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Phoenix Fire Department
Tier Health Assessment

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Since 1987, the Phoenix Fire Department Health Center has helped to restore the health of department members subjected to injury, illness or exposure. In addition, it was the intent of the Health Center to strengthen individuals so they could withstand both the physical and emotional insults of the job.

As our department increases in size and our members mature, it has become necessary to become proactive in our approach to intervene early enough in a member’s health to become effective. With early intervention, activities detrimental to the health of the member can be ceased, lifestyles can be altered, medications can be prescribed, and therapy or treatment can be initiated; with the member taking ownership of their overall health and actively participating in their wellness direction.

It has always been the policy of the Health Center Medical Director and his staff to recognize potentially health and life threatening maladies and initiate an alternative work assignment or complete work removal in order to preserve the health of the member and initiate proper treatment. With this in mind, the Fire Fighter Wellness Labor/Management Subcommittee created a guideline for this purpose entitled the Tier Health Assessment.

The Tier Health Assessment is designed to categorize a member’s health and place them in a Tier for assessment, monitoring and, if needed, removal from field assignment.

The Tiers are:

Within the Tier Health Assessment, there are five tests with parameters that indicate where a member’s health is placed.

The tests are:


Basic Medical Guidelines for Phoenix Firefighters

Health Parameters for Firefighters
with Tiers to Assess Need for Health/Wellness Intervention
HEALTH
STANDARDS		 TIER 4 TIER 3 TIER 2 TIER 1
Body Fat %* > 30% Male
> 34% Female		 25% - 30% Male
30% - 34% Female		 20% - 24% Male
24% - 29% Female		 < 20% Male
< 24% Female
Blood Pressure >160/110 > 150/100 > 140/90 < 140/90
FEV1/FVC**
Ratio		 < 59% < 65% < 75% > 75%
METS*** < 12.0 12.0 - 12.9 13.0 - 13.9 > 14.0
Blood Sugar
HbA1c+		 > 300
8.0		 200 - 299
> 7.5		 100 - 199
6.5 - 7.4		 65 - 99
< 6.5

Tier 4: Health issues sufficient to mandate removal from field and mandatory referral for wellness/fitness intervention

Tier 3: Health issues sufficient for mandatory referral for wellness/fitness intervention, but removal from field not yet required

Tier 2: Health issues noted where interventional support or change is recommended

Tier 1: Minimal health parameters to which fire members should maintain for field conditioning

* Body Fat as measured by the BOD POD (body composition tracking system). When considering for Tier 4, this measure should not be used independently, but considered along with other health risk factors

** Measured as part of Pulmonary Function Testing without use of bronchodilators

*** Measured as part of Cardiac Stress Testing, using Gerkin Protocol or other equivalent testing

+ Blood Sugar tested during fasting state. HbA1c performed for all Blood Glucose levels above 120 mg/dL

NOTE: Recommend strong effort to help members become and remain tobacco free.

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Last Modified on 08/01/2005 12:55:44