Post on 13-Jul-2020
Firefighter Normal Pension Age
Dr Tony Williams
Consultant Occupational Physician
• Picture of document
Normal Pension Age for Firefighters
A review for the Firefighters’ Pension
Committee
December 2012
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
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
Hutton Report 2010
• Recommended that NPA for 2006 Firefighters Pension Scheme should be benchmark for all Uniformed Services Schemes
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?
Review Group
• Occupational physiologists (Optimal Performance Ltd)
• Firefit rep (access to data)
• Employer rep
• Employee rep
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.
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
Standardised operational testing
Photos courtesy of South Wales FRS
VO2max testing
Chester Step Test
Shuttle Run Test
Allied Dunbar National Fitness Survey
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
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
Jackson et al 2009
Women
Men
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)
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
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
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)
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
Predicted ladder lift, Men
Predicted ladder lift, Women
Heat tolerance
• No direct link to age.
• Direct link to fitness, so indirect link to age where fitness declines.
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.
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
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
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
Predicted heart disease and stroke, men
Neoplasms
• Excluding non-melanoma skin cancer, per thousand
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
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
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
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
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
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
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
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
%
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
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
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.
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
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