A year-long study of the Fit for Snow injury prevention and general wellness program for patrollers, instructors and lift operators showed the program was extremely effective at reducing injuries in these workers. And that is not terribly surprising; Fit for Snow is based on hard data collected at five ski resorts in Western Canada. And the results mirror those in other industries, such as forestry and trucking.
During the 2010-11 season, we studied 75 patrollers, instructors and lift operators, to characterize the typical loads and stresses they experience on a daily basis. Workers underwent previously-validated testing protocols to identify areas of mismatch between the movement patterns they use and the demands of key work tasks.
The results showed that the vast majority of workers used strategies for stabilization that actually increased their risk of injury, creating shear forces across a joint due to poor posture and inappropriate muscle recruitment. Specifically:
During a test designed to load the lumbar spine (as in lifting a pair of skis) with destabilization (single leg-stance), only 7% of tested employees could control movement at the lumbar spine, hips and/or knees.
An endurance test designed to mimic loading of the lumbar spine, hips, and knees while travelling downhill indicated that only 3% of tested employees could control these joints when fatigued, and only 11% of tested employees could control movement at the shoulder joint when load was applied through the thoracic spine (as in shoveling).
Although it was perhaps somewhat unexpected to find that a generally young and healthy work force would show such a high rate of movement dysfunction, at least part of these poor results may arise from the high rate of previous injuries in this population (91%). But other causes are to blame as well: habits that form due to cultural postures, the stance on a snowboard or in ski boots, or the shift of posture and center of gravity from wearing a backpack.
Whatever the reason, it is possible to correct poor postures and inappropriate muscle recruitment patterns with relatively simple exercises that can be performed by the worker during the process of completing work tasks. And the research shows that re-setting these reflexes is a very effective means of decreasing injury rates.
We also analyzed dietary and hydration patterns. These are important because the brain and peripheral nerves rely on stable blood sugar levels for consistent performance. We monitored each worker every two hours over the workday to compare blood sugar and coincident levels of alertness.
As expected, cognition, vigilance, decision-making, speed of reflexes and reaction times were all impaired by unstable blood sugar patterns. A quarter of the employees showed at least one hypoglycemic event per day. When questioned regarding the symptoms of fluctuating glycemia (fatigue, confusion, poor concentration, anxiety, irritability, sudden change in body temperature, shakiness, loss of coordination), 51 percent of employees reported experiencing symptoms.
The impact of blood sugar levels on injury rates was huge. An examination of five years of injury records at the five test ski areas indicated that 60 to 80 percent of injuries occurred in late morning and afternoon, when blood sugar levels typically are low. Stabilizing blood sugar levels with the Fit for Snow program dropped the percentage of injuries during these time periods to 32 percent.
FITNESS, DIET SOLUTIONS
These findings, among others, were used to design a program specific to instructors, lift operators and patrollers. The program focuses not only on correcting the factors that contributed to the high injury rates, but also takes into account the lifestyle and culture of a young person working at a snowsport resort.
The Fit for Snow program consists of an introductory presentation of the rationale for the program, a small handbook, “The Top Ten Tips,” as well as a parent book, “Fit for Snow,” plus workshops for employees and supervisors on nutrition and fitness, and in-season support.
Supervisors in lift operations, snowsports school and patrol receive an additional hour of information on coaching strategies and how the program can be used to develop healthy lifestyles, as well as context-specific strategies to promote behavioral change on the job. Other department supervisors, including all outdoor operations, maintenance, f&b and human resource personnel can benefit from this level of involvement as well.
To test the effectiveness of the program, Fit for Snow was rolled out at the five test ski areas during the 2011-12 season, and the outcomes evaluated.
PUTTING IT TO THE TEST
Surveys of resort employees indicated that Fit for Snow was well accepted, and was often used beyond the 75 test participants at the resorts where management supported the program. (One resort replaced key managers, and there was no point of contact for program support; at another, the key contact was too busy to provide much support.) But the employee volunteers participated in the workshops with great enthusiasm, and there were many requests for the information in the program to be shared among co-workers who were not part of the test group.
