Testing Physical Capability in the UK Fire & Rescue Service. Review and Recommendations.

Transcription

1 Testing Physical Capability in the UK Fire & Rescue Service. Review and Recommendations. Richard Stevenson on behalf of the UK Firefit Steering Committee

2 This report has been produced by Richard Stevenson, Senior Physical Training Advisor to South Wales Fire & Rescue Service. However the author acknowledges the previous work carried out by Fiona Dale and Tara Krzywicki, with support from Milo Bodrozic, and Chris Ide. The work of Dr. Mark Rayson (of Optimal Performance Ltd.) is also recognised. 2

3 Introduction The National Firefighter selection Tests (NFT) are intended to provide the UK Fire & Rescue Service with a valid, role-specific and legally defensible method of assessing the potential to perform a number of key firefighting tasks. The battery of physical tests together with the psychometric assessment tools aim to ensure the recruitment of individuals that can demonstrate a level of physical proficiency along with the personal qualities and attributes identified for the role of firefighter. Whilst it is accepted that this new recruitment process is integral to the ongoing development of the UK Fire & Rescue Services, it is equally essential to ensure those chosen demonstrate their physical capability throughout their career. This becomes especially relevant when the physical demands of the job appear to be insufficient to enhance or maintain role-specific fitness levels (Rayson et al., 2004) in addition to the recognised age related declines in physical potential (Runge et al., 2004). Background In 1988, the Home Office issued a report summarising the findings of a 3-year study on the physical fitness of firemen. This research conducted by Chelsea College in London highlighted a number of concerns regarding the physical capability of serving firemen. It stated a substantial minority would endure undue physical stress at major fire incidents and during some drills (Scott et al., 1988). The authors indicated that this minority displayed no better than average fitness levels when compared with the UK male population. In conclusion, the authors recommended that a concerted effort be made to encourage on the job fitness training and this needed to take place as a matter of urgency (Scott et al., 1988). It also stated that the undertaking of such fitness training will not only help in producing a more efficient work force but will in addition be beneficial to all personnel when off duty (Scott et al., 1988). 3

4 Since this report was written, a number of other publications have identified the need for continual monitoring and support in order that firefighters maintain physical fitness levels. In early 1999, the Chief Inspector of Fire Services initiated a review as a result of growing concerns about the impact that sickness absence and ill-health retirements were having on the efficiency and effectiveness of the Fire Service. The report recommended Routine 6-monthly fitness checks should be compulsory for all operational personnel (wholetime and retained), and offered on a voluntary basis to all other staff. The Home Office should give guidance on the way these should be conducted (Home Office, 2000). In December 2004, A Fire and Rescue Service Circular on the Building Disaster Assessment Group s key research findings also reported: Fire and Rescue Services are reminded of the importance of ensuring that operational staff maintain fitness levels appropriate to their role. Regular fitness testing is important to ensure that staff maintain the required level of fitness to fulfil their role safely and effectively (Office of the Deputy Prime Minister, 2004). Despite the implications of the Chelsea College Report and the subsequent recommendations and reminders, some Fire & Rescue Services still have no regular physical fitness policy, perform no form of regular fitness testing and hold no specialist post to advise on physical training and/or fitness. For those Fire & Rescue Services that do currently undertake regular fitness assessments, there is great variance in the tests used, the frequency of administration, the standards set and the implications involved in failing the test itself. Many brigades utilise the services of Occupational Health and/or Operational Training Departments to administer these tests without the knowledge or understanding to accurately interpret results. Tests that are presently used for ongoing assessments in the UK include the sub-maximal Chester Step Test (Sykes, 1995), the Harvard Step Test, the maximal Multi-Stage Fitness Test (Leger & Lambert, 1982), cycle ergometry protocols using direct gas 4

5 analysis (McArdle et al., 1973; Astrand, 1965), and a 1-mile walk test (Kline et al., 1987). These differences exist partly due to the inadequacy of the existing guidelines which provide little in the way of standardised approaches, flexible tools and practical solutions to the development of policies and practices (Dale & Krzywicki, 2000). With the National firefighter selection tests entering into a unified, up-to-date approach, it is apparent that the gap between this new process and the ongoing fitness assessments is due to grow wider. Physical fitness testing Current guidelines, which indicate that a firefighter should demonstrate an aerobic capacity of 3.32 l.min -1 or 45.0 ml.kg.min -1 or greater were originally developed from the findings of the Chelsea College Report (Scott et al., 1988) and fitness assessments being performed at Cheshire Fire Service at the time (Riddell & Matthews, 1988). It is recognised that the role of firefighter has changed significantly over the last few years. Whilst there is agreement with the importance of this aspect of firefighting, it has recently been identified that combinations of aerobic and anaerobic capacity, strength, muscular endurance, flexibility and manual dexterity are all important components of firefighter fitness (Rayson, 2004). It is also recognised that the physical attributes needed to perform certain key firefighting tasks cannot be measured accurately by the current tests. The Chester Step Test is still one of the most commonly used assessment tools to monitor cardiorespiratory fitness within Fire and Rescue Services. It is inexpensive and relatively easy to administer. Nevertheless, there are significant limitations with its use. Whist the test s reproducibility has been confirmed as recently as April 2004 (Buckley et al., 2004), its accuracy and validity of predicting V0 2max is still poor (Buckley et al., 2004). It should be noted that the designer of the Chester Step Test 5

