miller Health Occupational Health and Fitness

Index

107. CCFBMS May 2008

USEFUL LINKS

NEWSLETTER

FACT SHEETS

John Miller conducted a Health Management program for The Group in May 2008.

31 people, 7 men and 24 women participants completed the following profiles: -

■ Health, Fitness and Wellbeing

■ Musculo-skeletal risk factor profile

The results are presented in graphic format, with commentary.

Click here to read what the assessments are all about

HEALTH, FITNESS AND WELLBEING PROFILE

The Health, Fitness and Wellbeing profile provides people with a very good idea of how well the various systems of the body are functioning, particularly the

• the mind

• autonomic nervous system

• immune system

• digestive system

• circulatory system

• elimination system

• musculo-skeletal system.

	Symptom	None		Not much			A fair bit			A lot
1.	Headaches including migraines	0	1	2	3	4	5	6	7	8	9	10
2.	Lack of energy and vitality	0	1	2	3	4	5	6	7	8	9	10
3.	Candida - jock itch, thrush, tinea ...	0	1	2	3	4	5	6	7	8	9	10
4.	Poor sleep. If on tablets score 10	0	1	2	3	4	5	6	7	8	9	10
5.	Snoring &/or sleep apnoea. Score 10 if using a mask	0	1	2	3	4	5	6	7	8	9	10
6.	Crook back, stiff neck, sore shoulders, dicky knee RSI ...	0	1	2	3	4	5	6	7	8	9	10
7.	Frequent colds, flu, sinus	0	1	2	3	4	5	6	7	8	9	10
8.	Unsettled stomach, reflux (Score 10 if on medication)	0	1	2	3	4	5	6	7	8	9	10
9.	Overweight - 1 point for every 2Kg	0	1	2	3	4	5	6	7	8	9	10
10.	Irritable bowel, constipation	0	1	2	3	4	5	6	7	8	9	10
11.	Asthma	0	1	2	3	4	5	6	7	8	9	10
12.	Low level of aerobic fitness	0	1	2	3	4	5	6	7	8	9	10
13.	Chest pain, palpitations	0	1	2	3	4	5	6	7	8	9	10
14.	Rashes, itchiness, skin outbreaks, psoriasis ...	0	1	2	3	4	5	6	7	8	9	10
15.	Mouth ulcers, cold sores	0	1	2	3	4	5	6	7	8	9	10
16.	Elevated blood pressure. Score 0 on pills	0	1	2	3	4	5	6	7	8	9	10
17.	Elevated blood cholesterol. Score o if on pills	0	1	2	3	4	5	6	7	8	9	10
18.	Elevated blood glucose. Score 0 if on medication	0	1	2	3	4	5	6	7	8	9	10
19.	Shakes, nervous ticks, mannerisms	0	1	2	3	4	5	6	7	8	9	10
20.	Grinding teeth	0	1	2	3	4	5	6	7	8	9	10
21.	Alcoholic drinks per day (2 pts/drink)	0	1	2	3	4	5	6	7	8	9	10
22.	Smoking. (1 pt/cigarette/day)	0	1	2	3	4	5	6	7	8	9	10
23.	Caffeine (1 pt/cup per day)	0	1	2	3	4	5	6	7	8	9	10
24.	Anxious about life, insecure, apprehensive	0	1	2	3	4	5	6	7	8	9	10
25.	Sad or depressed (On medication, score 0)	0	1	2	3	4	5	6	7	8	9	10
26.	In wrong job for now	0	1	2	3	4	5	6	7	8	9	10
27.	Under-appreciated at work	0	1	2	3	4	5	6	7	8	9	10
28.	Have poor work/life balance	0	1	2	3	4	5	6	7	8	9	10
29.	Unhappy with family life	0	1	2	3	4	5	6	7	8	9	10
30.	Unhappy with financial status	0	1	2	3	4	5	6	7	8	9	10

Score

The score of a normal, fit and healthy human being is less than 20

Higher scores are symptomatic of dysfunction of one or more body systems.

People with high levels of stress usually score well over 100.

For people with a score of more than 80, the ‘background noise’ of their life is becoming louder and louder. It is hard to concentrate on your work when body systems are dysfunctional.

We know a fit and healthy group when we see the majority of scores below 40. This was not the case with this group. By and large higher scores are usually a reflection of

• low levels of fitness

• an inability to deal with what life and work are serving up to people.

Remember, it is not what happens, but how we deal with what happens that determines our level of stress.

Classification of average scores: Excellent - less than 40. Good - 41 - 50. Fair 51-60. Poor - over 60.

This profile is described as poor. The average score was 65. Anyone scoring more than 80 is putting up with a lot of 'background noise'. Whilst I've rated the score as 'poor' we see many average scores that are more than 80. The pleasing aspect that there are no scores over 100.

