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By John Sherwood
I recently met with a partner department that, by policy, required strict use of NFPA 1580: Standard for Emergency Responder Occupational Health and Wellness for its annual wellness screenings. As we worked through several practical and operational issues created by that blanket adoption, something became clear to me: No authority fully adopts a model fire or building code in its entirety. Fire marshal offices and authorities having jurisdiction routinely adopt model codes by reference and then amend them to fit local authority, conditions, policy and resources.
So why should firefighter health and wellness be treated differently?
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Managing risk — not eliminating it
Fire and building codes exist because risk is inherent, and firefighting is no exception. The goal is not to eliminate risk but to manage it intelligently. Annual wellness screenings and fitness programs serve as the risk-management system for firefighter health, much like codes serve as the risk-management system for the code enforcement environment. That same risk-management philosophy applies to the standards that guide firefighter health and safety programs.
The 2025 edition of NFPA 1580 is now the consolidated standard combining NFPA 1581, 1582, 1583 and 1584. The consolidated edition provides an important framework for firefighter occupational safety, medical evaluations and wellness programming. However, treating it as a one-size-fits-all mandate rather than a model standard misses how codes are intended to function. Local adoption allows flexibility and thoughtful modification. What works for one department may not work for a neighboring jurisdiction. Just like fire and building codes, two neighboring departments can enforce very different versions of the same model code while still meeting its intent.
Minimum standards, not ideal conditions
Another core principle of NFPA codes is that they establish minimum standards, not ideal or best-case conditions. Fire and building codes do not make structures perfectly safe, they establish a baseline below which risk becomes unacceptable. Firefighter health and wellness programs function the same way. Annual wellness screenings, mental health evaluations, and baseline fitness standards are not designed to create elite athletes, nor are they punitive. They are minimum thresholds meant to reduce preventable injury, illness, and death. Expecting wellness programs to deliver perfect health is no more realistic than expecting a fire code to prevent every fire.
NFPA also recognizes that relying on individual choice or market pressure alone does not produce consistent safety outcomes. Without regulation, safety measures are often delayed, avoided, or unevenly applied. Firefighter health is no different. Without a structured, formal wellness program, firefighters often delay medical care, normalize symptoms, work through injuries, or avoid screenings altogether due to stigma, fear, or cultural expectations. We would never rely on building owners to voluntarily add exits or fire protection systems, and we should not rely on firefighters to self-regulate their health in a profession that historically rewards toughness and endurance.
Why the NFPA 1580 change matters
Among its many changes, the revised NFPA 1580 standard represents a fundamental shift in how aerobic capacity is evaluated. Instead of using absolute thresholds tied to job demands, NFPA 1580 adopts a percentile-based system derived from general population norms, adjusted by age and sex.
In practical terms, this means firefighters are now evaluated relative to people their age and sex in the general population, not relative to the physiological demands of firefighting.
It is important to note that aerobic capacity is one of the most misunderstood aspects of firefighter wellness is aerobic capacity. Aerobic fitness is not about running faster or longer for its own sake. It is about work capacity under load. Structural firefighting requires sustained high-intensity effort while wearing heavy PPE and SCBA, often in extreme heat, low visibility and psychologically stressful conditions, not to mention the additional strain of carrying victims, repeated lifting of heavy objects and the hormonal changes that occur when responding to a fire.
Research consistently shows that lower aerobic capacity is associated with increased fatigue, reduced work efficiency, higher injury rates and greater cardiovascular risk. Sudden cardiac events remain the leading cause of non-accidental line-of-duty deaths in the U.S. fire service. These are not abstract risks; they are operational realities.
Because of this, aerobic capacity has long been used as a proxy for a firefighter’s ability to safely perform essential job tasks. Historically, standards such as NFPA 1582 used absolute thresholds tied to the metabolic demands of firefighting, regardless of age or sex.
Consider this: A large retrospective study published in Applied Physiology, Nutrition, and Metabolism examined what this shift does in practice. Researchers analyzed data from more than 6,000 career firefighters who underwent direct aerobic capacity testing. Each firefighter was classified under both the previous NFPA 1582 framework and the revised NFPA 1580 framework, allowing a direct comparison of outcomes. The results were striking.
Under the previous standard, increased age, higher body mass index and sex were associated with lower odds of being classified as fit for duty. This reflects the reality that aerobic capacity tends to decline with age and increased cardiovascular risk. Under the revised NFPA 1580 standard, that relationship flipped. Firefighters in older age groups, particularly those aged 60 to 69, were nearly 38 times more likely to be classified as fit for duty compared to firefighters aged 20 to 29, despite having significantly lower relative aerobic capacity.
