Exhibit_12 _Physicians_Certification_2_5_16.pdf

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Exhibit 12 Physician's Certification PSO Medical Examination and Physical Abilities Test

General Background. Protective Security Officers (PSOs) provide integrated law enforcement support and security services daily to millions of tenants and visitors at federally owned/leased facilities nationwide. PSOs present a visible deterrent, safeguard and secure government assets, and provide a safe and secure environment for employees and visitors.

Physician's Certification contains a medical examination questionnaire and physical abilities test. The purpose of the medical examination questionnaire and physical abilities test is to guide physicians in determining a PSO candidate's medical fitness to perform job tasks. The Physician's Certification contains both specific medical standards and direction as to when additional diagnostic testing may be required. A licensed physician must complete this Certification.

This Exhibit has two sections:

Section 1. Physician's Certification Section 2. Attachments.

The following attachments are provided to identify PSO critical tasks/functions, Medical and Physical Standards, and Physical Abilities Testing (PAT) Manual testing:

Attachment 1. PSO Critical Tasks and Functions Attachment 2. Medical and Physical Standards Attachment 3. Physical Abilities Testing Manual Section 1. Physician's Certification

GENERAL HEALTH

1. Does the candidate exhibit a loss of smell, aphonia, or other abnormalities of the nose, throat, or ears that may prevent successful task performance?

2. Does the candidate exhibit evidence of chronic bronchitis, emphysema (moderate or severe), infectious pulmonary tuberculosis, or other respiratory abnormalities that may prevent successful task performance?

3. Does the candidate exhibit evidence of eczema, psoriasis, dermatitis, or other dermatological condition that may prevent successful task performance?

4. Does the candidate exhibit evidence of a gastrointestinal issue that may prevent successful task performance?

1. Does the candidate exhibit full range of motion?

2. Is the candidate able to get up and down easy from a kneeling position?

3. Is the candidate able to lift a minimum of 40 pounds from floor to waist?

4. Is the candidate able to bench press at least 40% of their body weight?

5. Is the candidate able to continuously perform sit-ups for at least 30 seconds?

6. Is the candidate able to continuously perform push-ups for at least 30 seconds?

Note: Questions 5 and 6: The candidate is to perform these tasks without stopping, irrespective of the number of repetitions. This task tests the candidates strength, range of motion, and flexibility while performing a certain continuous motion for 30 seconds. These tasks are not designed to test a candidate's ability to do sit-ups or push-ups.

MUSCULOSKELETAKL SYSTEM

Section 1. Physician's Certification

VISION

1. In the last three (3) years has the candidate consulted with a health care professional regarding an emotional or mental health condition or were hospitalized for such a condition?

2. In the last three (3) years has the candidate been court ordered to consult with a health care professional regarding an emotional or mental health condition?

3. Was the candidate EVER admitted as an inpatient for counseling or treatment regarding an emotional or mental health condition?

4. Has a court or administrative agency EVER declared the candidate mentally incompetent?

5. Does the candidate have ANY disorders that affects judgement, cognitive function, or safe and efficient performance of PSO critical tasks and functions?

6. Does the candidate use medications, such as; narcotics, sedative hypnotics, barbiturates, amphetamines, or any drug with potential for addiction, that is prescribed or taken for extended periods of time (e.g., beyond 10 consecutive days) for a persistent or recurring underlying condition?

1. Does the candidate wear corrective lenses? If yes, identify the type of lens(es) used, e.g., glasses, soft/hard contacts, which lens(es) are used most frequently, and identify the prescription strength.

2. Does the candidate have 20/30 vision while using both eyes?

3. Identify the candidates visual acuity (with and without) corrective lenses.

4. Is the candidate capable, in at least one eye, of reading a minimum of Jaegar Number 2 or equivalent type and size letter at a distance no less than 12 inches on a standard Jaegar chart?

5. Does the candidate exhibit normal color vision?

6. Does the candidate exhibit any visual conditions that may impact their ability to perform PSO critical tasks? Example, peripheral vision deficits or night blindness.

MENTAL HEALTH

HEARING

1. Does the candidate require the use of a hearing aid?

2. Does the candidate have hearing less than or equal to 25db?

3. Identify the candidates average hearing (corrected, if applicable) across the following Hz levels 500, 1000, 2000, and 3000; Corrected?

4. Does the candidate have hearing less than or equal to 45db?

5. Identify the candidate's hearing (corrected, if applicable) at the 4000 or 5000 Hz levels: Corrected?

6. Does the candidate have a hearing variance between left and right ears? If yes, identify the ear with more hearing loss.

What is the difference between the 500 to 3000 Hz range? Required: Test candidate further for sound localization deficiency, if difference exceeds 15 db.

What is the difference between the 4000 to 5000 Hz range? Required: Test candidate further for sound localization deficiency, if difference exceeds 30 db.

