Toothless tests: associations between the results of routine screening medical examinations and ill-health retirement of firefighters in west central Scotland.

The final routine medical examinations (RME) of 526 full-time firefighters, all male, retiring from Strathclyde Fire Brigade in the decade beginning 1 January 1985 were studied to determine differences between the results of the 328 taking ill-health retirement (IHR) and the 198 completing maximum service (MS). Mean ages at IHR and MS were 48 and 54 years/respectively. This was statistically significant (P = 0.0000), so the results of the third RMEs, performed after the subjects' 46th birthdays, were also analysed. The findings were also reduced into quinquennia. Since the RMEs were weighted towards cardiovascular disorders, the outcomes of the 37 IHRs from arterial disease were sought and compared to the final results of those with MS. In both final and third RMEs, those completing MS were more likely to be non-smokers (60.9 vs 41.4%; 51.6 vs 42.6%; P = 0.01 and 0.015). In the final RME, subjects with MS generally had normal lung function (abnormal results 4.8 vs 10.4%; P = 0.002), abnormal chest X-rays and near vision (22.4 vs 7.6%; 91.1 vs 51.6%; P = 0.000 for both). In the third RME, firefighters with IHR were more likely to have hypertriglyceridaemia (39.6 vs 22.4%; P = 0.004), and reduced distance vision (32.2 vs 21.2%; P = 0.03). Where IHR resulted from arterial disease, sufferers had raised mean cholesterol (6.76 vs 6.20 mmol/l; P = 0.049), raised median triglycerides (2.1 vs 1.55 mmol/l; P = 0.0236), hypertriglyceridaemia (44.4 vs 21.2%; P = 0.008) and less likely to be non-smokers (32.4 vs 60.9%; P = 0.001). Differences between body mass index, systolic and diastolic blood pressure, fasting and HDL cholesterol, electrocardiogram abnormalities, urinary abnormalities and total numbers of risk factors did not reach statistical significance, apart from isolated quinquennial episodes. These results suggest that, except for highlighting known health hazards, current RMEs are ineffective in identifying those at risk of ill-health retirement in this group.