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Diabetics as Firefighters

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  • #31
    At an old department I worked with a diabetic. Unfortunately, after this experience I would be wary to work with one again because of the bad experience's I had with this individual. Basically, he was relatively young, and because he had taken such poor care of his body he had been diagnosed as a Type 2 diabetic by the time he was 29. Now, many people live with this and can control it very well if they take positive steps toward working on the diet, etc. This individual did not take that route however, and on two occasions over 8 months of my time working there he had to be taken to the ER twice while on duty because of issues with his blood sugar. He just refused to take care of his body, eg no exercise, fast food all the time, you get the picture.

    I believe that many people who are disciplined could easily work as a diabetic, but unfortunately this guy just didn't get it. I think this was a "worst case scenario" type of thing. Don't know if he is still working or not, this was a couple of years ago.

    Comment


    • #32
      Originally posted by Escottie View Post
      and what your saying is not?
      no it is, i just said it to illistrate how silly your post was.

      Comment


      • #33
        Nfpa 1582 actual text, circa 2007

        If anyone would like a PDF of the entire NFPA 1582, drop me an e-mail at [email protected]. ~SDnR~

        [Start cut/paste]

        9.6.2 If the member has any endocrine and metabolic disorders,
        the member shall be individually evaluated in accordance
        with 9.6.3 through 9.6.7 to determine if the disorders
        compromise the member’s ability to safely perform the essential
        job tasks.

        9.6.3 Type 1 Diabetes Mellitus That Requires Treatment with
        Insulin.


        9.6.3.1* Physician Evaluation. Type 1 diabetes mellitus that requires
        treatment with insulin compromises the member’s ability
        to safely perform essential job tasks 5, 9, and 13, and the physician
        shall report the applicable job limitations to the fire department,
        unless the member meets all of the following criteria:

        (1) Is maintained by a physician knowledgeable in current
        management of diabetes mellitus on a basal/bolus (can
        include subcutaneous insulin infusion pump) regimen using
        insulin analogs.

        (2) Has demonstrated over a period of at least 1 year the motivation
        and understanding required to closely monitor and
        control capillary blood glucose levels through nutritional
        therapy and insulin administration. Assessment of this shall
        take into consideration the member’s experience and history dealing
        with erratic meal schedules, sleep disruption, and high
        aerobic and anaerobic workloads intrinsic to fire fighting.

        (3) Has a dilated retinal exam by a qualified ophthalmologist or
        optometrist that shows no higher grade of diabetic retinopathy
        than microaneurysms, as indicated on the International
        Clinical Diabetic Retinopathy Disease Severity Scale.

        (4) Has normal renal function based on a calculated creatinine
        clearance greater than 60 mL/min and absence of
        proteinuria. (Creatinine clearance can be calculated by
        use of the Cockroft-Gault or similar formula. Proteinuria is
        defined as 24-hour urine excretion of greater than or equal
        to 300 mg protein or greater than or equal to 300 mg of
        albumin per gram of creatinine in a random sample.)

        (5) Has no autonomic or peripheral neuropathy. (Peripheral
        neuropathy is determined by diminished ability to feel
        the vibration of a 128 cps tuning fork or the light touch of
        a 10-gram monofilament on the dorsum of the great toe
        proximal to the nail. Autonomic neuropathy can be determined
        by evidence of gastroparesis, postural hypotension,
        or abnormal tests of heart rate variability.)

        (6) Has normal cardiac function without evidence of myocardial
        ischemia on cardiac stress testing (to at least 12 METS)
        by ECG and cardiac imaging.

        (7) Has a signed statement from an endocrinologist knowledgeable
        in management of diabetes mellitus as well as
        the essential job tasks and hazards of fire fighting as described
        in Section 9.1 that the member meets the following
        criteria:

        (a) Is maintained on a stable basal/bolus regimen using insulin
        analogs and has demonstrated over a period of at
        least 1 year the motivation and understanding required
        to closely monitor and control capillary blood glucose
        levels despite varied activity schedules through nutritional
        therapy and insulin administration

        (b) Has achieved stable control of blood glucose as evidenced
        by Hemoglobin A1C consistently less than 8
        when monitored at least twice yearly

        (c) Does not have an increased risk of hypoglycemia due
        to alcohol use or other predisposing factors

        (d) Has had no episodes of severe hypoglycemia (defined as
        requiring assistance of another) in the preceding 1 year,
        with no more than one episode of severe hypoglycemia
        in the preceding 5 years

        (e) Is certified not to have a medical contraindication to
        fire-fighting training and operations

        9.6.3.2 Physician Guidance. When evaluating a member with
        Type 1 diabetes mellitus, the physician shall recognize that
        episodes of severe hypoglycemia are associated with an increased
        risk of subsequent episodes and that hypoglycemia
        can interfere with cognitive function and judgment. Presence
        of microvascular and neurological complications of diabetes
        might increase the risk of hypoglycemic events.
        Last edited by Stopdropnroll; 08-08-2008, 07:24 PM.

