Author(s): Kendall Holland. Published on May 1, 2012.


Giant Steps
Two key fire service standards feature important changes aimed at occupational safety and medical issues for firefighters

NFPA Journal®, May/June 2012 

By Kendall Holland 

The new editions of NFPA 1500, Fire Department Occupational Safety and Health Program, and NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments, include changes that represent significant steps forward for firefighter health and wellness. Many of those changes have been driven by user needs and by advancements in technology, including improvements made to personal protective equipment that allow for enhanced protection, the inclusion of vehicle data recorders in fire department apparatus, improvements made to breathing apparatus, the improved quality to prosthetics to allow for greater exposures to high levels of heat, improved technology to monitor and treat diabetes and cardiac conditions, and more. Both documents will likely face certified amending motions at the Association Technical Meeting; considering the scope of some of the documents’ proposed changes, this comes as no surprise, and is a natural part of the evolution of the standards.

NFPA 1500 is the “umbrella” document that sets forth the safety requirements related to occupational safety and health for the fire service. The first edition of this document was published back in 1987, and while much has changed in both the fire service and the requirements within the standard since then, the next edition will reflect major changes based on the needs and demands of the fire service. In some cases the fire service has driven the change, and in other cases the standard has driven the change. Changes to two very different aspects of the standard illustrate where it’s currently heading.

The first significant change has to do with critical incident stress programs, which are covered in Chapter 12 in the current edition. Addressing critical incident stress — the emotional, physical, and psychological stresses caused by a particular incident or call such as a fatal fire involving children, or an EMS call involving the sudden death of a child, or an incident where a fellow fire fighter is injured or killed — is of great importance, but it is only one aspect of the entire health and wellness continuum for firefighters. The committee, through a publicly proposed change, has changed the title of Chapter 12 from “Critical Incident Stress Program” to “Occupational Exposure to Atypically Stressful Events.” The intent behind this change was to recognize and address the many steps or procedures that can and need to be done as part of the management of the stress caused by an atypical stressful event, which varies from person to person; critical incident stress debriefing (CISD), for example, is just one step among many in dealing with stressful events. The change goes from a 10,000-foot view, where CISD is provided, to more of a 100,000-foot view, where the overall health and wellness of the firefighter, as it relates to an atypically stressful event, is evaluated and managed. Think of CISD as a single page out of the chapter for the management of stressful events. This change is occurring in both the chapter title as well as in the chapter text.


Firefighter Health: Progress + Needs
The following are findings from NFPA’s "Third Needs Assessment of the U.S. Fire Service," conducted in 2010 and published in June 2011.

  • Overall, 30 percent of departments have a program to maintain basic firefighter fitness and health, up from 20 percent in 2001 and 24 percent in 2005. There has been considerable progress in this area, but most departments that protect communities of less than 10,000 population — and therefore most of the country’s fire departments overall — still do not have these programs.
  • The larger the population protected by a fire department, the more likely it is that the department has a program dedicated to firefighter fitness and health.
  • In the latest survey, an estimated 682,000 firefighters worked in departments without programs to maintain basic firefighter fitness and health, down from 792,000 in 2001 and 737,000 in 2005.
  • 61 percent of firefighters worked in departments without such programs, according to the latest survey, down from 73 percent in 2001 and 67 percent in 2005.
  • Two-thirds (68 percent) of departments indicated they have a program for infectious disease control, up slightly from 64 percent in 2001 and 65 percent in 2005. More than 95 percent of departments protecting at least 25,000 population have such programs. Even for the smallest communities (less than 2,500 population protected), 54 percent of departments reported having such programs.

The second important change was to include as a requirement the use of the word “MAYDAY” when a firefighter is in danger or subject to emergency conditions. As the standard is currently written, a firefighter is required to declare “emergency traffic,” meaning he has an emergency communication that takes priority over any other communications occurring on the radio. The standard  also calls for the firefighter to use clear text, which is the use of plain language in radio communications transmissions, when identifying the emergency to the incident commander, and to also transmit the message “all clear, resume radio traffic” once they feel they are no longer subject to the emergency condition.

