Image by 12019 from Pixabay
Image by 12019 from Pixabay

Occupational health service professionals must be well-versed in the unique requirements and nature of firefighting, as well as the demanding conditions in which firefighters operate. Firefighting is an intense profession that demands both physical and mental resilience. Accidents and fires can occur anytime, anywhere, under various circumstances, necessitating accurate observations, quick decisions, and safe, efficient actions in unpredictable and hazardous conditions.

Health and Performance Requirements

Firefighters need to maintain good health and sufficient physical and mental capacity to handle demanding tasks without risking their own health or that of others. They face numerous hazards and stress factors, including mechanical injuries, extreme temperatures, machine and equipment accidents, physical overexertion, mental stress, biological exposure, and chemical injuries.

Firefighting and rescue tasks require the use of protective equipment, special garments, and a self-contained breathing apparatus weighing 6-15 kg. While wearing this equipment and carrying tools (weighing up to 50 kg), a firefighter must be able to climb stairs, assist victims, or resist the force of a water spout. Irregular working hours add to the stress.

Assessing a firefighter's ability to safely participate in smoke-diving without jeopardizing their health or that of others is crucial. Firefighters also undertake various rescue tasks, drive rescue vehicles, conduct inspections, and participate in paramedic actions.

Health Status and Medical Requirements

The health status of firefighters is evaluated through recruitment and periodical examinations. Recruitment examinations are conducted before any training begins. Certain health conditions, such as angina pectoris, asthma, diabetes, severe arthrosis, psychiatric diseases, and substance abuse, are considered insurmountable obstacles for firefighting. Each case is evaluated individually, and psychological tests play a significant role in the selection process.

Recruitment examinations include:

  1. Physical fitness tests
  2. Psychological tests
  3. Medical examination

Firefighters undergo periodical health examinations throughout their careers, which may also serve a preventive function. These examinations aim to screen for common risk factors of coronary diseases, early symptoms of various other diseases, and to prevent these diseases from developing or alleviate existing ailments. There are also special health examinations for specific assignments, such as surface rescue and underwater rescue divers.

Frequency and Content of Health Examinations

The frequency and content of health examinations depend on the number of examinees and available resources. It is recommended that younger firefighters (under 40) be examined every five years, or every three years if resources allow. More frequent evaluations are required in cases of poor physical condition, recovery from prolonged illness, voluntary assessments, requests from superiors, and nursing visits.

Firefighters over 40 should be examined every two years, and those over 50 every year. Routine tests may include blood tests (hemoglobin, cholesterol, glucose), urine tests (albumin, glucose), thorax x-rays, stress EKG, spirometry, spiroergometry, vision, and hearing tests.

Absolute Contraindications and Special Considerations

Certain health conditions are absolute contraindications for firefighting and rescue work, including coronary heart disease, brain circulation disturbances, certain cardiac arrhythmias, obstructive and restrictive lung diseases, mental diseases, and a history of substance abuse. Perfect hearing is not necessary, but firefighters must be able to communicate normally and sense the direction of sounds. Severe hearing loss or deafness in one ear, total blindness in one eye, and some other specific conditions are also contraindications.

Diabetes, rheumatoid arthritis, multiple sclerosis, leukemia, and other blood diseases are absolute contraindications. Pregnant firefighters are advised against tasks involving smoke-diving, heat exposure, or operations with dangerous chemicals.

Guidelines for Physical Work Capacity

Despite improvements in professional competence, work methods, and equipment, a firefighter’s ability to perform tasks like smoke-diving and rescue diving largely depends on their physical capacity. Finnish multidisciplinary studies have standardized health examinations and physical capacity assessments for firefighters. The minimum levels of aerobic and muscular capacity have been defined, with the most valid method being direct measurement in a specialized testing laboratory.

NFPA 1582: A Key Standard

Many international standards exist for firefighter medicals, but the NFPA 1582 document, updated in 2022, is one of the most commonly used worldwide. This standard provides guidance for physicians and healthcare providers responsible for fire department occupational medical programs, ensuring that candidates and current members are fit for duty and reducing the risk of occupational injuries and illnesses. It includes guidelines for annual physicals and comprehensive medical evaluations to identify any conditions that could impair a firefighter’s ability to perform their duties safely.

For more information the standards, visit NFPA 1582: Medical Examination Guidance for Physicians.