Rev. 9/27/18
C-TEC Public Safety Students,
We are looking forward to seeing you soon!
As you proceed to fulfill the physical fitness verification requirement for our public safety programs,
please note that you have two options:
1. Have your family physician (MD or DO only) complete the accompanying C-TEC Public Safety
Physical.
OR
2. You may utilize Licking Memorial Occupational Health located at 1865 Tamarack Rd. in Newark.
They will complete the CTEC Public Safety Physical. The Fire/EMT physical will be $455.00 which
will include a chest x-ray and stress test. The EMT physical will be $125.00. If you plan to take
both classes within a 15-month period of time mark both the Fire and EMT boxes on your
physical form.
In order to make an appointment at Licking Memorial Occupational Health, simply call the main
line, 220-564-4972, and tell the clerk you need to schedule a Student Firefighter/EMT physical
for CTEC/COTC.
Additional questionnaires that are included with the Licking Memorial Occupational Health
physical should be completed prior to your appointment to decrease the amount of time spent
at Occupational Health. Because Licking Memorial Occupational Health specializes in pre-
screenings and physicals with public safety agencies in central Ohio, some of the language is
employee oriented and can be completed as applicable.
o Patient Demographic – complete ”Patient Information” and “Reason for Visit Today”
sections (Reason for visit = CTEC/COTC Fire Fighter/EMT Physical)
o NFPA Firefighter / Police Questionnaire – complete all
o OSHA Respirator Medical Evaluation Questionnaire – complete all
o LMHP Occupation Health Audiometric Exam – complete patient section only
o Sleep Apnea Questionnaire – complete patient section only
*If you plan to take both the Fire and EMT classes within a 15-month period of time mark the Fire &
EMT box on your physical form not the EMT Only.
Please call 740-364-2282 in the event you have questions.
Thank you,
Erna Holland
C-TEC Public Safety Coordinator
PHYSICAL FITNESS VERIFICATION
for C-TEC Firefighting & EMT Students STUDENTS FULL NAME:___________________________________________ D.O.B. _____ / _____ / __________ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
TO THE PHYSICIAN (M.D. or D.O. ONLY)
Your Patient will be engaging in very strenuous and physically demanding exercise and activities while enrolled in the Firefighter Training and/or EMT training program @ C-TEC, and as such, is required by law to undergo a National Fire Protection Association (NFPA) 1582 compliant medical evaluation prior to beginning this course of study.
Please utilize the following 18 pages as your guidance for the NFPA 1582 Standard on Medical Requirements for Firefighters.
Physician’s Statement:
After conducting a thorough NFPA 1582 compliant examination and considering the
physical, physiological, intellectual, and psychological demands of Firefighting and/or EMT
training, I find no medical reason that ___________________________________ should be (Student’s Full Name)
excluded from performing the essential job tasks associated with the following occupational
course(s) of study:
FIREFIGHTING & EMT
EMT ONLY __________________________________ ________________________________ _____ / _____ / __________ Physician’s Name (Printed) Physician’s (Signature) DATE __________________________________ ________________________________ Physician’s Office Address Physician’s Medical License # __________________________________ City, State & Zip Code __________________________________ Physician’s Office Ph. #
__________________________________ _____ / _____ / __________ Students’s (Signature) DATE
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
This document is provided as a reference resource for physicians when determining the fitness of the candidate for
firefighting and/or emergency medical technician duties prior to entry into the Career & Technology Educational Centers
Please evaluate the candidate for any existing Category A or Category B medical conditions (pages 3 - 18) in reference
to the their ability to safely perform the Essential Job Tasks and Descriptions (listed on page 2), as related to their
respective course of study. (i.e., Firefighter [FF] or Emergency Medical Technician [EMT])
(C-TEC) training program(s).
or emergency operational environment by presenting a significant risk to the safety and health of
the person or others.
Candidates with CATEGORY B medical conditions shall be certified as meeting the medical
requirements for acceptance into the C-TEC EMT, FFI or FFII training program ONLY if they can
Category A: A medical condition that would preclude a person from performing as a member in a training
Category B: A medical condition that, based on its severity, could preclude a person from performing as a
member in a training or emergency operational environment by presenting a significant risk to the
safety and health of the person or others.
perform the essential job tasks WITHOUT posing significant safety and health risk to themselves,
members or civilians.
Candidates with CATEGORY A medical conditions SHALL NOT be certified as meeting the requirements
for acceptance into the C-TEC EMT, FFI or FFII training program.
Page 1
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
FF EMT
X (1)
X X (2)
X X (3)
X (4)
X (5)
X X (6)
X (7)
X (8)
X X (9)
X X (10)
X X (11)
X (12)
X X (13)
Essential Job Tasks and Descriptions.
and psychological demands of the occupation should be included when evaluating the candidate's ability to
perform the essential job tasks. The medical evaluation shall include a medical history, physical examination,
Purpose:
systems (sprinklers)
Functioning as an intergral component of a team, where sudden incapacitation of a member can
Exposure to toxic fumes, irritants, particulates, biological (infectious) and nonbiological hazards
and/or heated gases, despite the use of personal protective ensembles and SCBA
result in significant fluid loss that frequently progresses to clinical dehydration and can elevate core
temperature to levels exceeding 102.2 F (39 C)
Searching, finding, and rescue-dragging or carrying victims ranging from newborns to adults weighing
Depending on the local jurisdiction, climbing six or more flights of stairs while wearing a fire
protective ensemble, including SCBA, weighing a least 50 lb (22.6kg) or more and carrying equipment/
tools weighing an additional 20 to 40 lb (9 to 18 kg)
Wearing a fire protective ensemble, including SCBA, that is encapsulating and insulated, which will
other emergency response actions under stressful conditions including working in extremely hot or
cold environments for prolonged periods of time
Wearing SCBA, which includes a demand-valve type positive-pressure facepiece or HEPA filter masks,
which requires the ability to tolerate increased respiratory workloads
While wearing personal protective ensembles (PPE) and self-contained breathing apparatus (SCBA),
result in mission failure or in risk of injury or death to civilians or other team members.
over 200 lb (90 kg) to safety despite hazardous conditions and low visibility.
