'11
• . W\-r ~
7J 1rf Directorate General
Central Industrial Security Force
11)'\" IdJI3('; (Ministry of Home Affairs)
MED~~~~H 'ff
M-200 15(32)/Med.Dir./SHAPE Circular/2009-1987
Block No. 13, CGO Complex
Lodhi Road, New Delhi-03
Dated: 30 Dec'2009
To,
All Sector IsG including Director/IG (NISA/TS) & IG/APS
Subject: - Circular on SHAPE classification: Regarding.
This concerns clarifications regarding shape instructions issued vide CISF
Directorate (Pers Branch) letter No. E-320 12/2005/SHAPE/Pers.Il/145 dated 28th Jan'2009.
02. The clarifications are being issued so that our men & officers should be aware of
shape categorization system on the certain diseases which are taking a heavy toll of
manpower.
The diseases are:
a. Overweight & Obesity
b. Hypertension (High Blood Pressure)
c. Coronary Artery Disease (Which leads to Heart Attacks)
03. Principles of Classification of SHAPE Category System
In SHAPE category system, each \vord of SllAPE has meanings as follO\vs:
S -Psychiatric problems
H- Hearing (Ear diseases)
A- Appendages pertains to the problems of upper/ lower limbs i.e. arms and legs
P- Factor is related to other disease like Hypertension (High Blood Pressure), Cardiac
disease (Heart Diseases), Diabetes (High Sugar), Obesity (being Fat - overweight),
Cancer, etc.
E- Eye sight! Eye diseases
Shape classification in above factors i.e. S,H,A,P,E is graded in low medical category if
the health of a person is not up to mark for a certain period as well as depending upon
the type and severity of the infirmity or disease affecting him or any deficiency or excess
found in various blood tests and other investigations and weight. These categories are:
(a) SHAPE-2 ('1'-24): person will be kept in P temporary category for 24 weeks. Any
person non coming back to SHAPE-I in 24 weeks (6 months) goes to P-2-P i.e. P2
permanent.
(b) SHAPE-2-P (Permanent): A person can be kept in to P-2-P category for two years. If .
he improves, he can be upgraded to SHAPE-2 Temporary and than to SHAPE-I after
complete cure.
(c) SHAPE-3-P (Permanent): (i) If person who is SHAPE-2-P for 2 years does not
improve back to SHAPE-I in 2 years, he will go to SHAPE-3-P. Personnel will be
kept this category for two years.
(ii) SHAPE-3-P can also be given to a person who is suffering from some chronic
disease which may take more then two years to be recover.
(iii) If a person in SHAPE-3-P does not come back to SHAPE-2-P within 2 years, he
is given another chance for 2 years i.e. a total of 4 years. If he comes back to
SHAPE-2-P, it means he is improving and will be observed. If he does not improve,
he is put in SHAPE-S-P (Permanent) and will be boarded out.
(d) SHAPE-4-P is a special category in which a person is temporarily unfit for Force
duties due to temporary sickness, hospitalization etc. (On sick/leave on medical ground/
in hospital).
(e) SHAPE-S Permanent renders a person permanently unfit for service. Such a person
should be medically boarded out from service.
Note: -There are certain exceptions to above system in case of diseases like Cancer, Aids
etc.
04. Problems of Overweight and Obesity: - 'faking in to account the average nude weights
according to (~geand height, the individual who are found to be overweight will be dealt
with as under: -
a) If a person's weight is between 10% to 20% more than the ideal weight, the person is
advised in writing, to reduce his weight within 10 weeks under information to his
controlling officer. He / she will be reassessed immediately on completion of this period.
b) If the individual fails to reduce weight to the acceptable level even after 10 weeks,
he will be downgraded to medical category SHAP2E (T-24); and if he/ she reduces
weight to the acceptable 10% limit within this period, the classification proforma will be
completed i.e. he will be restored to SHAPE-l category. But if he fails to do so, he will
be put in P2 (T-48) i.e. SHAPE-2 for a further 24 weeks. Ifhe reduces he can come back
to SHAPE-I. But if he cannot, he will be in SHAPE-2 permanent. His category will
be SHAP2EI (T-72) i.e. for P2 for further 24 weeks. He must reduce and come back in
SHAPE-I within these 24 weeks, otherwise, he will be now in permanently in P-3
category i.e. if a person does not reduce in 72 weeks, he goes to SHAP3E
permanently until he can do a come back.
