firefighter normal pension age€¦ · continue serving another five years . new firefighter...
TRANSCRIPT
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Firefighter Normal Pension Age
Dr Tony Williams
Consultant Occupational Physician
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• Picture of document
Normal Pension Age for Firefighters
A review for the Firefighters’ Pension
Committee
December 2012
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Firefighter strike 2002
• More retired firefighters on ill-health pensions than ordinary pensions
• Resulted in major changes to terms and conditions of service, including new 2006 pension scheme
• Changed retirement age from 55 to 60
• Never considered whether firefighters could continue serving another five years
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New Firefighter Pension Scheme
• Previous review by Haisman in 1996 concluded:
– no need to change from 55
– firefighters were no fitter than general population and would have increasing difficulty achieving fitness standard
– more might succumb to chronic disease
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Hutton Report 2010
• Recommended that NPA for 2006 Firefighters Pension Scheme should be benchmark for all Uniformed Services Schemes
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How to decide if 60 is too old?
• Fitness
– How fit do firefighters have to be?
– How do we measure this fitness?
• Health
– When will firefighters develop chronic disease?
– How many will develop chronic disease during service?
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Review Group
• Occupational physiologists (Optimal Performance Ltd)
• Firefit rep (access to data)
• Employer rep
• Employee rep
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Fitness
• The ability to do the job at the pace required.
• The ability to get oxygen in the air to the muscles.
– VO2max, maximum volume of oxygen taken up in one minute per kilogram body mass.
• Need to define job and pace required.
– 2004 study identified roles and requirements.
– 2013/4 study will define pace required and recommend fitness requirement and tests.
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What standard?
• Prof Kevin Sykes, Chester, recommended VO2max of 42mlO2 kg-1 min-1
• Accepted as the standard for the review, but not endorsedVO2max of 42mlO2 kg-1 min-1
• VO2max of 42mlO2 kg-1 min-1 equivalent to 12 MET
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Standardised operational testing
Photos courtesy of South Wales FRS
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VO2max testing
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Chester Step Test
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Shuttle Run Test
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Allied Dunbar National Fitness Survey
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Aerobic fitness norms - Men
Age /
Years
Very low
3%
Low
8%
Fair
22%
Mod
34%
Good
22%
Very
good
8%
Elite
3%
20-24 < 32 32-37 38-43 44-50 51-56 57-62 > 62
25-29 < 31 31-35 36-42 43-48 49-53 54-59 > 59
30-34 < 29 29-34 35-40 41-45 46-51 52-56 > 56
35-39 < 28 28-32 33-38 39-43 44-48 49-54 > 54
40-44 < 26 26-31 32-35 36-41 42-46 47-51 > 51
45-49 < 25 25-29 30-34 35-39 40-43 44-48 > 48
50-54 < 24 24-27 28-32 33-36 37-41 42-46 > 46
55-59 < 22 22-26 27-30 31-34 35-39 40-43 > 43
60-65 < 21 21-24 25-28 29-32 33-36 37-40 > 40
Shvartz E, Reibold RC. Aerobic fitness norms for males and females aged 6 to
75 years: a review. Aviat Space Environ Med; 61:3-11, 1990
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Aerobic fitness norms - Women
Age /
Years
Very low
3%
Low
8%
Fair
22%
Mod
34%
Good
22%
Very
good
8%
Elite
3%
20-24 < 27 27-31 32-36 37-41 42-46 47-51 > 51
25-29 < 26 26-30 31-35 36-40 41-44 45-49 > 49
30-34 < 25 25-29 30-33 34-37 38-42 43-46 > 46
35-39 < 24 24-27 28-31 32-35 36-40 41-44 > 44
40-44 < 22 22-25 26-29 30-33 34-37 38-41 > 41
45-49 < 21 21-23 24-27 28-31 32-35 36-38 > 38
50-54 < 19 19-22 23-25 26-29 30-32 33-36 > 36
55-59 < 18 18-20 21-23 24-27 28-30 31-33 > 33
60-65 < 16 16-18 19-21 22-24 25-27 28-30 > 30
Shvartz E, Reibold RC. Aerobic fitness norms for males and females aged 6 to
75 years: a review. Aviat Space Environ Med; 61:3-11, 1990
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Jackson et al 2009
Women
Men
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Mean (+/-SD) VO2max from four UK FRS
0
10
20
30
40
50
60
70
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64
VO
2m
ax
(m
L∙k
g-1
∙min
-1)
Age (Years)
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Mean VO2max for UK FRS assuming lifestyle factors maintained/typical population decline
24
26
28
30
32
34
36
38
40
42
44
46
48
50
10 20 30 40 50 60 70 80 90
VO
2m
ax (m
L∙kg
-1∙m
in-1
)
Age (years)
Lifestyle factors maintained
Lifestyle factors follow population trends
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Strength
• No useful studies looking at general strength decline with age
• Assume grip strength is reasonable surrogate
• Chose the ‘ladder lift’ requirement as the standard requirement for firefighters
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Decline in grip strength with age
-14
-12
-10
-8
-6
-4
-2
0
2
4
10 20 30 40 50 60 70
Gri
p s
tre
ngt
h (k
gf)
Age (years)
Haisman 1996 (M)
Haisman 1996 (W)
Rantanen 1998 (M)
ADNFS 1992 (M)
ADNFS 1992 (W)
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Predicted decline in grip strength
20
25
30
35
40
45
50
55
20 30 40 50 60 70
Lad
de
r lif
t sc
ore
(kg
)
Age (years)
Men
Women
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Predicted ladder lift, Men
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Predicted ladder lift, Women
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Heat tolerance
• No direct link to age.