(FF while wearing PPE and SCBA)
While wearing PPE and SCBA, climbing ladders, operating from heights, walking or crawling in the
dark along narrow and uneven surfaces that might be wet or icy, and operating in proximity to
electrical power lines or other hazards
Unpredictable emergency requirements for prolonged periods of extreme physical exertion
without benefit of warm-up, scheduled rest periods, meals, access to medication (s), or hydration
Operating fire apparatus or other vehicles in an emergency mode with emergency lights and sirens
Critical, time-sensitive, complex problem solving during physical exertion in stressful, hazardous
environments, including hot, dark, tightly enclosed spaces, that is further aggravated by fatigue,
flashing lights, sirens, and other distractions
Ability to communicate (give and comprehend verbal orders) while wearing PPE and SCBA under
conditions of high background noise, poor visibility, and drenching hoselines and/or fixed protection
from fire apparatus to an occupancy [approximately 150 ft (50 m)], which can involve negotiating
multiple flights of stairs, ladders, and other obstacles
While wearing PPE and SCBA, advancing water-filled hoselines up to 2 1/2 inch (65mm) in diameter
objects, ventilating roofs or walls using power or hand tools, forcible entry), rescue operations, and
perform firefighting tasks (e.g., hoseline operations, extensive crawling, lifting and carrying heavy
Firefighter I and/or Firefighter II training program. Consideration to the physical, physiological, intellectural
and any laboratory tests required to detect physical or medical condition (s) that could adversely affect his/her
ability to safely perform the essential tasks as specified in NFPA1582, Chapter 5, and listed as follows:
A medical evaluation of this candidate shall be performed prior to his/her admittance into the C-TEC EMT,
Page 2
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
1.
2.
3.
1.
2.
3.
1.
2.
3.
1.
2.
3.
4.
1.
2.
Far visual acuity less than 20 / 40 binocular, corrected with contact lenses or spectacles, or far visual acuity
Deformities of the skull associated with evidence of disease of the brain, spinal cord, or peripheral nerves
to communicate effectively due to oropharyngeal dysfunction
Loss or congenital absence of the bony substance of the skull that could result in the inability to properly wear
perform one or more of the essential job tasks.
Category B medical conditions include the following:
Category A medical conditions include the following:
Head
less than 20 / 100 binocular for wearers of hard contacts or spectacles, uncorrected. (Successful long-term soft
contact lens wearers [i.e., six months without a problem] are not subject to the uncorrected standard.
Color perception - monochromatic vision resulting in inability to use imaging devices such as thermal
imaging cameras. This does not refer to abnormal color perception such as red/green color blindness
Monocular vision. Eligibilty for a DOT / CDL exemption is not applicable.
Any eye condition which results in the candidate being unable to safely perform one or more of the
essential job task.
Diseases of the eye such as retinal detachment, progressive retinopathy, or optic neuritis which can result in
Thoracic outlet syndrome which results in frequent episodes of pain or inability to perform work
Congenital cyst, chronic draining fistulas, or similar lesions which result in the inability to properly wear
protective equipment and the inability to communicate effectively due to oropharyngeal dysfunction
Contraction of neck muscles which result in the inability to properly wear protective equipment and the
inability to safely perform functions as a team member due to limitation of flexibility
Any skull or facial deformity that would not allow for a successful fit test for respirators used by the fire
service
Any head condition that results in the candidate not being able to safely perform one or of the essential
job tasks
Deformities of the skull such as depressions or exostoses which prevent proper wearing of protective
equipment
the failure to read placards and street sighn or to see and respond to hazardous situations
Opthalmological procedures such as radial keratotomy, Lasik procedure, or repair of retinal detachment
without sufficient time to allow stabilization of visual acuity and to ensure that there are no post-surgical
complications (approximately 2 weeks for radial keratotomy and Lasik-type surgeries, and 3 months for
retinal detachment).
Eyes and Vision
Neck
Category A medical conditions include any neck condition tha results in the candidate not being able to safely
Category B medical conditions shall include the following:
Category A medical conditions include the following:
Category B medical conditions include the following:
protective equipment, or the ability to communicate effectively due to oropharyngeal dysfunction
that could result in sudden incapacitation the inability to properly wear protective equipment, or the ability
Medical conditions Affecting Ability to Safely Perform Essential Job Tasks.
Head and Neck
Defect of skull preventing helmet use or leaving underlying brain unprotected.
Page 3
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
3.
>
>
>
1.
2.
3.
4.
1.
2.
3.
4.
5.
6.
7.
8.
9.
Any ear condition (or hearing impairment) which results in the candidate being unable to safely perform one
more of the essential job tasks.
Understanding spoken commands, both over the radio and while wearing SCBA
Hearing alarm signals, including building evacuation, low air alarm on the SCBA, and PASS alarms
Hearing and locating the source of calls for assistance from victims or other firefighters.
Chronic vertigo or impaired balance as demonstrated by inability to tandem gait walk.
On audiometric testing, average hearing loss in the unaided better ear greater than 40 decibels (db) at 500 Hz,
1000 Hz, 2000 Hz, and 3000 Hz when the audiometric device is calibrated to ANSI Z24.5, Audiometric Device
Meniere's syndrom or severe labyrinthitis.
Average uncorrected hearing deficit at the test frequencies of 500 Hz, 1000 Hz, 2000Hz, and 3000 Hz greater
Ears and Hearing
There are currently no hearing tests that accurately predict whether the firefighter will adequately be able to safely
perform essential job duties. Physician evaluation of the candidate should be completed based on the candate's
performance in reference to the following hearing specific tasks:
Bear in mind that all of these tasks are performed with varying background noise levels. Inablity to hear sound of
intensity or to distinguish voice from background noise can lead to failure to respond to immintently hazardous
Hearing aid or cochlear implant unless the candidate meets the criteria above criteria without them
Unequal hearing loss which leads to the inability to localize sounds, leading to failure in the ability to safely
perform search and rescue and other localization tasks.
Peripheral vision in the horizontal meridian of less than 110 degrees in the better eye or any condition that
significantly affects peripheral vision in both eyes.
Eyes and Vision/Category B (continued)
situations.
Category A medical conditions include the following:
Category B medical conditions include the following:
Atresia, stenosis, or tumor of the auditory canal.
Severe recurrent external otitis which results in the inability to hear sounds of low intensity or to distinguish
voice from background noise, leading to failure to respond to imminently hazardous situations.
Agenesis or traumatic deformity of the auricle which results in the ability to properly wear protective
equipment and the inability to hear sounds of low intensity or to distinguish voice from background noise,
leading to failure to respond to imminently hazardous situations.
