Fire fit: assessing comprehensive fitness and injury risk in the fire service

  • Gerald S. PoplinEmail author
  • Denise J. Roe
  • Jefferey L. Burgess
  • Wayne F. Peate
  • Robin B. Harris
Original Article



This study sought to develop a comprehensive measure of fitness that is predictive of injury risk and can be used in the fire service to assess individual-level health and fit-for-duty status.


A retrospective occupational cohort of 799 career fire service employees was observed over the years 2005–2009. An equally weighted score for comprehensive fitness was calculated based on cardiovascular fitness, muscular strength, endurance, flexibility, and body composition. Repeated measures survival analyses were used to estimate the risk of any injury, sprain or strain, and exercise-related injuries in relation to comprehensive fitness.


A well-distributed comprehensive fitness score was developed to distinguish three tiers of overall fitness status. Intraclass correlations identified flexibility, total grip strength, percent body fat, and resting heart rate as the most reliable fitness metrics, while push-ups, sit-ups, and aerobic capacity demonstrated poor reliability. In general, individuals with a lower comprehensive fitness status had an increased injury risk of injury as compared to the most fit individuals. The risk of any injury was 1.82 (95 % CI 1.06–3.11) times as likely for the least fit individuals, as compared to individuals in the top fire fitness category, increasing to 2.90 (95 % CI 1.48–5.66) when restricted to sprains and strains.


This 5-year analysis of clinical occupational health assessments enabled the development of a relevant metric for relating comprehensive fitness with the risk of injury. Results were consistent with previous studies focused on cardiorespiratory fitness, but also less susceptible to inter-individual variability of discrete measurements.