At the same time, younger firefighters, often with higher measured aerobic capacity, were more likely to be placed into restricted or program-required categories simply because of how percentile rankings work. In other words, fitness classifications shifted not because the job changed, but because the reference population did.
The study’s authors raised serious concerns that this approach may misalign fitness-for-duty classification with the unchanging physical demands of firefighting, potentially compromising occupational safety and creating confusion for administrators responsible for staffing and deployment decisions.
One job, one standard and legal defensibility
The concept of “one job, one standard” is not philosophical; it is legal and operational. In physically demanding public safety professions, fitness standards must be job-related, evidence-based and defensible. Courts have consistently held that employment standards must be tied to validated task analysis, often referred to as physical employment standards.
Fireground tasks do not change based on age or sex. Advancing charged hoselines, forcing entry, climbing stairs with equipment, performing rescues and operating for extended periods under heat stress impose the same physiological demands on everyone performing them. When standards shift from job-based criteria to population-based percentiles, departments risk uncoupling readiness from reality.
The research highlights this risk clearly. Classifying firefighters as fit for duty based on age-adjusted norms rather than demonstrated ability to meet job demands may expose departments to both operational risk and legal scrutiny, particularly if a cardiac event, injury or fatality occurs after a firefighter was cleared under a standard that does not reflect task requirements.
Fire codes address ongoing conditions, not just design
Fire codes also recognize that safety is not static. Building codes address design and construction, but fire codes focus on maintenance, operations and how conditions change over time. Firefighter health follows the same pattern.
Hiring standards establish entry-level fitness and health, but annual wellness screenings are what monitor how conditions evolve over a career. Passing a pre-employment physical, or even a single annual screening, does not guarantee lifelong health, just as buildings that passed inspection at construction can still become dangerous.
Health, like safety, degrades without inspection and maintenance. This is especially relevant as the fire service workforce continues to age. NFPA data show that most career firefighters are now between 30 and 60 years old. As age-related risk increases, the need for accurate, job-relevant wellness standards becomes even more critical.
Furthermore, NFPA codes are built around the concept of acceptable risk, not zero risk. Fire codes do not close buildings because they might catch fire. Similarly, wellness programs should not remove firefighters because they have risk factors. The purpose of screenings is to identify manageable risk, allow for early intervention, and reduce the likelihood of catastrophic outcomes. The objective is to keep firefighters working safely, not to exclude them unnecessarily. Risk management, not risk avoidance, is the goal.
Performance-based wellness: The code analogy holds
Fire and building codes routinely allow performance-based options and alternative methods that meet intent without rigid uniformity. Firefighter health and wellness programs should be approached the same way. A performance-based wellness model establishes clear outcomes for operational readiness, cardiovascular risk reduction, and injury prevention. This allows departments to achieve those outcomes through individualized fitness plans, medical accommodations, phased compliance, and return-to-duty pathways. NFPA 1580 itself allows for phased implementation. Using that flexibility is not noncompliance, it is consistent with how every other model code is applied.
Enforcement and culture matter
Finally, none of this works without consistent enforcement. Codes that are not enforced are meaningless. Wellness programs that are optional, punitive, or unsupported by leadership are performative at best. For health and wellness programs to succeed, they must be mandatory, non-punitive, confidential, and supported by both labor and management. Culture matters. Firefighters must trust that wellness programs exist to protect them, not to sideline them.
It’s time to treat wellness like a fire code
There is a hard truth in the fire service that codes are written in blood. Many fire and building code provisions exist because people died. Firefighter health and wellness programs are the fire code for firefighter readiness. Fire and building codes exist because we accept that fire is inevitable. Wellness programs exist because aging, illness and injury are inevitable in firefighting.
Adopting a modified, performance-based version of NFPA 1580 should not only be acceptable but also consistent with how every other model code is implemented. Just as we inspect buildings every year because conditions change, we screen firefighters because risk changes. We do not call fire codes punitive to building owners — we call them life safety. Firefighter wellness deserves the same respect.
ABOUT THE AUTHOR
John Sherwood, FSCEO, CFE, licensed paramedic, is the chief of staff for Front Line Mobile Health. Sherwood worked for the City of Grapevine (Texas) Fire Department where he rose through the ranks to assistant fire chief of Support, Planning and Administration. He retired after 26 years of service, joining Frontline Mobile Health in April 2023. He holds bachelor’s degrees in marketing and fire protection safety engineering technology and a master’s degree in fire and emergency management administration all from Oklahoma State University.