c) If the body weight is 20% more than the Ideal Body Weight (lBW), investigations will
be carried out to exclude any metabolic abnormality e.g.- abnormal GTT/RFT /Lipid
profile, IHO, Osteo-arthritis etc. If the officer has no metabolic abnormality and ECG is
normal, he should be examined by a Medical Specialist or in his absence, an experienced
CMO (SG), The latter must decide whether it is due to obesity or due to increased
muscle mass/ bone thickness by measuring the following parameters:
1) Body Mass Index (BMI): - Weight (in kg)
(Height in meter) 2
Normal range: 20-25
A person is definitely obese if it is 27 or more
2) Waist and hip ratio:
Method of measurement of waist: 'fake a point mid-way between the 1th rib and
upper border of iliac crest on both sides and measure with a tape,
Method of measurement of hip: Take upper point of greater trochanter of Femur on
both sides and measure the circumference with tape.
Normal range: 0.6 to 0.9 %
A person has definite central obesity ifit is more than 0.9%
3) Skin fold thickness:
It is measured with the help of caliper.
Normal range of sub-scapular skin fold: 18-20 mm
- Triceps skin fold thickness: 12-15 mm
All the above measurements will decidedly determine whether increase in weight is due
to obesity or due to increased muscle mass/bone thickness. If it is due to obesity the
individua'i should bt' downgraded to medical classification - SHAP2E (T-24). If the
individual fails to reduce his weight to ideal level by 48 weeks, he shall be placed in
SHAPE-2 permanent and if does not comply by 72 weeks, in SHAPE-3 permanent.
OS. Hypertension: - Guidelines for hypertension - Hypertension is known as a high blood
pressure more then the normal range. Grading of blood pressure is mentioned as below.
. 1---------...-----------.-'"--- -- ~--..-.-.
Grade ofh ertenslOn Bloo d pressure
---_._--_._-_. __ ._-~- -- -,'_ ... __ ..... ~-------
-------J Systolic H____ --
Diastolic
_~O and <80
~~) 140-1593~~_=~--==Q~_==-- or
80-89
90-99
--_ _----_.- _----_._-- - -.. ---_ __ __
-.- _ .. .. .. -
>160 -_.~._-----_.~--~
or
------_. __ >100 .-
--------------,-------.,-
180-209
------_.~-- 110-119
210 or more 120 or more
Common causes of hypertension
a) Hereditary
b) Lack of physical exercise
c) Smoking
d) Obesity and diabetes
e) Irregular and fatty diet
f) Mental stress
g) Heart disease
06. (I). CAD /lHD (lSCHAECMIC HEART DISEASE):-
The following policy shall be followed:
Clinical condition Classification to be recommended
i) Cases of coronary artery disease (CAD) P-I
with normal CAO, echo and TMT/Stress
Thallium.
ii) CAD with abnormal CAO with
successful PTCA & Stent; CABO with P-2 (T), to be evaluated regularly for one year
normal systolic LV function and without may be up-graded if remains as such to P-I or
angina. down graded if deteriorates.
iii) CAD with abnormal CAO with
successful PTCA & Stent / CABO but P-3 (T), to be evaluated regularly for one year
may be up-graded to P-2 on improvement or
with abnormal systolic LV function (Low
down graded to P-S
'ejection fraction).
Cases with congestive Cardiac p-s
dilated cardio-myopathy, marked
of the heart and cardiac
Valvular Heart Disease: P-5
Paroxysmal S. V. T.
P-3 to be up-graded to P-2 after EPS and Radio-frequency
ablation and to P-l ifremains asymptomatic for one ear.
Pennanent Pace-maker
Initially P-3, to be up-graded to P-2 if remains
im lantation: as m tomatic for one ear.
In the above clarification, he also includes she for lady officers, lady NGOs and other
All Sector IsG are requested to circulate the above guidelines
for knowledge of CISF personnel )t~
to all CISF units under
Director/DIG (Medical), CISF
to DO
: For kind information to DO/CISF please.
PS. to ADO (HQ)
: For kind information to ADO (HQ) please.
PS to ADO (APS)
: For kind information to ADO (APS) please.
lG/HQrs : For kind information please
lG/Adm : -do-
DIG/Adm : -do-
DelED? Cell
: You are requested to publish this guideline on CISF website please.
