Examining the relationship between firefighters' performance on physical ability test and measures of blood pressure, pulse rate, and aerobic capacity

Abstract

Introduction: Firefighting involves rapid decision-making and physically demanding tasks, yet firefighters are at an elevated cardiovascular risk. This study examined associations between blood pressure, heart rate, aerobic capacity, and physical ability test (PAT) performance in firefighters. We hypothesized that PAT performance would relate to resting cardiovascular measures and aerobic fitness. Methods: A secondary analysis was conducted using data from 599 full-time firefighters in the City of Cape Town Fire and Rescue Service. The PAT comprised occupation-specific tasks simulating firefighting duties. Measurements included height, weight, resting blood pressure, resting heart rate (RHR), and aerobic capacity. Post-PAT blood pressure and heart rates (HRs) were also recorded. Analyses included t-tests, ANOVA, and regression models. Results: Age, height, post-test systolic blood pressure (SBP), and SBP change were significantly associated with PAT times (p <0.001). Older firefighters were less likely to pass (OR=0.96), while males were 18 times more likely to pass than females. Greater differences in pre-to-post SBP and RHR were associated with higher pass rates (p < 0.001). Aerobic capacity had a positive influence on success (OR=1.06). Resting SBP, post-PAT SBP, HR responses, and their differences were significantly related to task-specific performance (p <0.05). Discussion: The findings align with prior research, which shows that obesity, elevated blood pressure, and higher heart rates negatively impact firefighting ability. Conclusion: Cardiovascular health, reflected by heart rate and blood pressure responses, strongly predicts PAT outcomes. Interventions such as regular physical activity and dietary strategies (e.g., the DASH diet) should be prioritized to improve cardiovascular health and enhance occupational performance, thereby reducing health risks in firefighters.