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Firefighter medical assessment

Firefighters may be exposed to extreme physical and psychological demands in hostile and dangerous environments. To comply with relevant statutory provisions, the medical screening for Firefighters is rigorous. Under the Health and Safety at Work Act 1974, the Fire and Rescue Service must reduce risk so far as is reasonably practicable. This means a medical condition giving rise to reasonably foreseeable occupational risk would not be acceptable.

However, the nature and effect of medical conditions vary, and it is therefore not possible to confirm medical conditions that would be unacceptable prior to an individual medical assessment. If you have a medical condition or a history of a medical condition which might present problems, the following general guidance should help you consider your medical suitability and whether additional specialist information will be necessary at your medical assessment.

A medical condition or functional limitation which, despite any reasonable adjustments, gives rise to significantly increased occupational risk of the following is likely to be unacceptable:

  • Collapse or sudden incapacitation
  • Impaired judgement or altered awareness
  • Substantial physical or psychological injury/ill health
  • Any other effect which would pose a substantial health and safety risk to yourself or others

A health questionnaire will need to be completed and signed by your GP prior to your medical screening. The medical will not be performed without the GP’s signature and will delay your recruitment process.

Qualified health professionals, such as an occupational health technician and occupational health nurse will complete and discuss the information on the form with you. A qualified occupational health doctor will complete the medical. The health information declared and testing undertaken during the medical will be assessed against the medical standards required for becoming a firefighter. There may be occasions when further information is required from your GP or Consultant. Your health information will remain confidential to the occupational health and fitness team only. Doctors and nurses are bound by their respective codes conduct for maintaining confidentiality.

Firefighter - eyesight requirements

All applicants will be required to undergo an eye examination by a qualified optician; this will require photo ID being signed by the optician and attached to the form. If no signed and photograph ID is completed and attached at the time of the medical the eyesight tests will be undertaken on the day. If the eyesight standards are not met on the day the tests will then need to be undertaken by the optician in the process just described above, this may delay your starting date. If you have any doubts regarding your eyesight, we suggest that you book an appointment with your optician and make them aware of the required standards (these can be found in the FAQs).

Colour Sensitivity (aka Colour Blindness)

If you believe that you have a colour sensitivity it is advised that you arrange a formal assessment with a suitably qualified professional prior to applying to assess the level of colour sensitivity. This assessment may include the Farnsworth D-15. This assessment must then be brought to your medical assessment.

An Ishihara test will be performed on the day and if a colour sensitivity test is found further assessment as described above will be required. This may delay your recruitment process

*We recommend prior to applying as, if we find colour sensitivity at the medical and having passed all other aspects of the recruitment process, you find yourself having to get the D-15 test done later your start date will be delayed, ie starting on a later course.

The medical assessment will include the following:

  • General health questionnaire includes a history of physical and mental health, (with additional respiratory questions for the Asbestos Regulations)
  • Measurement of pulse, blood pressure, height, weight and waist measurement
  • Urinalysis including substance misue testing
  • Alcohol testing (saliva)
  • Vision (both near and distance) plus colour vision
  • Spirometry (lung capacity test)
  • Audiometry (hearing test)
  • General physical examination (e.g. cardiovascular, neurological, respiratory, musculoskeletal etc)
  • Cardiovascular Fitness Test

FAQ's

The Vision Standards for becoming a Firefighter are as follows:
  • Vision must be binocular, with full visual fields.
  • Distance vision:
    • Uncorrected: 6/60 monocularly
    • Corrected: 6/9 binocularly, and a minimum of 6/12 in the worse eye
  • Near vision: be able to read N12 at 30cm binocularly; this may be achieved with corrective aids.

Post Refractive Surgery

Entry for recruits will not be considered until 12 months post-surgery to allow for stabilisation.