7. Does the candidate present evidence of inner, middles, or outer ear disorders affecting equilibrium?

1. Identify the candidate's aerobic capacity. Minimum required standard is (9 METs) or 31.5 ml/kg/min VO2 Max

2. Identify the candidate's resting blood pressure. Maximum required standard is 180 mmHg Systolic, 90 mmHg Diastolic

CARDIOVASCULAR SYSTEM

SUPPORTING AND GENERAL COMMENTS

1. Does the candidate have any limiting factors? 2. Summarize below any medical findings which, in your opinion, would limit this candidate from successfully performing PSO tasks or would otherwise make this candidate a hazard to himself/herself or others. If none, state none below. 3. Insert only this page of this exhibit in Tab A of the PSOs personnel file.

Section 2. Attachment 1. PSO Tasks and Functions Critical Tasks PSOs must have the physical capacity and training to accomplish critical common and occasional tasks. Information below is based on an abbreviated and consolidated list of critical tasks that are indicative of demands placed upon PSOs. Critical Tasks are divided into two types: Common and Occasional

Common Critical Tasks: Normal, everyday duties.

1. Stand post at the entry/exit gates to verify all persons' identification and conduct inquiries and surveillance of items, packages, and people. Check packages, briefcases, containers, or any other items in the possession of people entering or leaving a Federally controlled facility. 2. Operate metal detectors to search visitors for prohibited items. Operate x-ray machine to search deliveries, visitors' packages, equipment, and hand carried articles for prohibited items. 3. Monitor security and fire alarms and closed-circuit television to detect security risks or threats. 4. Conduct vehicle inspection, which may include inspecting under seats, in the trunk, and under the vehicle. 5. Conduct patrols in accordance with routes and schedules contained in post orders. Inspect facilities and perimeters for hazards, mechanical problems, and unsafe conditions and report problems to appropriate authorities. Close and secure open windows, doors, gates, or other access points. 6. Investigate the source of suspicious odors and sounds. 7. Patrol locations in areas which are a potentially hazardous to the public (e.g., construction sites). 8. Observe unique characteristics of an individual for identification purposes. Observe a person's body language to assess attitude and intention. 9. Close off areas to traffic, establish perimeters, and set up barricades to secure incident scenes or facilities.

Occasional Critical Tasks: Occur less frequently, but are critical to successful job performance and public safety. 1. Locate and review documents and information (e.g., logs, lists). Read memos and other written material to obtain and maintain knowledge. Review maps, floor plans, diagrams, or other information to become familiar with facility and property boundaries. 2. Use defensive tactics to prevent or control movements of individuals. 3. Subdue violent persons with or without assistance. Break up fights. Disarm individuals. 4. Apply handcuffs to individuals who are displaying erratic or violent behavior. 5. Use baton or chemical spray to temporarily incapacitate a violent individual. Participate in training in the use of chemical agents, restraining devices, and batons to be used in emergency situations. 6. Discharge firearm during daylight or in dark or low light environment while using flashlight. 7. Evacuate individuals from dangerous and/or life threatening situations. 8. Administer cardio-pulmonary resuscitation (CPR). 9. Pursue fleeing individual on foot.

PSOs may be exposed to a wide variety of environmental conditions including, but not limited to: working outdoors, excessive heat/cold, constant noise, slippery or uneven walking surfaces, working around moving objects or vehicles, shifts lasting eight or more hours while working alone, frequent, close contact with members of the public, potential threats or security risks, whether physical or verbal, and construction environment and associated hazards.

Section 2. Attachment 1. PSO Functions and Tasks PSO Functions and Tasks (5 Core Functions/84 total tasks). These tasks entail the minimum set of specific tasks all PSOs are expected to perform.

Access Control 1. Stand post at the entry/exit points to verify all persons' identification and conduct inquiries and surveillance of suspicious items, packages and people. 2. Ensure individuals do not depart with government material unless they are authorized to do so. 3. Verbally challenge individuals who are approaching restricted areas. 4. Direct individuals who cause a disturbance to leave the property. 5. Operate traffic control points. 6. Close off areas to traffic, establish perimeters, and set up barricades to secure incident scenes or facilities. 7. Control access to incident scenes. 8. Help ensure integrity of a crime scene, maintaining it in its original condition until law enforcement personnel take over. 9. Coordinate the receipt, issuance, and tracking of all keys, key cards, lock combinations, vehicle passes/decals, etc. 10. Identify suspicious persons or vehicles. Control Center Operations 1. Check radio equipment for proper operation. 2. Monitor security and fire alarms and closed-circuit television to detect security risks, threats, or prohibited items carried by visitors. 3. Dispatch PSOs in response to calls for service, alarms, or emergencies.