Severe mastoiditis or surigical deformity of the mastoid which results in the inability properly wear
protective equipment and the inability to hear sounds of low intensity or to distinguish voice from back-
ground noise, leading to failure to respond to imminently hazardous situations.
Testing.
Chronic otitis media which results in frequent episodes of pain and the inability to hear sounds of low
intensity or to distinguish voice from background noise, leading to failure to respond to imminently
than 40 dB in either ear.
hazardous situations.
Surgical procedures to correct or improve hearing or other conditions of the ear.
Page 4
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
1.
2.
3.
4.
1.
2.
3.
1.
2.
3.
4.
5.
6.
7.
8.
9.
1.
2.
3.
4.
5.
6.
7.
Active hemoptysis
Current empyema
Pulmonary hypertension
Active tuberculosis
A forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV) less than 70 percent predicted
independent of disease.
Obstructive lung diseases (e.g., emphysema, chronic bronchitis, asthma) with an absolute FEV₁/FVC less than
0.70 and with either the FEV₁ below normal or both the FEV₁ and the FVC below normal (less than 0.80).Hypoxemia - oxygen saturation less than 90 percent at rest or exercise desaturation by 4 % or to less than 90 %
(exercise testing indicated when resting oxygen is less than 94 % but greater than 90 %).
properly wear protective equipment.
Extensive oral tissue loss which results in the inability to wear protective equipment and the inability to
communicate effectively due to oropharyngeal dysfunction.
Relationship between the mandible and maxilla that interferes with satisfactory post-orthodontic
replacement or ability to use protective equipment or communicate due to oropharyngeal dysfunction.
Nose, Oropharynx, Trachea, Esophagus and Larynx
Category A medical conditions include the following:
Dental
Category A medical condititions include any dental condition that results in inability to safely perform one or more of
safely perform one or more of the essential job tasks.
Category B medical conditions include the following:
Diseases of the jaws or associated tissues which result in the inability to communicate effectively and / or to
properly wear protective equipment.
Orthodontic appliances which result in the inability to communicate to communicate effectively and / or to
Any nasal, oropharyngeal, tracheal, esophageal, or laryngeal condition that results in inability to safely
perform one or more of the essential job tasks including fit testing for respirators such as N-95 for medical
Tracheostomy
Aphonia
response, P-100 for particulates and certain vapors, and SCBA for fire and hazmat operations.
Category B medical conditions include the following:
Congenital or acquired deformity which results in the inability to properly wear protective equipment.
Allergic rhinitis which results in frequent episodes of pain and the inability to safely perform work, and the
inability to safely perform essential job tasks due to limitations of endurance.
Recurrent Epistaxis
Recurrent Sinusitis which results in frequent episodes of pain and the inability to safely perform essential job
tasks due to limitations of endurance and the inability to safely wear SCBA from facial pain, sinus congestion
and / or coughing.
Severe Dysphonia which results in the inability to communicate effectively due to oropharyngeal dysfunction
Anosmia
Tracheal stenosis
Nasopharyngeal polyposis
Obstructive apneas if unresponsive to treatment.
Lungs and Chest Wall
Category A medical conditions include the following:
Page 5
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
8.
9.
10.
1.
2.
3.
4.
5.
6.
7.
8.
9.
on several studies.
Bronchiectasis, if abnormal pulmonary function or recurrent infections
Infectious diseases of the lung or pleural space
Cystic fibrosis
Aerobic Capacity
Category A medical conditions include an aerobic capacity less than 12 metabolic equivalents (METS)
(12 METs = 42 mL O₂/kg/min). The evaluation of aerobic capacity should be performed after appropriate medical
evaluation. Testing should be conducted using an appropriate maximal or sub maximal protocol. Bicycle
ergometry is not appropriate because it underestimates true aerobic capacity. A low aerobic capacity can be an
indicator of, and is a risk factor for, ischemic heart disease. For firefighting, 12 METs or greater is necessary based
Asthma - reactive airways disease requiring bronchodilator or corticosteroid therapy for 2 consecutive months
in the previous 2 years, unless the candidate can meet the following requirements:
A candidate who has in the past required bronchodilator, corticosteroid, or anti-inflammatory therapy (e.g.,
leukotriene receptor antagonists, such as Montelukast) for asthma but who does not believe he / she has
asthma shall be evaluated by a pulmonologist or other expert in asthmatic lung disease, such as an allergist.
Lungs and Chest Wall / Category A (continued)
Any pulmonary condition that results in the candidate not being able to safely perform one or more of the
essential job tasks
Lung transplant
to determine if the candidate meets all of the following;
a. Asthma has resolved without symptoms off medications for 2 years,
b. Allergen avoidance or desensitization has been successful,
c. Spirometry demonstrates adequate reserve (FVC and FEV₁ greater than or equal to 90 %) and no broncho-
Central or obstructive apnea (e.g., sleep apnea) if unresponsive to treatment
dilator response measured off all bronchodilators on the day of testing.
d. Normal or negative response to provocative challenge testing [e.g., cold air, exercise (12 METS),
methacholine, histamine, mannitol, or hyperetonic saline] or negative response to exercise challenge.
Challenge testing shall be performed off all anti-inflammatory medications (e.g., inhaled or oral steroids,
leukotriene receptor antagonists) for 4 weeks preceding the test, off all antihistamines (e.g., oral allergy
medications) for 1 week, and off all bronchodilators on the day of testing.
Category B medical conditions include the following:
Pulmonary resectional surgery, chest wall surgery, and pneumothorax that results in the inability to safely
perform essential job tasks due to limitations of strength or endurance could result in the potential for
sudden incapacitation.
Pleural effusion
Fibrothorax, chest wall deformity, and diaphragm abnormalities that result in inability to safely perform
essential job tasks due to limitations of endurance.
Interstitial lung diseases
Pulmonary vascular diseases or history of pulmonary embolism
Page 6
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
1.
2.
3.
4.
5.
6.
7.
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10.
1.
2.
3.
4.
5.
6.
7.
8.
9.
(3) Aortic stenosis is acceptable if stenosis is mild -- that is, mean aortic valvular pressure gradient is less than
20 mm Hg.
(4) Aortic regurgitation is acceptable if left ventricular size is normal or slightly increased and systolic
Cardiac hypertrophy of hypertrophic cardiomyopathy
History of congenital abnormality that has been treated by surgery but with residual complications or that has
not been treated by surgery, leaving residuals or complications.
Chronic pericarditis, endocarditis, or myocarditis.
function is normal.
