(Functional capacity)
Aerobic fitness is related to a person’s ability to perform dynamic, moderate-to-high intensity physical activity
with large muscle groups for prolonged periods. Thus, it expresses the abilities of both cardiorespiratory and muscular systems to transport and utilize oxygen for energy.
A person’s maximal oxygen uptake (VO2 max) refers to the maximal amount of oxygen the individual can consume typically over one minute during an intense physical effort.
VO2 max is the gold standard measure of cardiorespiratory fitness (Bassett 2000).
Direct measures of VO2 are reliable and reproducible and provide the most accurate assessment of functional capacity (Sullivan 1984).
International standards
- Offshore workers:
- No specific mention to the test, doctor should assess mobility and physical performance. For candidate with CHD history; stress ECG test is required.
(Norwegian Directorate of Health 2012)
- Offshore, Aerobic capacity assessment is required for emergency response team, ERT. (UK Offshore Oil and Gas 2008).
- Offshore, Functional capacity test required for Offshore Fire Team Members. (GoM BP 2012).
- Firefighters: aerobic fitness, Vo2 max is required for the initial and the recurrent medical assessment (RFFS UK Medical & Fitness 2009).
- Firefighters: For candidate with chronic lung conditions, Evaluate VO2max as described by American College of Sports Medicine (ACSM) (NFPA 2012).
- Firefighters: cardiorespiratory fitness test (Vo2max); the test is necessary however, what test is used and whether fitness testing should be voluntary or compulsory is a matter for individual agencies(AFAC 2006).
- Divers: step test is routinely performed during the initial and the annual medical examinations (HSE UK, MA1, 2011).
- Hazardous Occupations:
- for candidate who have difficulty doing strenuous exercise and carrying the heavy air-supplied respirators. Where indicated, lung function tests and stress ECG can be carried out. (OHS Hong Kong 2004)
- OSHA Standard: Hazardous Waste Operations and Emergency Responses (HAZWOPER): Consider graded exercise “stress test” at discretion of attending physician especially if heat stress concern (OSHA 2009).
- Drivers: Aerobic Capacity Assessment is not routinely requested (UK DVLA 2014).
For candidate with HCD history The Bruce protocol is recommended for formal exercise testing (Austroads 2012).
According to the report of the cardiovascular advisory panel (Blumenthal et al 2002); Because of its lack of specificity and sensitivity and its unknown cost effectiveness when used as a screening tool in this population, the Panel is not able to recommend for or against the use of the exercise tolerance test (ETT) to assess CMV drivers who have risk factors but no symptoms or signs of CHD (FMCSA 2002).
Suggested indications: is required for fire fighters, ERT and employee for posts require high physical efforts.
References
- Bassett DR, Howley ET. Limiting factors for maximum oxygen uptake and determinants of endurance performance. Med Sci Sports Exerc 32:70-84, 2000.
- Sullivan M, Genter F, Savvides M, Roberts M, Myers J, Froelicher V. The reproducibility of hemodynamic, electrocardiographic, and gas exchange data during treadmill exercise in patients with stable angina pectoris. Chest 1984;86:375-82.
- Guidelines - health requirements for persons working on installations offshore. Norwegian Directorate of Health 2012.
- Medical Aspects of Fitness for Work Offshore ( 2008 The United Kingdom Offshore Oil and Gas)
- GoM Medical Aspects of Fitness for Offshore Work Safety Work Practice (BP 2012)
- RFFS Medical & Fitness Policy - AFOA, guidance document (2009) UK, from:
- http://www.afoa.co.uk/Documents/med-fit%20policy%20jan09.pdf
- NFPA 1582, Chapter 6 Medical Evaluations of Candidates - 2012
- Australasian Fire Authorities Council (AFAC) Medical Guidelines for Firefighters, March 2006
- HSE UK, The medical examination and assessment of divers (MA1) 2011, http://www.hse.gov.uk/Diving/ma1.pdf
- Doctors’ Guide to Medical Examinations for Workers engaged in Hazardous Occupations in Industrial Undertakings - Occupational Safety and Health – 2004, Hong Kong.
- Screening and Surveillance: A Guide to OSHA Standards, 2009 https://www.osha.gov/Publications/osha3162.pdf
- At a glance Guide to the current Medical Standards of Fitness to Drive'. Drivers Medical Group, DVLA, UK, May 2014
- Austroads (2012) ASSESSING FITNESS TO DRIVE, for commercial and private vehicle drivers, ISBN: 978-1-921991-86-8
- Blumenthal et al.Cardiovascular Advisory Panel guidelines for the medical examination of commercial motor Vehicle Drivers, FMCSA-USA, 2002