  • Uncorrected: 6/12 in the better eye
  • Corrected: 6/9 or better in the better eye
  • Eye disease: Have no history of night blindness or any other ocular disease that is likely to progress and result in future failure of the visual standards for serving firefighters.
  • Individuals with keratoconus are unlikely to be fit for firefighting duties
  • Compound astigmatism assesses for capability, history of headaches and eyestrain
  • Have an appropriate level of colour perception, please see above
  • Have not undergone refractive surgery in the previous 12 months. Individuals who have had Radial Keratotomy cannot be considered for operational firefighting duties due to the relatively high incidence of refractive instability.
  • Individuals who have undergone the following types of refractive surgery can be considered 12 months after surgery:
    • Photorefractive Keratectomy (PRK)
    • Laser assisted in-situ keratomileusis (LASIK)
    • Laser epithelial keratomileusis (LASEK)
  • Soft contact lenses can be worn.
  • Rigid (hard) lenses are not considered safe, as debris can become trapped beneath these, which can cause visual discomfort and disability.
  • Assessment after Refractive Surgery – an examination to consider the suitability of a refractive surgery patient for operational firefighting should include:
    • A slit lamp examination to confirm that the eye has returned to normal and that there is no significant loss of corneal transparency over the pupil area
    • Refraction, topographic examination and pachymetry to screen for keratectasia.
    • Candidates should have their visual performance assessed using a technique sensitive to the presence of scattered light and aberrations.

Firefighters must not only communicate over the radio, but they must respond to shouted warnings, audible alarms and cries for help – all above the environmental noise at incidents. Therefore, they need to have a minimum hearing level to be considered 'fit for role', which would normally be H2 (military standards). Hearing aids are allowed on the fire ground, however, they must meet certain standards.

At your medical you have a hearing test called a Pure Tone Audiometry (PTA), a calculation is performed on the results and if the standard of H1 or H2 is met no further testing will be required. If neither of these standards are achieved this will be considered a failure as standards will not be met.

Asthma does not necessarily prevent you from becoming a firefighter. However, firefighters are exposed to smoke and other toxicants as part of their job, which are irritating to the lungs / upper respiratory tract and can exacerbate the symptoms of wheezing in firefighters with asthma. Your condition will be assessed at the medical stage, after which a decision will be made as to your suitability for the role of firefighter. This will include:

  • Careful history that focuses on current symptoms and treatment requirements,
  • Potential triggers including exercise and irritant exposures
  • The frequency and history of exacerbations

Mental health issues can affect anyone, and it is estimated that 1 in 6 people in the past week will have experienced a common mental health problem. Most individuals can manage these episodes with self-help strategies, counselling support or medication (in some cases) and can continue to cope well in their everyday activities.

Having experienced such issues will not prevent you from applying to become a firefighter and all cases will be discussed confidentially with you during your medical assessment. If you have recently begun to have symptoms or started treatment, it could be that information will be required from your GP or Specialist to help during this assessment.

If you have a chronic mental health condition which requires ongoing treatment or input from a GP or specialist, we are likely to need medical reports to be able to offer an opinion on your fitness for firefighting. If you are aware that any of the above could apply to you, please get in touch with us to discuss this further

Our method of assessment is by using a standardised treadmill test and you have to reach a set standard. The level of fitness is maintained throughout a firefighter’s career, which is assessed annually.

Prior to engaging in physical activities as part of the firefighter application process, we will take blood pressure readings to ensure that it is safe for someone to do so. If the readings on the day indicate Stage 2 hypertension (see below), we will not allow an individual to undertake the physical assessments and suggest that they discuss the results with their GP.

Whilst we realise that it is possible for people to have some fluctuations in their blood pressure readings dependent on many factors, we will not have the opportunity to schedule further readings during the application process. Therefore, if you are aware that you do have, or previously had high blood pressure, you should take steps to ensure that this is professionally managed before attending for physical assessments.

What increases risk of developing high blood pressure?

There are various things that can cause an increase in blood pressure, including:

  • Being overweight
  • A diet high in salt
  • Not eating enough fruit and vegetables
  • Drinking too much alcohol or caffeine-based drinks i.e., coffee
  • Not engaging in regular physical activity
  • Smoking
  • A family history of high blood pressure

Lifestyle changes for managing blood pressure

To prevent or reduce high blood pressure, there are various lifestyle changes you can adopt which can help to lower your blood pressure:

  • If you are overweight, then weight loss can help
  • Regular physical activity
  • Reduce salt intake
  • Moderation on alcohol Intake

For more help and advice visit the British Heart Foundation heart matters page.

To help us to measure your blood pressure accurately when you attend, please refrain from food, caffeine, tobacco and alcohol for 30 minutes before arrival.

Please email any queries to the Occupational Health and Fitness mailbox and we will contact you to discuss further.