an improved understanding of the mechanisms of heat stress and its effects on the heart. We anticipate that the study will result in improved methods of prevention and treatment of heat-related cardiovascular stress that can be adopted by fire departments across the United States," said David Hostler, Ph.D., NREMT-P, research assistant professor, University of Pittsburgh department of emergency medicine and volunteer firefighter of the Guyasuta Volunteer Fire Department, O'Hara Township.

Firefighters from the Guyasuta Volunteer Fire Department and other departments across Allegheny County will be tested in the department of emergency medicine's specially-designed Emergency Responder Human Performance Lab. Physiological monitoring will include pulse, heart rate, blood pressure and core body temperature, while at rest and during exercise and while wearing the firefighter protective clothing. Blood samples will be taken before and after exercise to look for elevations in chemicals that promote blood clotting and are associated with increased cardiovascular risk. After exercise, various cooling and hydration treatments will be administered (e.g., oral fluids versus IV fluids, cooling blankets) to determine the most practical and effective method to reduce cardiovascular risk among firefighters. Similar tests will be performed during exposure to fire, smoke and heat when the firefighters are training at the Allegheny County Fire Academy.

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Co-investigators of this trial include Joe Suyama, M.D., assistant professor of emergency medicine and Steven Reis, M.D., associate vice-chancellor for clinical research, health sciences, and professor of medicine, University of Pittsburgh. Dr. Reis is a volunteer firefighter and medical officer of the Guyasuta Volunteer Fire Department.

Upon completion of the study, a list of recommendations will be given to the FEMA Assistance to Firefighter Program to be implemented by fire departments across the country looking to establish fire and EMS rehabilitation protocols.

Source: Maureen McGaffin
University of Pittsburgh Schools of the Health Sciences

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