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Evaluation of heat stress, heat strain, and rhabdomyolysis during structural fire fighter training
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    "The Health Hazard Evaluation Program received a request from a fire department to evaluate potential heat related illness (HRI) and rhabdomyolysis, or muscle tissue breakdown, in cadets and instructors during a training course. The 10-week training course consisted of classroom lectures, outdoor physical training, and live fire suppression exercises. During the eighth week of the course in August, we evaluated 30 cadets and 2 instructors over a 4-day period. Our evaluation included (1) measuring core body temperature (CBT), heart rate, and body weight; (2) analyzing participants' blood for creatine kinase, a marker of muscle breakdown, and dehydration; (3) interviewing participants about their daily fluid intake, HRI and rhabdomyolysis symptoms, and work and medical histories; (4) measuring environmental conditions; and (5) focus group discussions with participants about their rhabdomyolysis knowledge. The blood analysis results indicated that one participant met the criterion for rhabdomyolysis. Sixteen participants had blood creatine kinase levels above the normal range but did not meet the criterion for rhabdomyolysis. We found most participants experienced excessive heat strain during at least some portions of the evaluation. Most participants' CBT exceeded the ACGIH recommended limit of 101.3 degrees F daily, and twenty participants lost more than 1.5% of their body weight during a single training day. Environmental conditions also often exceeded heat stress limits. Through focus group discussions, we found that many fire fighters were not aware of rhabdomyolysis, their risk, and the potential consequences of untreated rhabdomyolysis. We recommended the fire department schedule training courses for cooler parts of the year and conduct the physically demanding training during cooler parts of the day. We also suggested educating fire fighters on the signs and symptoms of HRI and rhabdomyolysis and encouraging the early reporting of symptoms to supervisors and medical care providers." - NIOSHTIC-2

    NOSHTIC no. 20046797

    Recommended citation for this report: NIOSH [2015]. Evaluation of heat stress, heat strain, and rhabdomyolysis during structural re ghter training. By Eisenberg J, Methner M, Dowell CH, Mueller C. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, NIOSH HHE Report No. 2012-0039-3242.

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