1. NFPA 1582 1997 Edition Standard on Medical Requirements for Fire Fighters

2. NFPA 1582 Establishes medical requirements for Firefighters Adopted by NFPA, August 15, 1997 Intended for entry level as well as current firefighters

3. NFPA 1582 Technical Committee Development began in 1990 A joint task force of members Assisted by Physicians of Expertise Vision Hearing Cardiac Neurological Metabolic

4. Scope Firefighters Full paid/not paid Full time/part time Applicable to rescue, fire suppression and other emergency services

5. Purpose Specify minimum medical requirements for firefighters Help ensure firefighters are medically capable

6. Definitions Category A Precludes from firefighting duties Category B Based on severity may preclude

7. Fire Department Physician Licensed doctor of medicine or osteopathy Expertise in occupational safety and health Dr. George Hancock Medical Director, Occupational Health Services, Memorial Hermann Healthcare systems

8. Medical Evaluation Schedule Entry/Pre-employment Periodic Medical Evaluation < 29 years every three years 30 to 39 years every two years > 40 years every year Return To Work Evaluation

9. Vital Signs Medical History Occupational History Pulse Respiratory Rate Blood Pressure Temperature Height/Weight

10. Head and Neck No Category A Category B Deformities of Skull Loss of bony substance of skull Any other resulting in inability

11. Eyes and Vision Category A > 20/30 corrected, >20/100 uncorrected Peripheral < 140 degrees uncorrected Category B Diseases Ophthamological Procedures (RK) Any other resulting in inability

12. Ears and Hearing No Category A Category B > 25 dB in three of four frequencies 500, 1000, 2000, 3000 Hz > 30 dB in one of three frequencies 500, 1000, 2000 Hz Avg > 30 dB in the four frequencies 500, 1000, 2000, 3000 Hz

13. Ears and Hearing Category B (continued) Aterisia, severe stenosis or tumor Severe external otitis Severe agenisis or traumatic deformity of auricle Severe mastoiditis or surgical deformity of the mastoid Otitis media

14. Dental No Category A Category B Diseases of the Jaws or associated tissues Orthodontic appliances Oral Tissues, extensive loss Condition that precludes the use of protective equipment

15. Nose, Orapharynx, Trachea, Esophagus, Larnyx Category A Tracheostomy Aphonia Anosmia Category B Deformity Allergic Respiratory Disorder Dysponia

16. Lungs and Chest Wall Category A Active hemoptysis Empyemia Current pneumonia Pulmonary Hypertension Active Tuberculosis Infectious diseases of lungs or pleural space

17. Lungs and Chest Wall Category B Pulmonary resectional, Chest wall surgery, pneumothorax Bronchial asthma, reactive airways disease Fibrothorax, chest wall deformity, diaphragm abnormalities Chronic obstructive airways disease

18. Lungs and Chest Wall Category B (continued) Hypoxic disorders Interstitial lung diseases Pulmonary vascular diseases, pulmonary embolism Bronchiectasis

19. Heart Category A Angina pectoris, current Left bundle branch block or second degree Type II atrioventricular block Acute pericarditis, endocarditis, myocarditis

20. Heart Category A (continued) Heart failure, current Syncope, recurrent Automatic implantable cardiac defibrillator

21. Heart Category B Significant valvular lesions, prosthesis Coronary artery disease Atrial tachycardia, flutter, fibrillation Ventricular tachycardia Cardiac hypertrophy Recurrent paroxysmal tachycardia

22. Heart Category B (continued) Congenital abnormality Chronic pericarditis, endocarditis, myocarditis Cardiac pacemaker Coronary artery vasospasm

23. Vascular System No Category A Category B Hypertension Peripheral vascular disease Recurrent thrombophlebitis Chronic lymphedema Lesion of a major vessel

24. Vascular System Category B (continued) Circulatory instability due to orthostatic hypertension, persistent tachycardia, and severe peripheral vasomotor disturbances Aneurysm of the heart of major vessel