6 reported that the test had error margins of 5-15%, which is consistent with other predictive sub-maximal exercise tests (Stevens & Sykes, 1996). The potential for error is likely to exist even under ideal conditions because of a number of factors that are difficult to control. These factors include anxiety, poor stepping technique erratic breathing patterns, time of day, genetics and certain medications (Baron, 1994). In an attempt to avoid these ongoing problems, many fitness advisors and/or Fire and Rescue Services have adopted the maximal Multi-Stage Fitness Test. Whist its protocol is relevant, graded, easy to use and avoids some of the problems associated with sub-maximal protocols and heart rate telemetry, the test was originally developed on games playing students and when used on other populations, results do not accurately reflect cardiorespiratory fitness values (Stevens & Sykes, 1996). Additionally, both the Chester Step Test and the Multi-Stage Fitness Test discriminate against larger individuals when values are expressed in ml.kg.min -1. Often for firefighting tasks involving external loads, l.min -1 is the better predictor of task performance (Brewer, et al. 1999). Direct cycle ergometry methodologies using gas analysis (McArdle et al., 1973; Astrand, 1965) in relation to field tests are relatively expensive, complicated and immovable, which are often important considerations for Fire and Rescue Services. The field tests described, if used correctly can provide valuable baseline data about the fitness levels of individuals from which exercise programmes can be developed. The tests also enable fitness improvements to be monitored and to help motivate participants by establishing reasonable and achievable goals (Stevens & Sykes, 1996). However, these tests are not suitable in circumstances where a specific standard has been set for pass or fail and should therefore not be used for this purpose. Additionally, these tests are not specifically task-relevant and therefore not suitable for accurately assessing a firefighter s operational capability. It is important that the Fire and Rescue Services in its quest for fairness identifies practical, relevant and justifiable tests specifically to monitor physical capability throughout a firefighters career. 6

7 Key firefighting tasks As early as 1994, ALAMA guidance in reference to individuals performing physical fitness tests suggested that the pulse be telemetrically monitored during the test and that it be abandoned should the pulse rise above 90% of its theoretical maximum... In extreme cases, where this is obviously due to anxiety,...a vocational test may be used (Baron, 1994). However, no reference was made to the specifics of the vocational test. Until recently, there has been little research identifying the key tasks required of UK firefighters. However, in a report published in 2004 by Optimal Performance Ltd. on behalf of the Office of the Deputy Prime Minister (ODPM) key task elements of the role that place a significant or metabolic load on operational firefighters were identified (Rayson, 2004). The report goes on to state: Fire fighters perform a number of discreet activities both singly and in teams. These include walking, running, crawling, climbing, lifting, lowering, carrying and hammering. Standard Operating Procedures (SOP) involve activities such as ladder lifting and raising, hose running and connection, connecting soft-suction hoses to water supplies, manipulating and operating light portable pumps, and rescue and evacuation procedures. The Worst Case Scenario Plans involve casualty evacuations, search and rescue, operating heavy rescue equipment, propping and shoring buildings, and carrying equipment over uneven surfaces (rubble, ploughed fields, etc.)(rayson, 2004). In this report reference was made to previous research conducted by Rayson & Wilkinson (2002) for the National Firefighter Selection tests. As part of this process, 3 single-person simulated scenarios or Output Tests that consist of key tasks considered vital to the role of a firefighter were developed. Brief descriptions of the scenarios are presented in table 1. 7

8 Table 1. Three draft single-person simulations for trained firefighters for the Point of Entry Selection project, Rayson & Wilkinson (2002). Task Name Rural Simulation Domestic (S&R) Simulation Domestic (salvage) Simulation Description Hose drag (50m) from drum on appliance Walk/jog back to appliance (50m) 70mm hose carry (200m) Walk/jog back to appliance (200m) 70mm hose run (2 x 25m) Walk/jog back to appliance (150m) Suction hose and basket carry (200m) Walk/jog back to appliance (200m) Light portable pump carry (200m) Hose drag (30m) 30kg casualty carry (30m) Walk (10m) Crawl (20m) 55kg casualty drag (30m) 135 ladder lift 135 ladder extension 135 ladder climb By the author s own admission, considerable effort was put into getting these Output Tests endorsed by the National Firefighter Selection Steering Group. This research represents up-to-date analysis on UK firefighters and has involved experts and key stakeholders at various stages in the project (Rayson, 2004). The rural simulation scenario incorporates all the physical attributes associated with firefighter fitness and is likely to place a significant demand on the firefighter s aerobic and anaerobic energy systems. The findings of this study could be used not only in developing the National Firefighter Selection tests but also to the development of a test that could assess firefighting capability. 8