HEALTH CLIMATE SURVEY

Based on scores received in the Health, Fitness and Wellbeing profile we've compiled a Health Climate Survey. Scores on each item have ranked - the higher the score the worse the problem. We added the scores for each item. The results appear in the table below.

Symptoms/ issues / concerns	% of people scoring over 5
Crook back, sore shoulders	83
Low level of fitness	57
Lack of Energy	47
Poor sleep	43
Anxious	33
Reflux, unsettled stomach	30
Under appreciated at work	30
Headaches	27
Irritable bowel, constipation etc	27
Work-life balance	27
Overweight	23
Caffeine	23
Wrong job	23
Grinding teeth	20
Snoring, sleep apnoea	17
Depressed	17	2
Frequent colds, flu, sinus	13
Elevated cholesterol	13
Shortness of breath from asthma	10
Itchy, rashes, psoriasis	10
Unhappy family life	10
Chest pain, palpitations	7
Elevated glucose	7
Shakes, nervous mannerisms	7
Alcohol	7
Financial status	3
Furry tongue, thrush, tinea,	0
Mouth ulcers	0
Elevated blood pressure	0	0
Smoking	0	0

We registered those scores of 5 and over as being a symptom, issue or concern, the most pressing of which have been highlighted.

Perception

Based on people's perception (where they gave a particular symptom a score of 5 or more, and backed up by objective scores) the key issues are

•	Obesity 23% of people said they were more than 10Kg over weight. It's a symptom of metabolic dysfunction and relates to high energy diets and low energy lifestyles. It's suggestive of elevated levels of insulin floating around the body, which is a precursor of all manner of body system dysfunctions - elevated blood pressure, elevated cholesterol, elevated blood glucose. The recommendation, 23% of people need to get out and exercise at lunch time and eat from the top of the Hourglass.

•	Lack of energy Low levels of energy come from many sources, including: - - lack of a good aerobic fitness training program - a diet high in wheat flour and sugar - dullness - ...

•	Fitness 57% of participants indicated they weren't particularly fit. We recommend staff be given the greatest encouragement to leave the office at lunch time and get in some physical activity. One organisation we work for gives staff an hour and a half off for lunch, providing people exercise during that time. Fitness has a significant bearing on the scores for low levels of energy, poor sleep, snoring, depression and headaches.

•	Musculo-skeletal dysfunction 83% of staff were concerned about their musculo-skeletal dysfunctions. Musculo-skeletal dysfunction goes with low levels of strength and flexibility. Those are greatest risk need encouragement to attend a strength and flexibility training program several times a week.

•	Rashes and itchiness Can be caused by a range of things: - - a body that's stressed producing too much cortisol - a toxic diet - a sluggish elimination system - itching to get away from something - ...

•	Headaches Caused by - a diet high in wheat flour and sugar - caffeine withdrawal - lack of oxygen getting to the head - a sluggish elimination system - a head out of alignment due to tight and weak muscles - beating your head against a brick wall - ...

•	Colds and flu Symptom of a depressed immune system, one which can be strengthened by eating from the top of the Hourglass and getting plenty of aerobic exercise.

•	Under-appreciation at work 30% of people said they were under-appreciated at work. This is a course for concern and managers need to take note and put in train a series of measures to improve this score in say, 3 months time. This factor certainly needs addressing in more detail and re-evaluation.

•	Being in the wrong job There is a high and positive correlation between people being in the wrong job and people saying they are under-appreciated at work. There is evidence that a career development program may be needed in this workplace and/or people given strong encouragement to have a few sessions with the employee assistance program people - or me!

•	Diet A diet high in flour and sugar and low in fruit, vegetables and fibre leads to irritable and bowel, reflux.

	Depression and anxiety There is an epidemic of depression in our community and we encourage all organisations to target depression. 17% gave themselves a score higher than 5 on the depression question, indicating risk that needs to be dealt with. 2 people were on anti-depressant medication. There is an epidemic of depression in our community. This epidemic relates to poor health general and will, of course increase at the same rate as the epidemic of all other body system dysfunctions. The mind is just another part of the human ecosystem - an ecosystem under threat from low levels of health, fitness and wellbeing. It is important that people who are depressed or a risk of becoming depressed be encouraged to have regular counseling - through the EAP or other counselors - and be given encouragement to do the things that unstressed people. In particular it means encouraging people to exercise at lunch time. It means taking their holidays, eating wisely, not working too many hours and ‘getting a life’. Stress, anxiety and depression can be a a high price to pay for achievement. As the population becomes less physically active, eats diets high in flour and sugar and low in omega 3 fats, selenium and B group vitamins, lacks resilience, drinks too much alcohol and caffeine, has difficulty managing the internal and external conversations going on inside their head and/or live lives devoid of meaning and purpose, we can expect rates of anxiety and depression to increase. Whilst not wishing to make light of the true ‘black dog’ of clinical depression, for some people the symptoms of stress, unhappiness, sadness, grief, hopelessness, disappointment, despair, vacuity, anger and anxiety are being treated as if they were the symptoms of clinical depression. The best book about depression I've read, and what you can do about it, and one that I recommend highly is by psychiatrist, David Servan-Schreiber, Healing Without Freud or Prozac.

