Why Fight It? Implementing a Health and Fitness Program

By Jacob McAfee

Firefighter fitness and health have been on the “tip of the spear” for the last few years, and it’s not going away. More and more, the fire service is recognizing the need to improve the overall physical and mental health of our men and women. This is a good thing, right? Well, if you’ve been down the road to implementing a comprehensive medical and physical fitness program, then you might have had some varying opinions. National Fire Protection Association standards (NFPA) 1500, Standard on Fire Department Occupational Safety and Health Program; NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments; and NFPA 1583, Standard on Health-Related Fitness Programs for Fire Department Members, along with the International Association of Firefighters (IAFF) and the International Association of Fire Chiefs (IAFC) have laid the foundation to implement such a program with the introduction of the Wellness Fitness Initiative (WFI). I will take you through the components of the program, describe components that may lead to successful implementation, and talk about what it takes to get buy-in.

Throughout my career, I have been into fitness. From my days in the Marine Corps to my career as a firefighter, and I took pride in instilling that in my personnel; everyone’s life depends on each other. We put so much time and money into technology and equipment without realizing that none of it is worth anything if firefighters aren’t fit enough to use it under the most physically and mentally demanding conditions.

Download the United States Fire Administration’s 2012 Firefighter Fatalities in the United States report HERE

I’m a certified American Council on Exercise Peer Fitness Trainer, CrossFit level 1 trainer, a Z Health essentials of elite performance trainer, and “R” series trainer. So naturally, when I was asked to start a comprehensive health and wellness program, I jumped at the opportunity. The program was the IAFF/IAFC joint labor management WFI. So, I went to take my Peer Fitness trainer class and examination per the minimum requirement to administer a program at the fire department level as a health and fitness coordinator (HFC) or peer fitness trainer (PFT).

The program has some basic positions that make the program go: committed leadership in management and labor, the fire department physician, the HFCs, and the PFTs. I have worked at two other departments including my current department, where I am either a PFT or HFC. Some of the tasks associated with being the HFC are data computation, administering fitness evaluations, helping with rehabilitation, providing behavioral health resources and programs, ensuring medical evaluations are scheduled, providing fitness and nutrition education, smoking cessation, and more. One of my secondary duties is to serve as the fire department HFC and administer all parts of a comprehensive Health and Wellness program. Although my journey to implementing a Health and Wellness program from scratch at multiple departments had some trials and tribulations, my passion for taking care of our own pushed me to not only effectively implement the WFI program but improve it to make firefighters want to participate.

This program is designed to not only improve your firefighters’ health so they can live full, healthy professional lives but also do so in retirement. Most importantly, WFI’s goal is to improve the quality of life of all uniformed personnel.

So, why all of the push-back from the fire community? The NFPA standards I mentioned above cover fire department occupational safety and health, health-related fitness programs for firefighters, and comprehensive occupational medical programs for fire departments. These standards give the foundation for departments to not only ensure you’re fit enough to complete the arduous tasks associated with firefighting but to provide us with a litany of benchmarks to ensure the fire service and its members maintain an overall physical and mental well-being. The goal of the program in conjunction with the NFPA standards is to establish a program that does the following:

• Is positive and nonpunitive in design.
• Requires mandatory participation by all.
• Makes allowances for age, gender, and position within the department.
• Allows for on-duty participation, using equipment provided or arranged by the department.
• Provides for rehabilitation and remedial support for those in need.
• Contains training and education components.
• Is reasonable and equitable to all participants.

The WFI focuses on the following five main areas:

1. Fitness testing and exercise.
2. Medical evaluations.
3. Rehabilitation.
4. Behavioral health promotion.
5. Data collection.

Sounds reasonable, right? Although the program is great, and it’s exciting to see programs like this developed, there are many factors to consider when planning on implementing such a program. Before you get into how it works and what you need to do to support each function, you need to have top-down buy-in from leadership. The chief should be front and center on this, operating under the same mission, vision, goals, and objectives of the program. Implementing this type of program without leadership out in front and on the same page can hurt its validity. Any time you throw change at a fire service organization that will impact its norms, traditions, and beliefs, strong leadership is critical to ensure success. If you’re a union, state proper notification for impact and implementation becomes critical to ensure everyone agrees to the procedures on how the program will be implemented and administered.