Patrol and Response 1. Inspect appropriate countermeasures, including facility critical protection points and classified containers. 2. Inspect facilities for hazards, mechanical problems, and unsafe conditions and report problems to appropriate authorities. 3. Close and secure open windows, doors, gates, or other access points. 4. Manually open and close heavy gates and doors. 5. Conduct patrols in accordance with routes and schedules contained in post orders. 6. Inform dispatcher of present status and changes in conditions. 7. Patrol locations in areas which are potentially hazardous to the public (e.g. construction sites). 8. Inspect the perimeter, property, and buildings for hazards, intruders, and suspicious activities. 9. Observe the environment for suspicious vehicles or persons on or around Federal property. 10. Review maps, floor plans, diagrams, or other information to become familiar with facility and property boundaries. 11. Evacuate individuals from dangerous and/or life threatening situations. 12. Guide and assist First Responders (e.g., with scene management or security). 13. Assess the condition of injured individuals. 14. Perform basic first aid in response to emergencies. 15. Administer cardiopulmonary resuscitation (CPR). 16. Administer/deploy automatic external defibrillator (AED). 17. Use fire extinguisher to put out a minor fire. 18. Request emergency assistance in response to traffic accidents. 19. Assist in conducting accident and incident scene searches and investigations (e.g., check visitor logs, video) in search of relevant evidence and information to determine the facts of the situation. 20. Follow directions to and respond to emergency and routine calls for service until the situation is resolved or until relieved by a higher authority. 21. Investigate the source of suspicious odors and sounds. 22. Pursue fleeing individual. 23. Escort money, valuables, or people to provide security. 24. Escort facility tenants and visitors to and/or from their vehicles after hours.

Screening 1. Inspect packages, briefcases, containers, or any other items in the possession of people entering or leaving a federally controlled facility. 2. Operate metal detectors to search visitors for prohibited items. 3. Operate x-ray machine to search deliveries and visitors' packages, equipment, and hand carried articles for prohibited items. 4. Conduct vehicle inspection, which may include inspecting under seats, in the trunk, and under the vehicle. 5. Conduct frisks or pat downs for weapons or other unauthorized items. Visitor Processing 1. Verify proper identification of visitors required for issuance of visitor badges. 2. Process visitors.

Section 2. Attachment 1. PSO Tasks and Functions Common Tasks 1. Report potentially threatening situations and violations of law and security procedures. 2. Observe unique characteristics of an individual for identification purposes. 3. Collect information about stolen or missing property or suspicious activities to aid investigations. 4. Take detailed field notes so reports can be completed. 5. Write and/or speak situation reports regarding security related information (e.g., accidents, bomb threats, unlawful acts, characteristics of individuals). 6. Communicate with individuals to establish rapport. 7. Adjust communication to ensure understanding. 8. Provide direction or information to tenants or visitors. 9. Advise persons relative to problems, situations, etc. 10. Encourage people to approach by using effective non-verbal communication (e.g., making eye contact and greeting a person cordially). 11. Communicate with rude or abusive people. 12. Use body language to project control and influence. 13. Use voice commands to project control and direct actions. 14. Explain rules, regulations, and procedures to individuals. 15. Interact with a subject who does not speak English. 16. Interact with a subject who has communication impairment (e.g., is deaf, has a speech impediment). 17. Interact with a subject who has mobility impairment (e.g., is blind, is wheelchair bound). 18. Interact with public, including children. 19. Interview witnesses to obtain description of possible suspects or description of what happened. 20. Advise appropriate personnel of potentially hazardous conditions (e.g., slippery floors). 21. Communicate with first responders. 22. Testify in court regarding criminal activity or other incidents. 23. Report misconduct of other Security Officers. 24. Ensure that all security equipment is activated and operating properly; if not, report to proper authority. 25. Inventory physical objects (e.g., keys, keycards, vehicles, visitor badges) and log accordingly. 26. Locate and review documents and information (e.g., logs, lists). 27. Read memos and other written material to acquire and maintain knowledge. 28. Participate in search for missing child. 29. Activate alarm systems. 30. Provide backup assistance to Law Enforcement Officers and other PSOs. 31. Maintain situational awareness regarding individuals' body language, projected attitudes, and intentions. 32. Care for and maintain firearms. 33. Participate in firearms training. 34. Participate in training in the use of intermediate force weapons to be used in emergency situations. 35. Use intermediate force weapon to temporarily incapacitate a violent individual. 36. Operate firearm to protect self and others. 37. Maintain positive control and retention of firearms and intermediate weapons at all times. 38. Use defensive tactics to prevent or control movements of individuals. 39. Defend against violent combative person(s) to prevent injury to self or others. 40. Physically control individuals displaying disruptive or violent behavior, to include applying handcuffs.

Section 2. Attachment 2. Medical and Physical Standards PSOs shall meet the following medical standards:

Vision: Applicant must have binocular vision and must not test less than 20/30 (Snellen). An applicant who has undergone a Radial Keratotomy or laser correction procedure to correct his or her vision to an acceptable level is medically qualified for this position. Near vision, corrected or uncorrected, must be sufficient to read Jaeger Number 2 or equivalent type and size letter at a distance of no less than 12 inches on a standard Jaeger chart. Applicant must have normal color vision.