(5) Prosthetic valves are acceptable unless anticoagulaton is in effect.
Recurrent supraventricular or atrial tachycardia, fllutte, or fibrillation
Left bundle branch block unless exercise can be performed with an adequate heart rate response
Second-degree atrioventricular block in the absence of structural heart disease
sinus pause more than 3 seconds
Ventricular arrhythmia (history or presence of multifocal PVC's or nonsustained ventricular tachycardia on
resting EKG with or without symptoms; history or presence of sustained ventricular tachycardia with or
without symptoms).
Medical clearance requires the following:
(1) An echocardiograph that shows normal function and no evidence of structural abnormalities
(2) Stress testing with imaging to a workload of at least 12 METs off cardiac medications that shows no
evidence of ischemia, ventricular tachycardia, or ventricular fibrillation. Premature Ventricular
(PVCs) should resolve with increasing levels of exercise.
Recurrent syncope
A medical condition requiring an automatic implantable cardiac defibrillator or history of ventricular tachy-
cardia or ventricular fibrillation due to ischemic or valvular heart disease, or cardiomyopathy.
Heart transplant
Category B medical conditions include the following:
Valvular lesions of the heart, including prosthetic valves -- Specific recommendations include the following:
(1) Mitral stenosis is acceptable if in sinus rhythm and stenosis is mild -- that is, valve area is greater than
1.5 cm² or pulmonary artery systolic pressure is less than 35 mm Hg.
(2) Mitral insufficiency is acceptable if in sinus rhythm with normal left ventricular size and function.
Heart and Vascular System
Category A medical conditions include the following:
Coronary artery disease, including history of myocardial infarction, angina pectoris, coronary bypass surgery,
coronary angioplasty, and similar procedures
Cardiomyopathy or congestive heart failure, including signs or symptoms of compromised left or right
ventricular function or rhythm, including dyspnea, S3 gallop, peripheral edema, enlarged ventricle, abnormal
ejection fraction, and / or inability to increase cardiac output with exercise
Acute pericarditis, endocarditis, or myocarditis
Third-degree atrioventricular block
Cardiac pacemaker
Hypertrophic cardiomyopathy, including idiopathic hypertrophic subaortic stenosis
Any cardiac condition that results in the candidate not being able to safely perform one or more of the
essential job tasks
Page 7
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
1.
2.
3.
4.
5.
1.
2.
3.
4.
5.
6.
1.
2.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
Peptic or duodenal ulcer or Zollinger-Ellison syndrome with symptoms uncontrolled by drugs or surgery
Abdominal Organs and Gastrointestinal System
Category A medical conditions include the following:
Category B medical conditions include the following:
Presence of uncorrected inguinal / femoral / hernia regardless of symptoms
Any gastrointestinal condition that results in the candidate not being able to perform one or more of the
essential job tasks
causing incresed risk of infection and / or strangulation
Inflammatory bowel disease which causes disabling pain or diarrhea
Cholycystitis that causes frequent pain due to stones or infections resulting in frequent pain
Category B medical conditions include the following:
Vasospastic phenomena such as Raynaud's phenomenon
Thromboplebitis, thrombosis, or varicosities
Chronic lymphedema due to lymphadenopathy or venous valvular incompetency
Congenital or acquired lesions of the aorta or major vessels (i.e. syphilitic aortitis, domonstrable athero-
sclerosis that interferes with circulation and congenital acquired dilation of the aorta)
Circulatory instability as indicated by orthostatic hypotension, persistent tachycardia, and peripheral
vasomotor disturbances
History of surgical repair of aneurysm of the heart or major vessel
Hypertension
(a) Uncontrolled or poorly controlled hypertension (defined as: the presence of end organ damage or stage 2
hypertension [BP systolic > 160 mm Hg or BP diastolic BP diastolic > 100 mm Hg.] Following appropriate
1 month's time.)
(b) Hypertension with evidence of end organ failure
Thoracic or abdominal aortic aneurysm
Carotid artery stenosis or obstruction resulting in greater than or equal to 50 percent reduction in blood flow.
Peripheral vascular disease resulting in symptomatic claudication
Any other vascular condition that results in inability to safely perform one or more of the essential job tasks
and successful management of stage 1 or stage 2 hypertension, a candidate can be evaluated after
Vascular System
Category A medical conditions include the following:
Gastritis that causes recurrent pain and impairment
GI bleeding that causes fatigue and / or hemodynamic instability
Acute hepatitis (until resolution of acute hepatitis as determined by clinical examination and appropriate
laboratory testing
Hernia including the following:
(1) Uncorrected umbilical, ventral, or incisional hernia if significant risk exists for infection or strangulation
(2) Significant symptomatic hiatal hernia if associated with asthma, recurrent pneumonia, chronic pain, or
chronic ulcers
(3) Surgically corrected hernia more than 3 months after surgical correction with persistent abnormality
Intestinal obstruction (recent obstruction with impairment)
Chronic or recurrent pancreatitis
Diverticulitis
History of gastrointestinal surgery (a bowel resection with subsiquent frequent diarrhea)
Asplenia
Cirrhosis, hepatic or biliary that is symptomatic or in danger of bleeding
Page 8
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
14.
1.
2.
3.
4.
1.
2.
1.
2.
1.
2.
3.
4.
5.
Diseases of the ureter, bladder, or prostate
Spine and Axial Skeleton
Category A medical conditions include the following:
Scoliosis of thoracic or lumbar spine with angle greater than or equal to 40 degrees.
History of spinal surgery with rods that are still in place
Any spinal or skeletal condition producing sensory or motor deficit (s) or pain due to radiculopathy or nerve
root compression.
Any spinal or skeletal condition causing pain that frequently or recurrently requires narcotic analgesic
medication
(3) HDL cholesterol < 40 mg/dl for men, < 50 mg/dl for women
(4) Blood pressure > 135 / 85 mm Hg
(5) Fasting blood glucose > 110 mg/dl
Category A medical conditions include metabolic syndrome with aerobic capacity less than 12 METS
Category B medical conditions include metabolic syndrome with aerobic capacity greater than 12 METS
Reproductive System
Category A medical conditions include any genital condition that results in inability to perform one or more of the
essential job tasks.
