Healthy Aging for a Sustainable Workforce

Conference Discussion Papers and Resources (Part 1)

Overview of NAS report findings
Occupational safety and health issues among older workers
Injuries, illnesses, and fatalities among older workers
Challenges and opportunities of aging construction workers

Overview of NAS report findings:

Health and Safety Needs of Older Workers
Committee on the Health and Safety Needs of Older Workers
David H. Wegman and James P. McGee, Editors
National Academy Press, 2004

Conclusions and Recommendations

Chapter 9 of this report summarizes conclusions and presents detailed recommendations pertaining to three major themes that emerge from examination of the health and safety needs of older workers as follows:

(1) Conducting informative research requires improved databases and data systems necessary to track the health and safety needs of older workers and the programs that address them.

• New longitudinal datasets should be developed that contain detailed information on workers’ employment histories and the specific demands of their jobs, as well as objective information on the health and safety risks to workers on the job.
• Ongoing longitudinal surveys (for example, the Health and Retirement Study and the Panel Study of Income Dynamics) should either increase the information they gather on health and safety risk factors of the workplace or develop periodic modules to do so.
• The National Institute for Occupational Safety and Health (NIOSH) should collaborate with the Bureau of Labor Statistics (BLS) in conducting a comprehensive review and evaluation of occupational injury and illness or disorder reporting systems, examining the extent of, and trends in, underreporting and under-ascertainment.
• NIOSH should develop a database that characterizes types and levels of exposures associated with work; exposures considered should include chemical, physical, biomechanical, and psychosocial factors.
• The BLS should initiate reporting of workplace injury and illness or disorder rates according to demographic characteristics (for age, gender, and ethnicity at a minimum).
• The National Center for Health Statistics (NCHS) and NIOSH should develop a survey supplement on work risk factors and occupational disorders for periodic inclusion in the National Health Interview Surveys.
• The NCHS and NIOSH should collaborate in an effort to identify, using the National Health and Nutrition Examination Survey, subpopulations of older workers where chemical exposure is likely to be an important work risk factor and to develop a list of chemicals to be included in surveys of such populations in the future.
• NIOSH and the Department of Labor (DOL) should collaborate and be funded to develop a survey instrument and periodically conduct surveys to describe the prevalence of and trends in job characteristics and other workplace risk factors in a manner similar to the Quality of Employment Surveys.
• Enhanced efforts should be devoted to achieving a comprehensive, interactive O*NET database as quickly as possible.

(2) Research is needed to provide better understanding of the factors that relate to the health and safety needs of older workers.

• Substantial research should be conducted on the physiological, pathological, and functional effects of common and potentially harmful worksite exposures—physiochemical, biological, biomechanical, and psychosocial—on older workers.
• A research program should be conducted to provide systematic and substantial understanding of the effects of potentially harmful workplace exposures on individual and population outcomes among older workers with existing chronic conditions.
• Targeted research should be undertaken to identify the extent to which, and mechanisms whereby, socioeconomic and demographic variables are related to health and safety risks of older workers; the degree to which these variables predict employment in hazardous occupations and industries; and how they may be associated with retirement decisions and barriers.

(3) Research is needed to identify and clarify the aspects of policies, programs, and intervention techniques and strategies that are effective and that are not effective in addressing the health and safety needs of older workers.

Evaluation research should be conducted to determine the degree to which public policies intended to enable workers to remain at work safely and productively have met these objectives specifically with regard to older workers.

• For promising job design, training, and workplace accommodation interventions, research should be conducted to determine the prevalence, effectiveness, and associated costs of intervention.
• Research should be conducted to assess the effectiveness, benefits, and costs of worksite health promotion programs and techniques tailored to older workers.
• Research should be undertaken to assess the full (direct and indirect) costs of older workers’ occupational injuries and illnesses or disorders to individuals, family, and society.

Requisite funding for these efforts should be provided.

Occupational safety and health issues among older workers

Bureau of Labor Statistics Office of Safety and Health Statistics
Elizabeth Rogers

The presentation I gave explored data on workplace injuries, illnesses, and fatalities among older workers and was based on an article published in the Monthly Labor Review in October 2005. Data from the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses and Census of Fatal Occupational Injuries provide a wide range of information about occupational injuries, illnesses, and fatalities.