Hearing: Applicant average hearing at 500, 1000, 2000, and 3000 Hertz (Hz) must be less than or equal to 25 decibels. Applicant hearing at 4000 and 5000 Hz must be less than or equal to 45 decibels. If there is a difference in hearing between applicant's ears (in excess of 15 decibels at 500-3000 Hz range or in excess of 30 decibels at 4000-5000 Hz range), Applicant must receive a test for sound localization. Applicant shall not have ear disorders affecting equilibrium. Applicant may use a hearing aid.

Speech: Individual must be able to speak clearly and distinctly. Any disease or condition that significantly interferes with an individual's ability to speak is a disqualifying factor.

Cardiovascular System: Any disease or condition that interferes with cardiovascular function and an individual's safe and efficient job performance is a disqualifying factor. Applicant aerobic capacity is a minimum 9 MET or 31.5 ml/kg min VO2 Max.

Chest and Respiratory System: Individual must have a healthy respiratory system and receive an evaluation and clearance for use of disposable particulate respirators meeting N95 standards as established by National Institute for Occupational Safety and Health (NIOSH). Any disease or condition that interferes with respiratory function and an individual's safe and efficient job performance is a disqualifying factor.

Gastrointestinal System: Individual must have a healthy gastrointestinal tract. Any disease or condition that interferes with gastrointestinal function and an individual's safe and efficient job performance is a disqualifying factor.

Genitourinary System: Individual must have a healthy genitourinary system. Any disease or condition that interferes with an individual's safe and efficient job performance is disqualifying.

Endocrine and Metabolic Systems: Any condition affecting normal hormonal or metabolic functioning and response that is likely to adversely affect an individual's safe and efficient job performance is a disqualifying factor.

Musculoskeletal System: Any condition that adversely impacts on an individual's movement, agility, flexibility, strength, dexterity, coordination, or ability to accelerate, decelerate, or change directions, and that is likely to adversely affect an individual's safe and efficient performance of duties, is a disqualifying factor.

Hematology System: Any hematological condition characterized as chronic, caused a hematological crisis, or adversely impacts an individual's safe and efficient performance of duties is a disqualifying factor. Such conditions may include anemia or thrombocytopenia.

Section 2. Attachment 2. Medical and Physical Standards Neurological Systems: Any disease or condition that interferes with an individual's central or peripheral nervous system function and that is likely to adversely affect safe and efficient performance of duties is a disqualifying factor. Any condition with loss of motor skills, muscle strength, cognitive function, coordination, or gait; sensory loss (limb, hearing, or vision); tremor; pain; or effect on speech is a disqualifying factor.

Psychiatric Disorders: Any disorder that affects an individual's judgment, cognitive function, or safe and efficient performance of essential job functions, is a disqualifying factor.

Dermatology: Any disease or condition that may cause an individual to be unduly susceptible to injury or disease as a consequence of environmental exposures or which results in restricted functioning or movement and thereby impairs safe and efficient performance of essential job functions is a disqualifying factor.

Medication: Individual's use of medications such as narcotics, sedative hypnotics, barbiturates, amphetamines, or any drug with potential for addiction, that is taken for extended periods of time (e.g., beyond 10 days), or is prescribed for a persistent or recurring underlying condition, is a disqualifying factor.

Organ transplantation and prosthetic devices: Any transplantation or prosthetic device that adversely affects an individual's ability to safely and efficiently perform essential job functions is a disqualifying factor.

PSOs shall be physically able to perform tasks and/or functions listed below, in performance of assigned duties:

Frequent and prolonged walking, standing, sitting, and stooping, up to 12 hours per day, either indoors or outdoors, during daytime or nighttime. Outdoor posts may require an individual to withstand extreme heat, humidity, cold, and/or severe weather (e.g., snow, sleet, rain, hail, wind).

Frequent contact with general public, law enforcement, and dispatch center, requiring an ability to speak clearly and distinctly and remain calm in stressful situations (e.g., confrontations with angry, distraught, disturbed, or violent persons).

Ability to remain on post up to four consecutive hours without sitting, eating, or relieving bladder/bowels.

Ability to remain alert for up to 12 hours, with ability to mentally and physically react quickly to a variety of unexpected and dangerous situations. Use of senses (sight, hearing, smell, touch) is necessary to discern unusual or dangerous situations.

Ability to use post security equipment (metal detectors, X-rays, CCTV); ability to use handcuffs, baton, and firearm at any time while on duty.

Ability to read post assignments, write reports, and respond to both routine and emergency dispatches/orders.

Ability to subdue violent or potentially violent or disturbed individuals, or intervene in a crisis (e.g., provide emergency First Aid or/resuscitation while waiting for arrival of paramedics or other emergency personnel).

