### BASIS FOR THE 

**MEDICAL STANDARDS**

**Approved by the National Fire and Aviation Executive Board for the
Function of:**

### WILDLAND FIREFIGHTER (ARDUOUS DUTY)

\[NOTE: The following is intended for use in conjunction with the
"Medical Standards and Review Criteria for Medical Review Officers."
Please refer to that document for more complete and specific information
on the standards and assessment of individuals against those
standards.\]

Applicants for federal employment, as well as current federal employees,
are presumed to be medically qualified unless there is specific medical
evidence that they are not. For some positions, specific medical
standards or requirements are justified because of the arduous/hazardous
nature of the functions to be conducted or the circumstances under which
they are conducted, the need for a high degree of reliability and safety
for employees, and a commitment by the employing agency to maintain a
high degree of responsibility toward public safety.

The basis for the wildland firefighter medical standards is the
functional relationship between time/work volume, physical requirement,
environment, and physical exposure factors that may be expected with
fire fighting, and the emotional and physical ability of the firefighter
to carry out their tasks safely and efficiently. The Attachment to this
document provides a summary of these factors.

Sustaining an agency's decision to not hire, or to impose a job
restriction or limitation on an employee, the Office of Personnel
Management must consider whether the agency has

\(1\) documented the degree of the applicant's impairment; (2) weighed
the seriousness of the applicant's medical condition\[s\]; (3)
identified medication requirement\[s\]; (4) identified the essential
functions the applicant would need to perform at work; (5) identified
the environmental, industrial, and occupational conditions under which
the job tasks or essential functions would be required to be performed;
and (6) considered whether the functional requirements and work
conditions would aggravate, accelerate, exacerbate, or permanently
worsen any pre-existing medical condition the individual may have.

The wildland firefighter (arduous duty) medical standards establish the
levels of minimum medical fitness that the agency has determined to be
necessary for safe and efficient job performance. Specifically:

The PSYCHIATRIC standard relates (A) the firefighter's need for
judgement, mental functioning, and social/behavior skills with (B) the
essential functions and work conditions of a wildland firefighter,
including working on small and large teams, flying in helicopters and
fixed wing aircraft, and rapid pull out to safety zones under conditions
that may include isolated or remote sites, snakes, close quarters with
large numbers of other workers, limited and disrupted sleep, and long
work hours. Some psychiatric conditions, including those listed in the
standards, may not be compatible with safe and efficient performance of
wildland firefighter duties under these conditions.

The PROSTHETICS, TRANSPLANTS, AND IMPLANTS standard relates (A) the
firefighter's need to work safely and efficiently despite medical
conditions that have led to the need for a prosthesis, transplant or
implant with (B) the essential functions and work conditions of a
wildland firefighter, including using shovels or other hand tools to
construct fire lines, using personal protective equipment, engaging in
arduous exertion, carrying heavy loads, walking and climbing, kneeling
and stooping, and pulling out rapidly to safety zones, and doing so
under conditions that may include very steep terrain, rocky, loose or
muddy surfaces, wet leaves and grasses, isolated and remote sites, and
very long assignments. For individuals with transplants, prosthetics, or
implanted pumps or electrical devices, the examinee will have to provide
***[for agency review]{.underline}*** documentation from his/her surgeon
or physician that the individual (and, if applicable, his/her prosthetic
or implanted device) is considered to be fully cleared for the specified
functional requirements of wildland fire fighting.

The IMMUNE SYTEM/ALLERGIC DISORDERS standard relates (A) the
firefighter's need to be free of infectious disease, immune system, or
allergy conditions likely to present a safety risk to self or others
with (B) the essential functions and work conditions of a wildland
firefighter, including arduous exertion, driving or riding for many
hours, and providing rescue or evacuation assistance under conditions
that may include isolated or remote sites, allergens, close quarters
with large numbers of other workers, and long assignments. Some immune
system/allergic conditions, including those listed in the standards, may
not be compatible with safe and efficient performance of wildland
firefighter duties under these conditions.

The MEDICATION standard relates (A) the firefighter's need for full
physical and mental function and attention and a low risk of sudden or
subtle incapacitation with (B) the essential functions and work
conditions of a wildland firefighter under conditions that may include
open holes and drop offs, isolated and remote sites, irregular meals,
dehydration, and long work assignments. Some medications may not be
compatible with safe and efficient performance of wildland firefighter
duties under these conditions.

