3/26/2012. Body Weight : The Driving Force Behind High Medical, Workers Comp and Disability Claims and Costs! Recent Research Studies.

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1 Founder and Owner Thomas B. Gilliam, Ph.D. Body : The Driving Force Behind High Medical, Workers Comp and Disability Claims and Costs! Doctorate in exercise/muscle physiology Tenured Faculty Member : University of Michigan ( ) Co-author: Move It. Lose It. Live Healthy. book Sports Medicine Isokinetic strength assessments since 1974 Industrial dynamic physical capability assessments since 1982 Data Mining - Tracking and Statistical Analysis Industrial Physical Capability Services 2012 IPCS-MILILH Body No other health issue has impacted so many individuals in as many different negative ways as body weight. Ironically, body weight is the easiest to manage when it comes to your health. Recent Research Studies Berecki-Gisolf, et. al. JOEM, March 2012; The Impact of Aging on Work Disability and Return To Work. G.S.Smith, et. al. JOEM, Jan 2011; Impact of Gain or Loss on Health Care Costs R.M. Henke, et. al. JOEM, May 2010; Relationship Between Health Risks and Health Productivity Laws, C. and F. Schmid. NCCI, 2010; Reserving in the Age of Obesity. S. P. Tsai, et. al. JOEM, April 2011; Risk Factors for Illness Absence Due To MSD in a 4-Year Impact of Obesity on Increased Medical and WC Costs IPCS PCE Data Percent Association with Increased Medical and WC Cost Due to Obesity 46% 28% 59% 39% 74% 139% Obese - I Severe Morbid Data from Industrial Physical Capability Services, Inc. (IPCS) 206,000 new hire industrial applicants Participated in a physical capability evaluation (PCE) during hiring process throughout the U.S. Height and weight measured Body weight part of the proprietary mathematic validated model Medical Costs Workers Comp Costs *Henke et.al, JOEM, May 2010, Pepsi Study 1

2 Ft. Pounds Pounds 3/26/ % 36% 27% 18% 9% 2002 vs. 2010: Comparing Obesity Categories 41.8% 32.9% % 10.8% 7.7% % 24% 16% 8% Years Old: Comparing Obesity Categories 34.4% 27.7% 4.7% 2.7% 8.7% 7.1% % Body Mass Index Body Mass Index Body Mass Index >39 Body Mass Index Body Mass Index Body Mass Index >39 Severe and Morbid Obesity Results in Increased Costs and Losses Impact of Body on and Risk of Injury Body vs. Torque According to BMI The severe and morbid obese worker: Has twice as many workers comp claims Has 13 times more lost work days Average injury claim cost is 7 times greater Healthcare claim is $2,500 or more Normal Overweight BMI 30 to 35 BMI 35 to 40 BMI 40 to 45 BMI 45 to 50 BMI > Knee Torque BodyWt Purpose/Application of the Physical Capability Evaluation (PCE) Program To correctly match the physical capability of the worker to the physical demands of the job resulting in: a healthier and more fit worker lower claim s costs Process Validity for Physical Capability Testing Testing must be valid and current Testing must demonstrate Job Relatedness Testing must demonstrate Business Necessity Testing must work off Job Task Analysis to determine Target Score to test against The IPCS PCE meets these criteria (McDonald Hopkins letter dated July 2011) 2

3 Job Task Analysis Isokinetic Evaluation Job Relatedness RTW Case Study - Knee Injury Male, 28 yrs old, 74 inches tall, 232 pounds Delivery Driver, Food Service Industry ACL repair 6 months previous Passes FCE, MD release A & B Curves knee extension Not Rec IPCS Normal Knee Curves Abnormal Knee Curves 15 PCE Force Curve Analysis (FCA) The Analysis Force Curve Analysis Muscle Symmetry Analysis to Body Analysis Force curve analysis determines if injured joint has had complete rehab or is additional rehab necessary Abnormal Knee Curves 2012, IPCS, Inc. 17 3

4 PCE Muscle Symmetry Analysis (MSA) Body/Joint Symmetry - considers imbalances between: extremities, agonist\antagonist muscle groups, and upper and lower body ratio Upper and lower body symmetry Right and left shoulder symmetry for flexion and for extension Flexion and extension symmetry right and left Right and left knee symmetry for flexion and for extension Flexion and extension symmetry right and left to Body Analysis (SBWA) should be proportionate to body weight to prevent injury or re-injury The more the SBWA deviates from normal the greater the probability of re-injury Health and Injury Risk PSRA Health Risk Quadrants: How does the workforce measure up? High BMI Good Lower Risk for Injury and Disease Poor / Good / 14.1 % 36.7% Low High Risk for High & Power Poor Higher Risk For Injury and Disease 23.1% Poor / Low Risk for Good / 26.1% Normal BMI Excess *Derived from the IPCS database of 206,000 new hire industrial workers Muscle Is A Critical Factor To Disease and Injury Prevention Muscle is an organ largest organ in the body Muscle is made to work Movement Joint stability Osteoporosis Factors Which May Reduce During the Aging Process Loss of 25% of muscle mass by age 65 (Sarcopenia) Added fat weight with aging Loss of muscle functionality with aging 4

5 Sarcopenia Sarcopenia 25 Years 65 Years What happens when we pair Sarcopenia + Sedentary Lifestyle? Accelerated Loss of Muscle Mass With Age 10 Will muscle loss be accelerated? Loss of Muscle Accelerated with weight gain, lack of physical activity Normal Aging 75% 25 Age Gain + Lack of Physical Activity + Sarcopenia = Accelerated Loss of Muscle Mass & 25 Years 55 Years? What then happens to an individual s health risk as they age and fail to maintain or gain muscle mass & strength? 5

6 Loss of Muscle Mass/ is a Serious Risk Factor Increased risk for injury Work related Non-work related Loss of muscle functionality Difficulty climbing stairs Doing household chores Getting out of a chair Reduced capability of being active Increased fat weight It may not be life threatening, but what impact does strength have on: Daily functionality? The ability to move? The ability to work? A company s bottom line the economy? How Much of These Increased Costs are Due to Poor to Body Ratio? PSRA Health Risk Quadrants: High BMI Percent Association with Increased Medical and WC Cost Due to Obesity Poor / Good / % 28% 59% 39% 74% 139% Obese - I Severe Morbid Low High Risk for Poor / Low Risk for Good / High Medical Costs Workers Comp Costs Normal BMI *Henke et.al, JOEM, May 2010, Pepsi Study Physical Risk Assessment (PSRA): An Important Component of a Biometric Screening Measures: Force generating capability Muscle symmetry to body weight analysis Reports: Health Risk Summary BMI s and weaknesses in muscular strength and body symmetry PSRA Timeline for John Smith Original Test Date: 12/06/2010 Most Recent Test Date: 12/09/12 Health Risk Progression: Over the course of the last 2 years, Mr. Smith has progressed from PSRA results that placed him in the High Risk category to his current placement in the Moderate Risk category. Based on his progression we would recommend that he be tested again in 2 years from his last assessment date. PSRA 1 12/6/10 High Risk for PSRA 2 12/10/11 PSRA 3 12/09/12 Low Risk for 6

7 Healthy Muscle Mass Is Critical To: Successful rehabilitation Reduced risk for injury, reinjury and disease Achieving and maintaining a healthy body weight Healthy metabolic rate Muscle functionality Active lifestyle A healthier workforce! THANK YOU! Thomas B. Gilliam, PhD tgilliam@ipcs-inc.com Industrial Physical Capability Services 7