Occasional running, sprinting, lifting heavy weights, moving heavy objects, climbing stairs (e.g., in responding to emergencies, ensuring timely and complete facility evacuations, giving pursuit, etc.).

Section 2. Attachment 3. Physical Abilities Testing Manual Physical Ability Standard. This Manual provides detailed instructions for administering submaximal stamina test for Protective Security Officers (PSOs). Physical ability standards for PSOs are based on an extensive job analysis and are designed to ensure that candidates will be able to perform assigned tasks.

Aerobic Capacity Test Administration. To insure a candidate possesses adequate aerobic power (stamina), a standardized aerobic capacity test is administered. Aerobic test is a submaximal effort. Maximum oxygen consumption is estimated, rather than measured. Required standard is 9 METs or VO2max of 31.5 ml/kg/min.

A licensed physician or hiring agency may use any of the three (3) test methods listed, Step, Stepmill, or Treadmill. If the hiring agency administers or contracts a third-party vendor to administers the test, the licensed physician who signs Section 1. Physician's Certification, would have to agree to the hiring agency results.

Step Test: Heart rate is monitored while the candidate steps up and down from a bench 10 or 11 inches high and large enough such that a candidate can safely step up and down without risk for six minutes. Stepping rate ranges from 18 to 24 ascents per minute. Heart rate, step rate, and bench height are used to compute the candidate's maximum aerobic power in mL/kg/min (American College of Sports Medicine, 1980; Astrand and Rodahl, 1986).

Stepmill Test: Heart rate is monitored while the candidate steps on a moving tread with two stepping rates of 18 and 24 ascents per minute. The workload is increased after the first three minutes. Heart rate, step rate, and workload are used to compute the candidate's maximum aerobic power in mL/kg/min (American College of Sports Medicine, 1980; Astrand and Rodahl, 1986).

Treadmill Test: Heart rate is monitored while the candidate walks/jogs on a motorized treadmill at a known speed and inclination. The workload is increased after the first three minutes by increasing the inclination of the treadmill. Heart rate and treadmill speed and inclination are used to compute the candidate's maximum aerobic power in mL/kg/min (American College of Sports Medicine, 1980; Astrand and Rodahl, 1986).

Candidate Requirements: Candidates should not eat, smoke, or drink caffeinated beverages at least two hours prior to test. Candidates should avoid heavy physical exertion at least three hours prior to test. Candidate should be free of infection, including colds, prior to test

Test Administrator Requirements: American Red Cross or American Heart Association certified in cardiopulmonary resuscitation at the basic rescue level. Familiar with emergency procedures for the facility. Completely familiar with the required equipment and testing instructions before administering any tests. Maximum administrator to candidate ratio is one administrator to six candidates

Prior to Administering Test: Calculate and record candidate's resting heart rate (RHR) and maximum heart rate.

Determine and record heart rate at which to stop testing. Read all instructions to candidate

Section 2. Attachment 3. Physical Abilities Testing Manual

GETTING STARTED

Attach heart rate monitor electrodes (belted or disposable), to candidate. Make sure heart rate monitor is in good working order and candidate's heartbeat appears as a regular rhythmic cursor on monitor. Read the following statements to candidates prior to taking any test:

1. "You will be taking a test which will elevate your heart rate. You must get your physician's clearance before taking this test if you have:

Known or suspected heart disease High blood pressure (hypertension) Back problems Chronic obstructive pulmonary disease such as asthma, or If you are taking prescribed medication

2. You should also consider getting your physician's clearance if you:

Are in poor physical shape Are over 35, don't exert yourself regularly in occupational or recreational endeavors like hiking, walking, running, etc. or, Have any concerns about taking this test

3. You must stop taking test if you feel any of the following symptoms:

Pain or tightness in chest Dizziness or light-headedness Unusual shortness of breath, or Any unusual pain

4. Testing procedures simulate demands of PSO position and are no direct reflection on your personal health. Unfortunately, there is a natural tendency to interpret these procedures as a physical examination which makes a definitive statement about a candidate's health. Thus, "failing" these tests can be a source of concern to a candidate. THESE TESTS IN NO WAY SHOULD BE CONSTRUED AS A MEASURE OF YOUR PHYSICAL HEALTH."

During Test: It is important for the administrator to;

Continuously monitor the candidate's heart rate and observe the physical condition.

Occasionally ask the candidate, "How are you doing?"

Keep the candidate informed on how much time remains during test

Section 2. Attachment 3. Physical Abilities Testing Manual Step Test

REQUIRED EQUIPMENT

* Step Bench must be 10 or 11 inches high, at least 36 inches wide and at least 24 inches deep.

