Assessing physical health and performance

Given the physical demands of firefighting and the hazardous work environment, firefighters are continually exposed to the risk of injury or even death. A critical responsibility of fire department leadership is to ensure the fitness of their force. The 2018 NFPA 1582 Standard on Comprehensive Occupational Medical Program for Fire Departments provides a tool for assessing firefighters’ physical health.

Local departments in the Milwaukee and Waukesha areas follow different practices in utilizing the NFPA standard, though most encourage participation in annual screenings/physicals. Firefighters’ suspicions that screenings are used to remove them from duty tend to subside as they gain more experience with the program. Annual exams can perform a valuable function in detecting health care concerns before they become significant.

KEY FINDING: Relationship-building between firefighters and the screening provider establishes credibility and increases compliance. An experienced occupational health provider will be consistent in performing exams and can provide a personal touch, reassuring firefighters their purpose is not to give “black marks” that could jeopardize their ability to work. The provider can also help the firefighter understand the importance of tests for the kind of work they do. Some firefighters don’t have regular doctors and appreciate the opportunity to talk over concerns during their annual exams.

Changing the culture around mental health concerns

Local departments are giving increased attention to the mental health needs of their members regarding job- and family-related stress. They’re implementing a range of programs, from peer support teams, to EAPs, to chaplaincies. Traditionally, firefighting culture has been one of “sucking it up” when personal problems arise. Now, that is changing as seasoned veterans who are less likely to share their feelings are retiring and being replaced by younger members with more of a proclivity to listen to their colleague’s concerns.

The health and safety officer of one large department discussed their success in following the IAFF Peer Support Training model and, additionally, integrating it with an EAP. Mental health resources are vetted for their knowledge of firefighting culture so firefighters know they are talking with someone who understands. The first point of contact is a firefighter who can listen and guide further steps.

At a suburban department, firefighters preferred access to chaplains rather than a peer support approach. The department now has three, all trained on the same model, and sees members opening up to them on a non-faith basis.

When EAPs are involved, departments emphasized integrating them with people who have firsthand fire department experience. Another suburban department underscored this point, noting that firefighting culture permeates every aspect of firefighters’ lives. They have established a hotline where firefighters know they will talk to a trained firefighter — and are more likely to call as a result.

KEY FINDING: Programs addressing mental health issues must earn the trust of firefighters and demonstrate their worth. Fire chiefs said it’s a huge relief for firefighters to know they can talk to someone for whom firefighting is their “gig.”

Keeping up with drug use and screening

Marijuana and prescription drug use are acute workplace concerns today, and fire departments are having to review policies and procedures in light of societal changes. The world of drug screening has evolved over the last 25 years, but language in contracts with unions is often outdated. How should fire departments account for this as contracts are renegotiated and new recruits are sought? Bringing a trusted occupational health physician into the discussions is critical.

When performing drug screenings, look for THC, the active ingredient in marijuana. CBD doesn’t induce a high and has anti-inflammatory properties and medicinal uses. As it stands, however, the majority of medical review officers won’t accept CBD as an excuse for a positive screen.

Employees taking prescription medication for ADHD present an additional challenge. If a drug screen is positive for amphetamine, it should go to the lab to distinguish between methamphetamine and amphetamine. If amphetamines are being used medically, the medical review officer will likely certify the screen as negative and not a safety-for-work issue.

If there is concern or reasonable suspicion about a firefighter and the drug screen comes back negative, fire department leaders should be prudent and not assume everything is OK. People taking drugs legally can still misuse the substances, which should trigger a medical fitness-for-duty review.

KEY FINDING: Work with a certified and experienced occupational health provider. Their expertise can help you stay abreast of rapidly changing drug screening practices, and assist in directing you to appropriate resources (legal, HR) when updating drug policies and reviewing difficult cases.

Learn more about Workforce Health and how we can partner with your department to bring the best health and wellness programs to your members. Call our team at 414-777-3414 to start the conversation today.

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Abbie Gilewski


My name is Abbie Gilewski. I am a Kenosha firefighter. I am reaching out on behalf of the Kenosha fire peer fitness team. Last year five of our firefighters were funded by the city to participate in an ACE certified class to keep firefighters on track with our physical fitness because our job directly entails strength and cardio. As Froedert is relatively new to our city, we were trying to collaborate a program that gives incentives and research in between the hospitals we work with and out firefighters. Please direct me into the right direction if you are interested in collaborating with us to make our relationship strong.

Look forward to hearing from you,

Abbie Gilewski
Kenosha fire department
Station 4B

Froedtert & MCW

Hi Abbie – Thanks for your interest. I will share your message and contact information with our Workforce Health team, and someone will contact you. Thanks!