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Clotting and fibrinolytic changes after firefighting activities.

Smith DL; Horn GP; Petruzzello SJ; Fahey G; Woods J; Fernhall BO

Med Sci Sports Exerc 2014 Mar; 46(3):448-454

https://doi.org/10.1249/MSS.0b013e3182a76dd2

20045293

Approximately 45%-50% of all duty-related deaths among firefighters are due to sudden cardiovascular events, and a disproportionate number of these fatalities occur after strenuous fire suppression activities. PURPOSE: The objective of this study is to evaluate the effect of strenuous firefighting activities on platelets, coagulation, and fibrinolytic activity and to document the extent to which these variables recovered 2 h after completion of the firefighting activity. METHODS: Firefighters performed 18 min of simulated firefighting activities in a training structure that contained live fires. After firefighting activities, firefighters were provided with fluid and allowed to cool down and then recovered for 2 h in an adjacent room. Blood samples were obtained prefirefighting, postfirefighting, and 2 h postfirefighting. RESULTS: Platelet number, platelet activity, and coagulatory potential increased immediately postfirefighting and many variables (platelet function, partial thromboplastin time, and factor VIII) reflected a procoagulatory state even after 2 h of recovery. Fibrinolysis, as reflected by tissue plasminogen activator, also was enhanced immediately postfirefighting but returned to baseline values by 2 h postfirefighting. In contrast, inhibition of fibrinolysis, as evidenced by a reduction in plasminogen activator inhibitor-1, was depressed at 2 h postfirefighting. CONCLUSIONS: Firefighting resulted in elevated coagulatory and fibrinolytic activity. However, 2 h postfirefighting, tissue plasminogen activator returned to baseline and coagulatory potential remained elevated. The procoagulatory state that exists after firefighting may provide a mechanistic link to the reports of sudden cardiac events after strenuous fire suppression activities.

Fire-fighters; Fire-fighting; Mortality-data; Morbidity-rates; Cardiovascular-system; Cardiovascular-system-disease; Cardiovascular-system-disorders; Cardiovascular-function; Cardiovascular-disease; Physical-exercise; Physical-reactions; Physiological-effects; Physiology; Blood-samples; Humans; Men; Age-groups; Author Keywords: Hemostasis; Coagulation; Fibrinolysis; Platelet Activity

Denise L. Smith, Ph.D., Department of Health and Exercise Sciences, Skidmore College, 815 N. Broadway, Saratoga Springs, NY 12866

MSPEDA

20140301

Journal Article

dsmith@skidmore.edu

Grant

2014

Grant-Number-R03-OH-009111; M102014

3

0195-9131

Medicine and Science in Sports and Exercise

IL; NY

University of Illinois at Urbana-Champaign