Fire Officials Blame Inadequate Health Screening For Pack Test LODDs

Despite two recent line-of-duty deaths attributed to the wildland firefighter Pack Test, federal firefighting officials are standing by the test and saying their concern is not with the test itself but with the health screening of the people who elect to take it.

A total of 11 firefighters have died while taking the Pack Test since it was adopted in 1998, said Mike Apicello of the National Interagency Fire Center in Boise, Idaho. Nine of them died while taking the arduous version of the test, which requires a hike of three miles in 45 minutes with a 45-pound pack. Two died while taking the light version of the test, which requires a one-mile walk in 16 minutes.

There is also a moderate version of the test, which requires a two-mile hike with 25 pounds for 30 minutes.

The problem, federal experts say, is that some firefighters are not properly screened or physically prepared for the test. And many of them don't even need to take it. Apicello says there are 86 wildland firefighting positions, of which only about 25 require the arduous version of the Pack Test and some do not require any version.

As with any lodd, some concern and a call for further investigation has been raised by the IAFF. Officials from the International Association of Wildland Fire could not immediately be reached.

"While the two firefighters that recently died were not IAFF members, none the less, the test process in the Pack Test needs to be seriously evaluated, not just the test," said IAFF spokesman Richard M. Duffy. "The IAFF believes the use of a physical performance testing program that largely relies on a task-based timed test is extremely dangerous and has continued to oppose such tests."

Apicello said federal agencies require participants to complete a health screening questionnaire prior to taking the test, but procedures vary among state and local agencies. He said that of the eleven deaths, three or four were from federal agencies while the rest were from state or local agencies. Most of the firefighters were males over 40, he said.

Apicello said his greatest concern is that when people are not completely honest about their health and fitness, they become a detriment not only to themselves but to others on the fire line.

"If you can't be honest with yourself, you're not being fair to the people who might have to deal with you if you have an event on the incident," he said. "We need the safest work force we can have out there."

Duffy argues that the self-assessment for risk factors is not enough. "This is woefully inadequate, extremely dangerous and I believe the lack of a full medical evaluation prior to the test (and thereafter on an annual basis) was the causative factor in these deaths," he said. "Each of these individuals should be alive today."

The creator of the test, Dr. Brian Sharkey of the USDA Forest Service Technology and Development Center, says previous Pack Test deaths have already spurred re-examination of the risks and procedures involved. So is it safe for firefighters? "They have to determine that for themselves," he said.

Sharkey said he doesn't get access to details about the Pack Test deaths because of medical privacy laws. However, he sometimes hears that weight or pre-existing conditions were involved. He said some of the firefighters did have physicals that were unable to foresee any risk factors.

In order to avoid such a situation, Sharkey recommends getting medical approval and building up physical fitness gradually over many months, because inactive people increase their risk of a heart attack by 56 times, he said.

If firefighters are actually fit for the job, the Pack Test should be no big deal, he said. "It is perplexing that we still have people in active jobs who are inactive, or with heart conditions they don't disclose," he said. According to Sharkey's data, pass rates on the test exceed 90 percent in the United States, Canada, and Australia.

Sharkey said about 25,000 firefighters are involved wildland firefighting each season. However, this number does not include the rural and other fire department participants, and not all of these employees take the Pack Test. There is no specific estimate of Pack Test participants per year.

In addition to an honest assessment of personal health and fitness, experts recommend that anyone with questions get a doctor's opinion, and bring a letter to their doctor explaining the duties of the wildland firefighting position they plan to fill.

A medical examination is automatically recommended for those over 45, those with heart disease risk factors, and those who have been sedentary prior to a major increase in activity.

The IAFF's formal position is that the National Interagency Fire Center and all fire service entities need to adopt the physical and medical requirements specified in NFPA 1582, Standard on Comprehensive Occupational Medical Program for Fire Departments, to ensure that those who respond have the capability to perform arduous tasks in a hazardous environment, as well as to provide baseline medical records.

According to Sharkey, plans are underway to insure that incoming federal firefighters will get a medical exam. He said their medical history would be updated annually, and the physician examination and some medical tests would be repeated every five years until age 45, then every three years thereafter. This attention to health would be a good start, and hopefully local agencies will follow.