The consensus among committee members, though, is that the current language is vague and not in common use within the fire service or in other public safety agencies. The thinking here is that “MAYDAY” is a commonly used term to identify and declare an emergency situation, and that if multiple public safety agencies are using the same radio frequency — especially with the passage of the D-block, that portion of the radio frequency spectrum that will be dedicated solely for use by public safety officials — confusion would be reduced when someone declares a “MAYDAY” versus “emergency traffic.”

Considering medical advancements
While NFPA 1500 is intended to serve as the “umbrella” document for fire service occupational health and safety, NFPA 1582 is the standard that contains the medical requirements that must be met to be considered for a position as a fire department member, as well as for specific evaluations of medical conditions for people who are already fire department members. Chapter 6 contains the medical requirements and evaluations for fire department candidates, while Chapter 9 contains the medical requirements for fire department members when getting their annual medical physicals. Of all the fire service occupational safety and health documents, NFPA 1582 seems to attract the most attention, mainly because the standard contains requirements that can be somewhat controversial, depending on your perspective.

That isn’t likely to change with the next edition of NFPA 1582, which includes three areas where significant revisions have occurred: amputees and joint replacement, diabetes and endocrine/metabolic issues, and pregnancy. While each issue could generate enough discussion for a master’s thesis, it is important to understand why these proposed changes are significant and how they align the document and its requirements with current medical thought, application, and technology.

In the area of amputees and joint replacement, the committee recognizes that technologies of the past might have precluded individuals from being considered as candidates for the fire service, or even that existing fire service members might not be able to safely perform their jobs. That is simply no longer the case, however. Due to rapid advancements in technology, such as prosthetics having a higher failure threshold when exposed to heat and the improvement of some joints in joint replacements, the committee realized it was time to re-evaluate the requirements of the standard. The committee’s discussions revolved around a central question, which was essentially this: “If the military allows certain prosthetics to be used in combat, why can’t the fire service do the same?” The committee recognizes that with state-of-the-art prosthetics and joints available, a more thorough evaluation must take place when assessing the fire department candidate or member that might have one of these adjuncts in place. It is because of these advancements that the committee has significantly changed these requirements.

The same held true for diabetes and endocrine/metabolic issues — the committee again had to recognize that practices of the past were not as applicable today, and that the current requirements needed to change to reflect advancements in medicine and treatment modalities. The current edition states that medical conditions such as Type 1 diabetes disqualify candidates from consideration, unless they can show or prove that over a period of five years there has been no more than one hypoglycemic event. In the next edition, the committee has shortened that to three years and increased the hypoglycemic episodes to two.

The current edition of NFPA 1582 includes a chapter with requirements for fire service candidates who are pregnant — described as a category B medical condition that could preclude a person from performing in a training or emergency operational environment by presenting a significant risk to the safety and health of the person or others — but there is no information in the standard about fire department members who are pregnant. What the committee has attempted to do is to establish the need for the pregnant firefighter and her physician to recognize the inherent dangers of firefighting and the potential negative impacts they may have on the mother and the unborn child. The intent of the changes is for the fire department member, her physician, and the AHJ, such as a fire chief, to work together to reach a decision on the duties the firefighter is able to perform, a decision based on all parties knowing the potential risks those duties entail and at what point those risks outweigh the benefits of being able to safely perform the job.

Despite the significant changes to the new editions of NFPA 1500 and NFPA 1582, there is still a lot of work to be done. The overarching goal, after all, is to minimize the number of firefighter injuries and deaths through the development, adoption, and application of our occupational safety and health standards. Considering the ever-changing landscape of the fire service and the risks faced by firefighters on every call, it is essential that the requirements that revolve around occupational safety and health must also change.

Kendall Holland is a fire service specialist at NFPA.