Category B medical conditions include the following:
Urinary System
Category A medical conditions include the following:
Category B medical conditions include the following:
Renal failure or insufficiency requiring continuous ambulatory peritoneal dialysis (CAPD) or hemodialysis
Any urinary condition that results in the candidate not being able to safely perform one or more of the
essential job tasks
Pregnancy, for its duration
Dysmenorrhea
Endometriosis, ovarian cysts, or other gynecologic conditions
Testicular or epididymal mass
Diseases of the kidney
Cervical vertebral fractures with multiple vertebral body compression greater than 25 %; evidence of poster-
ior element involvement nerve root damage, disc involvement, dislocation (partial, moderate, severe),
abnormal exam, ligament instability, symptomatic, and / or less than 6 months post injury or less than 1 year
since surgery
Chronic active hepatis that results in weakness or general malaise
Metabolic Syndrome
Metabolic syndrome includes three or more of the following components:
(1) Abdominal obesity, defined as a waist circumference > 40 inches (>102 cm) in men, > 35 inches (> 88 cm) in women
(2) Triglycerides > 150 mg/dl
Abdominal Organs and Gastrointestinal System / Category B (continued)
Page 9
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
6.
7.
8.
1.
2.
3.
4.
5.
6.
7.
1.
2.
3.
4.
Amputation of either thumb proximal to the mid-proximal phalanx
Amputation or congenital absence of lower-extremity limb (foot or above) unless the candidate meets all of
the following conditions:
(1) Stable, unilateral below-the-knee (BKA) amputation with at least the proximal third of the tibia present
for a strong and stable attachment point with the prothesis
(2) Fitted with a prosthesis that will tolerate the conditions present in structural firefighting when worn in
conjunction with standard fire fighting PPE
(3) At least 6 months of prosthetic use in a variety of activities with no functional difficulties
(4) Amputee limb healed with no significant inflammation, persistent pain, necrosis, or indications of
Extremities
Category A medical conditions include the following:
Joint replacement, unless all the following conditions are met:
(1) Normal range of motion without history of dislocations post-replacement
(2) Repetitive and prolonged pulling, bending, rotations, kneeling, crawling, and climbing without pain or
impairment
(3) No Limiting pain
(4) Evaluation by an orthopedic specialist who concurs that the candidate can complete all essential job tasks
Amputation or congenital absence of upper-extremity limb (hand or higher)
neurological deficits, pain, or limit flexibility
Scoliosis with angle less than 40 degrees
Arthritis of the cervical, thoracic, or lumbosacral spine.
Facet atrophism, high lumbosacral angle, hyperlordosis, Schmorl's nodes, Scheuermann's disease, spina
bifida occulta, spondylolisthesis, spondolysis, or transitional vertebrae
History of infections or infarcts in the spinal cord, epidural space, vertebrae, or axial skeletal joints
History of diskectomy or laminectomy or vertebral fractures
History of spine fusion that results in instability; reduced mobility, strength, or range of motion; persistent
pain
Lumbosacral vertebral fractures with vertebral body compression greater than 50 %; evidence of posterior
Spine and Axial Skeleton / Category A (continued)
element involvement, nerve root damage, disc involvement, dislocation (partial, moderate, severe), frag-
mentation, abnormal exam, ligament instability, symptomatic, and / or less than 6 months post injury or less
than 1 year since surgery
Any spinal or skeletal condition that results in the candidate not being able to safely perform one or more of
the essential job tasks
Category B medical conditions include the following:
Congenital or developmental malformations of the back, particularly those that can cause instability,
abnormal exam, ligament instability, symptomatic, and / or less than 6 months post injury or less than 1 year
since surgery
Thoracic vertebral fractures with vertebral body compression greater than 50 %; evidence of posterior
element involvement, nerve root damage, disc involvement, dislocation (severe -- with or without surgery),
(6) Evaluated by a prosthetist or orthopedic specialist with expertise in the fitting and function of prosthetic
limbs who concurs that the candidate can complete all essential job tasks, including wearing PPE and
SCBA while climbing ladders or crawling in the dark along narrow and uneven surfaces that may be wet
or icy.
instability at the amputee limb attachment point
(5) No significant psychosocial issues pertaining to the loss of limb or use of the prosthesis
Page 10
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
1.
2.
3.
4.
5.
6.
7.
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2.
3.
4.
5.
6.
7.
8.
training and the performance of the fire-fighter essential job skills.
generalized, and psychomotor seizure disorders other than as follows:
*(1) No seizures for 1 year off all anti-epileptic medication or 5 years seizure free on a stable medication
regimen
specified in *(1) and *(4) [above], and that the candidate is neuroligically cleared for fire-fighting
*(4) Awake and asleep EEG studies with photic stimulation and hyperventilation are normal
(5) A definitive statement from a qualified neurological specialist that the candidate meets the criteria
> Operational environmental impact (e.g., heat, stress, activity, variable night shifts) on the candidates
ability to perform the essential job tasks should be considered and should be specifically addressed by a
neurological specialist
Myasthenia gravis with activity or evidence of progression within previous 3 years, free of disease
exacerbation, off all drugs and other treatment, with normal cognitive function, neurologic exam, and
respiratory status.
Progressive muscular dystrophy or atrophy
Uncorrected cerebral aneurysm
All single unprovoked seizures and epileptic conditions, including simple partial, complex partial,
Neurological Disorders
Category A medical conditions include the following:
Ataxias of heredo-degenerative type
Cerebral arteriosclerosis as evidenced by a history of transient ischemic attack, reversible ischemic neuro-
logical deficit, or ischemic stroke
Hemiparalysis or paralysis of a limb
Multiple sclerosis with activity or evidence of progression within previous 3 years:
> The candidate's neurological exam should be normal, and they should not require medications that can
impair their ability to safely perform essential job tasks.
Extremities / Category A - 4 (continued)
(7) Any extremity condition that results in the candidate not being able to perform one or more of the
essential job tasks
(2) Neurologic examination is normal
(3) Imaging (CAT or MRI scan) studies are normal
Category B medical conditions include the following:
History of shoulder dislocation with residual instability (subluxation) or significant limitation of motion,
with surgical repair
Significant limitation of function of shoulder, elbow, wrist, hand, or finger due to weakness, reduced range of
motion, atrophy, unequal length, absence, or partial amputation
Significant lack of full function of hip, knee, ankle, foot, or toes due to weakness, reduced range of motion,
atrophy, unequal lenth, absence, or partial amputation
History of meniscectomy or ligamentious repair of knee with residual instability or laxity of ligament or
intra-articular arthritis with resulting instability of limb, inadequate range of motion, or increased pain that
limits crawling, kneeling, jumping, safe ladder use, or safe stretcher carrying.
