Firefighting Career: What Medical Conditions Need To Be Reviewed?

Firefighting Career: What Medical Conditions Need To Be Reviewed?

Firefighting Career: What Medical Conditions Need To Be Reviewed

If you’re interested in a firefighting career, you need to understand that there are certain medical conditions that could disqualify you from entering this profession. Additionally, there are other conditions that may need to be reviewed on a case by case basis.

The strenuous job requirements of being a firefighter dictate that all firefighters need to have an optimum level of fitness and health. Depending on which state service you want to apply to, there are varying medical conditions that may disqualify you or will need further assessment.

We’re going to look at each fire service in Australia and New Zealand separately and discuss the requirements for medical reviews for each one.

Fire & Rescue NSW (FRNSW)


The medical assessment for anyone pursuing a firefighting career at FRNSW is completed by an occupation physician. Prior to the assessment, you’ll need to supply blood, urine, and spirometry tests plus an ECG. You’ll also have to provide medical documents that are related to any previous surgeries, hospitalisations or other health conditions. In addition, you need to provide a current status report from your treating doctor.

This information is then assessed against the demands of the job. Certain conditions will raise concerns. These include conditions that:

  • Carry a risk of sudden incapacity or impairment

  • Could affect functional capacity to perform your duties

  • Could be aggravated by your firefighting duties

After your initial medical assessment, a further review may be required. Concerning conditions which may disqualify you from becoming a firefighter include:

  • A previous heart attack

  • An implantable defibrillator

  • Diabetes which requires the use of insulin to control

  • If you wear hearing aids

  • The permanent need for blood-thinning medication

  • Any joint replacement surgery you may have had

We contacted FRNSW to see if they had a list of medical conditions that required further review and their response was:

“All medical assessments for firefighting positions in FRNSW are undertaken very much on a case by case basis and the provision of a list of conditions is therefore not possible.”

They did stress though, that good cardiac health was vitally important.

With regard to the COVID-19 vaccine mandate, FRNSW still requires COVID-19 vaccination (2 doses of a TGA-approved vaccine).

Department of Fire & Emergency Services WA (DFES)


According to DFES, applicants who want to pursue a firefighting career have to be occupationally, medically, and physically fit. Applicants also have to be free of any disability, disease, or impairment.

Conditions which could disqualify an applicant include:

  • Asthma

  • Diabetes

  • Joint replacement

  • Epilepsy

  • Degenerative arthritis / osteoarthritis

  • Hearing disorder

  • Eyesight disorder including certain degrees of colour blindness

DFES uses the Ishihara Plate test to test for colour vision. If an applicant fails this test, a further review is needed.

Any condition which is due to an injury or posture could increase the risk of injury on the job. These conditions require further assessment and review to give an indication of the short term impact.

We contacted DFES to see if we could get any more information and this is what they said:

“We are guided by the AFAC Medical Guidelines and each applicant who is shortlisted for a place on the trainee firefighter school undertakes a pre-employment medical screening.  This assesses an individual’s medical and physical ability to undertake the duties of the role.”

Since 10 June 2022, firefighters are no longer required to be vaccinated against COVID-19.

South Australian Metropolitan Fire Service (SAMFS)

Firefighting career with SAMFS

The following are conditions which will disqualify you from pursuing a firefighting career with SAMFS:

  • Ophthalmic conditions – includes:

    • Impaired vision less than 6/12 in the worst eye

    • Colour blindness

    • Iritis

    • Chronic conjunctivitis

    • Cataracts

    • Aphakia

    • Glaucoma

    • Squint

    • Nystagmus

    • Keratitis

    • Abnormal visual fields

    • Night blindness

    • Diplopia

    • Retained intraocular foreign body

    • History of retinal detachment

  • ENT conditions – includes:

    • Chronic or acute ear infection

    • Meniere’s disease

    • Anosmia

    • Aphonia

    • Severe nasal obstruction

    • Severe speech impediment including stammer

    • Perforated eardrum

    • Allergy

    • Severe hayfever which will necessitate extensive time off work.

  • Conditions of the Respiratory System – includes:

    • Asthma that requires medication or treatment with steroids

    • Spirometry

    • Recent or recurrent Pneumothorax

    • Chronic obstructive airways

    • Bronchiectasis

    • Active tuberculosis

    • Any chronic or active pulmonary condition.

