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Safety & Health: Survive Alive

More than four years ago, the board of the IAFC’s Safety, Health & Survival Section (SHS) met in Virginia over several cold and blustery January days to create a new strategic plan. Much of the discussion during these meetings focused on the repeated cycle of preventable line-of-duty deaths and disability year after year and how most of these could be prevented through annual medical physicals and early identification and intervention.

Since that time, the section’s strategic focus has been on attaining the vision of an annual medical exam for every one of the million-plus firefighters in the United States.

SHS has held three annual firefighter physicals summits since that strategic meeting. The first summit was held in conjunction with the Tampa 2 gathering in 2014; the second was in conjunction with Fire-Rescue International in Atlanta in 2015.

The third summit was held this past August at FRI in San Antonio. This summit focused on the successes enjoyed so far and identified next steps in the work towards achieving the vision of an annual medical physical for every firefighter.

These summits brought together a diverse group of stakeholders to develop a roadmap for answering the question, “How do we provide every firefighter, at no cost to them, an annual physical?”

The stakeholders included groups such as the FEMA Grants Directorate, insurance industry, fire service researchers and medical communities, labor and volunteer representatives, the USFA, the National Fallen Firefighters Foundation and many others.

One of the key barriers identified is health-care providers’ lack of understanding of firefighters’ unique occupational health needs. This barrier is a critical obstacle SHS and the IAFC identified as needing to be addressed as an early priority before further progress could be made.

In 2015, the IAFC, through the Firefighter Safety Through Advanced Research (FSTAR) program, was awarded a FEMA AFG grant to develop the Healthcare Provider’s Guide to Firefighter Physicals. The primary objective of this guide is to address this lack of understanding.

The guide opens with a description of the physiological demands, hazards and exposures of firefighting. It then leads into clinical recommendations backed by research and the experience from our working group of physicians, researchers and fire service experts.

Four other projects are also included in this grant:

  • Updating the SHS’s A Fire Department’s Guide to Implementing NFPA 1582
  • Conducting comprehensive marketing, education and outreach to the healthcare community on the importance of firefighter physicals
  • Developing and reporting from a national survey of current fire service physical-exam practices
  • Determining the feasibility of developing a certification for healthcare providers conducting NFPA 1582 physicals

In my own department in Broward County, Florida, we implemented mandatory NFPA 1582-compliant physicals, along with diagnostic ultrasounds, of the 700 members for the first time in the department’s history. The results were 737 “significant findings,” including but not limited to 6 cancers, 5 severe carotid artery blockages, 60 cases of hypertension and 8 abnormal stress tests. These are only a few examples in my department of how annual physical exams can prevent potentially devastating medical tragedies.

Whether your department funds annual physicals or not, now that we have the Healthcare Provider’s Guide to Firefighter Physicals, all firefighters—whether career or volunteer—should have a medical physical every year by a healthcare provider educated in the unique occupational needs of firefighters.

Have you scheduled your annual firefighter physical? If not, what are you waiting for?

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