        Comment


        • #34
          9.6.4 Type 2 Diabetes Mellitus That Requires Treatment with
          Insulin.


          9.6.4.1* Physician Evaluation. Type 2 diabetes mellitus that requires
          treatment with insulin compromises the member’s ability
          to safely perform essential job tasks 5, 9, and 13, and the physician
          shall report the applicable job limitations to the fire department,
          unless the member meets all of the following criteria:

          (1) Is maintained by a physician knowledgeable in current management
          of diabetes mellitus.

          (2) Has demonstrated over a period of at least 3 months the
          motivation and understanding required to closely monitor
          and control capillary blood glucose levels through nutritional
          therapy and insulin administration. Assessment of this
          shall take into consideration the member’s experience and prior
          history dealing with the erratic meal schedules, sleep disruption,
          and high aerobic and anaerobic workloads intrinsic to
          fire fighting.

          (3) Has a dilated retinal exam by a qualified ophthalmologist or
          optometrist that shows no higher grade of diabetic retinopathy
          than microaneurysms, as indicated on the International
          Clinical Diabetic Retinopathy Disease Severity Scale.

          (4) Has normal renal function based on a calculated creatinine
          clearance greater than 60 mL/min and absence of
          proteinuria. (Creatinine clearance can be calculated by
          use of the Cockroft-Gault or similar formula. Proteinuria
          is defined as 24-hour urine excretion of greater than or
          equal to 300 mg protein or greater than or equal to 300 mg
          of albumin per gram of creatinine in a random sample.)

          (5) Has no autonomic or peripheral neuropathy. (Peripheral
          neuropathy is determined by diminished ability to feel
          the vibration of a 128 cps tuning fork or the light touch of
          a 10-gram monofilament on the dorsum of the great toe
          proximal to the nail. Autonomic neuropathy can be determined
          by evidence of gastroparesis, postural hypotension,
          or abnormal tests of heart rate variability.)

          (6) Has normal cardiac function without evidence of myocardial
          ischemia on cardiac stress testing (to at least 12 METS)
          by ECG and cardiac imaging.

          (7) Has a signed statement from an endocrinologist knowledgeable
          in management of diabetes mellitus as well as
          the essential job tasks and hazards of fire fighting as described
          in Section 9.1 that the member meets the following
          criteria:

          (a) Is maintained on a stable insulin regimen and has demonstrated
          over a period of at least 3 months the motivation
          and understanding required to closely monitor
          and control capillary blood glucose levels despite varied
          activity schedules through nutritional therapy and insulin
          administration

          (b) Has achieved stable control of blood glucose as evidenced
          by Hemoglobin A1C less than 8 when monitored
          at least twice yearly, which must include evidence
          of a set schedule for blood glucose monitoring
          and a thorough review of data from such monitoring

          (c) Does not have an increased risk of hypoglycemia due
          to alcohol use or other predisposing factors

          (d) Has had no episodes of severe hypoglycemia (defined
          as requiring assistance of another) in the preceding 1
          year, with no more than one episode of severe hypoglycemia
          in the preceding 5 years

          (e) Is certified not to have a medical contraindication to
          fire-fighting training and operations

          9.6.4.2 Physician Guidance. When evaluating a member with
          Type 2 diabetes mellitus, the physician shall recognize that
          episodes of severe hypoglycemia are considered the best predictors
          of an increased risk of subsequent episodes and hypoglycemia
          interferes with cognitive function and judgment

          Comment


          • #35
            9.6.5 Diabetes Mellitus That Does Not Require Insulin Therapy.

            9.6.5.1 Physician Evaluation. Diabetes mellitus that does not
            require insulin therapy and that is controlled by diet, exercise,
            and/or oral hypoglycemic agents compromises the member’s
            ability to safely perform essential job tasks 5, 9, and 13, and the
            physician shall report the applicable job limitations to the
            fire department, unless the member meets all of the following
            criteria:

            (1) Has achieved a stable blood glucose as evidenced by Hemoglobin
            A1C level less than 8 during the prior 3-month
            period.

            (2) If on oral hypoglycemic agents, has had no episodes of severe
            hypoglycemia (defined as requiring assistance of another
            in the preceding year).

            (3) Has a dilated retinal exam by a qualified ophthalmologist or
            optometrist that shows no higher grade of diabetic retinopathy
            than microaneurysms, as indicated on the International
            Clinical Diabetic Retinopathy Disease Severity Scale.

            (4) Has normal renal function based on a calculated creatinine
            clearance greater than 60 mL/min and absence of
            proteinuria. (Creatinine clearance can be calculated by
            use of the Cockroft-Gault or similar formula. Proteinuria is
            defined as 24-hour urine excretion of greater than or equal
            to 300 mg protein or greater than or equal to 300 mg of
            albumin per gram of creatinine in a random sample.)

