A systematic review of job-specific workers’ health surveillance activities for fire-fighting, ambulance, police and military personnel

  • M. J. Plat
  • M. H. W. Frings-Dresen
  • J. K. Sluiter



Some occupations have tasks and activities that require monitoring safety and health aspects of the job; examples of such occupations are emergency services personnel and military personnel. The two objectives of this systematic review were to describe (1) the existing job-specific workers’ health surveillance (WHS) activities and (2) the effectiveness of job-specific WHS interventions with respect to work functioning, for selected jobs.


The search strategy systematically searched the PubMed, PsycINFO and OSH-update databases. The search strategy consisted of several synonyms of the job titles of interest, combined with synonyms for workers’ health surveillance. The methodological quality was checked.


At least one study was found for each of the following occupations fire fighters, ambulance personnel, police personnel and military personnel. For the first objective, 24 studies described several job-specific WHS activities aimed at aspects of psychological, ‘physical’ (energetic, biomechanical and balance), sense-related, environmental exposure or cardiovascular requirements. The seven studies found for the second objective measured different outcomes related to work functioning. The methodological quality of the interventions varied, but with the exception of one study, all scored over 55% of the maximum score. Six studies showed effectiveness on at least some of the defined outcomes. The studies described several job-specific interventions: a trauma resilience training, healthy lifestyle promotion, physical readiness training, respiratory muscle training, endurance and resistance training, a physical exercise programme and comparing vaccines.


Several examples of job-specific WHS activities were found for the four occupations. Compared to studies focusing on physical tasks, a few studies were found that focus on psychological tasks. Effectiveness studies for job-specific WHS interventions were scarce, although their results were promising. We recommend studying job-specific WHS in effectiveness studies.


Workers’ health surveillance Emergency services personnel Military personnel Systematic review Job-specific Job requirements 