  • Conditions of the Cardiovascular system – includes:

    • Hypertension

    • Coronary artery disease

    • Pathological murmur

    • Cardiac failure

    • Organic heart disease

    • Major cardiac arrhythmia

    • Tachycardia.

  • Musculoskeletal conditions – includes:

    • Chronic backache

    • Disc prolapse

    • Recurrent sciatica

    • Nerve root pressure

    • Spinal or limb deformity

    • Active joint disease

    • Chronic joint disorder

    • Ankylosing spondylitis

    • Muscular disorders that are progressive

    • Spinal or lower limb degeneration.

  • Conditions of the Central Nervous system – includes:

    • Epilepsy

    • Blackouts or fainting attacks

    • Vertigo

    • Cerebrovascular disease

    • Recurrent severe headache or migraine.

  • Gastrointestinal conditions – includes:

    • Active peptic ulcer

    • Reflux oesophagitis

    • Bowel disease with frequent diarrhoea

    • Ulcerative colitis

    • Crohn’s disease

    • Hernia

    • Hepatomegaly

    • Liver disease

    • Gall bladder disease

    • Pancreatitis.

  • Genito Urinary conditions – includes:

    • Recurrent urinary infections

    • Active sexually transmitted disease

    • Urinary incontinence

    • Hydronephrosis or polycystic kidney

    • Acute or chronic nephritis

    • Presence in the urine of glucose, blood, protein.

  • Endocrine conditions – includes:

    • Diabetes mellitis

    • Acute thyroid

    • Adrenal

    • Parathyroid or pituitary disease.

  • Conditions of the Haemopoietic system – includes:

    • Anaemia

    • Chronic blood disease

    • Lymphadenopathy

    • Splenomegaly

    • Any history of thrombo-embolic disease

    • Bleeding disorders including anticoagulation.

  • Any Infectious disease that compromises the immune system.

  • Any Malignancy

  • Dermatological conditions – includes:

    • Chronic skin disease

    • Severe facial acne that would inhibit the use of breathing apparatus

    • Pilonidal sinus

    • Severe allergic skin disorders.

  • Any Psychiatric conditions such as anxiety, psychosis, neurosis, depressive disorder, confined space disorder and acrophobia.

  • Head and Neck deformities that would inhibit the use of breathing apparatus.

  • Alcohol or Drug abuse

Any other conditions will be assessed and reviewed on a case by case basis.

With regard to COVID-19 health mandates, you are also required to submit proof of vaccination.

Fire Rescue Victoria

All applicants who wish to pursue a firefighting career with FRV have to supply a medical clearance form from a medical practitioner as part of their application process.

Disqualifying conditions include:

  • Asthma

  • Diabetes

  • Epilepsy

  • Hearing or eyesight disorders including colour blindness

For further clarification on conditions which will be assessed on a case by case basis, we found this information on their (new) website:

If you believe you have a particular condition that may prevent you from being granted medical clearance and you wish to clarify this prior to submitting your application, please contact:

Modern Medical
St Kilda Road Medical Centre
Level 1, 391 St Kilda Road
Melbourne 3004

For workers 18 and above, you’re required to submit evidence of COVID-19 vaccination in three doses.

Queensland Fire & Emergency Services (QFES)


According to the QFES medical standards[1], the following conditions will disqualify you from pursuing a firefighting career in QFES:

  • Vision Impairment – It is permissible to wear glasses to correct your vision as long as they meet the Australian standard, cannot be dislodged during strenuous activity, and will not impede the face seal of self-contained breathing apparatus. Contact lenses are not acceptable.

  • Colour blindness – Generally, this will require further assessment.

  • Hearing impairment

  • Cardiac conditions – This includes cardiomyopathy or other heart diseases. If the disease is mild, a further assessment can be obtained.

  • Myocardial Infarction – This will be assessed on a case by case basis.

  • Arrhythmias – If you have been symptom-free for 6 months and get a letter from your cardiologist, your case will be reviewed.

  • Insulin Dependent Diabetes – Type II diabetes that is treated with sulphonylureas may be considered if you are free of hypoglycaemia and other significant complications.

  • Epilepsy – If you’ve been clear of seizures for at least 2 years and take anti-epileptic drugs, your case may be reviewed.

  • Stroke due to cerebral artery occlusion from thrombosis, embolism, or vasospasm. Further assessment is considered if the stroke has left no neurological deficit or the cause of the stroke has been corrected.

