As a multifactorial disease it is recommended for Fire & Emergency

Services Personnel to undergo early detection and treatment as it may be lifesaving

(Smith, 2012; Soteriades, 2005). Having an underlying CVD related pathology in
addition to the CV strain experienced by the job stress puts individuals at high risk
(Soteriades, 2011). Currently, there are stringent physical employment standards in
place for candidates entering the workforce. There is no enforced, regulated ongoing fitness testing or documentation outlining medical or physical fitness
standards following the initial fitness testing in the US (Kales 2007; Soteriades,
2011). Periodic medical and fitness testing as well as return to work testing are
recommended by the NFPA yet most departments do not move forward with
implementation (Soteriades, 2011). The lack of standards and regulations for ongoing physical assessment is a current issue in Ontario, and throughout North
America. The majority of departments do not have health programs to promote
fitness and wellness (Fahy, 2005). Moreover, there are limited departments that
have access to and utilize the Personal Fitness Trainers (PFT) (Soteriades, 2011). A
team approach to improving healthy eating and physical activity has been
suggested for the fire service industry being that their occupation is dependent on
mutual accountability, shared goals and social cohesion (Ranby, 2011). Periodic
occupational fitness testing is warranted because the welfare of the firefighting
personnel is imperative to the safety and security of colleagues and the public.
Recent evidence suggests that 75% of firefighting personnel that die from a sudden
cardiac event do not receive regular medical screening (Smith, 2012). Weight
perception in firefighting department members is heavily skewed with 68% of
subjects having a tendency to underestimate their BMI classification (Baur, 2012).
Although subjects with increasing levels of BMI were able to correctly classify

themselves as obese, it is likely because they were in fact almost morbidly obese.
Unfortunately workers that misclassified themselves as healthy when they were
actually overweight believed it was acceptable because they were physically active
and therefore has cardio-protective effects, which was true compared to the general
public but not their healthy colleagues. Therefore, it has been recommended to
have objective weight management because many firefighting personnel may
underappreciate the risks associated with their body weight (Baur, 2012). For
comprehensive testing over a career it is recommend to administer pre-placement
medical exams, periodic medical exams, continued wellness programs and
successful completion of the PAT for new recruits as well as periodically for
veterans, and return to work evaluations (Soteriades 2011). Research demonstrates
that abdominal strength testing, upper back muscular endurance and anaerobic
power testing are fitness parameters important for fitness testing criteria
(Michaelides, 2011). However, it is important to recognize that body fat percentage
has the strongest correlation to the PAT performance (Michaelides, 2011)