miller Health Occupational Health and Fitness

Index

TSAOBR AUGUST 2010 - DRAFT REPORT

USEFUL LINKS

NEWSLETTER

FACT SHEETS

John Miller conducted a Health Management program for The Group in August 2010.

40 people, 39 men and 1 woman completed the following profiles: -

■ Health, Fitness and Wellbeing

■ Fitness

■ Musculo-skeletal risk

■ Career Satisfaction

■ Metabolic health

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 fair. The average score was 61. Anyone scoring more than 80 is putting up with a lot of 'background noise'.

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.

Issues/symptoms/concerns	% of people scoring over 5	Number scoring 10
Overweight	77	22
Low level of fitness	64
Elevated blood pressure	56	17
Crook back, sore shoulders	41
Snoring, sleep apnoea	31
Alcohol	31
Anxious	28
Elevated glucose	26	8
Under appreciated at work	26
Elevated cholesterol	23
Smoking	23
Reflux, unsettled stomach	21
Caffeine	21
Poor sleep	15
Itchy, rashes, psoriasis	13
Lack of Energy	10
Frequent colds, flu, sinus	10
Shortness of breath from asthma	10
Depressed	10	2
Financial status	8
Irritable bowel, constipation etc	5
Wrong job	5
Unhappy family life	5
Chest pain, palpitations	3
Headaches	0
Candida	0
Mouth ulcers	0
Shakes, nervous mannerisms	0
Grinding teeth	0
Work-life balance	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 77% of people said they were more than 10Kg over weight. 55% were more than 20Kg over weight. It's a symptom of metabolic dysfunction and relates to high energy diets and low energy lifestyles. These are people cooped up in cages all day with little room to move. They are people in jobs which encourage motion starvation. Obesity is 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. This is the result of the flour and sugar culture, people who following this series of assessments are now aware of the meals they can eat which will satisfy their hunger but not fatten them up. The recommendation, that people need to get more exercise, eat from the top of the Hourglass and lay off the grog. For people in camps, the great challenge for the cooks is to satisfy peoples without fattening them up. The recipe for this dietary regime is to prepare protein with vegetables for most meals. The more bread, pasta, scones and cake people eat the higher the likelihood they will become fatter. Reducing bread and alcohol in take would make a big difference to people's waist lines. The other thing cooks need to be aware of is not overloading plates. The cooks have an important role to play in reducing calorie intake and educating their customers on how to eat wisely. Mixed frozen vegetables with meat, fish, chicken and egg would be ideal. The opportunity to provide a cooked breakfast based on this formula would be a good thing. A breakfast high in flour and sugar stimulates insulin production leading over the years and decades to metabolic dysfunction - the symptoms of which are high blood pressure, obesity and diabetes.

	Fitness 64% said they were unfit. We recommend staff be given the greatest encouragement to engage in some physical activity before work. Fitness has a significant bearing on the scores for low levels of energy, poor sleep, snoring, depression and headaches.

	Blood pressure 56% of people indicated they had elevated blood pressure. 18 people (45%) were on blood pressure medication. This is not a fit and healthy group. High blood pressure is not caused by a lack of Avpro. Blood pressure is a symptom of body system dysfunction relating directly to - lack of aerobic fitness - being over weight - being stressed.

	Musculo-skeletal dysfunction 41% of people said they had some sort of musculo-skeletal dysfunction. Musculo-skeletal dysfunction goes with low levels of strength and flexibility. Most of it is personally generated. All staff need to be involved in a daily, 10 minute strength and flexibility work out in work time.

	Snoring 31% of people said they snored loudly enough for it to be a problem. The recipe for a good snore is to be male, be unfit and at least 20Kg over weight, to have high blood pressure, have a few drinks every night, be stressed out of their brain and sleep on their back.

	Alcohol intake 31% indicated a higher than acceptable level of alcohol consumption. I don't agree with the medical charities that you should have a drink every night. The people who score lowest in the Health, Fitness and Wellbeing profile only have a couple of drinks a week, if that. The problem with alcohol is that will power dissolves in it. Once you've had one, you're more likely to have another, and another ... Then out come the chips and cashews, finishing off with a couple rounds of Tim Tams.

	Depression and anxiety 28% of people indicated they were anxious. 10% gave themselves a score of 5 or more in answer to the question 'Are you depressed'. 2 people were on anti-depressant medication. These are very low scores compared with what we normally see. Having said that, there is an epidemic of depression in our community and we encourage all organisations to target depression. There is a significant core of depression that relates to poor health generally. All body systems are connected. The epidemic of depression will continue to escalate at the same rate as the epidemic of all other body system dysfunctions. People need to be given encouragement to exercise regularly and vigorous, eat less flour and sugar and imbibe less of the culturally chemicals - particularly nicotine, caffeine and alcohol. Because of the relationship of depression to fitness and diet there is a chance that some people have been misdiagnosed. Some aspects of depression relate to psychologically generated issues. It is important that these people be encouraged to have regular counselling - through the EAP or other counsellors - 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.

	Type 2 diabetes 26% had elevated blood glucose readings. 8 people were on diabetes medication. We found one person who had a blood glucose level of 20mmol/Lt, who didn't know he was diabetic and was not on medication. By and large type 2 diabetes is a fitness problem caused by a lack of regular, vigorous physical activity, a high flour and sugar diet and obesity.

	Under-appreciation at work 26% said they were under-appreciated at work. This is a poor result. Managers and staff need to have a big think about what can be done to improve this score

	Being in the wrong job Only 5% of people said they were in the wrong job. There is usually a high and positive correlation between people being in the wrong job and people saying they are under-appreciated at work. In this case this rule did not applied. By far and away these people are in the right job. They are a real asset to the organisation.

