Assessing the physical readiness of UK firefighters to return to work following injury: Developing a return-to-work tool.

In responding to emergencies, firefighters are exposed to physical and psychological stresses. Accordingly, firefighters are required to possess adequate levels of aerobic fitness, muscular strength, and endurance to cope with the physical demands of their job roles which include running, lifting ladders, carrying equipment and evacuating casualties. Due to these demands, the tasks of a firefighter are associated with an increased risk of work-related injury. Whilst national fitness standards have been created for firefighters in the UK, there is no national standard for the use of a return to work (RTW) assessment following an injury. A systematic review highlighted a substantial shortfall in the understanding of how to assess the readiness of a firefighter to RTW following injury. Accordingly, further research was required to better understand which tasks could be included in such an assessment and how best to implement it within firefighting services. To this end, a Delphi study was conducted to evaluate a consensus on the tasks that should be included in a RTW assessment. A consensus was gained for the operational firefighter tasks to be included in a RTW assessment. The results from this consensus created the framework for the Fit for Duty screening tool. Following the Delphi study, the reliability of the Fit for Duty screening tool for firefighters was undertaken. The Fit for Duty screening tool demonstrated good inter-rater reliability (FK=0.77-0.79) and good-excellent intra-rater reliability (α=0.77-1.00), with 94.3% of participants. The reliability of the Fit for Duty screening tool allows conclusions of a firefighter’s physical readiness to RTW to be made, which can inform a RTW decision for a firefighter. The use of the Fit for Duty screening tool could improve consistency of RTW processes across the UK fire & rescue services.