  • Asthma – can be assessed further.

  • Chronic respiratory disease.

  • Arthritis in knees, hips, back, shoulder, or neck. Includes recurrent shoulder dislocation.

  • Significant back disability. This can have the possibility of further assessment.

The following conditions will require further assessment and review:

  • Any cardiac condition

  • Ischaemic heart disease

  • Moderate to severe valvular disease

  • Cardiomyopathy

  • Hyperthyroidism

  • Any skin condition that impairs sweating

  • Obesity

  • The taking of certain medications such as:

    • Antihistamines

    • Beta-blockers

    • Anticholinergic drugs

    • Phenothiazine derivatives

    • Thyroid preparations

    • Amphetamines

    • Tricyclic antidepressants

    • Monoamine oxidase inhibitors

    • Diuretics

Each application will be assessed on a case by case basis.

QFES staff aren’t mandated anymore to be fully vaccinated against COVID-19.

Northern Territory Fire & Rescue Service (NTFRS)


Each applicant who hopes to have a firefighting career with NTFRS needs to be examined by an approved medical practitioner. According to their medical guidelines[2], the following conditions will disqualify an applicant:

  • Corrected distance vision less than 6/9 binocular in both eyes and less than 6/18 in either eye

  • Uncorrected distance vision less than 6/36 binocular in both eyes

  • Corrected near vision less than N5 in both eyes

  • Visual fields less than 120 degrees horizontal

  • Colour blindness (protan and deutran)

  • Retinal detachment

  • Diplopia

  • Night blindness

  • Severe corneal scarring

  • Monocular vision

  • Severe uncorrectable binaural hearing loss

  • Any condition that results in the sudden onset of vertigo

  • Angina

  • Heart failure

  • Cardiomyopathy

  • Heart valve defect

  • Cardiac arrhythmia

  • Recurrent syncope

  • Persistent severe hypertension especially with evidence of end-organ damage

  • Taking medications which cause postural hypotension or drowsiness

  • An untreated aortic or cerebral aneurysm

  • Present or recurrent pneumothorax

  • Severe asthma

  • Active TB

  • Total knee or hip replacement

  • Degenerative arthritis of hip, knee or ankle

  • Inflammatory arthropathy

  • Hip, knee or ankle injury with significant loss of movement

  • Spinal fracture

  • History of head injury with cognitive impairment

  • Epilepsy with a seizure-free period of less than 5 years

  • Multiple sclerosis

  • Muscular dystrophy

  • Parkinson’s disease

  • Dementia

  • Narcolepsy

  • Any brain injury affecting cognitive function, balance or neuromuscular function

  • Intellectual impairment

  • Malignant tumours of the bowel, GI tract, kidney or prostate

  • Pregnancy and 6 weeks postpartum

  • Incontinence of bowel or bladder

  • Active malignancies of blood and lymphatic systems

  • Significant anaemia

  • Thrombocytopaenia

  • Active tuberculosis

  • Infectious hepatitis

  • Any highly contagious infection

  • Diabetes mellitus with a history of low blood sugar and loss of consciousness

  • Rheumatoid arthritis

  • Organic brain dysfunction

  • Schizophrenia

  • Use of illegal or dependent drugs which may cause psychomotor impairment

The following conditions will require further assessment and review:

  • Mild colour blindness (deutran)

  • Cataracts

  • Any other progressive or recurring eye disease

  • Iritis

  • Glaucoma

  • Refractive surgery

  • Severe uncorrectable unilateral hearing loss

  • Meniere’s disease

  • Severe tinnitus

  • Vertigo

  • Otosclerosis

  • Acute or chronic pericarditis, endocarditis or myocarditis

  • A pacemaker

  • Defibrillator implant

  • Taking anti-coagulants especially warfarin

  • Asymptomatic heart valve lesions

  • History of coronary artery disease

  • Atrial tachycardia, flutter or fibrillation

  • ECG abnormality

  • Ventricular tachycardia

  • Bradycardia resulting in syncope

  • Recurrent paroxysmal tachycardia

  • History of congenital cardiac anomalies

  • Metabolic syndrome

  • Stroke due to haemorrhage

  • Transient ischaemic attack

  • Stroke due to ischaemia

  • History of treated aortic or cerebral aneurysm

  • Taking anticoagulant medication

  • Clinical evidence of peripheral vascular disease

  • Recurrent deep vein thrombosis

  • Any significant abnormality of the aorta, carotid arteries or other large blood vessels

