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Evaluation of rhabdomyolysis and heat stroke in structural firefighter cadets
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  • Description:
    "A representative of a city-operated structural firefighter cadet training program requested a health hazard evaluation concerning heat-related (HRI) illness and rhabdomyolysis among cadets. The request was prompted by the hospitalization of a cadet for heat stroke and rhabdomyolysis. The death of a second cadet was investigated in a separate evaluation. Both cadets became ill on the first day of the training course. During our site visit, we met with training course personnel; reviewed written facility policies, incident reports, workers' compensation claims, and medical records; observed cadet outdoor physical fitness activities and firefighter task-based training exercises; recorded environmental conditions and estimated metabolic effort expended during outside activates and exercises; and administered a knowledge assessment on HRI and rhabdomyolysis. We found that high exertion levels and elevated core body temperatures, inherent components of firefighter cadet training programs, represent potential risk factors for HRI and rhabdomyolysis among participants. Several factors at this training center may contribute to an increased risk of HRI and rhabdomyolysis among cadets. These include outdoor environmental conditions, gaps in knowledge about HRI and rhabdomyolysis, and the absence of basic HRI prevention measures. Our review identified multiple areas of improvement for the department's heat stress management program and HRI and rhabdomyolysis training materials. We recommended (1) expanding the existing heat stress management program to include refresher training, procedures on how to assess environmental heat conditions, and using a buddy system; (2) utilizing the department's exercise physiologists to help cadets safely maintain their physical fitness and heat acclimatization prior to the start of their training course; and (3) implementing a medical reassessment policy if more than a 3-6 month delay occurs between a cadet's initial medical evaluation and the start of their assigned training course." - NIOSHTIC-2 NIOSH no. 20057777 Recommended citation: NIOSH [2019]. Evaluation of health symptoms after a law enforcement operation. By Chiu S, Hornsby-Myers J, Trout D. Cincinnati, OH: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Health Hazard Evaluation Report 2019-0114-3358, https://www.cdc.gov/niosh/hhe/reports/pdfs/2019-0114-3358.pdf. 2019-0108-3360.pdf
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