The Aging Workforce: Occupational Safety, Health, Hygiene ... s/EEI Fall 2010/EEI_PPT... · The...
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The Aging Workforce: Occupational
Safety, Health, Hygiene and
Wellness Considerations
EEI Fall Occupational Safety &
Health Committee Conference
Orlando, Florida
Howard M. Sandler, MD
September 28, 2010
Changes to the Future of Work
• Workforce– Age
– Gender
– Culture
• Employment– Precarious
– Benefits
– Global & Virtual
• Hazards– New Technologies
– Organization of Work
– Stress
© 2010 Sandler Occupational Medicine Associates, Inc.
U.S. 21st Century Workforce
Challenges
Chronologically older
Limited availability
Key skills lacking
Global & Virtual
Diverse
– Race
– Gender
– Age Generations
– Culture
Source: Testimony by Tamara J. Erickson to the U.S. Senate
Committee on Health, Education, Labor and Pensions, May 2005© 2010 Sandler Occupational Medicine Associates, Inc.
Screeching to a Halt:
Growth in the Working-Age Population
Source: Deloitte Research/UN Population Division (http://esa.un.org/unpp/) It’s 2008: Do
You Know Where Your Talent Is? Why Acquisition and Retention Strategies Don’t Work, p.6
-50%
0%
50%
100%
150%
200%
Mexico Brazil India China South Australia Canada US Netherlands Spain France UK Russia Italy Japan Germany
Korea
1970-2010
2010-2050
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2007 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
5% 5%
-9%
18%
48%
15%
-20%
0%
20%
40%
60%
80%
16-24 25-34 35-44 45-54 55-64 65+
Age of Workers
Percent Growth in U.S. Population by Age: 2000-2010
Dramatically Different Patterns of
Growth by Age
Source: U.S. Census Bureau
© 2010 Sandler Occupational Medicine Associates, Inc.
. . . Continuing Into the Future
Age of Workers
Percent Growth in U.S. Workforce by Age: 2000-2020
7% 8% 7%
-10%
3%
73%
54%
-20%
0%
20%
40%
60%
80%
under 14 15-24 25-34 35-44 45-55 55-64 65+
Source: U.S. Census Bureau
© 2010 Sandler Occupational Medicine Associates, Inc.
In 2000, A Fairly “Young” World . . .
Under 5% 5% to 12.4% 12.5% to 20% Above 20%
Source: U.S. Census Bureau
Percent of Population Age 60+ in 2000
© 2010 Sandler Occupational Medicine Associates, Inc.
. . . Rapidly Aging by 2025
Source: U.S. Census Bureau
Under 5% 5% to 12.4% 12.5% to 20% Above 20%
Percent of Population Age 60+ in 2025
© 2010 Sandler Occupational Medicine Associates, Inc.
“Sudden” Boom in Life Expectancy
Source: U.S. Census Bureau, 2000
Life Expectancy at Birth: 1000 – 2000Age
76.5
47
3836
35
30
25
0
10
20
30
40
50
60
70
80
1000 1200 1400 1600 1800 1900 2000
© 2010 Sandler Occupational Medicine Associates, Inc.
Calendar Year
2007 NERC Utility Industry
Aging Worker Assessment
© 2010 Sandler Occupational Medicine Associates, Inc.
US Utility Workforce
• > 50% is age 45 or older
• By 2012, > 10,000 utility jobs potentially
not filled
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
• to disappear
• to go away
• to withdraw
Source: Webster's New Twentieth Century Dictionary
Webster's Definition of Retirement
© 2010 Sandler Occupational Medicine Associates, Inc.
Average Retirement Age of Males
Source: Center for Strategic and International Studies
France
64.5
59.2
65.2
60.5
64.5
60.6
66.2
62.3
66.2
62.7
66.5
63.6
67.2
Germany Italy Canada UK US Japan
1995196068
66
64
62
60
58
56
66.5
© 2010 Sandler Occupational Medicine Associates, Inc.
National Research Council StudyCommissioned by NIOSH, 2004
Characterize the older adult workforce over next 20-30 years
Identify the key policy and research issues
Address retirement patterns and characteristics of the older adult workforce and their jobs
Conduct workshop on differential effects of environmental hazards
© 2010 Sandler Occupational Medicine Associates, Inc.
