The purpose of this study was to establish a foundation for developing an evidence-based assessment guideline to be used by nursing and medical personnel when evaluating a firefighter's ability to return to work after a lower extremity injury. Two on-line survey instruments were used to record the opinions and beliefs of healthcare providers and firefighters. The final samples included 63 California healthcare providers (with and without professional work experience with firefighters) and 312 California firefighters. Most of the healthcare providers with professional work experience with firefighters use the National Fire Protection Association (NFPA) 1582 Standard on Comprehensive Occupational Medical Program for Fire Departments as a guide when performing medical evaluations on firefighters returning to work after an injury (66.7% responded either sometimes, often, or always). Among the providers, physicians reported more frequent use of the NFPA 1582 firefighter essential job function list than did nurse practitioners. Overall, 33 of the 63 healthcare provider respondents agreed that an evidence-based guideline would always be useful when evaluating a firefighter returning to work after a lower extremity injury. Healthcare providers were less familiar with the NFPA 1582 standard than were firefighters (chi-square test, p < .000). Among the firefighter respondents, 22.8% reported that their fire department had adopted NFPA 1582 in their fire agency. The job duties considered essential for a firefighter job varied among the firefighter respondents. Six job duties were believed to be essential by all the non-officers. There was no such agreement among the officers. Firefighter respondents who work in County fire departments differed in what job duties they believed to be essential from those in urban/city fire departments. This study provided information on testing and assessment modalities used by healthcare providers, the use of evidence-based guidelines by healthcare providers, the adoption and use of NFPA 1582, and the essential functions for a firefighter job from a firefighter's perspective, with comparisons based on firefighter rank and the type of fire agency where the firefighter worked. Further research is recommended to develop the needed evidence-based guideline and for policy implementation at the State and local levels.

LLU Discipline





School of Nursing

First Advisor

Winslow, Betty W.

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded

January 2011

Date (Title Page)




Library of Congress/MESH Subject Headings

Fire fighters; Occupational Health;

Subject - Local

Evidence-based Assessment Guidelines; Fire Fighters



Page Count

168 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives

Included in

Nursing Commons