* Heart rate monitor with extra sensor belt

* Stopwatch

* Metronome

* Calculator

* Well-ventilated room with constant comfortable temperature

* Writing utensils

* Telephone or call button to summon emergency medical assistance with emergency number clearly posted for reference

Step bench shall stable enough were a bench will not move and a candidate can safely step up and down.

The test protocol is as follows:

Level 1: Three minutes at 18 Steps per minute Level 2: Three minutes at 24 Steps per minute

TEST ADMINISTRATION

1. Read to candidate: "You will be stepping up and down on this bench for a period of six minutes or until your heart rate reaches 85% of your age predicted maximum, whichever comes first."

(Note: Test Administrator shall provide figures of maximum heart rate and 85% heart rate to candidate.)

2. Read to candidate: "It is important that on going up, you go all the way to where your leg is straight and your body is erect. (Demonstrate action). You may change lead legs, as you desire. (Demonstrate action). Your heart rate will be monitored during the entire test."

(Note: Have each candidate try three to five ascents with metronome audible, to acquire "feel" before starting test. After candidate has had a few successful attempts, tell them to stop and stop metronome.)

3. Read to candidate: "Are you ready?"

(Note: Start metronome at 18 steps per minute (72 beats per minute on metronome).

4. Read to candidate: "Begin test."

(Note: Start stopwatch as candidate starts their first step.)

5. Monitor heart rate continuously and observe candidate's physical condition. It is important for the administrator to:

a. Monitor heart rate continuously.

b. Observe candidate's physical condition.

c. Occasionally ask candidate, "How are you doing?"

d. Keep candidate informed on how much time remains during test.

TERMINATE TEST IF CANDIDATE DOES NOT FEEL HE/SHE CAN COMPLETE SIX MINUTES

Section 2. Attachment 3. Physical Abilities Testing Manual Step Test

TERMINATE TEST IF ANY SYMPTOMS LISTED IN PRECAUTIONS OCCURS

a. If candidate's heart rate exceeds 85% of age predicted maximum

b. Candidate is not physically qualified

c. He/she may be over stressed by test

DO NOT DISCUSS PERFORMANCE OR SCORES

6. Monitor candidate's pace. If candidate is markedly faster or slower than cadence, have him/her adjust accordingly. Take note of candidate's motion; coming to a fully erect position on each ascent; remind candidate if necessary.

7. Starting at two minutes and zero seconds, count number of complete steps taken during next 30 seconds. (i.e. stop counting at two minutes and 30 seconds). This value, multiplied by two, will be the step rate for Stage 1.

8. At two minutes and 45 seconds, tell candidate you are about to increase speed of test.

9. At two minutes and 55 seconds, note and record candidate's heart rate.

10. Increase speed of the metronome to 24 steps per minute (96 beats per minute on metronome).

11. Starting at five minutes and zero seconds, count number of complete steps taken during next 30 seconds (i.e. stop counting at five minutes and 30 seconds). This value, multiplied by two, will be the step rate for Stage 2.

12. At five minutes and 30 seconds, tell candidate: "30 seconds to go."

13. At five minutes and 50 seconds, tell candidate: "10 seconds to go."

14. At five minutes and 55 seconds, candidate should be starting her/his next to last ascent.

15. During ascent, tell candidate, "one more" and pause until he/she is starting last ascent and say: "Stop."

16. Note and record time at which candidate stopped test.

17. Note and record candidate's heart rate when test stopped.

18. It is useful to note time of day so time between tests may be determined.

Section 2. Attachment 3. Physical Abilities Testing Manual Step Test

SCORING THE STEP TEST

If candidate fails to complete at least five minutes of six minute test, score candidate as unqualified for any strenuous jobs. Estimates of METmax would be unreliable in this circumstance.

If candidate completes at least five minutes of six minute test, then predicted aerobic power (aerobic capacity or METmax), may be obtained.

Calculation of aerobic capacity entails using data from final stage of step test. A generalized equation which uses data of a single stage (i.e. the last stage) is as follows: For hand calculation of METmax using an 11" bench:

METmax = _[HRR{(0.2917*Step Rate) - 1}/(FHR - RHR)] + 1

For hand calculation of METmax using a 10" bench:

METmax = _[HRR{(0.2737*Step Rate) - 1}/(FHR - RHR)] + 1

Step Rate = Stepping rate on bench (e.g. 24 steps per minute or 18 steps per minute etc.).

FHR = Final Heart Rate at the end of the stepping period.

RHR = Resting Heart Rate.