The Survey of Occupational Injuries and Illnesses provides the number of workplace injuries and illnesses and the rate of such incidences, based on full-time equivalent workers. Data are available for most private-industry workers. For cases that involve days away from work, which are generally considered the most serious cases, the survey also provides detailed demographic data on the worker involved and detailed characteristics of the case, such as the event that precipitated the incident and the part of body affected. Nonfatal data included in the presentation were from 2007.

The Census of Fatal Occupational Injuries provides counts of the number of workplace fatalities and the rate of such incidents per worker. Data are for private industry, governments, the resident military, and the self-employed. For each fatality, data include information on the nature and event of the injury, the demographics of the decedent, and his or her industry and occupation. Fatality data included in the presentation and in this summary are preliminary 2007 data; revised 2007 fatality data are now available.

Workplace injuries and illnesses

Older workers required more days away from work to recover from a workplace injury or illness than did their younger counterparts. The median of days away from work for all workers was 7 days; for those aged 55–65, it was 12 days, and for those aged 65 and older, it was 16 days. Older workers have more disabling conditions, such as fractures and multiple injuries, than do younger workers; also, similar events (for example, falls) lead to more severe injuries in older workers than in others.

An example of the severity of injuries and illnesses sustained by older workers can be seen by looking at the nature of the injury or illness sustained. The nature of the injury or illness is defined as the principal physical characteristics of the injury or illness, such as a cut, a bruise, or a sprain. Although sprains, strains, and tears make up the largest single category at all ages, there is a notable tradeoff between that category and factures as age increases. For older workers, the percentage suffering a sprain, strain, or tear declines as the percentage suffering a fracture increases.

Workplace fatalities

Of the 5,488 workplace fatalities in 2007, 558—slightly more than 10 percent—were among workers aged 65 and older. But the fatality rate for older workers (9.9 fatalities per 100,000 workers) was nearly 3 times that of younger workers. The most prevalent fatal events among workers aged 65 and older were transportation incidents, falls, and contact with objects and equipment.

Case studies

The available data on workplace injuries, illnesses, and fatalities allow for case studies of a number of variables, including specific industries, occupations, and events. The remainder of the presentation explored two examples of such case studies, one of older truck drivers, the other of falls among older workers.

Truck drivers have consistently been one of the occupations with the greatest numbers of injury and illness cases involving days away from work. Heavy and tractor-trailer truck drivers of all ages experienced more than 57,000 cases involving days away from work in 2007, and within this occupation, clear differences in the injuries and illnesses are evident among older workers. More than 15 percent of older truck drivers’ injuries result in fractures, compared with 9.9 percent for all truck drivers.

Falls on the same level

This case study indicates how falls on the same level, which might not be considered particularly serious, can have more severe effects on older workers than on younger workers. For workers aged 65 and older, 4 out of 5 falls leading to days away from work were falls on the same level; for all workers, the ratio was 2 out of 3.

Sprains, strains, and tears are the most prevalent injury resulting from a fall on the same level for all workers, as well as for those aged 45–54 and 55–64. However, for those aged 65 and older, the most prevalent injury resulting from a fall on the same level is a fracture. More than 28 percent of falls on the same level among workers in this age group led to a fracture. Consequently, the percentage of such falls that result in a sprain, strain, or tear declined with age.

Among all workers, the occupations with the greatest number of falls on the same level were heavy and tractor-trailer truck drivers and retail salespersons. For workers aged 65 and older, the occupations with the greatest number of falls on the same level were retail salespersons, waiters and waitresses, and janitors and cleaners.

Fifteen percent of all occupational fatalities were the result of falls, with only about 10 percent of the falls being on the same level. Such events do not often lead to a fatality, except among older workers. For those aged 65 and older, 19 percent of fatalities were the result of falls and 23 percent of those falls were falls on the same level. Workers who died from fatal falls on the same level often injured their heads. The physical condition resulting from a fall on the same level was often multiple intracranial injuries and fractures. For cases in which the injury affected the limbs or trunk, workers may have had complications following medical treatment that ultimately led to their death.

Injuries, illnesses, and fatalities among older workers

Elizabeth Rogers and William J. Wiatrowski
October 2005, Vol. 128, No. 10

Older workers face many of the same workplace hazards as do other workers; the most prevalent events leading to job-related injuries or fatalities are falls, assaults, harmful exposures, or transportation incidents. But in many cases, the nature of the injury suffered by an older worker is more severe than that suffered by younger workers. Older workers who suffer a workplace injury may experience longer recovery periods than their younger counterparts. And older workers die from workplace injuries at a higher rate than do younger workers. This analysis focuses on occupational injuries, illnesses, and fatalities among older workers, and identifies differences in the severity of the events as a result of age.

