Health Risk Report

Eliminate Musculo-skeletal Dysfunction from the Workplace

32. Teaser August 2014

John Miller conducted the Global Back Care Musculo-skeletal Health Seminar for The Group in August 2014.

18 participants (12 men and 6 women) completed the following profiles

- Health, Fitness and Wellbeing

- Musculo-skeletal Risk

- Diet

- Stress

- Career satisfaction.

The results are presented in graphic format, with commentary.

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.

On this profile a good score is a low score.

	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 low levels of fitness and 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. Reasonable 51-60. Poor - over 60.

This profile is described as poor. The average score was 66. 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.

Symptoms/ issues / concerns	No. of people scoring over 5 on the profile	% of people scoring over 5	No. of people scoring 10
Musculo-skeletal dysfunction	9	50
Overweight	9	50
Unhappy family life	8	44
Poor sleep	7	39
Snoring, sleep apnoea	6	33
Work-life balance	6	33
Lack of Energy	5	28
Irritable bowel, constipation etc	5	28
Grinding teeth	5	28
Financial status	5	28
Low level of fitness	4	22
Anxious	4	22
Under appreciated at work	4	22
Itchy, rashes, psoriasis	3	17
Caffeine	3	17
Elevated cholesterol	2	11
Alcohol intake	2	11
Depressed	2	11	1
Wrong job	2	11
Candida	1	6
Frequent colds, flu, sinus	1	6
Reflux, unsettled stomach	1	6
Shortness of breath from asthma	1	6
Elevated glucose	1	6
Headaches	0	0
Chest pain, palpitations	0	0
Mouth ulcers	0	0
Elevated blood pressure	0	0
Shakes, nervous mannerisms	0	0
Smoking	0	0

It's normal that the scores for wrong job and under-appreciated at work are about the same. This was not the case in this survey. Many more people (36%) said they were under-appreciated.

Musculo-skeletal Risk factor Profile

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 9 objective and 3 subjective assessments.

• Current musculo-skeletal condition

• Closeness to ideal weight

• leg strength

• Abdominal strength test

• Upper body strength test

• Flexibility

• Ability to sit up straight with legs crossed

• Shoulder function

• Strength training behaviour

• Flexibility 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. Over 50% of people are experiencing pain and discomfort. In a corporate setting we'd recommend that those scoring less the 5 need to be required attend a prehab/rehab program, for their own benefit and that of the organisation.	20% of people were 15Kg or more overweight.

	Leg strength was very good.	Overall, not a bad result. Only 2 people out of 18 couldn't do one situp.

	Patchy. The best predictor of risk of lower back pain is the ability to do pressups.	Good. Only 2 people couldn't touch their toes. Lower back pain goes with poor hamstring flexibility.

	Around 40% of people couldn't sit up straight with legs crossed and hands clasped behind their back, without falling over. A major cause of lower back pain is tight buttock muscles.	Shoulder function was patchy.

Its always the case, few people have a regular strength and flexibility program. The group 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 for everyone.

Average score: 60. Not particularly good. This graph show why people are experiencing pain. Too many people are not doing the things they need to do to keep their musculo-skeletal system in good shape. There is a strong case of the group to implement an obligatory strength and flexibility program for those who scored less than 60 in this profile.

Fit for Work

Scores in the Musculo-skeletal Health Risk Assessment have been used for the Fit for Work Award.

Level	Award	Pressups	Situps	Squats	Awards for 40 people
6	Gold	30	30	30	3
5	Silver	25	25	25	2
4	Bronze	20	20	20	1
3	Green	15	15	15	5
2	Amber	10	10	10	1
1	Red	<10	<10	<10	6

Pressups, situps and squats in 60 seconds

A fair standard for people to aim at would be the Bronze Award - 20 situps, 20 pressups and 20 squats. You wouldn't judge anyone who failed to reach the bronze level as being fit for work.

