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Correlates of fitness for duty in hazardous materials firefighters.

Kales SN; Aldrich JM; Polyhronopoulos GN; Leitao EO; Artzerounian D; Gassert TH; Hu H; Kelsey KT; Sweet C; ChristianiDC
Am J Ind Med 1999 Dec; 36(6):618-629
BACKGROUND AND METHODS: From a statewide medical examination program, we identified firefighters who were deemed unfit for duty by attending physicians (ATTENDING FAIL, n=9) and those who would have been disqualified by the application of selected numerical criteria from the 1997 National Fire Protection Association (NFPA) guidelines (NFPA FAIL, n=27) and criteria from a Medical Workshop (WORK FAIL, n=16). The subjects who were unfit for duty or failed numerical criteria were compared with those who were fit for duty and passed all objective criteria (FIT group, n=302). All subjects were given an overall morbidity rating by a board certified internist. Comparisons on two surrogate measures of fitness, VO(2) max predicted and predicted coronary heart disease (CHD) risk, were also performed. RESULTS: We found a significant tendency towards worse results (e.g. higher blood pressure or lower spirometric function) among the three FAIL groups compared with the FIT group. The FAIL groups shared only a small overlap, however, with the firefighters with the highest morbidity ratings, lowest predicted VO(2) max, and highest CHD risks. Increasing morbidity was associated with higher age, lower spirometric function, lower predicted VO(2) max, increasing cholesterol, greater BMI, and higher predicted 10 year CHD risk. CONCLUSIONS: Although the presence of a single serious or poorly controlled condition may render an individual unfit for safe performance as a firefighter, examination of our cohort suggests that multiple risk factor models or overall clinical assessments are superior means of identifying firefighters with poor health status and increased CHD risk.
Emergency responders; Emergency response; Fire fighters; Fire fighting; Fire safety; Medical screening; Medical examinations; Medical monitoring; Blood pressure; Hazardous materials; Age factors; Respiratory function tests; Respiratory system disorders; Pulmonary function tests; Pulmonary function; Heart; Author Keywords: firefighters; fitness for duty; morbidity; body mass index; pulmonary function; cardiac/coronary risk predictors
Stefanos N. Kales, MD, MPH, Occupational Medicine, Department of Medicine, The Cambridge Hospital, 1493 Cambridge Street, Cambridge, MA 02139
Publication Date
Document Type
Journal Article
Email Address
Funding Amount
Funding Type
Fiscal Year
Identifying No.
Grant-Number-K01-OH-000156; Grant-Number-R01-OH-003729
Issue of Publication
Source Name
American Journal of Industrial Medicine
Performing Organization
Occupational Medicine, Cambridge Hospital, Cambridge, Massachusetts
Page last reviewed: June 15, 2021
Content source: National Institute for Occupational Safety and Health Education and Information Division