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| ID | Type | Description | Link |
|---|---|---|---|
| PG/11/27/28842 | Other Grant/Funding Number | British Heart Foundation |
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Fire-fighters are at increased risk of death from heart attacks when compared to other emergency service professionals whose jobs involve similar components such as emergency call-outs and shift work. The unique risk to fire-fighters is likely to reflect a combination of factors including extreme physical exertion, mental stress, heat and pollutant exposure.
In the largest analysis of cause of death amongst on-duty fire-fighters, fire-fighter deaths were classified according to the duty performed during the onset of symptoms or immediately prior to any sudden death. The majority of deaths due to a cardiovascular cause (i.e. heart attack) occurred during fire-suppression whilst this activity represented a relatively small amount of a fire-fighters professional time. Fire simulation training centers offer a unique opportunity to assess the heart, blood and blood vessel response to fire suppression in a controlled environment.
In this study the investigators will assess healthy career fire-fighters on two occasions: following a fire-suppression training exercise in a purpose built real-fire training center, and following a sedentary period as a control. The investigators will take blood samples to measure platelet activity (platelets are the particles in blood that help blood clot) and will examine how blood clots outside of the body. The investigators will then perform studies placing small needles in the arm to assess blood vessel function following fire suppression. By undertaking this comprehensive assessment of blood, blood vessel and heart function we hope to understand the mechanisms whereby the risk of a heart attack is influenced by fire suppression. The investigators hypothesize that following the fire-suppression exercise firefighters blood will clot more readily and their blood vessels will not relax properly which are two of the main processes in the development of a heart attack.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Real-fire training exercise | Active Comparator | Subjects will undergo a 20 minute standardised training exercise in a fire simulation facility. |
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| Sedentary training session | Sham Comparator | Subjects will undergo a training exercise where they will remain sedentary for 20 mins in an ambient temperature. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Forearm Vascular Study | Procedure | Forearm venous occlusion plethysmography to measure forearm blood flow during intra-arterial infusion of the vasodilators Verapamil (10-100 µg/min), bradykinin (100-1000 pmol/min), sodium nitroprusside (2-8 µg/min) and Acetylcholine (5-20 µg/min). |
| Measure | Description | Time Frame |
|---|---|---|
| Forearm blood flow measured by venous occlusion plethysmography in response to infused vasodilators | 3-6 hours post exposure |
| Measure | Description | Time Frame |
|---|---|---|
| Ex-vivo thrombus formation using the Badimon chamber | 2 hours post exposure | |
| Plasma t-PA and PAI concentrations following infusion of bradykinin | During forearm study, 3-6 hours post exposure |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| David E Newby, MD PhD | University of Edinburgh | Study Chair |
| Nicholas L Mills, MBChB PhD | University of Edinburgh | Study Director |
| Amanda L Hunter, MBChB | University of Edinburgh | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Royal Infirmary of Edinburgh Clinical Research Facility | Edinburgh | EH16 4SA | United Kingdom |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 28373523 | Result | Hunter AL, Shah AS, Langrish JP, Raftis JB, Lucking AJ, Brittan M, Venkatasubramanian S, Stables CL, Stelzle D, Marshall J, Graveling R, Flapan AD, Newby DE, Mills NL. Fire Simulation and Cardiovascular Health in Firefighters. Circulation. 2017 Apr 4;135(14):1284-1295. doi: 10.1161/CIRCULATIONAHA.116.025711. |
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| ID | Term |
|---|---|
| D013927 | Thrombosis |
| D009203 | Myocardial Infarction |
| ID | Term |
|---|---|
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D017202 | Myocardial Ischemia |
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| Badimon Chamber Study | Procedure | Ex-vivo assessment of thrombus formation using the Badimon Chamber |
|
| D006331 |
| Heart Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |