Are you fighting fit?
How effective are workplace fitness policies? An evidence-based fitness programme carried out on a sample group of firefighters proved encouraging.
Intense exertion under extreme conditions is an occupational hazard for firefighters, who must carry out arduous physical work for potentially long periods of time.
A satisfactory baseline level of fitness and a normal body fat range is needed to compensate for the additional physical burdens associated with wearing heavy personal protective clothing and equipment, and coping with adverse environmental conditions. (1)
Numerous studies have confirmed that individuals with higher aerobic fitness and normal ranges of body fat do perform better in adverse firefighting conditions, reducing the risks arising from the working environment. (2,3,4,5) A Home Office report published in March 2000 recommended that firefighters should receive support with physical training and undergo regular fitness monitoring. (6)
Fitness monitoring
South Wales Fire Service introduced a fitness policy in 1998. Annual health and fitness reviews were implemented, incorporating a lifestyle assessment and health education with the OHN. This was followed by a step test to measure aerobic fitness, and a body fat assessment conducted by the physical training adviser.
As many of the heavy manual tasks associated with firefighting require aerobic capacity (7), measuring this is an important predictor of a firefighters' performance effectiveness (8). Brigades have adopted the step test as a tool to measure aerobic capacity due to its low risk nature, because it is cheap to perform, portable and easy to administer.
The step test has a disadvantage in that it is a predictive test that does have an expected margin of error. Baker (7) identifies that this margin of error may vary by up to 16 per cent, and argues that other tests should be explored due to the step test's inadequacy.
However, Stevens prefers the step test as a method of assessing aerobic capacity due to its practicality for use in the Fire Service. (9) He compared it with two other tests to measure aerobic capacity, and concluded that the reliability of all the tests was similar. Steven's sample population was greater than Baker's, and the author would support Steven's opinion that the use of the step test in the UK Fire Service is sufficient to monitor and predict an individual's level of fitness. The existing margin of error should be considered and some discretion and a degree of common sense used when interpreting the results.
The physical training policy
The physical training adviser implemented an educational campaign prior to introducing fitness testing to raise awareness and support among firefighters.
A rolling programme of two-day courses was devised to train a minimum of four firefighters from each station to be Watch Fitness Advisers (WFA). They would then motivate colleagues to participate in exercises and supervise aerobically based physical training sessions at the station.
Firefighters were allocated 45 minutes each day for physical training. Once a WFA had been trained, it was agreed that their watch should be allowed three months preparation before undergoing a fitness test.
On reflection, this educational campaign was a major contributor to the success of the policy, as it highlighted the need for physical training and ensured most individuals had prepared well under supervision prior to implementing the testing programme.
Representative sample for study
A random sample of 52 firefighters, whose ranks ranged from firefighter to station officer, participated in the study.
The only criteria for inclusion was that all would have records of Chester step test scores, pre- and post-implementation of the physical training policy. The age bracket ranged between 26 and 55 years, providing a reasonable representation of the Brigade's age groups.
A questionnaire was distributed to gather data on opinion and the current level of physical training within the brigade. The response rate was 54 per cent. As the table above demonstrates, an evenly-balanced age group. Ninety-two per cent of the sample population exercise regularly, whether it be in work, at home or both. And only two individuals in the older age group said that they took no form of regular physical training.
Exercise within work hours
Firefighters are allocated 45 minutes each day for physical training and the questionnaire showed that 78 per cent of individuals used this time for that purpose. Firefighters work a rotational shift pattern where they work for two days, two nights and receive four days off.
The advice provided by the brigade's physical training adviser is that all firefighters should aim to exercise aerobically two-three times weekly for at least 20-30 minutes. The questionnaire response suggests that 78 per cent are exceeding this within work hours.
Exercise within own time
The survey revealed that 86 per cent of the sample population exercise regularly outside working hours. The majority of these firefighters also exercise at work, which is encouraging.
Participants agreed that aerobic fitness is important for firefighting, believing it benefits them in the long term. It was generally agreed that individuals were sufficiently informed of the policy and were happy with the concepts and components of the fitness review.
The main focus on introducing the policy was the preparation and education of WFAs and it appears that this was instrumental in encouraging the majority of individuals to participate.
Aerobic capacity
Testing pre- and post-implementation of the policy showed an improvement in aerobic capacity among all age groups. Having also considered the positive response by firefighters in favour of the policy, it is reasonable to interpret that allowing time for exercise at work and introducing annual health and fitness reviews has played a significant role in improving fitness levels.
Lusa et al demonstrated in his study that young and healthy individuals with fitness levels by far exceeding Home Office requirements find that wearing breathing apparatus in hot conditions still proves physically demanding, thus the need for increased fitness to reduce the risks of complications associated with such adverse conditions.
Conclusion
Despite the small numbers involved in this study, the results are encouraging. The brigade has adopted an evidence-based approach to its policy from the outset to encourage firefighters to aim for a high standard of fitness to prepare them for all eventualities.
The information gathered confirms there is an overall improvement in fitness scores since the policy was introduced. The majority of staff exercise at home as well as at work, and all but two who do not exercise at work said they maintained their fitness in their own time.
The highly-significant improvement in fitness scores, along with the overall opinions assessed on the questionnaire, indicates that the policy has improved attitudes, awareness and encouraged a responsible approach towards fitness.
The weight training, strength-orientated culture that has always been associated with the Fire Service is gradually being replaced with aerobic training and high stamina, which has better effects on fitness and long term health. A larger study would be advantageous to assess the overall situation across the brigade.
Lyndon Davis is an OH nurse with South Wales Fire Service and recently
obtained a BSc (Hons) in Occupational Health Nursing at the University of
Bristol
References
1: Sykes K (1991). Fitness to Shout About. Occupational Health 43(1):16-18
2: Lusa S, Louhevaara V, Smolander J, Kivimaki M, Korhonen O (1993). Physiological responses of firefighting students during simulated smoke diving in heat. Americal Industrial Hygiene Association Journal May; 54(5): 228-31
3: Misner JE, Plowman SA, Boileau RA (1987). Performance differences between males and females on simulated fire fighting tasks. Journal of Occupational Medicine; 29(10):801-05
4: Cheung SS, McLellan TM (1999). Comparison of short term aerobic training and high aerobic power on tolerance to uncompensable heat stress. Aviation Space Environmental Medicine; Jul 70(7):637-43
5: Love RG, Johnstone JBJ, Crawford J, Tesh KM, Graveling RA, Ritchie P, Hutchison PA, Wetherill GZ (1994) Study of the physiological effects of wearing breathing apparatus. Institute of Occupational Medicine Report Reference No. TM/94/05
6: Home Office Fire Service Inspectorate Report (2000) Fit for Duty? A thematic review by HM Fire service Inspectorate of sickness absence and ill-health retirements in the fire service
7: Baker S (1999) Fighting Fit Occupational Health 51(10):16-18
8: Sothmann MS, Saupe K, Jasenof D, Blaney J (1992) Heart rate response of fire fighters to actual emergencies. Implications for cardio respiratory fitness. Journal of Occupational Medicine 34(8):797-800
9: Stevens N, Sykes (1996) Aerobic fitness testing: an update. Journal of Occupational Health 48(12) :436-438
Who is exercising and where?
31-35
(7)
1
6
7 0
36-40
(3)
0
2
3 0
41-45
(7)
1
6
6 0
46-50
(4)
0
4 3 0
51-55
(4)
0
1 2 2