Quiz: Do you know the differences between OSHA, NFPA standards for firefighter physicals? (with Related Video)

As fire department physicians, we see a great deal of confusion and misinformation regarding the differences between OSHA 1910.156, Fire Brigade, and NFPA 1582, Comprehensive Occupational Medical Program for Fire Departments.  Challenge your knowledge with this True/False Quiz!

1. An OSHA 156 fire brigade physical is all that is required for firefighters to be cleared to work.
   False:  OSHA 1910.156 was issued more than 30 years ago and only has one paragraph addressing three medical issues. It states that:
   
   The employer shall assure that employees who are expected to do interior structural firefighting are physically capable of performing duties which may be assigned to them during emergencies. The employer shall not permit employees with known heart disease, epilepsy, or emphysema, to participate in fire brigade emergency activities unless a physician's certificate of the employees' fitness to participate in such activities is provided.
   
   NFPA 1582 is a 90-plus-page medical document that is regularly updated and accounts for advances in medical technology. The 2013 edition was issued in October, and serves as a guideline for fire department physicians to help keep firefighters working safely.
    
2. NFPA 1582 is more restrictive than is OSHA 156. 
   False: If anything, NFPA 1582 is more specific and presents guidance to physicians which lead to less indiscriminate disqualifications.  It is designed to help fire department physicians keep firefighters working safely even if they have medical issues.
    
3. Any doctor can perform physicals for firefighters.
   False: This is an issue that comes up time and time again. Physicians must be a licensed doctor of medicine and have gone through an accredited medical training program. Doctors who are unfamiliar with the standard tend to disqualify more firefighters than those who know the standard and are able to work within the guidelines set forth in the manual. NFPA even goes as far as to say:
   
   4.1.3 The fire department shall have an officially designated physician who shall be responsible for guiding, directing, and advising the members with regard to their health, fitness, and suitability for duty as required by NFPA 1500.
   
   If someone other than the fire department physician does your physicals, they should be reviewed by the fire department physician.
    
4. NFPA 1582 is designed to weed out firefighters.
   False: NFPA is a health and wellness document written by firefighters for firefighters and is designed first to be a tool to help firefighters become healthier. Secondly it is a medical screening exam to identify medical problems earlier since firefighters have increased risks. The goal of NFPA is to keep firefighters working safely.
    
5. A firefighter who is free of epilepsy, emphysema and heart disease is safe to fight fire.
   False: If it were only that simple. Medicine and medical interventions are becoming more complex and effective by the day. Firefighters who would have been medically excluded a few years ago are working safely and finishing their careers. NFPA 1582 is designed to allow a knowledgeable fire department physician to work with your firefighters to keep them working safely.
    
6. If you do an NFPA 1582 program, you will be out of compliance with OSHA.
   False: NFPA 1582 meets and exceeds OSHA 1910.156. 
    
7. An NFPA 1582 physical costs much more than an OSHA 156 physical.
   False: They cost about the same, but the NFPA physical gives a lot more bang for your buck.