Rhabdomyolysis at Work: Symptoms, Risks and What to Do

• Rhabdomyolysis (rhabdo) is a serious condition that can cause permanent disability or death.
• At work, heat and physical exertion raise the risk.
• It can look like heat illness or dehydration; only testing tells them apart.
• Early diagnosis and treatment prevent death and disability.

What it is

Rhabdo happens when damaged muscle releases its proteins and electrolytes into the blood. They can harm your organs and cause:

• death;
• dangerous heart rhythms (arrhythmias);
• seizures;
• kidney damage or kidney failure;
• permanent disability;
• nausea and vomiting.

Any muscle damage can cause it — heat, overuse, accidents and more.

Signs and symptoms

You may have one or more of:

• muscle cramps, aches or pain worse than you'd expect;
• dark urine, the color of tea or cola;
• weakness or tiredness — unable to finish work or a workout you managed before.

Symptoms alone can't confirm rhabdo. A health care provider can order blood tests for creatine kinase (CK), a marker of muscle damage; repeated tests show whether it is rising or falling.

Don't ignore these symptoms — get medical care right away. The earlier treatment starts, the better the chance of recovering without lasting harm. More: signs and symptoms.

Who's at risk

Anyone can get rhabdo; some workers — such as farm workers laboring in the heat — face more risk.

More: risk factors.

Prevention

Workers and employers can lower the risk by:

• keeping workers from overheating;
• encouraging workers to seek care when symptoms appear.

More: reducing risk.

Treatment

Early treatment prevents serious problems and speeds a return to work without lasting effects. A worker with symptoms should:

1. stop the activity;
2. drink more fluids, preferably water;
3. get immediate care at the nearest medical facility.

If heat stroke is suspected, follow these first aid steps. More: treatment.

Myths

• "Only unfit people get it." False: firefighters, marathon runners and professional athletes get rhabdo — even after work they've done before without trouble.
• "Dehydration causes it." False — but dehydration makes it worse, by hampering the body's clearing of the proteins and electrolytes that damage organs.

Look-alikes and relatives

• Heat exhaustion and heat cramps can cause similar symptoms. See heat-related illnesses.
• Compartment syndrome, also from muscle damage: some muscles sit in a thin, fibrous sheath that can't stretch far, so swelling builds pressure, cuts off blood flow and can kill the muscle. It's uncommon, but needs immediate treatment — delay can cause permanent disability.

Research: NIOSH's NIOSHTIC-2 database of occupational safety and health publications.

Sources

Based on "Rhabdomyolysis and Work," National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention; a work of the United States government in the public domain. The original's stock photographs are left out.