At the resorts that provided weekly coaching, this support was very well received. Many workers commented that they would have liked even more information, more access to continued coaching to achieve the recommended lifestyle modifications, and more evidence of internal support—such as healthier staff meals.
MEASURING THE EFFECTS
After implementing the program—improving hydration and the quality and timing of food intake, and using joint stability and fitness programs tailored to their individual needs—workers reported they felt reduced fatigue, an increased ability to stay alert, less joint and muscle pain, and improvements in skiing and riding performance. The single greatest criticism was that most staff wanted more support and information.
The study turned up objective evidence for the effectiveness of Fit for Snow as well. Participating resorts recorded a highly significant reduction in the number of injuries. Worker compensation claims were reduced by an average of 67 percent from the 2010-11 season to 2011-12 in participating resorts. For comparison, a survey of resorts that did not use Fit for Snow indicated that over that same period, claims increased by 10 percent (Fig. 1).
The average (mean) number of worker compensation claims (medical-aid and lost-time) declined at the five test resorts that utilized the Fit for Snow program during the 2011-12 season from the levels of the 2010-11 season. The change in the injury events at areas that did not use the program is also presented for comparison.
Historical numbers for injury events within the five test areas are shown in Figure 2. Compared to either the five-year average (2005-06 through 2009-10) or to the 2010-11 season, the total number of incidents during the season that Fit for Snow was used (2011-12) was about 25 percent lower. Minor first-aid visits increased, as one large resort saw a rise in these incidents. But the number of more serious medical-only and lost-time claims declined by 44 to 93 percent. The extent of the decline depended largely upon the degree of support that was provided internally from management at each resort. (See below, Effort In/Results Out for details.)
This graph presents the mean number of injury reports—first-aid only (FA), medical-only (MA), and lost-time (LT)—at the five test Snowsport resorts in Western Canada during the season that Fit for Snow was implemented (2011-12) compared to the season that the study data were gathered (2010-11) and a 5-year average (2005-06 to 2009-10). Minor first-aid visits increased, but more serious lost-time injuries declined dramatically.
These outcomes are similar to other culturally and contextually-specific programs that I have developed for forestry and mill workers, truck drivers and others. These were also based upon correcting movement inadequacies and stabilizing blood sugar levels. In each case, a significant improvement in employee wellness and a reduction of injuries have resulted.
In short: providing workers with a means of improving performance, and then furnishing the support necessary to effect change, makes it possible to enhance health and wellness and reduce injuries in a specific population, and reduce worker’s compensation claims at the same time.
EFFORT IN/RESULTS OUT
There is a great deal of evidence from other sources that worksite health promotion programs are effective at increasing worker productivity and reducing costs associated with poor health, inefficiencies, illnesses, and injuries. The literature consistently reports a return on investment on the order of 2.5:1 to 6:1.
However, to realize these kinds of gains, some key elements are necessary:
a culturally and contextually specific program;
strong support from management at all levels; and
consistent exposure to the program for at least four years.
To get the most from the program, there must be a clear mandate at all levels of management that the culture of the organization is worker health and wellness and—thanks to strong and alert employees—a culture of safety. Supervisors and department heads must take part in the training process, and all managers must commit to a multi-year effort of supporting the program by providing employees with concrete opportunities for success. Managers and supervisors can use weekly events, newsletter items, contests and other forms of engagement to keep employees engaged.
The effect of management support was very apparent in the spread of outcomes in the five Fit for Snow test resorts. Those with the highest level of support, from the resort GM on down to shift supervisors, achieved the highest reductions in injury events (a whopping 93 percent reduction in claims in one case). Things as simple as ensuring that employees have easy access to water while working can go a long way to change the resort’s culture toward a healthy and safe environment.
The science behind Fit for Snow is not revolutionary, but it’s important to make sure that the recommendations and training fit your employees’ culture. Those elements, and a solid commitment from management, can make a significant difference in the health and safety of your employees—and your bottom line.
For more information, contact Dr. Delia Roberts at firstname.lastname@example.org.