Hemostatic Responses to Multiple Bouts of Firefighting Activity: Female vs. Male Differences in a High Demand, High Performance Occupation.

Denise L Smith,Steven J Petruzzello,Gregory G Freund,Samuel I Bloom,Bo Fernhall,Gavin P Horn

doi:10.3390/ijerph19042124

Abstract

While the fire service has long been a male-dominated occupation, women’s participation in this strenuous, high risk, high performance activity has increased in recent years. Firefighting induces significant cardiovascular strain, including hemostatic disruption; however, the effect of sex on hemostatic responses has not been investigated despite evidence that there are sex-related differences in hemostatic variables at rest and following exercise. Thus, we investigated hemostatic responses in age- and BMI-matched male and female firefighters who performed 3–4 evolutions of firefighting drills over a 3 h period. Venous blood samples were collected before and after the firefighting training drills and hemostatic variables were assessed. Firefighting significantly increased platelet count and factor VIII, tissue plasminogen activator (t-PA) antigen, and t-PA activity, and decreased activated partial thromboplastin time and plasminogen activator inhibitor (PAI-1) activity. Females had lower values for epinephrine-induced platelet closure time, antithrombin III, PAI-1 activity, and PAI-1 antigen. There were no interactions between sex and time for any variables assessed. In conclusion, multiple bouts of firefighting activity resulted in a procoagulatory state. Although there were sex differences for several hemostatic variables, male and female firefighters did not differ in their hemostatic response to multiple bouts of firefighting.

Highlights

Introduction iationsFirefighters represent a unique occupational group that routinely perform dangerous work to protect their communities
There was no significant difference in plasma volume or body weight change between sexes
The main findings are that (a) multiple bouts of firefighting caused a shift towards a procoagulatory state and (b) sex did not affect the hemostatic responses to firefighting, as evidenced by a lack of significant time by sex interactions

Summary

Introduction

Firefighters represent a unique occupational group that routinely perform dangerous work to protect their communities. While firefighters face multiple occupational risks, it is noteworthy that approximately 50% of duty-related deaths among firefighters are due to sudden cardiac events (SCE) [1]. The fire service has long been a male-dominated occupation, but women’s participation has increased in recent years. Based on data submitted to the US Fire Department profile, it has been reported that there are 12,850 women career firefighters and 72,250 women volunteer firefighters in the US, comprising 7.3% of the US fire service overall [2]. Given our understanding of the physiological strain of firefighting and the () increasing number of female firefighters, there is a pressing need to understand the hemostatic responses to firefighting.

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Discussion

Conclusion