The VISION standard relates (A) the firefighter's need to be able to see
(including binocular vision, visual acuity, depth perception, peripheral
vision, and color vision) with (B) the essential functions and work
conditions of a wildland firefighter, including driving, walking,
climbing, constructing fire lines, and rapid pull out to safety zones
under conditions that may include very steep terrain, rocky, loose or
muddy ground surfaces, open holes or drop offs, and dim light or
darkness. The limit for uncorrected far vision is set at 20/100
binocular, consistent with the National Fire Protection Association's
Standard on Medical Requirements for Fire Fighters (NFPA 1582, 1997
Edition), and with a field assessment by the medical standards team in
which different levels of acuity were considered in an operational
setting related to the need for rapid or

emergency movement under the conditions noted above. Long-term users of
soft contact lenses are not subject to the uncorrected far vision
standard. Corrected far vision is set at 20/40, and the color vision
requirement is for red/green/amber (yellow), consistent with Department
of Transportation regulations for commercial driving and the need for
safe and efficient function under expected fire fighting conditions.
Peripheral vision is set as 85^0^ laterally, which is generally
considered to be normal. Some vision conditions, including those listed
in the standards, may not be compatible with safe and efficient
performance of wildland firefighter duties under these conditions.

The HEAD, NOSE, MOUTH, THROAT AND NECK standard relates (A) the
firefighter's need to be able to move the head without restriction,
breath freely, wear personal protective equipment, and communicate
clearly with (B) the essential functions and work conditions of a
wildland firefighter, including working on small and large teams, flying
in helicopters and fixed wing aircraft, and fighting fire under
conditions that may include high (and changing) altitudes, allergens,
varied climates, and isolated and remote sites. Some head, nose, mouth,
throat, and neck conditions, including those listed in the standards,
may not be compatible with safe and efficient performance of wildland
firefighter duties under these conditions.

The HEARING standard relates (A) the firefighter's need to hear verbal
communications and both natural and manmade warning sounds with (B) the
essential functions and work conditions of a wildland firefighter,
including working on small and large teams, driving, rapid pull out to
safety zones, and providing rescue or evacuation assistance under
conditions that may include isolated and remote sites, falling rocks and
trees, trucks and other large equipment. The hearing standard is set at
an average threshold of no greater than 40 dB at 500, 1000, 2000, and
3,000 Hz in each ear, consistent with the DOT regulations for commercial
drivers. This level is more lenient than that allowed by the NPFA 1582
standards (30 dB average threshold at these frequencies), or what is
considered to be "normal" hearing (25 dB), but is felt to provide a
reasonable hearing threshold level where louder than normal
communications may be expected. Hearing aides are [not]{.underline}
permitted in meeting this standard, due both to the limitation in
directional hearing afforded by hearing aides, and to the risk of
dislodging of a hearing aid during critical or emergency periods when
hearing must be acute. Some ear and hearing conditions, including those
listed in the standards, may not be compatible with safe and efficient
performance of wildland firefighter duties under these conditions.

The DERMATOLOGY standard relates (A) the firefighter's need for intact
and healthy skin with (B) the essential functions and work conditions of
a wildland firefighter, including use of personal protective equipment,
extensive walking and climbing, under conditions that may include highly
variable climates, extreme ultraviolet light exposure, extreme heat,
allergens, and isolated or remote sites. Some dermatologic conditions,
including those listed in the standards, may not be compatible with safe
and efficient performance of wildland firefighter duties under these
conditions.

The VASCULAR SYSTEM standard relates (A) the firefighter's need for a
healthy vascular system (including a lack of phlebitis, thrombosis,
venous stasis, or arterial insufficiency) with (B) the essential
functions and work conditions of a wildland firefighter, including
arduous exertion, driving or riding for extensive periods, flying in
helicopters and fixed wing aircraft, and extensive walking and climbing
under conditions that may include isolated or remote sites, and long
work assignments. Some vascular conditions, including those listed in
the standards, may not be compatible with safe and efficient performance
of wildland firefighter duties under these conditions.

The CARDIAC standard relates (A) the firefighter's need for a healthy
cardiovascular system and a low risk of sudden or subtle incapacitation
with (B) the essential functions and work conditions of a wildland
firefighter, including arduous exertion, lifting and carrying heavy
loads, extensive walking and climbing, and rapid pull out to safety
zones under conditions that may include very steep terrain, isolated and
remote sites, extreme heat, dehydration, and long work assignments. Some
cardiac conditions, including those listed in the standards, may not be
compatible with safe and efficient performance of wildland firefighter
duties under these conditions. The standard for blood pressure was set
at 140/90 or below (with or without medication). Above this level is
considered to be hypertension (high blood pressure), a condition
associated with increasing risk of cardiovascular morbidity and
mortality.