	Blood pressure nobody was on medication. Blood pressure is a symptom of body system dysfunction relating directly to - lack of aerobic fitness - being over weight - being stressed.

	Smoking Nobody smoked. This is a great result.

MUSCULO-SKELETAL RISK FACTOR

Our musculo-skeletal risk factor profile looked at a range of parameters including mobility, strength and flexibility and whether people are training to keep themselves strong and flexible.

The musculo-skeletal risk factor profile is comprised of a mix of 7 objective and 3 subjective assessments.

• Current musculo-skeletal condition

• Abdominal strength test

• Upper body strength test

• Flexibility

• Functional mobility – the ability to sit down and stand up with ease.

• Shoulder function

• Dominant hand grip

• Non-dominant hand grip

• Flexibility training behaviour

• Strength training behaviour

A score of 70% is attainable by those who have a regular and systematic training program.

Those scoring less than 70 are not doing sufficient in the way of strength and flexibility exercises. They are therefore exposing themselves to a high risk of musculo-skeletal dysfunction. (It would be bizarre for a workplace to offer to pay the rehabilitation costs of people who were not keeping themselves strong enough or flexible enough to do their job without succumbing to musculo-skeletal dysfunction, wouldn't it?)

This risk to The Organisation is much higher than the risk we see in other organisations. This is a poor result.


A poor result. It's good that people came to the session. Those scoring less the 6 need to obligate themselves to attend a prehab/rehab program, twice a week.		Despite some people declaring they were 10 or more Kg overweight in the health climate survey, just about everyone in this assessment said they were in pretty good shape.

With a few exceptions this is a good set of scores. On the whole, leg strength was good.		This is a poor result. It's one of the explanations for the high degree of musculo-skeletal dysfunction in the group. They lack the abdominal strength needed to keep their vertebrae in alignment.

This is not a good results. Poor arm, shoulder and upper back strength is a precursor of shoulder and arm pain.		This is a poor result. 6 people couldn't touch their toes at all. Too many people already have tight muscles along the back side of their body - calves, hamstrings, buttock and back. It's caused by two things - sitting down and not having a flexibility program. There is a high risk of lower back and neck dysfunction.

A mediocre result. People scoring less than 7 have a mobility problem.		A mediocre result. People need to loosen off those muscles that prevent them from standing up straight and increase shoulder strength and flexibility.

Its always the case, few people have a regular strength and flexibility program. The organisation needs to put in train a regular and systematic training program, on site, that includes 1. specialist prehab and rehab sessions for those at serious risk and those already dysfunctional and on compo 2. daily strength and flexibility sessions in the workplace. This means access to the organisations gym for all staff.

Average score: 53. Not good. People are not in particularly good musculo-skeletal condition. Low levels of strength and flexibility. There is a strong case of the organisation to implement an obligatory strength and flexibility program for those who scored less than 60 in this profile.

Lack of strength and flexibility is something that the Organisation needs to take seriously and monitor carefully and put in place an organisation-wide strategy to improve musculo-skeletal function. By far and away a high proportion of people do not have a strength and flexibility program. As a result they are getting weaker and tighter by the week, thereby exposing themselves and the organisation to risk.

When push comes to shove and people become dysfunctional, it will be The Organisation that ends up paying the high cost of an avoidable musculo-skeletal complaint. Click here to read the article from injury to dysfunction. Click here to read about swifties and fallacies.

In our opinion musculo-skeletal dysfunction caused by lack of a regular and systematic strength and flexibility program cannot be classified as an injury. Responsibility for musculo-skeletal dysfunction needs to be sheeted home to individual employees, though it’s unlikely to happen without the establishment of a culture within the organisation that supports, values and understands strength and flexibility.

We recommend a range of strength and flexibility classes that are readily available Australia-wide:

•	Posture and Flexibility
•	Yoga
•	CrookBack Clinic
•	Tai Chi
•	Pontius Pilates

The Organisation would place itself in the forefront of OH&S practice if it took the musculo-skeletal risk seriously, moved heaven and earth to educate all staff about this risk and encourage them to take part in a regular strength and flexibility program. Maybe The Organisation and its worker's compensation insurer could invest in a pilot program to increase staff strength and flexibility!

RECOMMENDATION

We strongly recommend that the people who are in current poor musculo-skeletal condition, and who lack abdominal strength, upper body strength, flexibility, shoulder function and functional mobility, in particular those who scored less than 60 on the profile, be obligated to attend regular, in-house strength and flexibility classes.

The pressure on the organisation's workers' compensation costs is such that to do otherwise would, in our opinion be to abrogate a responsibility for the prudent management of the organisation's finances.