9 Capability Taking the decision to withdraw a firefighter from operational duties is a serious issue and is not taken lightly by those that are tasked with the responsibility. Fire and Rescue Services however have an obligation to uphold a duty of care to it s employees under the Heath and Safety at Work Act of 1974 and as such have a part to play in ensuring that its employees are fit to perform role for which they were employed. Fire and Rescue Services utilise the expertise of medical advisors, occupational health specialists and in some but not all instances, exercise specialists to help them come to this decision. Fitness specialists as previously discussed however have a relatively inadequate set of tools with which to accurately make these judgements, and the decision to withdraw a firefighter based on the results of one of these tests could be scrutinised. The development of the rural simulation into a standardised aptitude test would give Fire and Rescue Services a greater degree of confidence when assessing a firefighter s capability to perform key firefighting tasks. Additionally, quantifying the aerobic component of this test would reinforce the justification for ongoing fitness assessments and give up-to-date findings on the fitness standards required. It is unlikely that individual Fire and Rescue Services would have the resources to implement this as a standard job related fitness test per se but it could act as a significant tool for assessing capability. In circumstances where a medical advisor, line manager, occupational health or fitness specialist may have concerns over a firefighters ability to perform their role, it could be deemed necessary for that firefighter (for his own safety and others working with them) to demonstrate his or her competence. Reasons for referral could include a borderline fitness result, body weight and/or body composition concerns and following periods of long-term absence or sickness. 9

10 Recommendations 1. Develop the rural simulation output for the ongoing assessment of firefighting capability. - Considerations should include health & safety (manual handling, equipment) and physiological concepts (warm up, sequence of events, warm down). 2 Establish the aerobic capacity required to successfully complete the rural simulation output test. - Relate results to current fitness testing protocols and provide guidance on physical training programmes to competently perform key firefighting tasks. Conclusion Fire and Rescue Services need to be certain that operational firefighters are physically capable to effectively perform their work. With the significant changes in the firefighter s role in the last few years and the diversity of those individuals now performing the job, the tests currently employed to test physical fitness are not sufficiently relevant. The development of a specific capability test on based on recent UK research will give Fire and Rescue Services a defensible tool to confidently test firefighting ability. 10

11 References Astrand, P.O. (1965). Work tests with the bicycle ergometer. Varberg, Sweden: AB Cykelfabriken Monark. Baron, C.B. (1994). Medical aspects of physical fitness for firefighting. In: ALAMA Guidance. Brewer, J (1999). A Fitness standard for the operational workforce of the London Fire and Civil Defence Authority, London Fire Service internal Report. Buckley, J.P., Sim, J., Eston, R.J., Hession, R. and Fox, R. (2004). Reliability and validity of measures taken during the Chester Step Test to Predict aerobic power and to prescribe aerobic exercise. British Journal of Sports Medicine, 38(2): Dale, F. & Krzywicki, T. (2000). Fitness in the fire service: The need for review. Unpublished findings. Home Office (2000). Fit for Duty? Seeking a healthier fire service. A thematic review of sickness absence and ill-health retirements in the fire service in England, Wales and Northern Ireland. Her Majesty s Fire Service Inspectorate. Kline GM, Porcari JP, Hintermeister R, et. al. (1987). Estimation of VO2 Max from a one mile track walk, gender, age, and body weight. Medicine and Science in sports and Exercise, 19: Leger, L. and Lambert, J (1982). A maximal multistage 20m shuttle run test to predict VO 2max, European Journal of Applied Physiology, 49:

12 McArdle, W.D., Katch, F.I., and Pecher, G.S. (1973). Comparison of continuous and discontinuous treadmill and bicycle tests for VO 2 max. Medicine and Science in Sports 5: Office of the Deputy Prime Minister (2004). The building disaster assessment group Key research findings. Fire and Rescue Service Circular, Rayson, MP. & Wilkinson, D. (2002). Point of Entry Selection (PES) Physical Workshop: 23 rd -27 th September 2002, Fire Service College, Moreton-in-Marsh. Optimal Performance Ltd. Report to ODPM Rayson, MP. (2004). Operational physiological capabilities of firefighters: literature review and research recommendations. Optimal Performance Ltd. on behalf of the Office of the Deputy Prime Minister. Riddell, D & Matthews, D. (1988). The Joint Working Party on Appointment Provisions. Runge, M., Rittweger, J., Russo, CR., Schiessl, H. and Felsenberg, D. (2004). Is muscle power output a key factor in the age-related decline in physical performance? A comparison of muscle cross section, chair-rising test and jumping power. Clinical Physiology and Functional Imaging, 24(6 )pp-335. Scott, G. (1988). The physical fitness of firemen: a summary report. Home Office. Scientific Research and Development Branch; University of London, Chelsea College. Stevens, N. and Sykes, K. (1996). Aerobic fitness testing; an update. Occupational Health, 48(12): Sykes, K. (1995). Chester Step Test. Journal of Occupational Health. 12