Americans are living longer than ever before, and increasing numbers of older Americans are working. These facts have led to expanded interest in the activities of older Americans, and their work life. Americans born at the beginning of the 21st century can expect to live an average of 77 years, an increase of 9 years, compared with persons born a half century ago. Those aged 65 in 2000 can expect to live 18 years. Considering age 65 to be a typical retirement age, individuals can expect to live nearly 2 additional decades. Both the need to feel productive and the need for income may lead these older Americans to work during what are typically considered retirement years.

Further, the cohort of older Americans is getting larger. There are currently 35 million Americans aged 65 and older, and another 28 million age 55–64. The baby-boom generation, those born in the years following World War II, are currently in their early 40s to late 50s. Over the next 20 years, the percent of Americans aged 65 and older will grow from the current 12 percent of the population to 21 percent. Clearly there is much interest in this group.

This excerpt is from an article published in the October 2005 issue of the Monthly Labor Review. The full text of the article is available in Adobe Acrobat's Portable Document Format (PDF).

Challenges and opportunities of aging construction workers

Sue Dong, DrPH
CPWR – The Center for Construction Research and Training
Silver Spring, MD

Introduction

The labor force in the United States is rapidly growing older. Construction workers are typically younger than the national labor force, but construction workers are also aging. The average age of construction workers was 39.5 years old in 2007, 3.5 years older than it was in 1985. The median age was 34 years for construction workers in 1985, while it was 39 years in 2007. The proportion of construction workers aged 45-64 years increased from 25 percent in 1985 to 34 percent in 2007. Older workers are more vulnerable to risks at worksites due to possible declining cognitive and physical abilities with age. Given the hazards at construction sites and high physical demands of the construction industry, this aging trend is a significant challenge for construction safety and health.

To better understand this special population group and identify the patterns of work-related injuries and illnesses, health insurance, and health care among older construction workers, we analyzed several large, nationally representative datasets, including the Census of Fatal Occupational Injuries (CFOI), the Survey of Occupational Injuries and Illnesses (SOII), the Current Population Survey (CPS), the March Supplement to the CPS, the National Health Interview Survey (NHIS), the Medical Expenditure Panel Survey (MEPS), and the Health and Retirement Study (HRS). We also used the BLS’ Current Employment Statistics’ most recent two years of data to measure the effects of the current economic downturn on construction employment. In addition, we predicted the trends of the aging construction workforce for the next decade using the BLS’ Employment Projections for 2006 to 2016. Tabulations were conducted using SAS (version 9.2).

Main Findings
Aging construction workers

As a result of the housing boom, construction employment dramatically increased in the last 15 years from 7 million in 1992 to 11.8 million in 2007. With the employment growth, the construction workforce divided into two main demographics: the entry of a large number of young Hispanic workers and the existing workforce that is growing older. The average age of non-Hispanic construction workers was 41.2 years in 2007, about 6.6 years older than Hispanic construction workers.

Age structure varied among construction subgroups. Self-employed construction workers were much older than wage-and-salary workers (44.7 years vs. 37.9 years). About one in four construction workers were self-employed or independent contractors; a total of 2.6 million in 2007. One in three self-employed construction workers were 50 years or older. Additionally, nearly 15 percent of construction workers were unionized in 2007. Among workers who were 50 years and older, nearly 19 percent were union members, compared with only 11 percent of construction workers who were under 35 years old. On average, union members in construction were 3 years older than non-union workers (40.5 years vs. 37.5 years).

During the economic downturn, more than one million wage-and-salary construction workers lost their job. Hispanic workers and workers who were not unionized were more likely to be unemployed. The average retirement age in construction has increased to 61.4 years in 2006 from 59.3 years in 1994. It is expected that many older construction workers may delay retirement as long as the housing and stock market remain troubled and unstable. The growth of the older population combined with the increased participation rates of the elderly will cause the workforce to continually age until 2020. This challenge of an aging workforce will be considerable for the construction industry in terms of skills shortages, safety and health, and health care.