NRC Study (2004), cont’d
• Life course perspective emphasizes aging productively versus age
• Beginning clearly to detect age-related changes
• Can address disease risk factors to extend years of healthy living
• Promote research to capture precursors of age-related changes
© 2010 Sandler Occupational Medicine Associates, Inc.
Proportion of 50+ yr olds Still
Employed at Subsequent Agesby Age Attained and Class (U.S.)
0
10
20
30
40
50
60
70
80
White Collar Blue Collar Service
60
65
70
US Bureau of Census 1981-2000© 2010 Sandler Occupational Medicine Associates, Inc.
Age and Chronic Conditions: How
healthy are older workers?
© 2010 Sandler Occupational Medicine Associates, Inc.
Aging Increases the Risk for:
• Hypertension
• Cardiovascular Disease (Stroke, MI, PAD)
• Insufficient Sleep
• Fatigue
• Arthritis/Musculoskeletal Disorders
• Diabetes
• Incontinence
• Dry Eyes
• Kidney Disease
• Multiple Medication Usage
• Delayed Recovery From Injury
© 2010 Sandler Occupational Medicine Associates, Inc.
Aging Increases the Risk for
• Obesity/Overweight (2/3 of older Americans)
• Dementia
• Depression
• Decreased Cognition
• Cancer
• Visual Difficulties
• Hearing Loss
• Decreased Pulmonary Capacity
• Chronic Obstructive Pulmonary Disease
• Decreased Strength, Coordination, Reaction Time
© 2010 Sandler Occupational Medicine Associates, Inc.
From Risk Factor to Disease
• Obesity Diabetes CV, PN,
GERD, Arthritis, IPF
• GERD Asthma, IPF
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
Aging: A Balance of Factors
• Possible Limitations
– Mental Capacity
– Chronic Conditions
– Physical Capacity
• Compensating Factors?
– Attitude
– Judgment
– Flexibility
– Interest in learning new things
© 2010 Sandler Occupational Medicine Associates, Inc.
Mental Capacity
• Laboratory Tests
– Cognition speed
• Information retrieval slower, unless material is
familiar
– Learning and recall slower, but equally
successful in the end
– Greater retention, higher learning
achievement and more likely to complete a
new field of study than younger workers
© 2010 Sandler Occupational Medicine Associates, Inc.
Mental Capacity:Relevance to On-the-Job Performance
• Lab tests do not translate well to actual work
settings
• Factors other than psychometric cognitive
abilities appear important to perform well at
work
– How well worker gets along with co-workers
– Desire to perform well
• Individual measures are quite sensitive to
occupational class© 2010 Sandler Occupational Medicine Associates, Inc.
Diagnoses Among Disability Female Pensioners by Age
(Sweden 1990-1993)
0
10
20
30
40
50
60
70
<29 30-44 45+
Psych Disorders Cardiovascular MSD
Höög & Stattin, 1996 © 2010 Sandler Occupational Medicine Associates, Inc.
Workers with >1 Chronic
Condition by Age (U.S.)
0
10
20
30
40
50
60
70
>1
51-64 65-74 75+ Non-workers
HRS 1998© 2010 Sandler Occupational Medicine Associates, Inc.
Prevalence of chronic conditions
among adults aged 65 years or older
varied by race/ethnicity in 2002-2003
© 2010 Sandler Occupational Medicine Associates, Inc.
Physical Capacity: Can Older Workers
Keep Up?
• Physiology
– Maximal strength at 20-30 years
– O2 uptake reduced to 70% (max) by 65 years
– Older adults work closer to capacity
• Match Ability to Job Requirements
– Change in industry from manufacturing to services
– Change in job duties from physical to mental
© 2010 Sandler Occupational Medicine Associates, Inc.
Productivity Loss at Work: Health-
Related and Work-Related Factors(van den Heuvel et al, 2010)
• Health Factors
– Sickness Absence > Low Performance
• Low Performance Risk Factors
– Psychological Complaints >>
Musculoskeletal Symptoms
• Psychosocial Factors
– Low Performance > Sickness Absence
© 2010 Sandler Occupational Medicine Associates, Inc.
Percentage of Fire Fighters in Each
Age Group Exceeding Selected
Clinical Criteria
Age Groups
Criteria 20-25 30-35 40-45 50-55 60-65
>25% Body Fat 0 27 60 83 77
Borderline to moderate hypertension 20 33 53 70 73
Positive exercise stress test 0 0 7 10 40
Mid to moderate pulmonary impairment 10 13 30 23 53
© 2010 Sandler Occupational Medicine Associates, Inc.
