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Snow is accumulating in the mountains, and the young men and women who staff winter resorts are arriving. Unfortunately, many of them will suffer injuries this winter, and with those injuries comes a social and financial cost. In an effort to stem these costs, several British Columbia resorts joined with me to develop and implement a Fit for Snow injury prevention program for resort employees.

Injuries to employees at snowsport resorts in British Columbia average more than $1 million in annual compensation costs. To reduce those costs and boost the health of employees, the Canada West Ski Areas Association and WorkSafeBC have helped develop an injury prevention program specific to these workers.

Last year I visited five ski areas to collect data on 75 patrollers, instructors and lift operators to better understand the physical and mental stresses these workers experience. We found that most were deficient in at least one of the characteristics we studied: movement patterns, agility, fitness, and diet.

Some of the findings were as expected, but some were rather surprising. For example, most people believe that young people working outdoors, skiing or snowboarding all day, would have a high level of fitness, and that they would be able to burn off cafeteria food and pub nights. It turns out that this is not the case.

Workers in the three groups had slightly different demographics, with instructors tending to be older and lift ops being younger. Years of work experience generally reflected these age differences. However, the study also included veteran lift operators and rookie patrollers. Patrollers had the highest percentage of males.

SURVIVAL OF THE FITTEST?
While patrollers were the fittest, only two participants in the entire study were able to complete a series of functional movement tests without any dysfunction (one of these was female). The tests consisted of three separate movement scenarios designed to mimic those that resort employees perform routinely during their assigned duties, as well as those experienced during skiing and snowboarding.

The poor performance by all three groups may have been due, in part, to the very high rates of previous injury: 76 percent of patrollers, 92 percent of instructors and 87 percent of lift operators reported some level of pain and restriction of activity due to previous injuries.

The indications of poor fitness also included a surprisingly high percentage of workers with excessive body fat levels: 42 percent of instructors, 38 percent of lift ops and 24 percent of patrollers were overweight, and 20 percent of instructors, 27 percent of lift ops and 8 percent of patrollers were actually obese.

To evaluate the actual physical load experienced by workers, we used a device that records heart rate and movement in three planes every 15 seconds during the work day.

These data revealed some very surprising results that largely explain the low fitness levels observed in these workers. The daily average heart rate for all three groups of employees were below 100 beats/min-not much higher than was found in a study with truck drivers. Only the patrollers spent any significant amount of time above a heart rate of 130 beats/min, in the zone that represents strenuous work. In fact, on average, the instructors and lift ops barely met the daily minimum requirement for physical activity for basic health.

The lack of physical output at the hill was compounded by the employees' reported exercise habits outside of work. Only 45 percent of instructors and 37 percent of lift operators reported participating on a regular basis in any form of sports or physical activity outside of their employment activities, summer or winter. In contrast, 70 percent of patrollers exercised outside of work.

These findings are significant, because the risk of musculoskeletal injury is directly proportional to fitness level. The fitter you are, the lower the risk of injury. It doesn't matter what the task or type of exercise; fitter people are less likely to be injured than unfit participants. Two key examples: Core strength and leg strength are predictive of ACL injuries, and regular exercise reduces the risk of sprains, back pain, and chronic pain in the knee and shoulder.

Clearly, resort employees will benefit from higher fitness levels. That's why the injury prevention program that we will test this winter includes some specific core activation exercises as well as a general program to build base fitness. The Fit for Snow program has been designed to give snowsport resort workers the specific fitness that they need to reduce their risk of injury, quickly and efficiently in a way that is consistent with their lifestyle. By getting the chance to actually test it out, we'll be able to determine what actually works the best and connects with workers before releasing the program to the broader North American industry in time for the 2012-13 season.

YOU ARE WHAT YOU EAT
The study also included an assessment of dietary habits. This revealed that few workers were meeting the recommended intakes for good health for many important nutrients, including water. Though there were some differences between the three groups of employees, the consumption of saturated fats and sugar was much too high in all workers. But it was the poor eating patterns that were of the greatest concern, as their effect on attentiveness and reaction speed goes beyond general health and actually contributes to injuries.

To demonstrate this effect, we studied the impact of high sugar intake by measuring blood sugar levels and reaction time during the day. The nervous system, including the brain and peripheral nerves, is dependent on blood sugar for good performance, and the findings for resort workers were consistent with other groups that I have studied.

Because sugars are absorbed quickly, blood sugar rises quickly after the intake of a sweet snack, then falls to near-fasting levels. When workers were tested for speed and accuracy of response to a complex unexpected visual stimulus, both reaction time and cognition were consistently better when blood sugar levels were stabilized-in some cases up to nearly a full second faster. Actually seeing the impact of what you eat on your ability to react to an unexpected situation makes a very convincing demonstration, even when you are 20 years old and feel invincible.

Because of the pronounced effect of swings in blood sugar on concentration, alertness, decision making and reflexes, one of the main strategies of the injury prevention program is educating workers about how to eat to stabilize blood sugar and enhance their performance at work and while riding.

MAKING IT STICK
The question, of course, is whether or not employees will adopt the proposed solutions of improved dietary practices and specific fitness. It is here that the support of managers becomes crucial. In my experience any such program relies on four critical elements:

• The program has to be culturally acceptable to the worker.

• There has to be commitment from individuals at all levels, from the employee to senior management. The Fit to Snow program emphasizes the performance enhancement aspect of increased fitness and sharper reflexes as a means to engage workers. But there must be an active demonstration that management endorses the program in a meaningful way, including time, money and other forms of support.

• Workers must feel respected throughout the program’s implementation. Their concerns must be validated, or they will not be willing to consider lifestyle changes.

• The organization must repeat its endorsement consistently over a period of at least four years before it becomes fully incorporated into the culture of the organization. It’s not enough to deliver the program once. To become ingrained in the company’s culture, it has to be introduced and supported through several cycles of employees. Eventually, it becomes self sustaining as employees follow the new practices because it is what they choose to do, not because it is imposed from above.

Can it really work? It already is. Several of the resorts that participated in the initial study are finding that workers are more conscientious about hydration and dietary practices, and that alone has translated into a significant improvement in injury rates.

The five test areas will be offering their staff 2.5 additional hours of training this year, and handing out a pocket-sized Top 10 Tips booklet as well as a Fit for Snow manual packed full of helpful suggestions for meal and snack preparation. This includes advice on shopping on a budget, healthy recipes, and strategies for managing blood sugar on the hill. There is an early-season get-fit-quick program, and a tiered program for building core stability and other important elements of joint protection. Some of these exercises can even be done while riding the chair. Next spring, we will evaluate what worked and what did not and refine the program further. (SAM will report those findings as soon as they are available, likely next summer. —Ed.)

Employee safety pays for itself. There are published studies that show an extremely favorable return on investment for enhanced health and wellness in employees. In the first year of my work with another group of young seasonal workers, injury and illness rates were decreased by 40 percent. Ten years later, for the first time in the history of that industry, we had a season with zero recordable incidents, and the culture of the group has changed to include base fitness, adequate hydration, and a diet high in fruits and vegetables, complex carbohydrates and low-fat protein. Can you afford not to implement such a program?



For more information on the Fit to Snow program, e-mail Delia at DRoberts@selkirk.ca.