Reasons for Rejection: Why People Fail to Qualify as Firefighters

In the decade beginning 1 January 1985, 916 individuals (includingfive females) were medically examined with a view to joiningthe full-time service of Strathclyde Fire Brigade (SFB). Onehundred and nine (11.9%), including two females, were rejected.The five main causes of failure were: ocular (n = 46, 42.2%);lack of stamina (n = 21, 19.2%); ‘others’ (n = 12,11.0%); cardiovascular (n = 9, 8.3%) and orthopaedic (n = 6,5.5%). Thirty-two had chest X-rays. One abnormality was found— an azygous lobe — but it played no part in thedecision to decline the applicant. There was little life- orhealth-threatening pathology found. The most serious cases weremurmurs consistent with mitral stenosis and regurgitation (oneeach), one case of ocular melanoma, four cases of hypertensionand two cases of haematuria/ proteinuria (++). This study showsthat potentially serious findings can occasionally be detectedin a population of 18–30 year olds who might be expectedto be of better than average fitness, and that routine chestX-rays are not helpful in the selection process.