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What happens at your WellAmerica firefighter physical?

What happens at your WellAmerica firefighter physical?


Below is a list of what is required for most fire departments/districts annual physicals, and many of the questions we get asked most frequently.

Each year we find medical conditions that require further follow-up. Some directly affect your job performance (for example, poor vision). Other conditions may have a delayed effect on your health such as a high cholesterol level. These will be discussed at the time of your exam.


  • Blood work should be done at least 1 week in advance, so we have the results when you come in for your physical.
  • You MUST fast for 12-14 hours before lab work, drink water ONLY.
  • Men 40 and older who will be getting a PSA (blood test for prostate health) with their blood draw, please refrain from having sexual relations, motorcycling, or mountain biking 24 hours before your blood draw. It can cause your PSA results to be abnormal.


  • When you come for your physical, please wear comfortable workout clothes and sneakers for exercise!
    • If you already did your workout with a peer fitness trainer at your station, you don’t need to wear workout clothes.
  • Do NOT drink or use anything with caffeine, nicotine, sports drinks or anything that will raise your heart rate 4 – 6 hours before your physical. These elevate the pulse/heart rate and will give false readings.
  • If you are over 40 and doing a treadmill in our office, PLEASE FAST for 2 hours before. You may drink water.
  • The following is what you can expect to happen at your physical:
    • Check height, weight, blood pressure and pulse.
    • A resting EKG (heart).
    • Hearing and vision evaluations.
    • A pulmonary function test (lungs), if needed.
    • A chest x-ray (if needed).
    • Review of blood and urine test results.
    • Percent body fat check.
    • Grip strength test.
    • TB test or questionnaire.
    • Push-ups (30 with metronome), plank (2 minutes) and flexibility.
    • Maximal stress treadmill (if needed).
    • A comprehensive physical exam by a board certified physician or nurse practitioner supervised by a board certified physician who will go over your test results, discuss any areas of concern and suggest a game plan to resolve those concerns whether it be more tests with your personal care physician, something you can do yourself or a visit to a nutritionist or peer fitness trainer.

The following is a list of most frequently asked questions:

Which cholesterol is the good one?

  • HDL is the goodcholesterol because it protects against heart attacks by cleaning the artery walls, removing excess cholesterol from the body and lowering heart disease risk. According to the labs we use, HDL should be greater than 40 mg per dl for men and greater than 50 mg per dl for women, if you don’t have other risk factors. (All laboratories use different parameters so check your lab sheet to see what their parameters are.)

Which cholesterol is the bad one?

  • LDL is the bad cholesterol because it can build up in the artery walls, and restrict blood flow or even block it completely. The result can be a heart attack, stroke or impotence. According to the labs we use, your LDL should be less than 130 mg per dl if you don’t have other risk factors such as diabetes or history of cardio-vascular disease. (All laboratories use different parameters so check your lab sheet to see what their parameters are.)

How do I lower my risk factors?

  • Eat less cholesterol containing foods – read food labels.
  • Exercise regularly.
  • Lose weight if you weigh too much.
  • If you use tobacco, stop.
  • Eat foods/supplements that lower cholesterol: oatmeal, flaxseed, omega 3 oils, psyllium, plant oils (olive, canola), or Benechol. If these steps don’t lower your LDL level enough, your doctor may put you on medication.

Quick and easy ways to help lower your cholesterol:

  • Buy lean cuts of meats.
  • Remove all visible fat before cooking, including the skin on chicken before cooking it.
  • Eat white meat and not dark.
  • Eat oatmeal.
  • Don’t eat fried foods or high-fat sauces.
  • Bake, broil or grill meat instead of frying it.
  • One egg yolk a day is okay.
  • Egg whites or egg substitutes are okay.
  • Use low-fat dairy products, such as skim milk or 1% milk, low-fat frozen yogurt, low-fat cheeses and ice cream.
  • Eat fiber. Fruits and vegetables are good sources of fiber.
  • If you’re having a sandwich go easy on the mayonnaise, meat and cheese, but go heavy on lettuce, tomato, sprouts.
  • Choose extra-lean ground beef, ground turkey or veggie burgers. When browning meat, drain off fat and rinse with hot water or absorb fat with paper towels.
  • Look for nonfat cooking methods on packaged prepared foods.
  • For baked goods, substitute applesauce for the required amount of oil or margarine. Applesauce adds and holds moisture just like fat does.


Lack of physical activity has been shown to double a person’s risk of getting heart disease. When combined with a low-fat diet, regular activity can help you decrease your total cholesterol level, increase your HDL level and make you feel better overall.

Here are some tips for adding physical activity in your life:

  • Choose 5 days a week and walk 30 minutes each day, take the dog with you. Or choose 3 days a week and walk 50 minutes each day.
  • At work, take a 15 minute walk at lunch, or before you go home. Maybe both?
  • Walk or bike to the store instead of driving.
  • Work in the garden.
  • Park ½ to 1 mile away from the mall or office; that’s a 10 – 20 minute walk twice a day.
  • Take the stairs instead of the elevator.
  • Schedule exercise time on your calendar; regard it as important as any other appointment.

What are some of the blood tests for and what are the ranges?

  • Fasting blood sugar or glucose can be elevated in diabetes. Normal is 65 to 109.
  • The six standard Liver Function tests and values are:
    • Alkaline Phosphates 39-117GGT 5-65ALT 2-60AST 10-41LacticDehydrogenase100-220 Bilirubin, Total 0.2-1.1Hepatitis Profile:
  • Positive Hepatitis B Surface Antibody (Ab) means you’re immune to hepatitis B. However, if you have a blood borne pathogen exposure see your doctor.
  • Uric acid:
    • Can be elevated with gout (hot, red tender joints). Rich high protein foods can also cause an increase. Normal is 3.5 – 8.0.
  • Aerobic Capacity/V02:
    • Calculated from your step test pulse or treadmill max heart rate, is needed to perform the cardio/pulmonary work of firefighting. The IAFF/IAFC advises a minimum of 42. What do the numbers on the pulmonary function test stand for?
    • FEV 1 is the amount of air you can blow out in 1 second. It can decrease with problems like asthma.
    • FVC is the total amount of air you can blow out. It can decrease with diseases such as asbestos or silica exposure.

What are desired body fat numbers?

Men = 12-16% Women = 18-22%

Hepatitis A/B immunizations:

When should you get them/update them?

  • Hepatitis A is advised for international travel (except Australia, New Zealand, Western Europe, Israel, and Canada) and all firefighters (NFPA 1852, 2013 edition).
  • Hepatitis B is advised for most health care and public safety workers.
  • If you have a blood borne pathogen exposure you will need your titer (antibodies) checked to see if you need a booster.
  • For both Hepatitis A and B: Routine boosters have not been advised by the CDC.