History of intra-articular, malunited, or nonunion of upper or lower extremity fracture with signs of
symptoms (e.g., pain, swelling, atrophy, range of motion, gait)
History of osteomyelitis, septic, or rheumatoid arthritis with resulting functional impairment, disease
activity, and chronicity.
Bone hardware such as metal plates or rods supporting bone during healing
Page 11
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
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10.
11.
1.
2.
3.
4.
5.
1.
2.
3.
1.
2.
3.
4.
Neurological Disorders / Category A (continued)
Dementia (Alzeheimer's and other neurodegenerative diseases) with symptomatic loss of function or cog-
nitive impairment (e.g., less than or equal to 28 on Mini-Mental Status Exam)
Parkinson's disease and other movement disorders resulting in uncontrolled movements, bradykinesia, or
cognitive impairment (e.g., less than or equal to 28 on Mini-Mental Status Exam)
Any neurological condition that results in the candidate not being able to safely perform one or more of the
essential job tasks
Category B medical conditions include the following:
sensation, or complaint of pain
History of subarachnoid or intraparenchymal hemorrhage
Abnormalities from recent head injury such as severe cerebral contusion or concussion
Skin
Category A medical conditions include the following:
Metastatic or locally extensive basal or squamous cell carcinoma or melanoma
Congenital malformations
Migraine other than as follows:
Exam and imaging studies should be normal, and medications needed to control chronic pain should not
affect neurologic or cardiac function (energy, cognitive ability, equilibrium, etc.) Examples include the
following;
(1) Neuropathy (cranial, perpheral, plexus, etc.). Motor and sensory neurologic exams and diagnostic /
imaging studies (as needed) should be normal, and medications needed to control pain should not
affect nervous system function (energy, cognitive ability, equilibrium, etc.).
(2) Myopathy and / or myositis. Motor strength is normal, pain is controlled without narcotics, renal function
is normal, and neither heart nor diaphragm is involved.
(3) History of infectious myoneuropathies (e.g., Guillain-Barre , post-botulism, post-polio syndrome).
Cognitive function, neurologic exam, and diagnostic imaging studies (as needed) should be normal.
Clinical disorders with paresis, dyscoordination, deformity, abnormal motor activity, abnormality of
Any dermatologic condition that would not allow for a successful fit test for any required respirators or SCBA
Any dermatologic condition that results in the candidate not being able to safely perform one or more of the
Category B medical conditions include the following:
Skin conditions of a chronic or recurrent nature (eczema, cystic acne, psoriasis) that cause skin openings or
inflammation or irritation of the skin surface.
The candidate should be evaluated for severity, chronicity, pain, likelihood of serious occupational infectious
essential job tasks
Surgery or skin grafting
Mycosis fungoides
The candidate should be evaluated for systemic involvement, skin involvement that interferes with essential job
tasks, or presence of localized complications such as fissures, weeping, or ulcerations, due to risk of burn
The candidate should be evaluated for thinned, stretched skin that is at risk for easy breakdown, burn damage,
abnormal sensations, or infection.
exposure, requirement for continuous medication, and impairment of ability to safely perform essential job
tasks.
Cutaneous lupus erythematosis
injury and / or infection.
The candidate should be evaluated for associated systemic lupus, skin integrity, and Raynaud's phenomenon.
Page 12
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
1.
2.
3.
4.
Skin / Category B (continued)
Raynaud's phenomenon.
The candidate should be evaluated for functional limitation of hand and / or foot when exposed to cold or
systemic involvement of skin, muscles, heart, lungs, or neurologic system that would compromise the safe
performance of essential job tasks.
Scleroderma (skin)
essential job tasks.
Stasis dermatitis
The candidate should be evaluated for sclerodactyly with significant loss of function or systemic involvement.
Vasculitic skin lesions
The candidate should be evaluated for associated leg swelling, loss of function, or systemic involvement.
Atopic dermatitis / eczema
The candidate should be evaluate for percent body involvement with redness and scaling, requirement for reg-
ular application of lubrication / medication, and / or potential effect on safe performance of essential job tasks.
Contact or seborrheic dermatitis
The candidated should be evaluated for extent, severity, chronicity, and known precipitants with attention to
potential risk of serious, occupational infectious exposures or other interference with safe performance of
The candidate should be evaluated for swelling, redness, scaling, itching, weeping, and / or cracking, pain,
loss of function (e.g., cannot stand for long periods of time), or ulceration.
Albinism, Darier's disease, ichthyosis, Marfan syndrome, neurofibromatosis, and other genetic conditions
The candidate should be evaluated for functional limititations, ability to wear helmet, SCBA or other required
occupational infectious exposure.
Mechano-bullous disorders (epidermolysis bullosa, Hailey pemphigus, porphyria, pemphigoid)
The candidate should be evaluated for extent and acuity of blistering, loss of function, aggravating agent(s)
if known, ability to wear protective ensemble, ability to tolerate moderate, incidental, job-related trauma to
skin, risk of occupational infectious exposure, or inability to safely perform essential job tasks.
Urticaria or angioedema
The candidated should be evaluated for extent, severity, chronicity, association with underlying medical
condition, and requirement for medications (antihistamines) that interfere with the ability to safely perform
essential job tasks.
respirators with proper fit testing, and protective clothing, and requirements for continuous treatment.
Folliculitis, pseudo-folliculitis, miliaria, keloid folliculitis
The candidate should be evaluated for extent, chronicity, and interference with safe performance of essential
job tasks.
Hidradenitis suppurativa, furuncles, carbuncles, or Grade IV acne (cyctic)
The candidate should be evaluated for extent, chronicity, pain, ability to wear protective ensemble, and risk of
Blood and Blood-Forming Organs
Category A medical conditions include the following:
Hemorrhagic states requiring replacement therapy
Sickle cell disease (homozygous)
Clotting disorders
Any other hematological condition that results in inability to safely perform one or more of the essential job
tasks.
Page 13
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
1.
2.
3.
4.
5.
6.
1.
2.
(1) Is maintained by a physician knowledgeable in current management of diabetes mellitus.
