New NIOSH Resources Help Fire Fighters Recognize Symptoms of Rhabdomyolysis

Press Contact: Stephanie Stevens (202)245-0641

Firefighting, both structural and wildland, involves tasks in environments that place fire fighters at increased risk for rhabdomyolysis (often referred to as rhabdo) when on the job. Rhabdomyolysis is a breakdown of muscle tissue that releases proteins and electrolytes into the bloodstream and can cause heart and kidney damage. If left untreated, severe rhabdo may be fatal or result in permanent disability. Heat exposure and intense physical effort are just two of many known risk factors for rhabdo.

The National Institute of Occupational Safety and Health (NIOSH) developed two sets of factsheets—one for structural firefighters and their healthcare providers and another for wildland firefighters and their healthcare providers—to increase awareness about the signs and symptoms of rhabdomyolysis and help firefighters get early treatment to prevent more serious medical problems. NIOSH also developed wallet cards for both types of firefighters that remind healthcare providers that firefighters have an increased risk for rhabdo.

Symptoms of rhabdomyolysis may include:

• Muscle cramps, aches, or pain that are more severe than expected
• Exercise intolerance – unable to complete a usual workout routine
• Abnormally dark (tea- or cola-colored) urine
• Weakness

Symptoms may not appear for up to several days after a firefighter was physically active or exposed to heat. Rhabdo symptoms may look similar to heat cramps and dehydration. The only way to tell for certain if rhabdo is occurring is to have a healthcare provider draw blood to check for creatine kinase, an enzyme inside of muscle tissue that is released when muscle is injured or dies. Early diagnosis and start of treatment for rhabdo is essential and can ensure recovery from rhabdo without any lasting effects.

The factsheets are available from the NIOSH website. NIOSH also encourages firefighters to share the factsheets with their healthcare provider.
Factsheets for wildland firefighters and their healthcare providers:

What Wildland Fire Fighters Need to Know about Rhabdomyolysis

Rhabdomyolysis in Wildland Fire Fighters: A Patient Population at Risk

Wallet cards for wildland fire fighters

Factsheets for structural firefighters and their healthcare providers:

What Structural Fire Fighters Need to Know about Rhabdomyolysis

Rhabdomyolysis in Structural Fire Fighters: A Patient Population at Risk

Wallet cards for structural fire fighters

For more information on work-related heat stress, visit the NIOSH website.

NIOSH is the federal institute that conducts research and makes recommendations for preventing work-related injuries, illnesses, and deaths. For more information about NIOSH visit www.cdc.gov/niosh.