Researchers stress fitness for firefighters, EMTs
Obese recruits found in study
Boston researchers are sounding the alarm about the physical fitness of candidates for firefighting and emergency medical technician jobs in Massachusetts.
Roughly 77 percent of recruits were overweight or obese as measured by standard body-mass index, the researchers found, according to a study published online yesterday in the journal Obesity.
All of the normal-weight recruits passed minimum exercise tests recommended by the National Fire Protection Association, a nonprofit that sets standards for the industry. But 7 percent of the overweight and 42 percent of the obese recruits failed to meet the minimum standard, said the researchers from Boston University School of Medicine, Harvard University, and the Cambridge Health Alliance.
The findings, they said, have profound public safety and economic implications because emergency responders who are unable to perform physically challenging work put themselves, their colleagues, and the public at risk. They also potentially sap funding, the researchers said, because obesity is directly linked to higher risk for cardiovascular problems and other maladies, and responders who are disabled on the job are entitled to disability pensions.
"If the current trend we have demonstrated is unchecked, we would expect not only the number of heart attacks to go up, but we could expect them at younger ages, so we would have people either dying younger or going out on disability at younger ages," said Dr. Stefanos Kales, a senior author of the study and director of the occupational and environmental medicine residency at Harvard's School of Public Health.
Among the 370 recruits from Greater Boston communities studied between 2004 and 2007, 22 percent were normal weight; about 44 percent were overweight; and 33 percent were obese. The researchers declined to identify the communities studied.
They said they excluded results from candidates older than 35 and those who had failed minimum standards set by their prospective employers to focus only on young recruits and those most likely to be hired. They also said that, given the rising epidemic of obesity nationwide, they believe their findings would be similar for emergency-responder recruits across the country.
Local fire chiefs and EMS officials generally agreed that candidates are getting heavier, but questioned whether that affected their ability to do the job.
"Before we send [recruits] to training or to enter the academy, they have to pass a physical test - carrying a 180-pound dummy up three flights up stairs, perform CPR for a few minutes, then carry it down the stairs, simulating real-world experience," said Rich Serino, chief of Boston's EMS.
After recruits are hired, fitness and good nutrition are emphasized, he said, but physical fitness tests are not repeated during their careers. Fitness tests for EMT and firefighter candidates vary greatly from community to community and between public and private ambulance companies, according to the study's lead author, Antonios Tsismenakis, a second-year medical student at BU's School of Medicine. Tsismenakis, a former EMT in a Boston-area private ambulance company, said he was not required to pass any physical exam for his position from 2002 to 2006.
Ware's fire chief, Tom Coulombe, who is a vice president of the Fire Chiefs Association of Massachusetts and has been a firefighter for 22 years, said more departments are pushing for recruits to be healthier.
"There is a lot more emphasis on a national, state, and local level now than even five years ago," he said.
"One of the nice things about a fire department is that it's a family atmosphere, they spend so much time together and every shift has a good cook," Coulombe said. "It used to be lunches and evening meals were a full-blown meal, and I don't see that anymore."
The study's authors said they plan to talk to Massachusetts and national firefighting groups about educating recruits about good nutrition, exercise, and health risks from obesity.
"There should be exercise equipment at the job site and time appropriated during the day to make use of the equipment, as well as periodic health maintenance screenings," Tsismenakis said. "Those screenings don't exist in the majority of fire departments."
Kay Lazar can be reached at klazar@globe.com. 