In recent months, growing concern has emerged about the physical fitness assessments required of firefighters in the Netherlands, particularly the Periodiek Preventief Medisch Onderzoek (PPMO), after reports indicated that the test may pose serious health risks. According to a study commissioned by the Veiligheidsregio Drenthe and conducted by advisory firm Ter Morsche, the PPMO has been linked to multiple cardiac events, including at least eight heart attacks and several resuscitations over a two-year period. These findings have prompted a broader discussion about whether the test accurately reflects the physical demands of firefighting or if it exceeds safe limits for certain individuals.
The PPMO is an annual medical evaluation mandatory for firefighters in many Dutch safety regions, designed to assess whether personnel can perform their duties without endangering themselves, colleagues, or the public. As described by BrandweerNederland.nl, the test includes physically demanding components such as forcing doors, rolling out hoses, climbing ladders whereas wearing full gear, crawling through tunnels, navigating obstacles and rescuing a person—all under conditions that simulate real emergency scenarios. The goal is to ensure firefighters remain fit for duty in high-stress, extreme environments where lives depend on their performance.
However, critics argue that certain elements of the PPMO may be disproportionately strenuous. The Ter Morsche report highlighted specific concerns about the firefighting obstacle course and the stair-climbing test, noting that the tunnel crawl is particularly challenging for taller individuals, while the ball-lifting component places excessive strain on women. Data from 2024 showed that of the 8,085 PPMO tests administered that year, 7% of men failed, compared to 18% of women—a significant disparity suggesting the test may not be equitable across different body types or genders.
These disparities raise important questions about the design and validity of fitness assessments in physically demanding professions. While maintaining rigorous standards is essential for operational safety, assessments must also be fair, evidence-based, and aligned with actual job requirements. The PPMO’s current structure has come under scrutiny for potentially prioritizing intensity over relevance, possibly putting older, taller, or female firefighters at unnecessary risk during evaluation.
The Veiligheidsregio Drenthe has not yet announced specific changes to the PPMO protocol following the Ter Morsche findings. However, the report’s conclusions have contributed to ongoing national conversations about occupational health in emergency services. Firefighter unions and occupational health specialists have called for a review of the test’s components, emphasizing the need for assessments that are both medically sound and inclusive.
For firefighters, the stakes of failing the PPMO extend beyond personal health—they can affect employment status, shift assignments, and team readiness. Yet, passing a test that induces cardiac strain defeats its purpose. As one occupational health expert noted in the Ter Morsche report, a fitness evaluation should protect, not endanger, those This proves meant to qualify.
Moving forward, any revisions to the PPMO will likely depend on further research, stakeholder input, and alignment with national occupational health guidelines. Until then, firefighters across the Netherlands continue to undergo the annual assessment, balancing the need for readiness with growing concerns about the test’s safety and fairness.
Those seeking official information about the PPMO can consult the BrandweerNederland.nl website, which provides detailed guidelines on the test’s purpose, frequency, and procedures. Updates on any potential revisions to the assessment will be issued through regional veiligheidsregios or national fire service authorities.