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Firefighter health assessment

Sudden cardiac death accounts for roughly half of all on-duty death among firefighters.  Firefighters are exposed to a lot of stress- from static exertion (advancing hose lines, heavy material handling), aerobic (stair and ladder climbing) and anaerobic (forcible entry) efforts, sympathetic arousal, and exposure to toxic material. All these occupational requirements result in a lot of strain on the heart.
Studies show that extreme conditions in firefighting can lead to significant cardiac events. Cardiopulmonary exercise testing (CPET) measures ventilation and gas exchange such as oxygen consumption and carbon dioxide production.  VO2max (maximum oxygen consumption during exercise) is an excellent indicator of cardiorespiratory fitness. Cardiorespiratory fitness is a vital component of health, wellness, and longevity, and has been identified as an important component of annual clinical evaluation.
According to the National Fire Protection Association Standards 1582, VO2max of 42 ml of O2/kg/min (or 12 metabolic equivalents) is accepted as the requirement for the aerobic capacity of firefighters to safely carry out occupational related duties.

CPET is a better, more accurate, assessment than treadmill testing for the annual firefighter physical.  In fact, firefighter safety through advanced research (FSTAR) recommends CPET over traditional stress testing.