By Gregg Squeglia
Firefighting is considered to be among the most physically demanding occupations. Long work shifts, heavy EMS call volumes, and the need to ramp up to full speed on a moment’s notice all contribute to the potential for injury. Added to this is the aging process, which tends to make the workforce slower and stiffer over time. The National Fire Protection Association (NFPA) has long been aware of the need for physical fitness programs for firefighters, and since the year 2000 has published NFPA Standard 1583, Standard for Health-Related Fitness Programs for Fire Department Members. The standard serves as an outline for the department’s command staff regarding physical fitness. It contains five components across the health and fitness spectrum which must be adhered to for a department to claim compliance. The components are
1. Assignment of a qualified health and fitness coordinator
2. Periodic fitness assessment for all members
3. An exercise training program that is available to all members
4. Education and counseling regarding health promotion for all members
5. Process for collecting and maintaining health-related fitness program data.
Implementation of the program begins with the appointment of the health and fitness coordinator (HFC). The HFC serves as the administrator of the health and fitness program, and although this is specifically a chief’s program, the HFC will oversee the day-to-day operation and make sure that the program does not wither or become neglected. The standard states that the HFC shall have specific academic course work relevant to the program components as well as formal certification from a professional organization. Some departments may have members with the requisite training and experience (e.g., a member who majored in exercise physiology in college). However, if an existing staff member cannot be identified, the standard allows for the department to contract with an outside agent. Physical therapists, athletic trainers, and nurse practitioners are choices readily available in most communities. Besides the academic requirements, department officers should identify someone who demonstrates leadership and is approachable, since peer fitness trainers and the individual members will occasionally wish to consult with this individual regarding personal health matters.
Periodic fitness/physical assessments are important in any industry where manual work is deemed an essential job function, but especially so with the fire service. Here, not only is one’s own health at stake but also that of team members, patients, and fire victims. NFPA 1583 states that the fitness assessment will be conducted at least annually and will be composed of five elements: aerobic capacity, body composition, muscular strength, muscular endurance, and flexibility. All elements can be tested and measured with a minimum of equipment within the firehouse. The aerobic capacity test includes measurement of VO2 max, considered to be the best metric regarding overall aerobic power. It can be conducted on a treadmill if the station has one or via a shuttle run test that can be given in the parking lot. The shuttle run has the advantage of testing multiple members at one time, although it is considered a bit less accurate. Skinfold calipers to measure body composition and force gauges to measure muscular strength would also be required to complete the fitness assessment. If your department has a trained health and fitness coordinator to administer the test, then it may be worthwhile to purchase these items (at a cost of roughly $1,300). Otherwise, the department could use their contracted HFC to administer the test; he would supply the equipment. In addition to the required items in the standard, many departments have implemented the Functional Movement Screen (www.functionalmovement.com) as an integral part of the fitness assessment. The FMS has been widely considered to be predictive of injury in an otherwise healthy population, and the information gained from its use will lead to an exercise and fitness program designed to prevent overexertion injury and that is tailored to each member’s needs.
The exercise program component of NFPA 1583 has several sub-elements but in general will include an educational component regarding the benefits of exercise, guidelines on warm-up and cool-down periods, aerobic exercise availability, muscular flexibility, strength and endurance, and a component on “healthy back” exercises. The standard also dictates that members will receive an individualized exercise prescription based on the results of the fitness assessment. This is where we see the importance of the Peer Fitness Trainer (PFT). The PFT program is certified through the American Council on Exercise (ACE) and was developed in conjunction with the International Association of Fire Chiefs and the International Association of Fire Fighters. The PFT attends a five-day workshop and takes an examination to become certified; he then works under the direction of the health and fitness coordinator. The PFT may perform Individual exercise revisions and coaching. This is a valuable and underutilized resource for the promotion of preventative and corrective exercises, as well as for those members who have recently returned to work from an injury and may benefit from some continued supervision during exercise. The cost of the PFT program is currently $930.00 for the workshop and examination. For further information, go to http://www.acefitness.org/getcertified/certification_iaff.aspx.
Health promotion education, the fourth component of NFPA 1583, basically states that the department will make available information regarding health risk reduction, fitness, and the prevention of occupational injury. A convenient and effective way to do this is through a bulletin board. General or fire industry-specific information is readily available and can be posted on the board along with take-away pamphlets and brochures. Annual or semiannual training seminars on lifting, materials handling, and ergonomics are also a popular method of reducing injury and meeting the standard. One important point is worth noting here: This information is for administrators as well as line firefighters. In any industry, leaders and top management need to be involved with the program to effectively reduce the injury rate. Without commitment from the officers, the program will atrophy and the material on the bulletin board will become old and dusty.
The last element, data collection, is fairly straightforward. Demographics, fitness assessment results, and program participation data are collected and saved to allow comparison at a future date–i.e. the next fitness assessment or the next year’s group data. Although a department may wish to create a custom database using an available tool such as Microsoft Access, using Excel spreadsheets will also work and takes less technical savvy. A separate page for fitness assessment results needs to be created for each member and a separate page for group results. Although simple to implement, this process creates powerful information which allows the leadership to know if the program is working and where improvements need to be made. Positive outcomes also help to justify budget decisions such as the training and certification of PFTs or the purchase of new exercise equipment.
Implementation of this standard may take several months. Obtaining funds through the department’s normal budget process or through grants will take some time, and some aspects such as scheduling out the fitness assessments for each crew team over several shifts will take detailed planning. Larger departments may wish to create a task force to include management, labor, and any outside consultants who may be involved for this purpose. Smaller departments may wish to have their existing safety committee take up the work of implementation. In either case, it is best to have ample planning time and not to rush the process. A poor implementation will lead to poor understanding of the program’s components and may lead the fitness initiative to compete with and be overcome by other pressing issues. It could also fail to produce positive outcomes, which may result in loss of funding for the next year. However, if the program is carried out well, the department is likely to notice several positive results, including a reduction in overexertion injuries, reduced lost work days, and improved ability to perform with full turnout gear and SCBA. Many fire departments have implemented this standard, especially as part of the broader IAFC/IAFF Wellness Fitness Initiative. Their stories can be viewed online at http://www.iaff.org/hs/wfiresource/default.html.
Questions regarding implementing NFPA 1583 can be directed to Gregg Squeglia at gregg@truefitpt.com.
Gregg Squeglia has been a practicing physical therapist for 16 years, with much of that time dedicated to the management and treatment of worker compensation injuries. He graduated from the University of New England in 1996 and has taken advanced training in functional capacity evaluations, physical demands analysis, and implementation of injury prevention programs. Squeglia has delivered classes and lectures on injury prevention to private companies and government agencies and has developed the Fire & EMS Injury Prevention Program, tailored to meet the unique physical demands of this industry. He also serves as a military intelligence officer in the Army National Guard and is an Iraq War veteran.