  • BP less than 150/95 which is persistent and not responding to treatment

  • Certain types of asthma

  • Conditions with functional lung volumes of 20% or more below the predicted value

  • Restrictive lung disease

  • Chest wall deformity

  • Previous lung surgery

  • History of tracheostomy

  • Lung cancer

  • Bronchiectasis

  • Sleep apnoea

  • History of a back condition requiring diskectomy, laminectomy or spinal fusion

  • Hip resurfacing procedures

  • Loss of articular cartilage

  • Knee reconstruction

  • Amputation or deformity of a joint or limb

  • Recurrent dislocation of the shoulder

  • Recurrent or tendonitis of shoulder, elbow, wrist or hand

  • Carpal tunnel syndrome

  • Fracture or dislocation of any bone or joint

  • Osteomyelitis or arthritis of any joint in the spine

  • Ankylosing spondylitis

  • Skull, jaw or facial conditions that may restrict the ability to wear a helmet or breathing apparatus

  • Thoracic outlet syndrome

  • A single seizure for which the cause is unclear or highly unlikely to recurrent

  • Epilepsy where the person has been seizure-free for more than 5 years without taking medication

  • Stroke

  • Clinical pain syndrome

  • Peripheral sensory or motor neuropathy

  • Peripheral nerve injury

  • Spinal cord injury

  • Any significant head injury or concussion

  • Brain tumour

  • Congenital neurological malformations

  • Hernia

  • Acute infectious or non-infectious hepatitis

  • Pancreatitis

  • Inflammatory bowel disease

  • Acute GI bleeding

  • Malignant tumours following treatment

  • Menorrhagia

  • Loss of kidney or other abdominal organs

  • Acute or chronic renal failure

  • Mild anaemia

  • Thalassemia

  • Treated malignancies of the blood or lymphatic systems with no abnormality in the full blood count

  • Chronic fatigue syndrome

  • Splenomegaly

  • HIV or hepatitis c infections

  • Mild connective tissue disease

  • Evidence of a predisposition to heat stress

  • Thyroid, adrenal or pituitary gland disorders

  • Psychiatric condition associated with substance abuse

  • History of post-traumatic stress disorder

  • History of major depression, bipolar disorder, personality disorders

  • Regular use of alcohol or drugs that may affect the safe performance of operational duties

NTFRS does not require the COVID-19 vaccination.

Tasmania Fire Service (TFS)

Tasmania Fire Service

We couldn’t find very much information regarding medical conditions. However, their application process does indicate that you need a medical clearance form that is completed and signed by your GP.

We contacted TFS to see if we could get more information and this is their reply:

“We aren’t able to specify that a person may not become a FF because of a specified medical condition. We have our applicants see an Occupational Physician with the attached form so that each condition can be taken into consideration by a professional.”

The form that they supplied had some additional information. Namely, the following conditions would preclude someone from becoming a firefighter:

  • A history of asthma
  • Significant hay fever
  • Obesity
  • Significant colour blindness
  • Impaired eyesight or hearing

With regard to COVID-19 health mandates, starting 1 July 2022, TFS doesn’t require its staff to be vaccinated.

Fire & Emergency New Zealand (FENZ)

Firefighting career with FENZ

If you suffer from any condition that limits your mobility in any way, you will be disqualified from a firefighting career with Fire & Emergency New Zealand.

The following conditions will require further assessment:

  • Asthma

  • Insulin-dependent diabetes

  • Epilepsy or loss of consciousness

  • Some heart conditions

  • Psychological conditions

FENZ will assess each applicant on a case by case basis.

FENZ does not also require COVID-19 vaccination.

If you’re interested in a firefighting career, we hope you found this information helpful. If you have any questions about firefighting, feel free to send them to us via chat, email, or in the comments below.



Hope this has answered any questions you may have had, if not feel free to send me an email for clarification.



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Brent C

After becoming a Firefighter, I developed a massive interest in the Fire Services Recruitment and Selection Processes. I've been in the fire service working since 2007 to learn everything about how Fire Services Recruitment works. I've tested and refined proven methods to help people get the edge over the competition. Today, over 300 of my former students are living their Firefighter dream.

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