Features Health and wellness Hot topics
WellBeing: May 2010

With one in three firefighters injured annually in North America we know our personnel face high odds of being injured. It’s understood by unions, management and frontline fire personnel that a comprehensive wellness-fitness program can secure the highest level of health for firefighters.

Programs such as the IAFF/IAFC joint labour management Wellness Fitness Initiative (WFI) have been shown to reduce the number of work-related injuries and lost workdays. Indeed, Statistics Canada says a majority of Canadian corporations offer wellness programs for their employees yet many fire departments struggle with the implementation of these types of programs. Most absent and arguably the most critical component is the annual medical evaluation.

There is often debate over the differences between NFPA 1582 and the WFI and it usually revolves around the topic of fit for duty versus wellness. The medical components of the two are essentially the same but the difference lies in application. The NFPA is generally made up of standards used to determine job status; wellness is regarded as overall health promotion regardless of current health status. The difference may appear subtle but it can have a huge impact on your program’s success. It’s critical that when you establish a program you get employee buy in. The focus needs to be on individual health promotion versus adherence to an industry standard or your wellness physician will be perceived with the same negative connotations as a Workers Compensation physician.

The mandate of the WFI is to “develop an overall wellness fitness system with a holistic, positive, rehabilitating and educational focus”. Many programs fail to reach their potential because they impose a standard before establishing trust. A program’s success hinges on changing the workplace culture. Creating an environment of trust and respect with a focus on individual health promotion and education that empowers the employee results in a positive shift in the workplace culture. Once this shift occurs then management needs – such as adherence to a standard and personnel accountability – can be met.

The obvious concern is the fear of allowing personnel to remain on full duty if a medical condition is discovered that would normally preclude them from working. Many organizations may already have personnel in this situation but have chosen to do nothing because they are unsure how to confront the problem. It’s the wellness physician’s job to provide the patient with unbiased health information and guidance that is centered on the patient’s personal well-being. Employees will make the appropriate decisions if they are properly educated about their condition and trust the physician. The worst that can happen is that employees who don’t trust a department physician will avoid divulging any information beyond what is required. By providing proper guidance and support, management’s goal is to empower employees to take responsibility for their health. In the WFI “there are no blanket prohibitions to determine job status”. If a medical condition exists that limits someone’s ability to perform a task then it is the responsibility of the WFI physician to work with the individual to determine the best course of action. The personal health of the individual is the priority; the physician serves as the advocate to ensure the appropriate treatment strategy ensues. Whenever possible, the firefighter has an active role in the decision process.

Another important concept to consider in the implementation of a health and wellness program is mandatory and non-punitive. The WFI requires mandatory participation and is non-punitive. Simply stated, the program won’t work if the employee won’t participate. The program may only be punitive if employees don’t participate. In order to affect a lifestyle change for firefighters on and off duty, this initiative must focus on delivering a positive, individualized plan. All results are confidential and are measured against the individual’s previous examinations and assessments and not against any standard. The non-punitive component means that no personnel will lose pay. In extreme cases, where a serious medical condition exists that impacts job status, all efforts are made to correct the situation (through treatment) along with an appropriate accommodated work position with no loss of pay. It’s in the best interest of everyone involved to get an employee back to full duty if the condition is correctable.

Health information is personal and must be safeguarded. In order for personnel to divulge their health history, complete a lifestyle questionnaire, undergo laboratory, radiology and physical exams and make voluntary changes to their personal lives, they must truly trust the system. Once trust is established and firefighters believe that their individual interests are a priority, then the program can reach its potential – the program works and everyone wins; it just needs to be applied properly.

Ian Crosby is in his 17th year with the Calgary Fire Department and serves as its wellness and fitness co-ordinator. Crosby developed the department’s Wellness Centre, which opened February 2005. He is a member of the IAFF/IAFC/ACE Peer Fitness Trainer (PFT) Oversight Committee and an instructor for the PFT certification program. E-mail him at Ian.Crosby@calgary.ca