Anglian Water Services employs 3,800 staff, providing water and waste water services to about six million industrial, commercial and domestic customers. Half of its employees are field-based, many in physically demanding, manual roles.
Since 1998, the average age of the workforce has increased by 10 years and the proportion of employees over the age of 40 has risen from 44% to 50%. Current indications suggest that the normal retirement age may increase in the next 25 years, placing greater emphasis on employees being fit, particularly for manual work. These demographic changes, together with age discrimination legislation, will require employers to address the need to retain older workers in suitable occupations.
The manual manual
Anglian Water has invested in trying to engineer manual handling hazards out of existing work tasks. All staff attend a job-specific manual handling course about how to approach specific tasks, and they must also attend refresher courses every two years.
Instead of rolling out the same course every time, the company was keen to provide training that employees would enjoy, benefit and learn from.
The occupational health (OH) department was concerned that research showed people must maintain their fitness, strength and flexibility, or become more vulnerable to injury as they age. Evidence showed that younger employees were less fit than is often presumed, so the whole workforce could benefit from an alternative approach to manual handling.
The OH team decided to assess employees’ susceptibility to musculoskeletal injury, and developed the Fit for the Future programme. While the full manual handling training is given to new employees at induction, to comply with the Manual Handling Operations Regulation 1992 requirements, Fit for the Future has now replaced the ongoing manual handling training.
Anglian Water was already focusing on workability (what employees can do), not disability (what they can’t do), through objective assessment. Fit for the Future is a stepped programme for all operational staff to facilitate behaviour change towards taking regular exercise to maintain fitness and increase wellbeing.
The programme forms part of Anglian Water’s OH and safety management system. Programme objectives are:
To educate the workforce about the importance of overall physical fitness and the benefits of maintaining physical fitness with age
To introduce simple objective measures of physical fitness for employees that can be easily understood by all, and which form a common understanding of the elements of fitness and a common standard of fitness for all to strive to achieve
To provide education and support to those falling short of the fitness standard to change their behaviour and help them develop strategies to improve their fitness To provide specific programmes for those with identified fitness problems to facilitate improvement in their health.
The OH department worked with RehabWorks, an external training provider, to write course material and deliver the programme.
Before beginning the programme attendees are offered an induction on how it links to the existing manual handling programme. This is followed by a three-hour session educating staff about how their physical fitness will naturally deteriorate with age, and the importance of physical fitness and the benefits of maintaining physical fitness as they age.
The training sessions also include education on general health and the impact obesity can have on an employee’s health and fitness.
The session includes an hour-long fitness test and provides information about appropriate exercises to address any fitness, strength, flexibility and core stability issues. The process also identifies those with significant fitness problems, and these individuals are offered either a further training session or an assessment with a physiotherapist or a medical referral, whichever is the most appropriate.
Up to 12 delegates attend each of the sessions, with RehabWorks providing the course material and equipment. RehabWorks informs Anglian Water of delegates requiring booking on to step two of the programme, or if further intervention is required.
Up to 10 employees attend the three-hour training session to repeat tests to see whether fitness has improved following the initial education programme. During this session, employees identify reasons why they may not maintain their physical fitness, and how they can alter their lifestyles to incorporate various types of exercise to improve all areas of their fitness.
The course also incorporates employees’ approaches to their general wellbeing, including diet and mental wellbeing. These points are then further explored with the individual to try to overcome barriers in the future. A personal action plan and goals for improvement are then constructed.
This is undertaken for all employees at the biannual repeat Fit for the Future training sessions.
Fit for the future scoring
The scores from the 10 practical tests are added together. Employees with a score of 15 or above are invited to the second session.
As updating employees on manual handling is a regulatory requirement, most of the resources were already in place. Fit for the Future was altered to provide a more rounded, comprehensive long-term fitness opportunity for employees.
The OH manager attended and undertook presentations at appropriate company meetings around the region before the start of the Fit for the Future programme.
Communication and dialogue
Each employee is provided with their own training manual which includes information about the course as well as the physical tests and the scoring and exercises that will improve fitness. Because all the information is available to employees they can assess themselves at any time to see if their fitness programme is making a difference. The tests will also be undertaken at the employee biannual training.