• Direct link to fitness, so indirect link to age where fitness declines.
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Shiftwork
• Some evidence of decreased tolerance with age.
• Likely to be self-selection relatively early in career.
• No clear identified change between ages 55 and 60.
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Health
• General population trends with age, looking at mortality and at common diseases:
– Heart disease and stroke
– Diabetes
– Neoplasms
– Respiratory disease
– Osteoarthritis
– Common mental disorders
• Compared these with mortality data and ill health retirement data from FRS
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0
5
10
15
20
25
25-34 35-44 45-54 55-64 65-74
Dea
ths
per
th
ou
san
d
age ranges
Death rates per thousand, males, England and Wales
2010
All causes
All diseases ofcirculatory system
Ischaemic heartdisease
Cerebrovasculardisease
Diabetes
Neoplasms
Respiratory disease
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Prevalence of vascular diseases, England
0
50
100
150
200
250
300
350
400
25-34 35-44 45-54 55-64 65-74
ever
dia
gn
ose
d w
ith
per
th
ou
san
d
Prevalence of vascular diseases by age, males, 2006, England
CHD
Stroke
MI
Angina
CVD
0
50
100
150
200
250
25-34 35-44 45-54 55-64 65-74
ever
dia
gn
ose
d w
ith
per
th
ou
san
d
Prevalence of vascular diseases by age, Females, England, 2006
CHD
Stroke
MI
Angina
CVD
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Predicted heart disease and stroke, men
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Neoplasms
• Excluding non-melanoma skin cancer, per thousand
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0
20
40
60
80
100
120
16--24 25-34 35-44 45-54 55-64 65-74
do
cto
r-d
iag
no
sed
per
th
ou
san
d
age ranges
Prevalence of chronic respiratory disease,
England 2010
Men
Women
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0
100
200
300
400
500
600
16-44 45-64 65-74
Pre
va
len
ce p
er t
ho
usa
nd
Prevalence of self-reported pain by site, Men, central
England 1998
back
shoulder
hip
knee
any area
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0
10
20
30
40
50
60
70
80
90
100
35-39 40-44 45-49 50-54 55-59 60-64 65-69 70-74
Pre
va
len
ce p
er t
ho
usa
nd
Prevalence of radiographic
hip osteoarthritis by age 2009
Men
Women
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0
50
100
150
200
250
300
350
400
50-59 60-69 70-79
Pre
va
len
ce p
er t
ho
usa
nd
Prevalence of both symptomatic and
radiologically diagnosed knee OA, UK 2008
Men
Women
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0
20
40
60
80
100
120
18-29 30-44 45-59 >60
Co
nsl
uta
tio
ns
per
th
ou
san
d
Cumulative rate of consultation for back pain, UK
1998
Men
Women
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0
20
40
60
80
100
120
140
160
16-34 35-44 45-54 55-64 65-74
nu
mb
ers
per
th
ou
san
d p
op
ula
tio
n
Incidence of common mental disorders, England 2007
Men
Women
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0
2
4
6
8
10
12
14
16
18
20
2002-3 2003-4 2004-5 2005-6 2006-7 2007-8 2008-9 2009-10 2010-11 2011-12
Ill health retirements per 1000 firefighters
IHR per 1000 whole time IHR per 1000 retained
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0
5
10
15
20
25
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64
Percentage of firefighters in each age range
%
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0
5
10
15
20
25
<20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64
Numbers ill-health retired per year 2007-12
number per 1000 number
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0
0.2
0.4
0.6
0.8
1
1.2
40-44 45-49 50-54 55-59
Ill health retirements per 1000 for each age range
back conditions
Knee arthritis
heart disease
respiratory disease
cancer
common mentaldisorders
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Overall predictions from IHR data
• IHR in age group 50-54 = 5/1000
• IHR in age group 55-59 = 7/1000
• Overall impact on IHR levels, with substantial increase in numbers aged 50-55 as well as 55-59 would be increase from current 1/1000 to 2/1000.
• Actual increase of 30-40 firefighters per annum.
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Main issues
• Lack of a fitness standard is crucial
• Gender – more women will be closer to VO2max of 42mlO2kg-1 min-1, so greater percentage will become unfit with age.
• Without lifestyle intervention, 85% unfit at age 55, 92% at age 60
• With lifestyle intervention, 15% unfit at age 55, 23% unfit at age 60
• Current figures show 51% unfit at age 50-54, 66% unfit at age 55-59
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Recommendations
• Sort out a fitness standard
• Introduce regular fitness training
• Allow firefighters to retire after age 55 on reduced pension without penalty
• Link IHR pension to early retirement pension to avoid rewarding IHR
• Start collecting data on all firefighters