  1. Arnetz BB, Nevedal DC, Lumley MA, Backman L, Lublin A (2009) Trauma resilience training for police: psychophysiological and performance effects. J Police Crim Psych 24:1–9CrossRefGoogle Scholar
  2. Arvey RD, Landon TE (1992) Development of physical ability tests for police officers: a construct validation approach. J Appl Psychol Monogr 77(6):996–1009CrossRefGoogle Scholar
  3. Åstrand P, Rodahl K, Dahl H et al (2003) Textbook of work physiology. Physiological bases of exercise. Human Kinetics, ChampaignGoogle Scholar
  4. Bos J, Mol E, Visser B, Frings-Dresen MHW (2004) The physical demands upon (Dutch) fire-fighters in relation to the maximum acceptable energetic workload. Ergonomics 47(4):446–460CrossRefGoogle Scholar
  5. Büyükçakir CC (2005) Hearing loss in Turkish aviators. Military Med 170(7):572–576Google Scholar
  6. Byczek L, Walton SM, Conrad KM, Reichelt PA, Samo DG (2004) Cardiovascular risks in firefighters. AAOHN J 52(2):66–76Google Scholar
  7. Capodaglio EM, Imbriani M, Criffo A (1996) A method for the assessment of fitness in aerobically taxing occupations. Int J Occup Med Environ Health 9(3):227–234Google Scholar
  8. Downs SH, Black N (1998) The feasibility of creating a checklist for the assessment of the methodological quality both of randomised and non-randomised studies of health care interventions. J Epidemiol Commun Health 52:377–384CrossRefGoogle Scholar
  9. Eick AA, Wang Z, Hughes H, Ford SM, Tobler SK (2009) Comparison of the trivalent live attenuated vs. inactivated influenza vaccines among US military service members. Vaccine 27:3568–3575CrossRefGoogle Scholar
  10. Elliot DL, Goldberg L, Kuehl KS, Moe EL, Breger RKR, Pickering MA (2007) The PHLAME (promoting healthy lifestyles: alternative models’ Effects) firefighter study: outcomes of two models of behaviour change. JOEM 49(2):204–212Google Scholar
  11. Erneston AG, Ricks MR, Tate TJ, Ana RS (1996) Vision readiness in the United States air force revisited. Military Med 161(1):27–28Google Scholar
  12. Gamble RP, Boreham CAG, Stevens AB (1993) Effects of a 10-week exercise intervention programme on exercise and work capacities in Belfast’s ambulancemen. Occup Med 43:85–89CrossRefGoogle Scholar
  13. Gerkin D (1995) Firefighters: fitness for duty. Occup Med 10(4):871–876Google Scholar
  14. Greven F, Kerstjens HAM, Duijm F, Eppinga P, de Meer G, Heederik D (2009) Respiratory effects in the aftermath of a major fire in a chemical waste depot. Scand J Work Environ Health 35(5):368–375Google Scholar
  15. Hatch BC, Hilber DJ, Elledge JB, Stout JW, Lee RB (2009) The effects of visual acuity on target discrimination and shooting performance. Optom Vis Sci 86(12):E1359–E1367CrossRefGoogle Scholar
  16. Hulshof CTJ, MHW Frings-Dresen (2010) International OH systems. Part 2: occupational health delivery in the Netherlands. Occup Health Work 6 (5):19–23Google Scholar
  17. Kelly KJ, Connelly E, Reinhold GA, Byrne M, Prezant DJ (2002) Assessment of health effects in New York city firefighters after exposure to polychlorinated biphenyls (PCBs) and polychlorinated dibenzofurans (PCDFs): the Staten island transformer fire health surveillance project. Arch Environ Health 57(4):282–293CrossRefGoogle Scholar
  18. Knapik JJ, Rieger W, Palkoska F, van Camp S, Darakjy S (2009) United States army physical readiness training: rationale and evaluation of the physical training doctrine. J Strength Condit Res 23(4):1353–1362CrossRefGoogle Scholar
  19. Kow D, Aw T-C (2003) Surveillance in occupational health. Occup Environ Med 60:705–710CrossRefGoogle Scholar
  20. Kraemer WJ, Vescovi JS, Volek JS, Nindl BC, Newon RU, Patton JF et al (2004) Effects of concurrent resistance and aerobic training on load-bearing performance and the army physical fitness test. Military Med 169(12):994–999Google Scholar
  21. Levin SM, Herbert R, Moline JM, Todd AC, Stevenson L, Landsbergis P et al (2004) Physical health status of world trade center rescue, recovery workers, volunteers-New York city, July 2002–August. Morb Mortal Week Report 53(35):807–812Google Scholar
  22. Louhevaara V, Soukainen LusaS, Tulppo M, Tuomi P, Kajaste T (1994) Development and evaluation of a test drill for assessing physical work capacity of fire fighters. Int J Industr Ergonom 13:139–146CrossRefGoogle Scholar
  23. McDiarmid EngelhardtSM, Oliver M, Gucer P, Wilson PD, Kane R et al (2007) Health surveillance of gulf war I veterans exposed to depleted uranium: updating the cohort. Health Phys 93(1):60–73CrossRefGoogle Scholar
  24. Naghii MR (2006) The importance of body weight and weight management for military personnel. Mil Med 171(6):550–555Google Scholar
  25. NVAB (2005) Guidance workers’ health surveillance [In Dutch: Leidraad Preventief medisch onderzoek]. Utrecht, the Netherlands, NVABGoogle Scholar
  26. Osborn GD (1976) Validation physical agility tests. The police chief 43–46Google Scholar
  27. Payne W, Harvey J (2010) A framework for the design and development of physical employment tests and standards. Ergonomics 53(7):858–871CrossRefGoogle Scholar
  28. Plat MJ, Frings-Dresen MHW, Sluiter JK (2010a) Reproducibility and validity of the stair-climb test for fire fighters. Int Arch Occup Environ Health 83:725–731CrossRefGoogle Scholar
  29. Plat MJ, Frings-Dresen MHW, Sluiter JK (2010b) Clinimetric quality of the fire fighting simulation test as part of the Dutch fire fighters workers’ health surveillance. BMC Health Services Res 10:32CrossRefGoogle Scholar
  30. Punakallio A (2003) Balance abilities of different-aged workers in physically demanding jobs. J Occup Rehab 13(1):33–43CrossRefGoogle Scholar
  31. Richmond VL, Rayson MP, Wilkinson DM, Carter JM, Blacker SD, Nevill A et al (2008) Development of an operational fitness test for the royal air force. Ergonomics 51(6):935–946CrossRefGoogle Scholar
  32. Sluiter JK (2006) High-demand jobs: age-related diversity in work ability? Appl Ergon 37(4):429–440CrossRefGoogle Scholar
  33. Soteriades ES, Hauser R, Kawachi I, Liarokapis D, Christiani DC, Kales SN (2005) Obesity and cardiovascular disease risk factors in firefighters: a prospective cohort study. Obesity Res 13(10):1756–1763CrossRefGoogle Scholar
  34. Sothmann MS, Gebhardt DL, Baker TA, Kastello GM, Sheppard VA (2004) Performance requirements of physically strenuous occupations: validating minimum standards for muscular strength and endurance. Ergonomics 47(8):864–875CrossRefGoogle Scholar
  35. Sperlich B, Fricke H, de Marées M, Linville JW, Mester J (2009) Does respiratory muscle training increase physical performance? Mil Med 174(9):977–982Google Scholar
  36. Strating M, Bakker RH, Dijkstra GJ, Lemmink KAPM, Groothoff JW (2010) A job-related fitness test for the Dutch police. Occup Med 60:255–260CrossRefGoogle Scholar
  37. Technical and ethical guidelines for workers’ health surveillance (1998) Geneva, International Labour Office (Occupational Safety and Health Series No. 72)Google Scholar
  38. Vanderburgh PM, Flanagan S (2000) The backpack run test: a model for a fair and occupationally relevant military fitness test. Mil Med 165(5):418–421Google Scholar
  39. Vimercati L, Bisceglia L, Tato I, Beliotta MR, Russo A, Martina C et al (2006) Biological monitoring and allergic sensitization in traffic police officers exposed to urban air pollution. Int J Immunopathol Pharmacol 19(4):57–60Google Scholar
  40. Weaver JL, McAlister WH (2001) Vision readiness of the reserve forces of the U.S. Army. Mil Med 166(1):64–66Google Scholar
  41. Winwood PC, Tuckey MR, Peters R, Dollard MF (2009) Identification and measurement of work-related psychological injury: piloting the psychological injury risk indicator among frontline police. JOEM 51(9):1057–1065Google Scholar
  42. Wright KM, Huffman AH, Adler AB, Castro CA (2002) Psychological screening program overview. Mil Med 167(10):853–861Google Scholar

Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • M. J. Plat
    • 1
  • M. H. W. Frings-Dresen
    • 1
  • J. K. Sluiter
    • 1
  1. 1.Coronel Institute of Occupational HealthAcademic Medical Center, University of AmsterdamAmsterdamThe Netherlands

Personalised recommendations