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The distinction between a wellness initiative and a fitness-for-duty examination is significant. Usually when we think of medical exams for the fire service, we think of certifying firefighters for the strenuous physical demands of the job (fitness for duty). A wellness program is different in that it provides each participant the opportunity to gain a broad view of his or her overall health through the completion of a health-risk appraisal questionnaire and participation in a comprehensive medical and physical examination process.
The Baltimore City and Memphis programs included general health screening, submaximal stress testing and physical fitness assessments with personalized exercise prescriptions for each participant. The desired outcome of both programs was to help firefighters identify health and general wellness issues that may not otherwise be obvious on a routine examination, to identify potential health issues years before they become a significant medical issue and to provide recommendations to each firefighter on how to make healthier lifestyle choices to improve their general health and well being. Each participant receives a comprehensive report that provides personalized recommendations on how to improve individual health and wellness. Provided “help information” focuses on diet, exercise and stress reduction. Another key element of the wellness program is a cardiovascular risk assessment and targeting of specific issues such as smoking cessation, nutrition and cholesterol reduction to cut an individual’s risk of a heart attack or stroke.
Participants in the Baltimore City program have expressed positive feedback regarding the comprehensiveness of both the evaluations and the post-testing reports. The program is continuing in 2012.
In the Memphis program, firefighters were given supplemental wellness evaluations to complement their medical examinations. The program identified many health issues that the firefighters addressed through primary-care physicians, enabling them to become healthier and avert potentially more significant issues later on.
Facing hazards on the job
Firefighting is physically demanding and offers a unique challenge to healthcare-delivery systems. The highly stressful job brings with it psychological risk, the potential for catastrophic injury and the concern of contracting occupational illnesses, including cancers triggered by exposure to toxic smoke and fumes.
As such, it is strongly advocated that those in the fire service participate in routine medical evaluations to improve their health, rather than face the additional risk of being a firefighter without a clue. A good place to start is with a wellness evaluation to review one’s current state of health and make specific recommendations focused on the individual firefighter’s needs. n