Firefighter Occupational health and fitness Injury risk 



The authors wish to thank the men and women of the Tucson Fire Department whom, in addition to regularly responding to our individual worst days, played an active role in this project while pursuing to improve the health and safety of all fire service employees. Similarly, Emily Scobie, Becky Arnold, and all employees of WellAmerica deserve our utmost gratitude for their persistent efforts.This work was supported by grant 5R01OH009469 from the US Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health (CDC/NIOSH). The contents of this article are solely the responsibility of the authors and do not necessarily represent the official views of the CDC/NIOSH.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. American College of Sports Medicine (2010) ACSM’s resource manual for guidelines for exercise testing and prescription, 8th edn. Lippincott Williams & Wilkins, PhiladelphiaGoogle Scholar
  2. Astrand PO, Bergh U, Kilbom A (1997) A 33-yr follow-up of peak oxygen uptake and related variables of former physical education students. J Appl Physiol 82:1844–1852Google Scholar
  3. Barnard RJ, Duncan HW (1975) Heart rate and ECG responses of fire fighters. J Occup Med 17:247–250Google Scholar
  4. Baur DM, Christophi CA, Kales SN (2012a) Metabolic syndrome is inversely related to cardio-respiratory fitness in male career firefighters. J Strength Cond Res 26(9):2331–2337CrossRefGoogle Scholar
  5. Baur DM, Leiba A, Christophi CA, Kales SN (2012b) Low fitness is associated with exercise abnormalities among asymptomatic firefighters. Occup Med 62(7):566–569CrossRefGoogle Scholar
  6. 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
  7. Brown J, Stickford J (2009) Physiological stress associated with structural firefighting observed in professional firefighters. Indiana University Firefighter Health & Safety Research, BloomingtonGoogle Scholar
  8. Cerretelli P, Di Prampero PE (1987) Gas exchange in exercise. Handbook of physiology. American Physiological Society, Bethesda, pp 297–339Google Scholar
  9. Davis PO, Dotson CO, Santa Maria DL (1982) Relationship between simulated fire fighting tasks and physical performance measures. Med Sci Sports Exerc 14(1):65–71CrossRefGoogle Scholar
  10. Gerkin R, Kelley P, Perry R (1997) Correlation of VO2-max during maximal treadmill stress testing with VO2 at 85 % predicted maximal heart rate: a retrospective review of the phoenix fire department treadmill protocol. Technical Report to the Medical Director of the Phoenix Fire Department Medical CenterGoogle Scholar
  11. Gledhill N, Jamnik VK (1992) Characterization of the physical demands of firefighting. Can J Sport Sci 17(3):207–213Google Scholar
  12. Heyward VH (2010) Advanced fitness assessment and exercise prescription, 6th edn. Burgess Publishing Company and Human Kinetics, ChamaignGoogle Scholar
  13. Hollenberg M, Yang J, Haight TJ, Tager IB (2006) Longitudinal changes in aerobic capacity: implications for concepts of aging. J Gerontol 61A(8):851–858CrossRefGoogle Scholar
  14. Holmer I, Gavhed D (2007) Classification of metabolic and respiratory demands in fire fighting activity with extreme workloads. Appl Ergon 38:45–52CrossRefGoogle Scholar
  15. International Association of Fire Fighters (2008) The fire service joint labor management wellness fitness initiative, 3rd edn. pp 49–56. Accessed July 2012
  16. International Association of Firefighters (2000) Candidate physical ability test. International Association of Fire Fighters, International Association of Fire Chiefs, Washington, DCGoogle Scholar
  17. Kilbom A (1980) Physical work capacity of firemen. With special reference to demands during fire fighting. Scand J Work Environ Health 6(1):48–57CrossRefGoogle Scholar
  18. Lee AJ, Myers JL, Garraway WM (1997) Influence of players’ physique on rugby football injuries. Br J Sports Med 31:135–138CrossRefGoogle Scholar
  19. Lemon PR, Hermiston RT (1977) Physiological profile of profession fire fighters. J Occup Med 19(5):337–340Google Scholar
  20. Malley KS, Goldstein AM, Aldrich TK, Kelly KJ, Weiden M, Coplan N, Karwa ML, Prezant DJ (1999) Effects of fire fighting uniform (modern, modified modern, and traditional) design changes on exercise duration in New York City firefighters. J Occup Environ Med 41(12):1104–1115CrossRefGoogle Scholar
  21. McGuire DK, Levine BD, Williamson JW, Snell PG, Blomqvist G, Saltin B, Mitchell JH (2001a) A 30-year follow-up of the Dallas Bed Rest and Training Study: I. Effect of age on the cardiovascular response to exercise. Circulation 104:1350–1357CrossRefGoogle Scholar
  22. McGuire DK, Levine BD, Williamson JW, Snell PG, Blomqvist G, Saltin B, Mitchell JH (2001b) A 30-year follow-up of the Dallas Bed Rest and Training Study: II. Effect of age on the cardiovascular adaptation to exercise training. Circulation 104:1358–1366CrossRefGoogle Scholar
  23. Michaelides MA, Parpa KM, Henry LJ, Thompson GB, Brown BS (2011) Assessment of physical fitness aspects and their relationship to firefighters’ job abilities. J Strength Cond Res 25(4):956–965CrossRefGoogle Scholar
  24. Moore-Merrell L, Zhou A, McDonald-Valentine S, Goldstein R, Slocum C (2008) Contributing factors to firefighter line-of-duty injury in metropolitan fire departments in the United States. International Association of Fire Firefighters, Washington, DCGoogle Scholar
  25. National Fire Protection Association (2007) 1582 Standard on Comprehensive Occupational medical Program for Fire, Departments edn. Quincy, MAGoogle Scholar
  26. Poplin GS, Harris RB, Pollack KL, Peate W, Burgess JL (2012) Beyond the fireground: injuries in the fire service. Injury Prev 18:228–233CrossRefGoogle Scholar
  27. Poplin GS, Roe DJ, Harris RB, Peate W, Burgess JL (2014) The association of aerobic fitness with injuries in the fire service. Am J Epidemiol 2:149–155CrossRefGoogle Scholar
  28. Rosner B (2000) Fundamentals of biostatistics, 5th edn. Duxbury Press, Pacific GroveGoogle Scholar
  29. Sharkey BJ, Gaskill SE (2009) Fitness and work capacity, 2009th edn. National Wildfire Coordinating Group, MissoulaGoogle Scholar
  30. Smith DL (2011) Firefighter fitness: improving performance and preventing injuries and fatalities. Curr Sports Med Rep 10(3):167–172CrossRefGoogle Scholar
  31. Smith DL, Manning TS, Petruzzello SJ (2001) Effect of strenuous live-fire drills on cardiovascular and psychological responses of recruit firefighters. Ergonomics 44(3):244–254CrossRefGoogle Scholar
  32. Sothmann MS, Saupe KW, Jasenof D, Blaney J, Fuhrman SD, Woulfe T, Raven PB, Pawelczyk JP, Dotson CO, Landy FJ, Smith JJ, Davis PO (1990) Advancing age and the cardiorespiratory stress of fire suppression: determining a minimum standard for aerobic fitness. Hum Perform 3(4):217–236CrossRefGoogle Scholar
  33. von Heimburg ED, Rasmussen AK, Medbo JI (2006) Physiological responses of firefighters and performance predictors during a simulated rescue of hospital patients. Ergonomics 49(2):111–126CrossRefGoogle Scholar
  34. Williams-Bell FM, Villar R, Sharratt MT, Hughson RL (2009) Physiological demands of the firefighter candidate physical ability test. Med Sci Sports Exerc 41(3):653–662CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  • Gerald S. Poplin
    • 1
    • 2
    Email author
  • Denise J. Roe
    • 2
  • Jefferey L. Burgess
    • 3
  • Wayne F. Peate
    • 3
  • Robin B. Harris
    • 2
  1. 1.Center for Applied BiomechanicsUniversity of VirginiaCharlottesvilleUSA
  2. 2.Division of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonUSA
  3. 3.Division of Community, Environment and Policy, Mel and Enid Zuckerman College of Public HealthUniversity of ArizonaTucsonUSA

Personalised recommendations