Outlined here are just a few of the great elements included within the WFI’s five main areas as well as my local wellness fitness program:

Fitness testing and exercise includes the following:

• Annual fitness evaluations that test cardiovascular health, arm strength, leg strength, grip strength, core strength, endurance, and flexibility following medical clearance.
• Certification through the American Council on Exercise as PFTs to administer the evaluations, compile each individual’s results, provide nutrition and exercise education, and create fitness wellness programs that are educational and nonpunitive.
• On-duty workout time.
• Participation by all uniformed personnel.

Medical evaluations include the following:

• Takes an initial baseline medical evaluation after hiring and annual physical thereafter, according to the recommendations laid out in NFPA 1582. Medical evaluations combine multiple components to evaluate firefighter’s health and fitness as it pertains to firefighting tasks.
• General components of the evaluation that includes audiology; blood and urine tests; and physical exams to include head, neck, cardiovascular, pulmonary, vision, and more. Some of the core components include spirometer tests for pulmonary function, chest x-rays, and electrocardiograms.
• Medical requirements that detail the type of exam and the frequency each should be performed based on member’s ability to perform specific job tasks.
• The fire department physician will make recommendations, if any, to restrict a member’s ability to perform any job tasks and notify the department of any restrictions.
• The fire department physician will clear the individual to participate in the fitness assessment under the supervision of the HFC.

These evaluations look out for each individual member and his family as well as the members around him. Being able to identify possible serious medical conditions so that they may be addressed is vitally important to firefighter safety and health departmentwide.

Injury avoidance and rehabilitation does the following:

• Provides PFTs that can assist in injury rehabilitation.
• Provides resources and facilities for rehabilitation to members that become injured.
• Early education on occupational injury and illness prevention.
• Provides ergonomic analysis of tasks to determine the most efficient work process.
• Promotes a strong safety culture through incentive and recognition programs.

Behavioral health promotion does the following:

• Provides employees and their families’ resources and access to employee assistance programs.
• Ensures that critical incident stress debriefing policy is in place.
• Promotes education and awareness to all uniformed personnel and their families relating to behavioral health issues and recognition.

Data collection does the following:

• Collect aggregate data on fire department medical evaluations. This information will help evaluate the effectiveness of the department’s basic medical health as a whole.
• Collects lost work time, disability, and other injuries and illness to compare to past data.
• Collects individual fitness results that provide the member with changes in his fitness level throughout his career.
• Provides an overall fitness and medical health report for the department as a whole and promote the improvements

Whatever program you decide to implement, a comprehensive health and wellness program is a must have to ensure you are taking every opportunity to care for your members and their families. Although not every department out there follows NFPA standards, there is enough information out there to justify the existence of some type of overall health and wellness program that encompasses similar elements. Implementing such a program ensures you are doing everything you can to provide the best service to your community and take care of your own. I look forward to seeing firefighter fatalities and injuries from preventable conditions reduced from an increased awareness and implementation of wellness programs.

Photo found on Wikimedia Commons courtesy of LTIY.

Jacob McAfee is a 14-year veteran in the fire & emergency services profession, serving in a variety of positions across the military and Department of Defense (DoD). He is the assistant chief of fire prevention and operations at USAF Plant 42 Fire Department in Palmdale, California. McAfee began his career with the United States Marine Corps as an Aircraft Rescue Firefighter and after eight years of service and multiple deployments he left active service honorably in 2007. He has lead and mentored personnel in Iraq as a captain and division chief with outstanding results. Since then, he has served as an assistant chief of operations, fire marshal, fire prevention chief, and health and fitness coordinator as a civilian with the DoD. 

McAfee is a chief fire officer (CFO) designee and has earned a master’s degree in occupational safety and health and emergency management. He is working on his PhD in emergency management at Capella University and is attending the National Fire Academy’s Executive Fire Officer Program. He is an instructor for the California Office of Emergency Services—hazardous materials section, the California State Fire Marshal, the National Safety Council, and the American Heart Association. McAfee also instructs hazardous materials, urban search and rescue, and incident command courses throughout California. He is IFSAC/Pro Board certified fire officer IV, inspector III, instructor III, hazmat technician, hazmat officer, confined space technician, swift water rescue technician, trench rescue technician, advanced rope, and collapse structure technician.