Adverse health requirements in fire fighters as start for guidance of occupational physicians in WHS

Introduction
A job-specific workers’ health surveillance (WHS) was developed for fire fighters, in which several health requirements were tested. The aim of this study was twofold: to signal adverse health requirements in fire fighters and to study whether occupational physicians apply these findings as start for their guidance.

Methods
WHS was executed by 278 fire fighters. Parameters used for psychological requirements were sleepiness, work-related fatigue, depression, posttraumatic stress and anxiety. For physical requirements the cardio-respiratory and musculoskeletal aspects and carrying capacity were assessed. For sense-related requirements (colour) vision and hearing were assessed. Risk factors for cardiovascular diseases were also investigated. For the first aim relative frequencies of adverse health requirements were calculated. Following the WHS fire fighters had an individual consultation with the occupational physician about the results. Occupational physicians were asked to follow a guideline with interventions when adverse health requirements were found and to report which interventions were initiated. Frequencies of initiated interventions were calculated for the second aim.

Results
Most prevalent adverse health outcomes were cardiovascular risk factors – BMI (55%), systolic blood pressure (23%) and smoking (22%) – and a job-specific physical test (25%). Nearly 80% of the adverse psychological requirements were correctly noticed by occupational physicians and interventions were partly or completely started. Physical and sense-related requirements were noticed in 50% of the cases and interventions correctly initiated. In total, eight out of ten interventions were partly or completely started after adverse cardiovascular requirements were found.

Discussion
Adverse health requirements for fire fighters involved mostly cardiovascular risk factors and physical signals. When adverse health requirements were noticed by the occupational physician, over 50% of the interventions were initiated correctly by occupational physicians. In the training for occupational physicians, attention should be paid to initiate interventions more frequently for physical and sense-related requirements.