Recommendations

Measure risk and Manage Risk

There is an epidemic of personally-generated musculo-skeletal dysfunction in our workplaces.

Most organisations neither measure the risk nor manage it.

Their workers compensation insurer doesn't measure the risk either. They don't rate premiums against individual risk.

We recommend the Organisation take seriously and monitor carefully the incidence of personally-generated musculo-skeletal dysfunction and put in place an organisation-wide strategy to improve strength, flexibility and mobility. 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.

A high proportion of people said they would willingly agree to take part in a daily exercise program to improve their musculo-skeletal health.

A high proportion of people said they'd take part in a prehab program.

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. 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 the importance of staff keeping themselves strong and flexible.

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 obligated 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.

Prehab and rehab classes

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 - who failed to attain the bronze award - 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.

Diet profile

The diet profile is designed to assist participants to check out whether they are eating wisely and also one which has appropriate amounts of carbohydrate, protein and fat. It also looks at various eating habits, eg eating too much, eating for comfort ...

• Closeness to ideal weight?

• Do you eat a decent breakfast?

• Do you eat a high fat diet?

• Do you eat a high starch diet?

• Do you eat from the top of the Diet Hourglass?

• How much water do you during each day?

• Do you supplement your diet with essential micro-nutrients – vitamins,

minerals, essential fats (omega 3) and glyco-proteins - and

nutraceuticals - ginko, aloe vera, Echinacea ...?

• Do you eat too much?

• Are you ruled by your addictions to fat, sugar and starch?

• Does the back end of your system work like a charm?

We use the Hourglass Diet as out eating model.

The 'pass mark' for each parameter is 7/10.

Low scores are usually symptomatic of high fat, high starch, low fibre diets. The results: - people become over fat and constipated.

A good score is a high score. A poor score is a low score.


	As a group this is a better than normal result. However, on this estimation 40% were 10 or more kilos over their ideal weight.	Too many people filling themselves up on flour and sugar at breakfast time. This is due to the Kellogification of our diets. The 'fat police' have just about stripped a decent cooked breakfast out of existence.

	If you're over weight you've either got a fat guts ...	or a starch guts, or a sugar guts or a beer guts.

	The nature of our culture is that it's too easy to eat junk food.	A few people are not drinking enough water. We're too affluent - we can afford to drink coffee, fruit juice, flavoured milk and carbonated drinks to slake our thirst; every thing but water. 'Water, water every where ...' but no-one wants to drink it!

	Unless you eat the perfect diet, there is a good case for supplementing one's diet. Our food lacks vitamins minerals and essential fats.	Not only do I fail to eat from the top of the Hourglass, I also eat too much. It's hard to satisfy the inner hunger by eating.

	There's an epidemic of food addiction, particularly to chocolate, cola drinks, cake, biscuits, ice-cream ...	Back end function depends on eating less fat, flour and sugar and more fruit, vegetables and fibre. Psyllium husk works a treat.
Patchy. Total score 70. A good score. It's too easy to eat a high energy dense diet of manufactured food - particularly foods containing large amounts of fat, flour and sugar - food that comes in packets, tins, cans, bottles, cardboard boxes and plastic bags. This is a group that needs to design strategies to get more fruit, vegetables and water down their throat.

Australia is in a grip of an obesity and body system dysfunction epidemic generated by too much of the wrong food on the one hand, and too little of the right food on the other. It is my opinion that diets high in refined, cereal-based carbohydrates and sugar (the garbohydrates) are the suspects. Too few people seem to be aware that their level of body fat is affected by the amount of flour and sugar they take in each day. The high starch diet has replaced the high fat diet, with the same consequences. The garbohydrate diet stimulates insulin production which leads to fat gain, and all manner of metabolic dysfunctions.

Most people have a flour and sugar breakfast, attributed to the kelloggification of the Australian diet. You don't eat biscuits for lunch and dinner so why are you eating them for breakfast? The breakfast eating behaviour of Australians is dreadful. Few people have fruit. Even fewer have vegetables, or adequate protein and fat.