(Endocrine and Metabolic Disorders / Category A / items 1 (1)** and 1 (2)**
b. Has had hemoglobin A1C measured at least four times a year (intervals of 2 to 3 months) over the last
12 months prior to evaluation if the diagnosis of diabetes has been present over 1 year. A
hemoglobin A1C reading of 8 percent or greater shall trigger a medical evaluation to determine
if a condition exists in addition to diabetes that is responsible for the hemoglobin A1C not
accurately reflecting average glucose levels. This shall include evidence of a set schedule for
blood glucose monitoring and a thorough review of data from such monitoring.
c. Does not have an increased risk of hypoglycemia due to alcohol use or other predisposing factors.
d. Has had no episodes of severe hypoglycemia (defined as requiring assistance of another) in the
of proteinuria. (Creatinine clearance can be calculated by use of the Cockroft-Gault or similar formula.
Proteinuria is defined as 24-hour urine excretion of greater than or equal to 300mg protein or greater
than or equal to 300 mg of albumin per gram of creatinine in a random sample.
(5) Has normal cardiac function without evidence of myocardial ischemia on cardiac stress testing (to at least
12 METs) by ECG and cardiac imaging.
(6) Has a signed statement and medical records from an endocrinologist or a physician with demonstrated
knowledge in the current management of diabetes mellitus as well as knowledge of the essential job
tasks and hazards of firefighting and that the candidate meets the following criteria:
a. Is being successfully maintained on a regiment consistent with items:
Category B medical conditions include the following:
Blood and Blood-Forming Organs (continued)
Anemia
Leukopenia
Polycythemia vera
(2)** Has demonstrated over a period of at least 6 months the motivation and understanding required to
closely monitor and control capillary blood glucose levels through nutritional therapy and insulin
administration. Assessment of this shall take into consideration the erratic meal schedules, sleep
interruptions and high aerobic and anaerobic workloads intrinsic to firefighting.
(3) Has a dilated retinal exam by a qualified ophthamologist or optometrist that shows no higher grade of
Splenomegaly
History of thromboembolic disease
Any other hematological condition that results in inability to safely perform one or more of the essential
job tasks.
Endocrine and Metabolic Disorders
Category A medical conditions include the following:
Type 1 diabetes mellitus, unless a candidate meets all of the following criteria:
(1)** Is maintained by a physician knowledgeable in current management of diabetes mellitus on a basal /
bolus (can include subcutaneous insulin infusion pump) regimen using insulin analogs.
diabetic retinopathy than microaneurysms, as indicated on the International Clinical Diabetic
Retinopathy Disease Severity Scale.
(4) Has normal renal function based on a calculated creatinine clearance greater than 60 mL/min and absence
preceding 1 year, with no more than two episodes of severe hypoglycemia in the preceding 3
years.
e. Is certified not to have a medical contraindication to firefighting training and operations.
Insulin-requiring Type 2 diabetes mellitus, unless a candidate meets all of the following criteria:
Page 14
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
3.
1.
2.
Endocrine and Metabolic Disorders / Category A -2 (continued)
(2) Has demonstrated over a period of at least 3 months the motivation and understanding required to
closely monitor and control capillary blood glucose levels through nutritional therapy and insulin
administration. Assessment of this shall take into consideration the erratic meal schedules, sleep
disruption, and high aerobic and anaerobic workloads intrinsic to firefighting.
(3) Has a dilated retinal exam by a qualified ophthamologist or optometrist that shows no higher grade of
diabetic retinopathy than microaneurysms, as indicated on the International Clinical Diabetic
Retinopathy Disease Severity Scale.
knowledge in the current management of diabetes mellitus as well as knowledge of the essential job
tasks and hazards of firefighting and that the candidate meets the following criteria:
a. Is maintained on a stable insulin regimen and has demonstrated over a period of 3 months the
motivation and understanding required to closely monitor and control capillary blood glucose
levels despite varied activity schedules through nutritional therapy and insuling administration.
b. Has had hemoglobin A1C measured at least four times a year (intervals of 2 to 3 months) over the last
preceding 1 year, with no more than two episodes of severe hypoglycemia in the preceding
3 years.
e. Is certified not to have a medical contraindication to firefighting training and operations
Any endocrine or metabolic condition that results in the candidate not being able to safely perform one or
more of the essential job tasks
Category B medical conditions include the following:
Diseases of the adrenal gland, pituitary gland, parathyroid gland, or thyroid gland of clinical significance --
The candidate should be evaluated for absence of orthostatic hypotension, electrolyte disorders, ability to
maintain hydration during exercise under extreme environmental conditions, and normal thyroxine levels
with supplementation.
Nutritional deficiency diseases or other metabolic disorder
than or equal to 300 mg of albumin per gram of creatinine in a random sample.
(5) Has no autonomic or peripheral neuropathy. (Peripheral neuropathy is determined by diminished ability
to feel the vibration of a 128 cps tuning fork or the light touch of a 10-gram monofilament on the
dorsum of the great toe proximal to the nail. Autonomic neuropathy can be determined by evidence of
gastroparesis, postural hypotension, or abnormal test of heart rate variability.
(6) Has normal cardiac function without evidence of myocardial ischemia on cardiac stress testing (to at least
12 METs) by ECG and cardiac imaging.
(4) Has normal renal function based on a calculated creatinine clearance greater than 60 mL/min and absence
of proteinuria. (Creatinine clearance can be calculated by use of the Cockroft-Gault or similar formula.
Proteinuria is defined as 24-hour urine excretion of greater than or equal to 300mg protein or greater
12 months prior to evaluation if the diagnosis of diabetes has been present over 1 year. A
hemoglobin A1C reading of 8 percent or greater shall trigger a medical evaluation to determine
if a condition exists in addition to diabetes that is responsible for the hemoglobin A1C not
accurately reflecting average glucose levels. This shall include evidence of a set schedule for
blood glucose monitoring and a thorough review of data from such monitoring.
c. Does not have an increased risk of hypoglycemia due to alcohol use or other predisposing factors.
d. Has had no episodes of severe hypoglycemia (defined as requiring assistance of another) in the
(7) Has a signed statement and medical records from an endocrinologist or a physician with demonstrated
Page 15
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
3.
1.
2.
3.
1.
2.
months prior to evaluation if the diagnosis of diabetes has been present over 1 year. A hemoglobin A1C
reading of 8 percent or greater shall trigger a medical evaluation to determine if a condition exists in
addition to diabetes that is responsible for the hemoglobin A1C not accurately reflecting average
Retinopathy Disease Severity Scale.
(4) Has normal renal function based on a calculated creatinine clearance greater than 60 mL/min and absence
of proteinuria. (Creatinine clearance can be calculated by use of the Cockroft-Gault or similar formula.