During the launch of the programme, all internal communication channels were exploited to inform staff of the new programme. These communications included cascade briefings, presentations to senior managers via the key communicators forum and various business bulletins in the company magazine and on the intranet site.
Physical fitness declines with age. This is partly genetic and partly because as people get older, many become less active. Older people who exercise regularly tend to be fitter, stronger, more self-confident, and enjoy improved general health and the physical energy to work more productively.
Research has shown that muscle strength, heart and lung functions and, to some extent, mental capacity decline with age, but these changes can be compensated for by modifying working conditions and maintaining the physical fitness of the worker.
Evidence from the pilot study showed that the programme worked and improved the fitness of the workforce. Although the programme was originally developed for the ageing workforce it is just as useful for younger employees.
Because of the lifestyle of many youngsters, their fitness levels are not comparable to a young person 30 years ago. This, in turn, means that they are less fit and are more likely to cause serious damage to their wellbeing at a much earlier age. For this reason, all employees whose jobs involve manual handling are put through the course, regardless of their age.
The pilot study clearly signalled the credibility of the programme. As summarised below, there was a marked improvement in fitness levels of those who were particularly vulnerable.
The Fit for the Future programme is based on sound research on ageing by Wolinsky et al, who examined the benefits of physical activity and exercise. Results indicated that the major factors associated with higher activity levels in older people were: better perceived health, no worries about health conditions, fewer body limitations and a real sense of control over health issues. Contrary to popular conception, the type and intensity of exercise are not the key determinant of improved health.
There are four types of exercises required to maintain fitness, and these form the basis of the Fit for the Future programme.
Endurance activities are activities that increase breathing and heart rate. They improve the health of the heart, lungs and circulatory system. Without regular exercise there is a 1% reduction in VO2 Maximum (a measure of aerobic fitness) annually. Endurance improves stamina for work and lifestyle tasks. It may also delay or prevent diseases associated with ageing such as diabetes, colon cancer, heart disease and stroke.
Strength exercises build or maintain muscles. There is evidence that strength declines by 10% per decade after the age of 30 unless regular exercise is performed. Strength exercises increase metabolism, helping to keep weight and blood sugar in check. This is therefore preventative for obesity and diabetes. Weight-bearing strength exercises are important in the prevention of osteoporosis.
Balance exercise helps prevent falls which are a major cause of broken wrists and hips leading to premature disability and loss of independence.
Flexibility exercises maintain range of motion and the ability to move joints easily. Putting joints through a full range of motion helps prevent degenerative arthritis by maintaining a high level of nutrition to the joint surfaces.
In addition, poor posture is directly associated with poor levels of fitness. Poor posture causes stiffness of the spinal, hip and shoulder joints. It causes weakness of selective muscle groups leading to muscle imbalance. It causes compression of internal organs and can attribute to respiratory and digestive complaints, and is a factor in stress-related conditions.
Here are some individuals’ reports about changes following their participation in the Fit for the Future programme:
Body weight: loss of 19 kgs
Diet change: from high fat to healthy low GI diet – for the benefit of the family
Fitness activities for the family: Norwich football club season ticket exchanged for family gym membership
Purchase of home gym installed in garage
Increased activity: circuit training, walking and cycling
Using Fit for the Future handbook to have fun with the grandchildren.
Feedback from Wave 2: Suggestions for improvements from participants
Excellent – would love to do it again
Would like to keep coming back to be monitored every 6-9 months
More information about correct-sized portions of food
Other health measures: blood pressure, body mass index and weight
Regular courses and advice on joint problems and appropriate exercise regimes.
Sonja Schwartz is OHN adviser at Anglian Water Services.
Back performance scale (BPS) for the assessment of mobility related activities in back pain
Strand L, Moe Nilssen R, Physical Therapy 2002, vol. 82, no12, pp. 1213-1223
Assessing flexibility and strength in industrial workers HD Saunders 1995
Kilne, G., et al Estimation of VO2 max from a one mile track walk, gender, age and body weight. Med Sci. Sports Exerc., 19:253, 1987
Wolinsky, FD; Stump, TE; and Clark, DO. Antecedents and consequences of physical activity and exercise among older adults The Gerontologist, Vol 35, Issue 4 451-462