Firefit Conference 2008 ‘Fit for Service, Fit for the Future’ Kevin Sykes Professor of Occupational Health & Fitness Firefit Conference 2008 ‘Fit for Service, Fit for the Future’ Physiology of Ageing - and possible effects on firefighters Kevin Sykes Professor of Occupational Health & Fitness Director Centre for Exercise & Nutrition Science University of Chester

“So, Mr Jones, how old are you?” “32?” If you didn’t know how old you are…….. ….how old would you think you are ?

Many of us are health-conscious But many still take their health for granted….. … until they lose it! Prevention is better than cure

We can now expect to live 10 years longer than in the 1950s Increase in Life Expectancy 2005 Females live 5yrs longer than males

UK Life Expectancy Females: Average 82yrs Highest 86yrs Kensington, Chelsea, E.Dorset Lowest70yrsGlasgow 75% of females will be alive after the age of 75 50% of males will be alive after the age of 75 Males: Average 77yrs Highest 81yrs Kensington, Chelsea, E.Dorset Lowest65yrsGlasgow

6 37% CVD 28% Cancer

36% CVD 24% Cancer

Lifespan v ‘Healthspan’ Men Women Expected Lifespan: 77yrs 82yrs Expected ‘Healthspan’:67yrs 72yrs ADD Life to years… not years to life

100% value sedentary

Aerobic Fitness & Ageing Decrease in cardiac function: e.g.  HR = 220-Age  Cardiac Output  Stroke Volume Decrease in Circulatory capacity: e.g.  Increase in peripheral resistance  Less blood flow to active muscle Decrease in muscle O 2 uptake: e.g.  Reduced a-vO 2 diff  Reduction in mitochondria & oxidative enzymes Reduced Respiratory function  (FVC, FEV, RV, MaxVe -1 ) VO 2 Max decreases by 10% per decade after 25-30yrs HOWEVER…… Fit 60yr old fitter than sedentary 20-30yr olds!

Low aerobic fitness is more important precursor of all-cause mortality than any of the other risk factors Aerobic Fitness, Ageing & Longevity

* Least fit x2 as likely to die prematurely from all causes * Reduced lifespan and healthspan Aerobic Fitness, Ageing & Longevity

Strength & Ageing Max muscle strength is achieved between 25-35yrs Strength decreases around 10% per decade after Primary cause ‘sarcopenia’:  50% reduction in Motor Units yrs  Loss of muscle mass  Loss of Total muscle fibres  Reduced muscle X-section  Loss of Fast twitch fibres  Reduced CNS responses However, large individual variations – some stronger at 60 than many at 30.

Strength & Ageing Resistance training can markedly improve strength in both males and females at all ages Improvements in strength of 50-70yr olds males following resistance training. Many 60yr olds were stronger than 30yr olds

Ageing & Flexibility Decrease in passive and active range of movement Shortened muscles Weaker ligaments, tendons, joint capsule Increased likelihood of injury Decrease in kinaesthetic awareness

Ageing & Body Composition Gradual gain in body weight from 20-70yrs Decrease in muscle Increase in fat (subcutaneous, depot, intramuscular & essential) Decrease in bone mass (e.g. mineral density)

Hazardous Waste

A cluster of CV risk factors - insulin resistance - hyperinsulinaemia - impaired glucose tolerance or diabetes - raised triglycerides - raised LDLs - decreased HDLs “Diabesity” Hazardous Waist Advancing age – spreading waistline - reduced fitness – Metabolic Syndrome

Normal When insulin is bound to the insulin receptor of the cell, glucose can be transported into the cell and be used.

Type 2 Diabetes Insulin receptors not functioning Insulin cannot bind Glucose cannot be transported into the cells Around 90% of all diabetics are Type 2

Benefits of Exercise for Diabetes Improve insulin sensitivity Improve glycaemic control

Possible Effects of Ageing on Firefighters

Typical aerobic cost of fire fighting = 35mlsO 2 /kg/min To be working at 80-85% of maximum, aerobic capacity needs to be at least 42mlsO 2 /kg/min Proposed minimum aerobic fitness standard = 42mlsO 2 /kg/min Firefit Steering Group (2007).

Norms for Aerobic Capacity (mlsO 2 /kg/min) MalesAge Group Fitness Rating Excellent Good Average Below Average Poor<30<28<26<24<22 FemalesAge Group Fitness Rating Excellent Good Average Below Average Poor<29<27<24<22<20 Sykes 1996

Intense physical activity is a strong triggering factor for heart attack, especially among physically inactive, older and unfit individuals. 100%HRMax 85%HRMax

Heat Stress Tolerance & Ageing Reduced thermal tolerance Reduced sweat production – less heat lost by evaporation More susceptible to fatal heat injuries

Ageing & Balance Good balance important for operational firefighters - Working on roofs, smoky places, slippery surfaces while wearing PPE & BA Wearing PPE & BA affects functional balance in older compared to younger firefighters (BA was more a sig. factor). Postural balance (with eyes closed) was more negatively affected among the older subjects than the younger ones. Punakallio et al (2003) Dynamic (Functional) & Static (Postural Sway) Balance - general decrease with ageing

An Integrated Workplace Health & Fitness Programme for Operational & Civilian Staff ….. OH, FBU, HR, H&S and Welfare …..

Systematic reduction in sickness rates & injury Systematic improvements in BP, BW, BMI, Waist, Lipids, Fitness Workplace Health & Fitness Programme

Ageing and Firefighter Fitness Aerobic Endurance Strength Local Muscle Endurance Flexibility Agility & Balance Body Composition Metabolic Fitness - Insulin sensitivity, glucose tolerance, normal BP, heart-healthy blood lipid profiles & fat-burn capability

Ageing & Operational Firefighting Age is a poor predictor of job performance among operational firefighters Physical fitness and mental abilities showed the strongest relationship with job performance These vary greatly across individuals regardless of age Increase in MSDs Fit note or Sick Note ? Gender issues ? Importance of Physical Fitness

Trainability & Age Exercise training improves physiological responses and fitness levels at any age. 37yrs 59yrs Bill Pearl

Extracurricular Coronary

Firefit Conference 2008 ‘Fit for Service, Fit for the Future’ Kevin Sykes Professor of Occupational Health & Fitness Firefit Conference 2008 ‘Fit for Service, Fit for the Future’ Physiology of Ageing - and possible effects on firefighters Physical Fitness for Firefighting Kevin Sykes Professor of Occupational Health & Fitness Director Centre for Exercise & Nutrition Science University of Chester