The CHEST AND RESPIRATORY SYSTEM standard relates (A) the firefighter's
need for a healthy respiratory system and residual aerobic capacity with
(B) the essential functions and work conditions of a wildland
firefighter, including arduous exertion, carrying heavy loads, and
extensive walking and climbing under conditions that may include very
steep terrain, high altitudes, airborne particulates, and allergens.
Some chest and respiratory conditions, including those listed in the
standards, may not be compatible with safe and efficient performance of
wildland firefighter duties under these conditions. The stated standards
of 70% of predicted values for forced vital capacity (FVC), forced
expiratory volume at 1 second (FEV~1~), and the ratio of FEV~1~/FVC are
intended as screens for further evaluation, not mandatory values. The
requirement for agency review when inhalers are used is based on both
the general incompatibility of inhalers and high heat or fire (according
to guidance from inhaler manufacturers) and concern regarding the degree
of respiratory sensitivity an individual may bring to a setting of high
irritant exposure.

The ENDOCRINE AND METABOLIC SYSTEM standard relates (A) the
firefighter's need for normal body function and maintenance and a low
risk of sudden or subtle incapacitation with (B) the essential functions
and work conditions of a wildland firefighter, including arduous
exertion under conditions that may include isolated and remote sites,
hunger and irregular meals, dehydration, irregular hours, and long
assignments. Some endocrine and metabolic conditions, including those
listed in the standards, may not be compatible with safe and efficient
performance of wildland firefighter duties under these conditions.

The CONDITION OF PREGNANCY does not become an issue under most
circumstances since the condition is not a disability, and is a
time-limited condition. If a female applicant or incumbent raises the
issue of pregnancy as the basis for a request for a special benefit, a
change in duty status, or job restrictions, then justification and
clarifying information for that request must be provided by the woman's
obstetrician or primary care physician, along with the estimated time
period the special conditions are expected to apply.

The HEMATOPOIETIC SYSTEM standard relates (A) the firefighter's need for
a healthy blood and blood producing system and a low risk of sudden or
subtle incapacitation with (B) the essential functions and work
conditions of a wildland firefighter, including arduous exertion under
conditions that may include high altitudes, isolated and remote sites,
extreme heat, close quarters with large numbers of other workers,
dehydration, and long assignments. Some blood and blood producing
conditions, including those listed in the standards, may not be
compatible with safe and efficient performance of wildland firefighter
duties under these conditions.

The MUSCULOSKELETAL SYSTEM standard relates (A) the firefighter's need
for strength, flexibility, range of motion, and joint stability with (B)
the essential functions and work conditions of a wildland firefighter,
including arduous exertion, extensive walking and climbing, kneeling and
stooping, lifting and carrying heavy loads, and rapid pull out to safety
zones under conditions that may include rocky, loose, or muddy ground
surfaces, thick vegetation, wet leaves and grass, and falling rocks and
trees. Some musculoskeletal conditions, including those listed in the
standards, may not be compatible with safe and efficient performance of
wildland firefighter duties under these conditions.

The CENTRAL AND PERIPHERAL NERVOUS SYSTEM and VESTIBULAR SYSTEM
standards relate (A) the firefighter's need for balance, sensation of
surroundings and self, and a low risk of sudden or subtle incapacitation
with (B) the essential functions and work conditions of a wildland
firefighter, including use of hand and power tools, flying in
helicopters and fixed wing aircraft, and extensive walking and climbing
under conditions that may include isolated and remote sites, very steep
terrain, rocky, loose, or muddy ground surfaces, wet leaves and grass,
heights, open holes and drop offs, falling rocks and trees, trucks and
other large equipment, and high heat. Some sensory conditions, including
those listed in the standards, may not be compatible with safe and
efficient performance of wildland firefighter duties under these
conditions.

The GASTROINTESTINAL SYSTEM standard relates (A) the firefighter's need
to be able to consume adequate nutrition and calories, and to have a low
risk of sudden or subtle incapacitation, with (B) the essential
functions and work conditions of a wildland firefighter, including
arduous exertion, driving or riding for many hours, and flying in
helicopters and fixed wing aircraft under conditions that may include
isolated or remote sites, close quarters with large number of other
workers, hunger and irregular meals, and long assignments. Some
gastrointestinal conditions, including those listed in the standards,
may not be compatible with safe and efficient performance of wildland
firefighter duties under these conditions.

