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