HRR = Heart Rate Reserve (Age Predicted HR Max - RHR) Section 2. Attachment 3. Physical Abilities Testing Manual Stepmill Test

REQUIRED EQUIPMENT

* Stepmill must be designed for commercial use with treads at least 20 inches wide by 60 inches long with a tread height of eight (8) inches

* Heart rate monitor with extra sensor belt

* Stopwatch

* Metronome

* Calculator

* Well-ventilated room with constant comfortable temperature

* Writing utensils

* Telephone or call button to summon emergency medical assistance with emergency number clearly posted for reference

Test protocol is as follows:

Level 1: Three minutes at 4 METs, 18 steps per minute Level 2: Three minutes at 7 METs, 24 Steps per minute

TEST ADMINISTRATION

1. Read to candidate: "You will be stepping up and down on this stepmill for a period of six minutes or until your heart rate reaches 85% of your age predicted maximum, whichever comes first. (Note: Administrator should provide maximum heart rate and 85% heart rate figures to candidate.) You can rest your hands on the rail but you cannot exert any pressure or press down on the handrails while stepping. Your heart rate will be monitored during entire test."

2. Have candidate try stepmill for up to one minute or until candidate says he or she feels comfortable and has the feel of stepping in the stepmill before starting test. After they have had a brief period to get acclimated, tell them to stop.

3. Read to candidate: "Are you ready?"

4. Start the stepmill program and verify that it is on Level 1.

5. Read to candidate: "Begin test." (Note: The timer should start counting from zero.)

6. Monitor heart rate continuously and observe candidate's physical condition. It is important for the administrator to:

a. Monitor heart rate continuously.

b. Observe candidate's physical condition.

c. Occasionally ask candidate, "How are you doing?"

d. Keep candidate informed on how much time remains in test.

TERMINATE TEST IF CANDIDATE DOES NOT FEEL HE/SHE CAN COMPLETE SIX MINUTES.

TERMINATE TEST IF ANY SYMPTOMS LISTED IN PRECAUTIONS OCCURS:

a. If candidate's heart rate exceeds 85% of age predicted maximum

b. Candidate is not physically qualified

c. He/she may be over stressed by test

DO NOT DISCUSS PERFORMANCE OR SCORES.

Section 2. Attachment 3. Physical Abilities Testing Manual Stepmill Test

7. At two minutes and 45 seconds, tell candidate that you are about to increase the speed of test.

8. At two minutes and 55 seconds, note and record heart rate.

9. Proceed to Level 2 on stepmill. (Note: Should be programmed to increase intensity automatically.)

10. At five minutes and 30 seconds, tell candidate: "30 seconds to go."

11. At five minutes and 50 seconds, tell candidate: "10 seconds to go."

12. At five minutes and 55 seconds, candidate should be starting her/his next to last ascent.

13. During ascent, tell candidate, "One more" and pause until he or she is starting last ascent and say: "Stop."

14. Note and record time at which candidate stopped test.

15. Note and record candidate's heart rate when test is stopped.

16. It is useful to note time of day so time between tests may be determined.

SCORING THE STEPMILL TEST

If candidate fails to complete at least five minutes of six minute test, score candidate as unqualified for any strenuous jobs. Estimates of METmax would be unreliable in this circumstance.

If candidate completes at least five minutes of six minute test, then predicted aerobic power (aerobic capacity or METmax) may be obtained.

Calculation of aerobic capacity entails using data from final stage of the Stepmill Test. A generalized equation which uses the data of a single stage (i.e. last stage in which the exercise intensity level was 7 METs) is as follows:

METmax = [HRR * 7 - 1}/(FHR - RHR)] + 1

Seven (7) = METs during Level Two (2) or second stage of test FHR = Final Heart Rate at the end of the stepping period RHR = Resting Heart Rate HRR = Heart Rate Reserve (Age Predicted HR Max - RHR) Section 2. Attachment 3. Physical Abilities Testing Manual Treadmill Test

REQUIRED EQUIPMENT

* Treadmill must be designed for commercial use, motorized, and capable of differential speed and inclination.

* Heart rate monitor with extra sensor belt

* Stopwatch

* Metronome

* Calculator

* Well-ventilated room with constant comfortable temperature

* Writing utensils

* Telephone or call button to summon emergency medical assistance with emergency number clearly posted for reference

Test protocol is as follows:

Level 1: Three minutes at three miles per hour, 2.0% incline Level 2: Three minutes at three miles per hour, 7.0% incline

TEST ADMINISTRATION

1. Read to candidate: "You will be walking on a treadmill for a period of six minutes or until your heart rate reaches 85% of your age predicted maximum, whichever comes first (Note: Administrator should provide the maximum heart rate and 85% heart rate figures to the candidate). It is important you maintain a comfortable gait. Your heart rate will be monitored during entire test."

2. Have candidate try walking on treadmill for up to one (1) minute or until candidate says he or she feels comfortable and has the feel of stepping in treadmill before starting test. After they have had a brief period to get acclimated, tell them to stop.

3. Read to candidate: "Are you ready?"

4. Start treadmill program and verify it is on Level 1.

5. Read to candidate: "Begin test." (Note: The timer should start counting from zero.)

6. Monitor heart rate continuously and observe candidate's physical condition. It is important for the administrator to:

a. Monitor heart rate continuously.

b. Observe candidate's physical condition.

c. Occasionally ask candidate, "How are you doing?"

d. Keep candidate informed on how much time remains in test

TERMINATE TEST IF CANDIDATE DOES NOT FEEL HE/SHE CAN COMPLETE SIX MINUTES.

