Effect of Fire Suppression and Emergency Duties on Vascular Function
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Purpose
Firefighters are at increased risk of death from heart attacks when compared to other emergencyy service professionals whose jobs involve similar components such as emergency call-outs and shift work. In the largest analysis of cause of death amongst on-duty firefighters, firefighter 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 firefighters professional time. There was also a risk of death associated with other duties such as emergency non-fire response and physical exertion.
The investigators hypothesize that participation in active fire-fighting duties impairs blood vessel function and increases blood clot formation when compared with non-fire-fighting activities. In this study, healthy career firefighters will be assessed after three periods of duty: fire-suppression, emergency response without fire suppression and following a sedentary shift. 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 these duties. By undertaking this comprehensive assessment of blood, blood vessel and heart function the investigators hope to understand the mechanisms whereby the risk of a heart attack, fatal or otherwise, is posed throughout these distinct duties that firefighters undertake on a daily basis.
| Condition | Intervention |
|---|---|
|
Vascular Function Atherothrombosis |
Procedure: Forearm Vascular Study Procedure: Badimon Chamber |
| Study Type: | Observational |
| Study Design: | Observational Model: Case-Crossover Time Perspective: Prospective |
| Official Title: | Effect of Fire Suppression and Emergency Duties on Vascular Function in Firefighters |
- Forearm blood flow measured by venous occlusion plethysmography in response to infused vasodilators [ Time Frame: up to 12 hours after exposure ] [ Designated as safety issue: No ]
- Ex-vivo thrombus formation using the Badimon chamber [ Time Frame: up to 12 hours after exposure ] [ Designated as safety issue: No ]
- Plasma t-PA and PAI concentrations following infusion of bradykinin [ Time Frame: During forearm study, up to 12 hours after exposure ] [ Designated as safety issue: No ]
Biospecimen Retention: Samples Without DNA
Plasma and urine samples
| Estimated Enrollment: | 30 |
| Study Start Date: | February 2012 |
| Estimated Primary Completion Date: | August 2014 (Final data collection date for primary outcome measure) |
| Groups/Cohorts | Assigned Interventions |
|---|---|
|
Fire suppression
Firefighters will attend for vascular assessments following a night shift where they have performed fire suppression
|
Procedure: Forearm Vascular Study
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).
Other Names:
Procedure: Badimon Chamber
Ex-vivo assessment of thrombus formation using the Badimon Chamber
|
|
Non-fire emergency duty
Firefighters will attend for vascular assessments following a night shift where they have had an emergency response without fire suppression eg. road traffic collision.
|
Procedure: Forearm Vascular Study
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).
Other Names:
Procedure: Badimon Chamber
Ex-vivo assessment of thrombus formation using the Badimon Chamber
|
|
Sedentary shift
Firefighters will attend for vascular assessments following a night shift where they have remained sedentary throughout the shift.
|
Procedure: Forearm Vascular Study
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).
Other Names:
Procedure: Badimon Chamber
Ex-vivo assessment of thrombus formation using the Badimon Chamber
|
Eligibility| Ages Eligible for Study: | 18 Years to 60 Years |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | Yes |
| Sampling Method: | Probability Sample |
Subjects will be healthy, non-smoking, whole-time firefighters working within Lothian and Borders Fire and Rescue Service
Inclusion Criteria:
- Non-smoking healthy firefighters
Exclusion Criteria:
- Current smoker
- History of lung or ischaemic heart disease
- Malignant arrhythmia
- Systolic blood pressure >190mmHg or <100mmHg
- Renal or hepatic dysfunction
- Previous history of blood dyscrasia
- Unable to tolerate the supine position
- Blood donation within the last 3 months
- Recent respiratory tract infection within the past 4 weeks
- Routine medication including aspirin and NSAIDs
Contacts and Locations| Contact: Amanda L Hunter, MBChB | +441312426437 | amanda.hunter@ed.ac.uk |
| Contact: Nicholas L Mills, MBChB PhD | +441312426437 | nick.mills@ed.ac.uk |
| United Kingdom | |
| Royal Infirmary of Edinburgh Clinical Research Facility | Recruiting |
| Edinburgh, United Kingdom, EH16 4SA | |
| Contact: Amanda L Hunter, MBChB +441312426437 amanda.hunter@ed.ac.uk | |
| Contact: Nicholas L Mills, MBChB PhD +441312426437 nick.mills@ed.ac.uk | |
| Principal Investigator: Amanda L Hunter, MBChB | |
| Study Chair: | David E Newby, MD PhD | University of Edinburgh |
| Study Director: | Nicholas L Mills, MBChB PhD | University of Edinburgh |
| Principal Investigator: | Amanda L Hunter, MBChB | University of Edinburgh |
More Information
No publications provided
| Responsible Party: | University of Edinburgh |
| ClinicalTrials.gov Identifier: | NCT01805063 History of Changes |
| Other Study ID Numbers: | 11-SS-0049, PG/11/27/28842 |
| Study First Received: | March 4, 2013 |
| Last Updated: | March 4, 2013 |
| Health Authority: | United Kingdom: National Health Service |
Keywords provided by University of Edinburgh:
|
firefighters myocardial infarction endothelial function thrombosis |
fire suppression non-fire emergency duty sedentary shift |
Additional relevant MeSH terms:
|
Emergencies Disease Attributes Pathologic Processes |
ClinicalTrials.gov processed this record on May 21, 2013