Comparison of Fixed and Age-Sex-Adjusted NFPA Standards for Cardiopulmonary Fitness in Thai Wildland Firefighters.

Panumasvivat, Jinjuta; Assavanopakun, Pheerasak; Wangsan, Kampanat; Surawattanasakul, Vithawat; Sirikul, Wachiranun; Chantaklang, Pannawich; Vinsirivorakul, Thitirat · J Occup Environ Med · 2026

cross_sectional · Level IV

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Abstract

This study examined Thai wildland firefighters' cardiopulmonary fitness, comparing previous and updated NFPA criteria. Chiang Mai wildland firefighters' health was cross-sectionally examined. Chester Step cardiopulmonary fitness was assessed using the fixed 12-MET threshold and age- and sex-adjusted 50th percentile criterion. McNemar test indicated standard concordance, and multivariable linear regression found MET values. Statistical significance was assigned by p-values < 0.05. Significant differences in fitness classifications between two methods (p < 0.05). Two previously passed participants failed, while 13 previously failed participants passed. Age (B=-0.07; 95% CI: -0.13, -0.01; p=0.016) and resting heart rate (B=-0.11; 95% CI: -0.16, -0.07; p<0.001) strongly correlated with METs. The age- and sex-adjusted 50th percentile criteria requirements allow for better cardiovascular fitness and practical work duties. Updates in standards are beneficial for firefighters' safety and health monitoring.