One comment on “Health and Wellness Program

  1. Harvey … I totally concur with you on a conceptual basis. The fatality and injury rates among volunteer firefighters is a travesty, and only a preventive and health promotion approach can address this. However, this is a steep hill to climb, as you know.

    In the Midwest and Southeast where I have spent the majority of my professional time, I have observed the following progression of health attitudes among volunteer firefighters over and over (I know there are exceptions, but I think that this model is a pretty good fit overall):

    1. The New Guys (20s): Like all twenty-somethings, absolutely convinced of their inherent good health and physical fitness; a firm belief that not having an office job will automatically keep them physically fit forever, regardless of nicotine, alcohol and fast food intake; looks askance at the “older guys” (30+ year olds) who have somehow let themselves go and gotten all fat and out of shape. Primary health/safety risks for this group: Driving too fast, not wearing seatbelts, not using PPE.

    2. Middle Aged Firefighters (30s – 40s): The effects of poor lifestyle choices (booze, smoking, etc) have crept up on many of these guys, although they are probably in denial about it; Now seasoned firefighters, they are valued by the department for their knowledge, but their inability to keep up, particulary for high-stress tasks, is becoming more apparent; Some will become cardiac risks, most will still deny the need for a comprehensive health and fitness program for themselves, or just refuse to participate due to inconvenience or personal bias. Primary health/safety risks for this group: Not using seatbelts, not using PPE, overexertion during fire operations (although more likely to lead to injury than death at this age).

    3. The Old Guys (50+ years): The chickens have really come home to roost for some of these guys, with the health effects of hard living, obesity, smoking and reluctance to use SCBA starting to show in a big way. While it is time to consider retiring from firefighting (or transitioning to a support role), pride (fatalism?) drives many of these guys to keep putting on their turnouts and dragging hoses. This group is most at-risk for death or injury on the incident scene, with cardiac events becoming increasingly likely, endangering both themselves and their crew-mates. Primary health/safety risks for this group: Overexertion leading to death.

    What’s the solution? Since you can’t enforce fitness oriented lifestyle changes on volunteers, and incentive programs don’t seem to work, it seems that regular, rigorous physical exams based on nationally-accepted standards are the best screening tool; perhaps used in combination with annual physical fitness tests for those wanting to perform firefighting duties (like the annual pack test for wildland firefighters). This will, of course, result in staffing shortfalls for many departments, and the only solution for this will be distasteful/unacceptable to many: Consolidation with neighboring departments, conversion to paid staffing, and/or reduction in services to the public.

    Also, the Certified Fireground Resource Technician program developed by the Mississippi State Fire Academy seems like it would be a good option for many departments. This program provides a pathway to an “honorable” exit for those too old or infirm to perform firefighting duties, setting them up with a comprehensive training program that allows them to effectively perform essential support functions on the incident scene. More states should probably be considering a program like this as a means of preserving valuable experience while chipping away at our appalling fatality rates among older firefighters.

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