Make no mistake, fire and emergency medical service is physically demanding work — always has been and always will be. Despite the technology that has made the job safer and less punishing, fighting fires still involves people lugging hose into burning buildings and carrying Mrs. Smith down two flights of stairs at 3 a.m. Over the course of a 25- or 30-year career, the small aches and pains can accumulate into larger health issues.
In November 2007, I went for what was the final health assessment of my 25-plus-year career with Chesterfield County (VA) Fire & EMS Department (CFEMS). When it first began offering annual health assessments to career personnel in 1990–participation in the program was voluntary–CFEMS was one of the more progressive departments in the United States (And still is). As I finished my career with the organization later that week, I now had 17 years of health assessment data by which to measure how successfully I‘d navigated the physical challenges of my chosen profession.
To paraphrase the physician who conducted my assessment after reviewing the multi-page self-assessment and data collection form, I was a 50-year-old male who was in excellent physical condition based on my physical assessment. My only significant medical history involved elevated cholesterol levels (which are being managed to this day with a combination of diet and exercise).
Let’s take a closer look my assessment results in regard to common firefighter health issues:
- Cardiovascular health. Resting blood pressure of 124/82 mm/Hg. Exertion blood pressure (following three minutes of running in place) 130/86 mm/Hg. 12-lead ECG was within normal parameters in all leads. (We received a treadmill stress test every three years; my last one was was done the previous year and showed no abnormalities).
- Pulmonary health. My pulmonary function test was within normal limits and indicated that I had the lung function of a 30-year-old male.
- Weight control. I stood 5 feet 4 inches tall and I weighed 140 pounds when I came on the job in 1982; on the day of my final physical I weighed in at 160 pounds. On the Body-Mass Index scale, which CFEMS uses as a performance measure, I came up at an index of 27.5, which placed me in a place I didn’t want to be on the scale — overweight. Normal range for my height should be 18.5 to 24.9. Obviously I still had some work to do there (In 2013, I’m still working on it, though on the “bright side” I’m still hovering “a bit north” of 160 pounds).
- Hearing. Despite what my wife tells me every day, my hearing test indicated that I‘d only lost the ability to hear sounds on the very edge of high frequency. (Such loss is not attributable to exposure to noise, but rather to infection. I had seen an ear, nose and throat specialist in the past couple of years for recurring ear infections, and the doctors attributed that loss to repeated ear infections in my childhood).
- Injuries. I was very fortunate in that I‘d never experienced an on-the-job injury, lost time or otherwise. We earned 15 hours of sick leave each month, and the accumulated balance carries over each year; I retired with 3,720 hours on the books. (Oh, how I wished that we’d had a leave buy-back program for all that sick leave!). Over the course of my career I‘dearned 4,605 hours, which meant I‘d only used 20% of my available sick leave over the past 25 years.
So what‘s the point? We hear and see a great deal these days about reducing the mortality and morbidity rates for firefighters, and much of that focus lately is on the health, wellness and safety issues. These include reducing heart attacks from cardiovascular disease or improving compliance with seatbelt usage, as opposed to operational factors such as structural collapses or flashover events. The positive results of my last physical assessment, which were very consistent with those of the previous 16 assessments, are directly linked to the behaviors of my organization and my individual behaviors.
- Cardiovascular health. The department always has allotted time in the workday for physical training. When I first went to work, we had a plan that consisted of a chart of compulsory calisthenics that everyone on the shift had to complete. From there we progressed through a variety of structured programs that addressed cardiovascular weight and flexibility training. I learned very early that the most important part of the firefighter safety ensemble was me — the body I put into my gear. (My running days are over; now I get my 30 minutes of aerobic activity each day by walking briskly while wearing a 30-pound weighted vest).
- Pulmonary health. I‘ve never smoked and my department has always had a mandatory mask policy when it comes to SCBA use. In my career, we never had a smoke inhalation injury.
- Weight control. I‘ll skip this part if it‘s OK with you. (This is what‘s known in some circles as taking “literary license.”)
- Hearing. I first began wearing shooting earmuff–style hearing protection in the front seat while responding to calls in 1985 when I became a company officer. Since then I‘ve always worn the muff-style protection when responding as a chief officer and I‘ve always worn disposable earplugs on the emergency scene and the training grounds.
- Chesterfield County has a county-wide hearing conservation policy for all county employees and my department goes beyond those requirements in several areas. Starting in the early 1990s, we started installing radio/intercom headsets in the riding positions on our apparatus; today all of our units have the headsets and they are standard equipment on new apparatus.
- Injuries. My department always provided us with the best protective clothing, SCBA, eye protection, and more that money could buy (we were in the third generation of SCBA during my career). We hired our first department safety officer in the 1985. We learned to use ICS, and have used it for every emergency, everyday, since 1985. We‘ve always had a mandatory seatbelt-use policy and our drivers have always had to stop at red lights and stop signs while responding to emergencies. Our safety slogan reflects how much safety is part of our organizational DNA: “Risk a lot to save a life, Risk a little to save a little, Risk nothing to save nothing.”
It seems to me that many fire and EMS organizations are a bit “Johnny-come-lately” when it comes to the health and well-being of their people, and some still have not come to the party. I was very fortunate to have spent my career with one of the organizations that‘s frequently been on the forefront of efforts to constantly make improvements for the safety, health and welfare of its people. I was just another of our folks in our organization who reached the goal of retiring with good health.