Work Settings:
Employing Older Workers• Decreased performance
– For physically demanding work only
• Work uncommonly demands maximal effort
• Non-physical advantages that older workers
bring to a job are rarely measured
• Workers abilities matched to the job results
in less morbidity
– Accommodation thinking rare in industry1
• May change with ADA Amendments Act of 2008
• Workers are changing (aging) and jobs are changing
1 Eur J App Phys 2003 89:536
© 2010 Sandler Occupational Medicine Associates, Inc.
Financial/Regulatory Impact of
Aging Workers
• Direct Health Care Costs
• Lowered Injury Rates but More Expensive Injuries/Disease (Slower Recovery)
• Increased Time Off by Disease/Injury
• Increased Disability Levels and Costs
• Raising Social Security Eligibility Age
• Americans with Disabilities Act
• Family Medical Leave Act
• Increased Workers Compensation for ―Contribution‖ of Work Duties/Exposures
© 2010 Sandler Occupational Medicine Associates, Inc.
ADA/Regulatory Impact of
Aging Workers
• Prosthetic Limbs
• Canes, Walkers, Wheelchairs
• Pacemakers
• ―Ostomies‖
• Shift Work
• Overtime
© 2010 Sandler Occupational Medicine Associates, Inc.
Aging Productivity
• Injury risk and its consequences differ in older workers
• Medical costs rise with age
– Estimated 25% increase from age 40 to 50 to 35% from age 50 to 60
• BUT, age is less a factor in health care costs than the presence of such risk factors as smoking, obesity, lack of exercise, and diabetes!
• There is such a thing as ―aging productively‖ or ―healthy aging‖!
© 2010 Sandler Occupational Medicine Associates, Inc.
Do aging workers need special accommodations?– A well-designed workplace benefits
everyone
– Work stations and job tasks need to be matched to the capacity of each worker
– There should be no conflict between ergonomic principles vs. reasonable accommodations
© 2010 Sandler Occupational Medicine Associates, Inc.
Are there any specific health and safety concerns related to aging
workers?
– Older workers have fewer injuries, but when one occurs, that injury tends to be more severe and it takes worker longer to get better.
– Injuries differ in older workers—there are more musculoskeletal injuries (especially involving the low back)
– No consistent relationship between aging and work performance!
© 2010 Sandler Occupational Medicine Associates, Inc.
Future Research Needs
• Conduct Longitudinal Studies of Older Workers
– Impact of work risks on older workers
– Interactions with chronic health conditions
– Socio-Economics Status relationships to:• Hazardous employment
• Retirement decisions and barriers to continued work
• Surveys
– Update National Occupational Exposure Survey (NIOSH and OSHA)
– Develop a new Quality of Employment Survey (NIOSH and OSHA)
© 2010 Sandler Occupational Medicine Associates, Inc.
Future Research Needs
• Develop ability to measure rates by age, gender and ethnicity (BLS)
• Aging Productively Management Programs
© 2010 Sandler Occupational Medicine Associates, Inc.
2009 Aging Worker Legislation
• Older Worker Opportunity Act of 2009– Would diminish barriers to part-time work for older
workers such as loss of health coverage and decreased pension benefits by providing a tax credit to hire older workers
• S. 469/H.R. 1198– Would make it easier for feds to rehire fed retirees
part-time without forcing worker to reduce their salary by their pension amount
© 2010 Sandler Occupational Medicine Associates, Inc.
2009 Aging Worker Legislation
• Phased Retirement Bill– Would allow phased retirement for feds
• Health Care & Training for Older Workers Act of 2009 (S.281)– Would extend COBRA from time of retirement until
seniors become eligible for Medicare at age 65
© 2010 Sandler Occupational Medicine Associates, Inc.
What Should Your Utility
Company be Doing?
• Demographic Analyses
• Cost Analysis by injury, illness, age, type of claim
• Implementing/Updating Medical Standards
• Expanding Range of Reasonable Job Accommodations
• Health Promotion Activities
• Disease/Case Management
• Special Exposure Considerations
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
© 2010 Sandler Occupational Medicine Associates, Inc.
Thank You For Your Interest!
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