            (5) Has no autonomic or peripheral neuropathy. (Peripheral
            neuropathy is determined by diminished ability to feel
            the vibration of a 128 cps tuning fork or the light touch of
            a 10-gram monofilament on the dorsum of the great toe
            proximal to the nail. Autonomic neuropathy can be determined
            by evidence of gastroparesis, postural hypotension,
            or abnormal tests of heart rate variability.)

            (6) Has normal cardiac function without evidence of myocardial
            ischemia on cardiac stress testing (to at least 12 METS)
            by ECG and cardiac imaging.

            Comment


            • #36
              Essential Job Tasks

              Here are the essential job tasks mentioned in the openers

              Chapter 5 Essential Job Tasks
              5.1 Essential Job Tasks and Descriptions.
              5.1.1 The fire department shall evaluate the following 13 essential
              job tasks against the types and levels of emergency services
              provided to the local community by the fire department, the
              types of structures and occupancies comprising the community,
              and the configuration of the fire department to determine the
              essential job tasks of fire department members and candidates:
              (1)*Performing fire-fighting tasks (e.g., hoseline operations,
              extensive crawling, lifting and carrying heavy objects, ventilating
              roofs or walls using power or hand tools, forcible
              entry), rescue operations, and other emergency response
              actions under stressful conditions while wearing personal
              protective ensembles and self-contained breathing apparatus
              (SCBA), including working in extremely hot or cold
              environments for prolonged time periods
              (2) Wearing an SCBA, which includes a demand valve–
              type positive-pressure facepiece or HEPA filter masks,
              which requires the ability to tolerate increased respiratory
              workloads
              (3) Exposure to toxic fumes, irritants, particulates, biological
              (infectious) and nonbiological hazards, and/or
              heated gases, despite the use of personal protective
              ensembles and SCBA
              (4) Depending on the local jurisdiction, climbing six or
              more flights of stairs while wearing fire protective ensemble
              weighing at least 50 lb (22.6 kg) or more and
              carrying equipment/tools weighing an additional 20
              to 40 lb (9 to 18 kg)
              (5) Wearing fire protective ensemble that is encapsulating and
              insulated, which will result in significant fluid loss that frequently
              progresses to clinical dehydration and can elevate
              core temperature to levels exceeding 102.2°F (39°C)
              (6) Searching, finding, and rescue-dragging or carrying victims
              ranging from newborns up to adults weighing over
              200 lb (90 kg) to safety despite hazardous conditions and
              low visibility
              (7) Advancing water-filled hoselines up to 21⁄2 in. (65 mm)
              in diameter from fire apparatus to occupancy [approximately
              150 ft (50 m)], which can involve negotiating
              multiple flights of stairs, ladders, and other obstacles
              1582–8 COMPREHENSIVE OCCUPATIONAL MEDICAL PROGRAM FOR FIRE DEPARTMENTS
              2007 Edition
              (8) Climbing ladders, operating from heights, walking or
              crawling in the dark along narrow and uneven surfaces,
              and operating in proximity to electrical power lines and/or
              other hazards
              (9) Unpredictable emergency requirements for prolonged
              periods of extreme physical exertion without benefit of
              warm-up, scheduled rest periods, meals, access to medication(
              s), or hydration
              (10) Operating fire apparatus or other vehicles in an emergency
              mode with emergency lights and sirens
              (11) Critical, time-sensitive, complex problem solving during
              physical exertion in stressful, hazardous environments,
              including hot, dark, tightly enclosed spaces, that is further
              aggravated by fatigue, flashing lights, sirens, and
              other distractions
              (12) Ability to communicate (give and comprehend verbal orders)
              while wearing personal protective ensembles and
              SCBA under conditions of high background noise, poor
              visibility, and drenching from hoselines and/or fixed protection
              systems (sprinklers)
              (13) Functioning as an integral component of a team, where
              sudden incapacitation of a member can result in mission
              failure or in risk of injury or death to civilians or other
              team members

              Comment


              • #37
                Originally posted by nameless View Post
                no it is, i just said it to illistrate how silly your post was.
                I respect your opinion so don't think that I am trying to be a pain in the ***

                Comment


                • #38
                  Just Wondering

                  Hi, I am sixteen and a type one diabetic. I was just wondering if I can be a firefighter. If I can be a firefighter I was wondering what I need to do to get hired with a department. All I know is that diabetics can't drive fire trucks but I don't know how true that is. I saw someone post something on some other site saying that diabetics can't be firefighters because they might go low during a fire and can't stop and get something to eat. I personally believe that is true but won't happen because stations like the one where I am a fire explore will only go on a fire call once a month or less. I would like to hear from people that are firefighters or knows anybody who is a diabetic (type one) working as a firefighter.

                  thank you and stay safe.

                  Comment

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