TERMINATE TEST IF ANY SYMPTOMS LISTED IN PRECAUTIONS OCCURS:

a. If heart rate exceeds 85% of age predicted maximum

b. Candidate is not physically qualified

c. He/she may be over stressed by the test

Section 2. Attachment 3. Physical Abilities Testing Manual Treadmill Test

DO NOT DISCUSS PERFORMANCE OR SCORES.

7. Monitor pace and placement on treadmill. If candidate begins to move to back of treadmill, have him or her speed up and move to front.

8. At two minutes 45 seconds, tell candidate that you are about to increase incline of treadmill.

9. At two minutes and 45 seconds, note and record heart rate.

10. Proceed to Level 2 on treadmill. (Note: Should be programmed to increase intensity automatically.)

11. At five minutes and 30 seconds, tell candidate: "30 seconds to go."

12. At five minutes and 50 seconds, tell candidate: "10 seconds to go."

13. At five minutes and 55 seconds, tell candidate: "Five (5) seconds to go."

14. At six minutes, say: "Stop."

15. Note and record time at which candidate stopped test.

16. Note and record candidate's heart rate when test is stopped. It is useful to note time of day so time between tests may be determined.

SCORING THE TREADMILL TEST

If candidate fails to complete at least five minutes of six minute test, score candidate as unqualified for any strenuous jobs. Estimates of METmax would be unreliable in this circumstance.

If candidate completes at least five minutes of six minute test, then predicted aerobic power (aerobic capacity or METmax) may be obtained.

Calculation of aerobic capacity entails using data from final stage of treadmill test. A generalized equation which uses data of a single stage (i.e., the last stage) is as follows:

METmax = HRR [(MET Cost of Stage) - 1] + 1

FHR - RHR

MET Cost of Stage = [22.86 x (0.1 + 1.8 x G)] + 1 @ 3 mph G = % grade as a decimal fraction (e.g., 7.5% = 0.075) Note: For the recommended Treadmill Test the energy cost values are as follows:

Stage 1:4.3 METS at three (3) mph, 2.0% inclination; 6.4 METS at three (3) mph, 7.0% inclination.

FHR = Final Heart Rate at the end of the stepping period RHR = Resting Heart Rate HRR = Heart Rate Reserve (Age Predicted HR Max - RHR) NOTE: Above equation can be used for any single stage treadmill test. If multiple stage test has been administered, use final stage data to calculate the MET score Section 2. Attachment 3. Physical Abilities Testing Manual

Calculations: Estimating Resting Heart Rate*

Age and Health Condition: *If, at rest, the candidate displays a resting heart rate below the estimates listed, use the measured heart rate.

Male Female

Under 40, healthy in appearance, not estimated to be overweight, and from questioning, pursues an active lifestyle (work and/or recreation). 70 76 Under 40 and overweight or sedentary lifestyle, OR Over 40, not overweight, and active. 74 80 Over 40 and sedentary. 78 84

Estimating Maximum Heart Rate (HRmax). Maximal heart rate does not differ substantially between genders, but does decrease with age. Following chart identifies an accurate estimate of HRmax and Heart Rate to Terminate Testing.

Determining Heart Rate at Which to Terminate Testing. A submaximal aerobic capacity test should be stopped if heart rate reaches 85% of candidate's estimated maximum. A table of age and predicted maximum heart rates and level to stop the testing is presented below. Testing without a licensed physician present is considered safe only up to 85% to 90% of maximum heart rate. This value can be determined by the following equation, and should be prominently recorded on a data sheet:

Heart Rate to Terminate Aerobic Capacity Test = 0.85 x Max HR

NOTE: Heart rate to terminate test (HRtt) could be set at even lower levels in instances where there is special concern about a given candidate (i.e., older candidate, or suspected very low fitness). Some facilities may elect to take a generally more conservative approach. To a certain extent, this can be accomplished without loss of accuracy.

Age HRmax HRtt Age HRmax HRtt 21 199 169 44 184 156 22 199 169 45 183 156 23 198 168 46 183 155 24 197 168 47 182 155 25 197 167 48 181 154 26 196 167 49 181 153 27 195 166 50 180 153 28 195 165 51 179 152 29 194 165 52 179 152 30 193 164 53 178 151 31 193 164 54 177 151 32 192 163 55 177 150 33 191 163 56 176 149 34 191 162 57 175 149 35 190 161 58 175 148 36 189 161 59 174 148 37 189 160 60 173 147 38 188 160 61 173 147 39 187 159 62 172 146 40 187 159 63 171 146 41 186 158 64 171 145 42 185 157 65+ 170 144 43 185 157

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