Online Exclusive Archives
September/October 2008

NFPA Journal® online exclusive, September 2008

In a job such as firefighting, which requires intense physical activity, consistent quality health maintenance is crucial. Chronic exposure to heat, smoke, and toxins cause numerous adverse physiological changes, says Dr. Michael Hamrock, the Boston, Massachusetts, Fire Department’s medical examiner, and evidence suggests that firefighters have a greater risk of developing coronary artery disease and cancer than other Boston residents.

According to Roderick J. Fraser, Jr., fire commissioner of the Boston, Massachusetts, Fire Department, however, only 32 percent of Boston firefighters currently get an annual physical examination as compared to 50 percent of City of Boston employees as a whole.

In a letter to Boston firefighters, Commissioner Fraser announced that the city has developed a Wellness Initiative in conjunction with Harvard Pilgrim Health Care, one of its primary health insurance providers. As outlined in the letter, Harvard Pilgrim will conduct on-site screenings for high blood pressure and high cholesterol, two health problems closely linked to firefighting. Harvard Pilgrim Health Care will visit each fire department location at times that will accommodate all shifts, and firefighters will be able to meet one-on-one with health professionals who will explain the results and make individual nutrition recommendations. The free screenings are confidential, and firefighters can take advantage of the screenings even if they are not Harvard Pilgrim members.

In addition, Harvard Pilgrim will allow firefighters’ primary care physicians to perform additional screenings and lab tests during their annual physical examinations. These screenings and tests are designed to deal with the particular health risks associated with firefighting. Dr. Hamrock will provide firefighters with letters outlining what screening and tests should be performed. Again, these procedures will be available at no additional expense.

Finally, the Department will invest in new fitness equipment at each station.

In his letter to physicians, Dr. Hamrock says that comprehensive annual physical exams and screening tests should focus on primary prevention of cardiovascular disease and cancer. These tests should screen for diabetes, hypertension, smoking, alcohol and substance abuse, obesity, family history of coronary artery disease, sedentary lifestyle, and high cholesterol. In addition, firefighters should be tested for skin, kidney, brain, lung, prostate, colon, and bladder cancer, as well as leukemia and lymphoma, 10 years earlier than the general population, where applicable.

The annual exam should also include:

• Blood Pressure, pulse, respiratory rate, and temperature
• Oxygen saturation
• Weight and body fat index
• Thorough skin exam
• Eye exam and hearing testing
• Oral exam
• Heart and lung exam
• Abdominal and testicular exam
• Prostate and rectal exam with fecal occult blood testing
• Pelvic and Pap exam for female firefighters
• Vascular, neurological and mental status exams
• Comprehensive metabolic and chemistry panel
• Liver function tests
• Hepatitis profile
• Complete blood count
• Thyroid panel
• Hemoglobin A1c (for diabetes monitoring)
• Fasting lipid profile and blood glucose
• Urinalysis
• EKG
• PSA (Prostate specific antigen begin at age 40 for prostate cancer screening)
• Pulmonary function test every three years
• Chest x-ray every three years
• Colonoscopy (begin age 40 and every five years)
• Exercise stress test (begin age 40 and every three years)
• Mammograms for female firefighters (begin age 35 and then every year)

For more information, please visit www.cityofboston.gov/fire.

In this Section:
			When the Angels Came Calling This year marks the 50th anniversary of one of the most tragic school fires to ever take place in the United States.
			Boston Fire Department Brings Health Care to the Firehouse In a job such as firefighting, which requires intense physical activity, consistent quality health maintenance is crucial.
			Using Fire Alarm Systems in Campus Mass Notification Using new and existing voice-communication fire alarm systems can help limit or mitigate an incident on your campus.
			North Charleston Wins the 2007 Rolf Jensen Memorial Award The department overhauled its “Smoke Alarm Assistance Program” with the addition of GIS (geographic information system).
			Propane Cylinder Exchange Cabinets Exchanging empty propane cylinders for full cylinders has become common place, but is it safe?
			Intelligibility of Fire Alarm and Emergency Communications Systems NFPA's Fire Protection Research Foundation has launched a study to explore some of the issues of voice communication intelligibility.
			NFPA Codes and Standards Snapshot NFPA Journal talks to Gregory Harrington, staff liaison for NFPA 909, Protection of Cultural Resources Properties-Museums, Libraries, and Places of Worship.