More a question of ‘fitness’ for purpose

08 April 2010

Last week, the heavily trailed ‘fit note’ came into being, replacing that 60 year old institution, the ‘sick note’. Vaguely reminiscent of the expression ‘is the glass half empty or half full?’ the more positively entitled fit note has been launched to tackle the problem of work absenteeism. Instead of being simply ‘sick’, from April 6 2010 a person is either ‘not fit for work’ or ‘may be fit for work’, subject to his or her employer’s ability – or willingness – to support them through a planned rehabilitation.

The change was implemented by the Department of Work and Pensions as part of a drive to help people stay in work and reduce the estimated £100bn a year that sickness leave costs the economy. The new form was developed in consultation with practising doctors, the Royal College of GPs and the British Medical Association, and is very strongly supported by various interested bodies, not least among them being the Engineering Employers’ Federation (EEF).

According to a survey carried out in 2009 by the EEF and specialist insurer Unum, overall levels of sickness absence in manufacturing have continued to fall in recent years, with the total now standing at 6.2 days per employee, per year. This continues a trend in which three million fewer days are now being lost due to sickness absence each year in manufacturing, compared with 2005; equivalent to one day less per employee. The increased emphasis on sickness absence management is highlighted by 91% of companies having a written absence policy. In addition, 50% and 43% of employers train their managers to address short and long-term absence respectively.

Many employers, however, remain unsure about how to respond to fit notes. According to research by the management consultant, Kronos, 64% of business owners claim to have had no official guidance on what to do when an employee produces the document. Meanwhile, 80% said they do not think fit notes will reduce absence and 35% said they were unaware of them altogether.

At least one regional chamber of commerce is concerned that the ‘may be fit to return to work’ option could see employers becoming embroiled in legal disputes with their employees. This option describes a phased return to work, with possible amended duties, altered hours and workplace adaptations. With this option, some businesses may not be clear as to what ‘reasonable adjustments’ are. Moreover, they may not have the resources to adapt workplaces or make amendments to duties that might affect established workplace routines or other members of staff. And if the employer fails to carry out any recommended changes and the employee meets the qualification required by the disability discrimination legislation, then they might find themselves on the receiving end of disability discrimination claim.

But the EEF is not fazed by these concerns. The organisation’s chief medical adviser, Sayeed Khan says that after more than 60 years of using the old sick note the new fit note is the right tool for modern medicine and a modern society. “To improve sickness absence management we have to change the culture away from what people can’t do, to what they can do,” says Professor Khan. “The new system is a welcome change and, for those companies that embrace it, it will bring significant business benefits.”

That is to be seen. Perhaps a more root and branch approach would be to study the underlying reasons why we have such levels of work absenteeism in the first place, rather than relying on the dubious benefits of re-titled forms and complicated workplace procedures.

Ergonomics and the truth about body shape

You only have to go into your friendly off-the-peg clothing store to realise that much of what is on offer is designed for a ‘standard’ body shape, the dimensions of which vary proportionately according to a rather coarse scale. Your real waist measurement might be 35 inches but you have to make a choice: squeeze into a 34in waistband or flap about in a 38 with a correspondingly enlarged hip allowance. Yes, you can go to a tailor, but then that’s rather expensive isn’t it?

For the vast majority of mankind, products are designed and dimensioned according to standards, yet they always appear to be out of kilter with one’s own form, don’t they? The train or airline seat is too narrow or has a lumbar support in the wrong place – that sort of thing. Human beings come in all shapes and sizes, certainly, but with changing standards of living, those body dimensions have been increasing steadily over the last few decades – and it’s a global phenomenon. So much so, that the International Standards Organisation (ISO) has decided to act.

To ensure that clothing, workplaces, transportation, homes and recreational activities match today’s body sizes comfortably and safely, ISO has published a report compiling up-to-date anthropometric data (human body measurements across populations). The report (ISO/TR 7250-2:2010, Basic human body measurements for technological design – Part 2: Statistical summaries of body measurements from individual ISO populations), is the second part of a series on body measurements, which seeks to identify physical variations in human body sizes and shapes around the world. The aim is to give manufacturers a realistic view of today’s population diversity and optimise technological design accordingly.

For instance, the report tell us that while the average height and weight of an American man are respectively 1.76m and 80kg, those of the average Thai man are 1.67m and 64kg. Meanwhile, an average Dutch woman measures 1.67m and weighs 72kg, while an average Japanese woman measures 1.57m and weighs 51kg.

Report project leader, Makiko Kouchi, believes that inadequate measures in products and environments compromise our health by putting unnecessary strain on our bodies, like the chair that is too tight or the supermarket shelves that are too high to reach. “Harmonizing our surroundings to our body size, shape and capability by applying ergonomic principles is the key to ensuring our well-being,” Dr Kouchi asserts.

The ISO/TR 7250-2 report provides updated country-specific body size data, focusing on working age people within ‘ISO populations’ (those countries whose national standards institutes are members of ISO). It features key statistics for ergonomic design such as body mass, stature, eye height, chest depth, hip breadth and so on, in both standing and sitting positions. Dr Kouchi again:

“We developed ISO/TR 7250-2 with the principle of ‘equity’ in mind. More often than not, products are designed on a mass production basis, which ignores human variation. The report will help manufacturers to better gear their products to their target customers, taking into account the considerable differences in body shapes and sizes that can exist. This will ensure that products respect the ergonomic needs of their populations, and that no size is ‘discriminated’ no matter how big or small.”

Squeezing into my latest sartorial acquisition, I say ‘aye’ to that!

Les Hunt
Editor