	Smoking 23% of people smoked. This is slightly above the community average of around 18%. Now lets move heaven and earth to assist these people to give it away altogether.

	Reflux 21% of people suffered from reflux. If you eat too much of the wrong food you get reflux.

	Caffeine Intake 21% indicated they had too high a caffeine intake.

FITNESS

The fitness profile is comprised of a mix of 10 objective and subjective assessments.

• Are you keeping yourself fit and healthy to the best of your ability?

• What was your score on the Health, Fitness and Wellbeing profile?

• Are you about your ideal weight?

• Leg strength

• Abdominal strength test

• Upper body strength test

• Flexibility test

• Mobility test

• Aerobic fitness

• Level of energy and vitality.

A reasonable score is over 70%.

Those receiving less than 70 are not training with sufficient vigour or intensity on a regular and systematic basis to keep themselves fit and healthy.


Too many people confess to not keeping themselves as fit and healthy as they would like.		As a group, the Health, Fitness and Wellbeing Profile scores were patchy.

As a group this is a poor result. However, on this estimation 80% were 10 or more kilos over their ideal weight. Being overweight greatly compromises mobility.		With 5 exceptions a very good score.

A poor result. Most of the participants failed the test by being unable to complete 17 situps in 30 seconds.		A poor result. Most people are lacking in upper body and arm strength

14 people couldn't touch their toes. A poor result which leads to back, neck and shoulder dysfunction.		A poor result. Too many people had trouble getting down onto the floor and back up again.

A poor result. It's the sort of test though where every one should be able to get to 40 laps in 5 minutes. Most were scratching to get 25. One person just got to 10 laps in 5 minutes.		A fair result.

Overall the fitness scores was 46. As a group overall fitness - aerobic fitness, strength and flexibility was poor. All except 4 people failed the test.

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

• Closeness to ideal weight

• Leg strength

• Abdominal strength test

• Upper body strength test

• Flexibility

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

• Shoulder function

• 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?)


Not a particularly good result. Nearly 50% of people have some serious musculo-skeletal issues. They are experiencing some pain and discomfort. Those scoring less the 6 need to be required attend a prehab/rehab program, for their own benefit and that of the organisation. We rate the organisation's risk as HIGH.		As a group this is a poor result.

Good result.		A poor result. Most people can't do 1 sit up.

A poor result. 7 people couldn't do 1 pressup. Most people couldn't do 10.		10 people couldn't touch their toes. A poor result which leads to back, neck and shoulder dysfunction.

A poor result.		Patchy.

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. 2. daily 10 minute strength and flexibility sessions for all staff.

Average score: 40. A poor result. This is a group waiting musculo-skeletal pain to land on them. The risk of musculo-skeletal dysfunction is high due to low levels of strength and flexibility. There is a strong case for 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 the 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 and 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!

The lack of strength and flexibility training coupled with poor abdominal strength, upper body strength, flexibility and shoulder function is a cause for concern and needs the attention of individual staff and managers.

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.

CAREER SATISFACTION PROFILE

The parameters in the profile relate to a mix of factors influences by the participant, management and their colleagues.

• How close are you to doing the job you’d really like to be doing?

• Are you in the right job for now?

• Is work giving you life or sucking life out of you?

• Are you focused on your career options?

• Do you get good feedback from your manager?

• Do you receive an appropriate financial reward?

• Do you feel you and your work are valued and appreciated?

• Do you work for an organisation that cares about people?

• Do you enjoy the company of the people you work with?

• What’s the level of morale like in your work group?

Normally, when results on the overall career profile are less than 70/100, people agree that they’re not in the right job. Certainly those scoring less than 60 have sufficient issues relating to career management as to seriously consider going somewhere else.

SCORING GUIDELINES

Excellent, scoring 8 or more

Good, scoring 7 or more

Fair, scoring 5 or 6

Poor, scoring less than 5

‘Pass mark’ on all parameters 7/10.


	This is a very good score. These people love their jobs.	This is an excellent result. I don't think I've seen one better. These people are doing the job they love doing. Many don't want to stop.

	These people don't find work stressful.	For those who scored 7/10 it didn't matter.

	This is a patchy result. Too many people gave their manager a score of less than 7. That's not good. Of all our profile questions, this one is usually the worst answered. In this organisation there's some extra work for managers. Too many people ware nb0ot getting regular feedback from their manager. Many hardly ever see their manager.	With a few exceptions, these people are pretty satisfied with what they sell themselves for.

	This is a patchy result. 50% of people believe their work could be better valued and appreciated.	Patchy. The aim is to have all staff recording a score of 7 or more. There is work to do here.

	This is a good score. In the main, people like working with each other. We rarely see scores like this.	Morale is pretty good. It's generally the case that our morale is good when my morale is good. The exceptions need to be dealt with.

Average score: 80. This is an excellent result. Rarely do we see a score this high. Most people are definitely in the right job. For those scoring less than 60, there is a strong suggestion they're not in the right job. The situation may be redeemable.

The Buddha and Confucius both said 'Find the job you'd love to do and you don't have to do another days work in your life.'

METABOLIC HEALTH PROFILE

The parameters in the profile relate to a mix of factors influencing metabolic health.

• Age - does weary some - particularly those who don't train

• Closeness to ideal weight

• Aerobic fitness

• Aerobic fitness training program

• Blood glucose level

• Cholesterol level

• Systolic blood pressure

• Diastolic blood pressure?

• Smoking behaviour

• Score on health, fitness and wellbeing profile