Proteinuria is defined as 24-hour urine excretion of greater than or equal to 300mg protein or greater
than or equal to 300 mg of albumin per gram of creatinine in a random sample.
(5) Has no autonomic or peripheral neuropathy. (Peripheral neuropathy is determined by diminished ability
Connective tissue disease, such as dermatomyositis, systemic lupus erythematosus, scleroderma, and
rheumatoid arthritis.
History of thermal, chemical, or electircal burn injury with residual functional deficit;
Previous burn injury per se does not interfere with the essential job tasks of firefighting. Extensive burn injury
with or without the need for skin grafting can result in skin surfaces that are easily damaged, sensitive to
chemical or solvent exposure, or lacking in sweat or sebaceous glands. The candidate should be evaluated for
heat or cold intolerance, range of motion and motor strength, and ability to wear personal protective clothing
and equipment.
Documented evidence of a predisposition to recurrent heat stress rhabdomyoloysis, metabolic acidosis, or
exertion-related incapacitation
Tumors and Malignant Diseases
Category A medical conditions include the following:
Malignant disease that is newly diagnosed, untreated, or currently being treated, or
due to the increased risk for reoccurance under active surveillance
Any tumor or similar condition that results in the candidate not being able to safely perform one or more of
the essential job tasks
Systemic Diseases and Miscellaneous Conditions
Category A medical conditions include any systemic condition that results in the candidate not being able to safely
perform one or more of the essential job tasks.
Category B medical conditions include the following:
glucose levels. This shall include evidence of a set schedule for blood glucose monitoring and a
thorough review of data from such monitoring.
(2) If on oral hypoglycemic agents, has had no episodes of severe hypoglycemia (defined as requiring
assistance of another) in the preceding year.
(3) Has a dilated retinal exam by a qualified ophthamologist or optometrist that shows no higher grade of
diabetic retinopathy than microaneurysms, as indicated on the International Clinical Diabetic
to feel the vibration of a 128 cps tuning fork or the light touch of a 10-gram monofilament on the
dorsum of the great toe proximal to the nail. Autonomic neuropathy can be determined by evidence of
gastroparesis, postural hypotension, or abnormal test of heart rate variability.
(6) Has normal cardiac function without evidence of myocardial ischemia on cardiac stress testing (to at least
12 METs) by ECG and cardiac imaging.
Diabetes mellitus, not on insuling therapy, but controlled by diet, exercise, and / oral hypoglycemic agents
unless all of the following are met:
Endocrine and Metabolic Disorders / Category B (continued)
(1) Has had hemoglobin A1C measured at least four times a year (intervals of 2 to 3 months) over the last 12
Page 16
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
1.
2.
1.
2.
3.
4.
5.
6.
7.
8.
Anebolic steroids
Any chemical, drug, or medication that results in the candidate not being able to safely perform one or more
of the essential job tasks
Full-dose or low-dose anticoagulation medications or any drugs that prolong prothrombin time (PT), partial
thromboplastin time (PTT), or international normalized ratio (INR)
Beta-adrenergic blocking agents at doses that prevent a normal cardiac rate response to exercise, high-dose
diuretics, or central acting antihypertensive agents (e.g., clonidine)
Respiratory medications: inhaled bronchodilators, inhaled corticosteroids, systemic corticosteroids,
theophylline, and leukotriene receptor antagonists (e.g., Montelukast)
Leukotriene receptor antagonists are not Category A condition if used to treat conditions not affecting the
lower respiratory system.
High dose corticosteroids for chronic disease
Category B medical conditions include the following:
A history of psychiatric condition or substance abuse problem
Requirement for medications that increase an individual's risk of heat stress, or other interference with the
ability to safely perform essential job tasks
Chemicals, Drugs, and Medications
Category A medical conditions include those that require chronic or frequent treatment with any of the following
medications or classes of medications:
Narcotics, including methadone
Sedative-hypnotics
nutrition and hydration, and medication requirements.
(6) History of bone or soft tissue tumors or malignancies -- the candidate should be evaluated for muscle
strength, deformity interfering with function, or the ability to wear protective ensemble.
(7) History of hematological malignancies -- the candidated should be evaluated for anemia, leukopenia, or
thrombocytopenia, or residual cardiac, pulmonary, GI, dermatological, or neurological effects of surgery,
radiation, or chemotherapy.
Psychiatric Conditions
Category A medical conditions include any psychological condition that results in the candidate not being able to
safely perform one or more of the essential job tasks.
Category B medical conditions shall be evaluated on the basis of an individual's current physical condition and on the
staging and prognosis of the malignancy (i.e., likelihood that the disease will recur or progress), and include
effects on balance, coordination, strength, speech, judgment; and medication requirements.
(3) History of head and neck malignancy --the candidate should be evaluated for the ability to wear SCBA and
maintain nutrition or oral hydration.
(4) History of lung cancer -- the candidate should be evaluated for residual pulmonary function and medication
requirements.
(5) History of GI or GU malignancy -- the candidate should be evaluated for abnormal bowel or urinary function
that would interfere with emergency operations where toilet facilities are unavailable, the ability to maintain
the following:
(1) Benign tumors -- the candidate should be evaluated for space-occupying lesion, treatment, or sequelae
affecting their ability to perform essential job tasks.
(2) History of CNS tumor or malignancy -- the candidate should be evaluated for history or risk of seizure; residual
Tumors and Malignant Diseases (continued)
Page 17
REFERENCE MATERIAL BASED ON NFPA 1582:
STANDARD ON COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS 2013 EDITION
1.
2.
3.
4.
5.
6.
7.
The candidate should be evaluated for an underlying condition requiring the medication and effects of medication
that could affect ability to safely perform essential job tasks.
Chemicals, Drugs, and Medications (continued)
A1 - Evidence of illegal drug use detected through testing, conducted in accordance with Substance Abuse and Mental
Health Service Administration (SAMHSA), shall be a Category A medical condition
A2 - Evidence of clinical intoxication or a measured blood alcohol level that exceeds the legal definition of intoxication
according to Ohio Revised Code, at the time of medical evaluation shall be a Category A medical condition.
Category B medical conditions include the following:
Muscle relaxants
Leukotriene receptor antagonists (e.g., Montelukast) used for allergies that do not affect the lower
respiratory system
Cardiovascular agents
Stimulants
Psychiatric medications
Other than high-dose systemic corticosteroids
Antihistamines
Page 18
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