Stress Risk Profile

Participants completed a simple stress and relaxation profile designed to assist them in making an assessment of how they were affected by stress. It is based on the habits of unstressed people.

If you do what unstressed people do you are less at risk of becoming stressed. I’m yet to see someone who said they were highly stressed or depressed who got a high score on this profile. A good score is over 70.

• How would you rate your current stress level

• Do you get a good night’s sleep?

• Do you take your holidays?

• Are you keeping yourself fit and healthy?

• Is there balance in your life?

• Do you take time off at lunch time?

• How many hours a week do you work?

• Are you good at giving back to your Self?

• Do you meditate?

• Are you happy with your family (and romantic) life?

The matter of stress always needs to be addressed by organisations as part of a personal development thrust, and aimed at all staff. If stress management type programs are to be conducted, all staff need to be involved, otherwise those at most risk and those who are currently most stressed (and too wrapped up in their own busyness) will not attend.

For those who spend long hours at work, I often wonder whether the behaviour is externally or internally driven. I suspect the latter. No body on their death bed ever said 'I wish I'd spent more time at the office.'

A few people are struggling with their family life. This is another fertile area for personal development and counselling programs. It's hard to concentrate at work when your home life is in turmoil

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.

A good score is a high score. A poor score is a low score.


	This is a good result.	This is a mediocre result. 50% of the group don't sleep as well as they would like. The first casualty of anxiety and low levels of fitness is sleep. Find out the cause of the problem. Exercise more, drink less.

	A poor result. Paul Pearsal in his book Superimmunity' said you need a 21 day away from home holiday every year.	Not a good result. Too many people are not keeping themselves in the shape they'd like to be in - and which they need to be in.

	This is a reasonable result.	A poor result. Too many people don't take time off to switch off and get outside in the fresh air. This is a reflection of poor management - personal and organisational

	This is a patchy result. No one on their death bed ever said 'I wish I'd spent more time at the office.' The people working the longest hours are women with young children who have a shift before work, a shift at work, a shift after work and the graveyard shift as well.	The people who scored less than 7/10 are too busy to look after and nurture their Self.

	Very few people meditate. The reasons to do so are compelling.	Family life satisfaction is good for most people, but not for some.

Average score: 59. This is not a particularly good score. People could do more to look after their Self. I recommend that people scoring less that 50 spend time with a counsellor or life coach, or go to a personal development weekend to get themselves centred and grounded on looking after their Self - start doing the things unstressed people do to avoid becoming stressed.

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.

A good score is a high score. A poor score is a low score.


	This is a very mediocre score. 2 people don't know what they want to be when they grow up!	With 3 exceptions this is a good result.

	With 3 exceptions another good result. Work is probably about as stressful as you want it to be. Walk away. Make appointments for your Self that allow you to get on with your work unhindered by interruptions.	A poor result. Too many people not focused. For those scoring 7/10 it didn't matter.

	This is a pretty good result. Of all our profile questions, this one is usually the worst answered. In this organisation there's some extra work for managers. For staff our recommendation is always to manage up. Take your manager out for morning tea once a month and talk about yourself and your work. Get some regular feedback. Don't wait for the big one at the end of the year. If you manager doesn't have time for you, get another one!	With 1exception, these people are pretty satisfied with what they sell themselves for. If you're not happy, you're selling yourself short.

	With 1 exception, this is a very good result. Work is valued and appreciated.	With 1 exception, this is a good score. The aim is to have all staff recording a score of 7 or more.

	This is a very, very good score. People like working with each other. We rarely see scores like this.	Morale is very 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: 69. Compared with other groups, this is a good result. For the person who scored less than 70, there is the whiff of a suggestion they're not in the right job. The situation is certainly 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.'

Global Back Care is a division of Miller Health Pty Ltd

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