Heat Stress Disorders Clinical Trial
Official title:
Enhanced Firefighter Rehab Trial: Aspirin Versus Placebo
The purpose of this study is to determine if aspirin taken by firefighters prevents platelets from becoming sticky when body temperature rises during work in protective clothing.
Firefighters have the highest rate of line-of duty death (LODD) in the United States. More
than half of these LODD are cardiovascular related occurring disproportionately around fire
suppression activities. In addition, shift work, lifestyle factors, and the exposures
associated with fire suppression (e.g. smoke, chemicals) may predispose the firefighter to
earlier onset of heart disease or cause a pro-inflammatory state leading to endothelial
dysfunction.
Fire suppression activities exacerbate cardiovascular strain and endothelial dysfunction and
provide potential triggers for ischemic events (e.g. myocardial infarction, stroke). There is
a rapid rise in heart rate following the activation of a fire company which may persist for
as long as 20 minutes. Even in cases where heavy work is not being performed, the repetitive
upper body exercise associated with tool use raises heart rate disproportionately to oxygen
consumption.
Finally, there is a rapid rise in core body temperature from increased physical activity,
environmental heat and impaired thermoregulation that has been shown to cause
vasoconstriction and activate coagulation during heat stress (12, 13). This has recently been
demonstrated in firefighters working in thermal protective clothing. The combination of
triggers created during fire suppression may result in heart attack or stroke, especially in
firefighters with risk factors for cardiovascular disease.
Interventions beyond basic fireground rehab may be required to minimize the effect of these
triggers and enhance a firefighter's health and wellness. Fireground rehab typically focuses
on cooling and rehydration of the firefighter following fire suppression or training with the
assumption that these interventions will correct the underlying pathophysiology. Effective
fireground rehab must deliver appropriate interventions and monitor the progress of the
firefighter. While correcting hyperthermia and hypohydration are essential for continued
performance, it is not clear if these therapies correct alterations in platelet or
endothelial function or if other interventions are necessary to correct these physiological
disturbances. Furthermore, the options for monitoring the firefighter beyond simply measuring
heart and respiratory rate are limited. In our FEMA-funded Fireground Rehab Evaluation (FIRE)
Trial, we demonstrated that five commercially available thermometers did not reliably measure
or estimate core temperature following uncompensable heat stress (UHS) making it impossible
to gauge the effectiveness of rehab interventions.
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| Status | Clinical Trial | Phase | |
|---|---|---|---|
| Completed |
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|
N/A | |
| Recruiting |
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N/A |