25. Abdominal Organs and Gastrointestinal Category A Chronic active hepatitis Category B Cholecyctitis Gastritis Hemorrhoids Acute hepatitis Hernia

26. Abdominal Organs and Gastrointestinal Category B (continued) Inflammatory bowel disease Intestinal obstruction Pancreatitis Resection, bowel Ulcer, gastrointestinal Cirrhosis, hepatic or biliary

27. Genitourinary No Category A Category B Pregnancy, duration Dysmenorrhea Endometriosis, Ovarian cysts, gynecological conditions Testicular mass or epididymal mass

28. Urinary No Category A Category B Diseases of the kidney Diseases of the ureter, bladder or prostate

29. Spine, Scapulae, Ribs and Sacroiliac Joints No Category A Category B Arthritis Structural abnormality, fracture, dislocation Nucleus pulposus, herniation, Hx of laminectomy

30. Extremities No Category A Category B Limitation of motion of joint Amputation or deformity of joint Dislocation of a joint

31. Extremities Category B (continued) Joint reconstruction, ligamentous instability, joint replacement Chronic osteoarthritis, traumatic arthritis Inflammatory arthritis

32. Neurological Disorders Category A Ataxias of heredo-degenerative type Cerebral arteriosclerosis Multiple sclerosis with activity Progressive muscular dystrophy or atrophy All epileptic conditions

33. Neurological Disorders Category B Congenital malformations Migraine Clinical Disorders with abnormality of sensation Subarachnoid or intracerebral hemorrhage Abnormalities from recent head injury

34. Skin No Category A Category B Acne or inflammatory disease Eczema

35. Blood and Blood Forming Organs Category A Hemorrhagic states requiring replacement therapy Sickle cell disease

36. Blood and Blood Forming Organs Category B Anemia Leukopenia Polycythemia Splenomegaly History of thromboembolic disease

37. Endocrine and Metabolic Disorders Category A Diabetes mellitus and history of incapacitating hypoglycemia

38. Endocrine and Metabolic Disorders Category B Diseases of of the adrenal, pituitary, parathyroid, or thyroid of clinical significance Nutritional deficiency or metabolic disorder Diabetes mellitus w/o history of incapacitating hypoglycemia

39. Systemic Diseases and Miscellaneous No Category A Category B Connective tissue disease Past thermal injury Predisposition to heat stress

40. Tumors and Malignant Diseases No Category A Category B Malignant disease

41. Psychiatric Conditions No Category A Category B History of psychiatric disease or substance abuse, individual basis and current condition

42. Chemicals, Drugs, and Medications No Category A Category B Anticoagulant or cardiovascular agents Narcotics Sedative-hypnotics or Psychoactive agents Stimulants Steroids

43. SLFD 1582 History Requested 1997 and 1998 Approved Budget Year 1998/99 for 40+ yoa Firefighters Approved Budget Year 1999/00 for 30+, 40+ yoa Firefighters Approved Budget Year 2000/01 for <29, 40+ yoa Firefighters

44. Category A: What Happens Doctor will consult with you. City will be informed of your inability to perform as a firefighter. You have the option to disclose.

45. Category B: What Happens Doctor will consult with you. City will be informed if you are not eligible to perform firefighting duties. Your option to disclose.

46. Incumbent Firefighter Variances Applies to those hired prior to NFPA 1998/1999 physicals Vision Correctable to 20/30. Other issues on case by case basis based on the judgment of the FD Physician, the Fire Chief and Human Resources.

47. Scheduling Make appointment by May 18 Phyllis Braun, 281-276-2030 Completed physical by August 31 Your responsibility You will be held accountable

48. Questions? I may not know the correct answers but will make every effort to obtain them. Please E-Mail or meet with me in person.

49. Thank You. Plan to Go Home Healthy and Uninjured.