The GENITOURINARY SYSTEM standard relates (A) the firefighter's need for
a healthy genitourinary system and a low risk of sudden or subtle
incapacitation with (B) the essential functions and work conditions of a
wildland firefighter, including arduous exertion, driving or riding for
long periods, and flying in helicopters and fixed wing aircraft under
conditions that may include isolated or remote sites, hunger and
irregular meals, dehydration, and long assignments. Some genitourinary
conditions, including those listed in the standards, may not be
compatible with safe and efficient performance of wildland firefighter
duties under these conditions.

The agency's medical evaluation and clearance procedures are performed
in accordance with the guidance as set forth in the following
legislative authorities and references:

-   The Rehabilitation Act of 1973, as amended, 29 U.S.C. 791, et seq.

-   29 CFR 1614, Equal Employment Opportunity Commission

-   5 CFR 339, Medical Qualification Determinations, March 8, 1989

-   5 U.S.C., Sections 3312 and 3318, Preference Eligibles

**Attachment**

**[ESSENTIAL FUNCTIONS AND WORK CONDITIONS OF A]{.underline}**

## **WILDLAND FIREFIGHTER**

+----------------+------------------+-----------------+---------------+
| **Time/Work    | **Physical       | # Environment   | **Physical    |
| Volume**       | Requirements**   |                 | Exposures**   |
+----------------+------------------+-----------------+---------------+
| ###            |                  |                 |               |
| *May include:* |                  |                 |               |
+----------------+------------------+-----------------+---------------+
| long hours     | use shovel,      | very steep      | light (bright |
| (minimum of 12 | Pulaski, and     | terrain         | sunshine/UV)  |
| hour shifts)   | other hand tools |                 |               |
|                | to construct     | rocky, loose,   | burning       |
| irregular      | fire lines       | or muddy ground | materials     |
| hours          |                  | surfaces        |               |
|                | lift and carry   |                 | extreme heat  |
| shift work     | more than 50#    | thick           |               |
|                |                  | vegetation      | airborne      |
| time zone      | lifting or       |                 | particulates  |
| changes        | loading boxes    | down/standing   |               |
|                | and equipment    | trees           | fumes, gases  |
| multiple and   |                  |                 |               |
| consecutive    | drive or ride    | wet             | falling rocks |
| assignments    | for many hours   | leaves/grasses  | and trees     |
|                |                  |                 |               |
| pace of work   | fly in           | varied climates | allergens     |
| typically set  | helicopters and  | (cold/hot       |               |
| by emergency   | fixed wing       | /wet/dry/humid/ | loud noises   |
| situations     | airplanes        |                 |               |
|                |                  | snow/rain)      | snakes        |
| ability to     | work             |                 |               |
| meet "arduous" | independently,   | varied light    | insects/ticks |
| level          | and on small and | conditions,     |               |
| performance    | large teams      | including dim   | poisonous     |
| testing (the   |                  | light or        | plants        |
| "Pack Test"),  | use PPE          | darkness        |               |
| which includes | (includes hard   |                 | trucks and    |
| carrying a 45  | hat, boots,      | high altitudes  | other large   |
| pound pack 3   | eyewear, and     |                 | equipment     |
| miles in 45    | other equipment) | heights         |               |
| minutes,       |                  |                 | close         |
| approximating  | arduous exertion | holes and drop  | quarters,     |
| an oxygen      |                  | offs            | large numbers |
| consumption    | extensive        |                 | of other      |
| (VO~2~ max) of | walking,         | very rough      | workers       |
| 45             | climbing         | roads           |               |
| mL/kg-minute   |                  |                 | limi          |
|                | kneeling         | open bodies of  | ted/disrupted |
| typically      |                  | water           | sleep         |
| 14-day         | stooping         |                 |               |
| assignments    |                  | isolated/remote | hun           |
|                | pulling hoses    | sites           | ger/irregular |
| > *But may     |                  |                 | meals         |
| > extend up to | running          | no ready access |               |
| > 21-day       |                  | to medical help | dehydration   |
| > assignments* | jumping          |                 |               |
|                |                  |                 |               |
|                | twisting         |                 |               |
|                |                  |                 |               |
|                | bending          |                 |               |
|                |                  |                 |               |
|                | rapid pull-out   |                 |               |
|                | to safety zones  |                 |               |
|                |                  |                 |               |
|                | provide rescue   |                 |               |
|                | or evacuation    |                 |               |
|                | assistance       |                 |               |
|                |                  |                 |               |
|                | use of a fire    |                 |               |
|                | shelter          |                 |               |
+----------------+------------------+-----------------+---------------+

#