Skills shortages

Despite the current economic downturn, skills shortage is still a concern in construction. A major influence on the age composition of the labor force has been by the baby-boomer generation, which includes those born between 1946 and 1964. This group has accounted for a large portion in the construction industry. In 2007, about 4 million construction workers were baby boomers, accounting for 37 percent of the construction workforce. This group is currently approaching retirement age. The data revealed that baby boomers in construction were retiring earlier than those in the overall labor force. This relatively early exit of the baby boomers in construction from the prime-aged workforce will have a profound effect since subsequent generation X, known as baby busters, who were born between 1965 and 1983, is smaller in size.

Anticipated industry growth in the next decade and replacement needs will increase the demand for more skilled construction workers. It is estimated that in the time frame of 2006-2016, construction employers will need 282,263 laborers, 255,558 carpenters, 140,316 electricians, 124,558 plumbers, and 107,902 operating engineers as new workforce entrants. On average, 390,000 new construction workers will be needed annually in the next decade, but the active number of construction apprentices in the 2008 fiscal year was only 258,109. The current economic crisis has currently reduced labor shortages, but in the long run, scarcity of qualified and skilled construction workers will hamper the recovery of the industry when the economy improves.

Safety and health

The rate of work-related deaths steadily increased with age, resulting in the greatest risk for older workers 55 years and older. This trend was also observed when assessing the leading cause of death: falls. There were 5.2 fall fatalities per 100,000 full-time workers aged 55 and older, compared with 3.1 and 3.9 fall fatalities per 100,000 full-time workers for those aged 15-34 years and 35-54 years, respectively.

Nonfatal injuries yielded a different pattern. For the leading cause of nonfatal injuries (i.e., contact with objects), workers in the 15-34 year age group had a rate of 89.1 per 10,000 full-time workers, as opposed to 53.2 per 10,000 full-time workers for those aged 55 and older.

Age and health were directly associated in which health deteriorated with age. Older construction workers’ perceived health leaned more towards the negative end of the spectrum when compared with their younger counterparts. Acute and chronic health conditions were generally non-occupational, but these conditions could be exacerbated by working activities and ultimately lead to absenteeism, poor performance, and exiting the workforce. Among construction workers who were above 50 years old, the prevalence of chronic diseases and ailments was found to dramatically increased in the past three months, such as low back pain (31.2 percent), joint problems (31.9 percent), hearing loss (34.4 percent), vision problems (despite corrective glasses or lens, 15.3 percent), hypertension (46.4 percent), and diabetes (8 percent for those aged 55 and older). Some health problems also caused difficulty with activities among older construction workers: lung/breathing problems (5.5 percent), musculoskeletal/connective tissue problems (7.1 percent), and arthritis/joint symptoms (21.3 percent).

Health insurance and heath care costs

Health care is often greatly influenced by health insurance coverage. Nearly 23 percent of construction workers aged 50 years and older were uninsured. Having insurance generally affects staying on top of health care and seeking medical attention. In a dangerous industry such as construction, being insured allows workers to combat the continual risks they face and take better care of themselves.

In general, workers aged 50 and older visited health professionals more frequently than younger workers. Health expenditures for older workers were over 2.5 times more than those of younger workers. In 2006, older workers spent $3,336 per person on average, whereas younger workers only spent $1,256 per person on average (2005 dollars). Therefore, uninsurance was a more serious problem for older workers than for their younger counterparts.

Conclusion

The findings suggest that health policies and employment policies should take the aging workforce into consideration. Older workers will be critical to a successful economic recovery due to their skills and experience. Safety and health interventions (e.g., injury prevention, job redesign, and ergonomic programs) should meet the needs of older workers, especially older construction workers who face high risks and high physical demands at worksites. The value of older workers will overcome the negative effects of aging with appropriate management and cooperation among labor-management, health care providers, health and disability insurers, health educators, and researchers. It is essential to retain labor standards and conditions of employment in the face of this economic crisis. The trends of the aging workforce also bring attention to issues such as delaying retirement, retiree health benefits that are both available and affordable, and income production in retirement.

References

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• Edington, DW. (2001). University of Michigan Health Management Research Center. American Journal of Health Promotion.
• Feinsod R, Davenport, TO. (2006). “The Aging Workforce: Challenge or Opportunity?” World at Work Journal, Third quarter.
• Perrin, T. (2005). “The Business Case for Workers Age 50+: Planning for Tomorrow’s Talent Needs in Today’s Competitive Environment.” A report for AARP, www.aarp.org/employerresourcecenter.
• Toossi, M. (2006). A New Look at Long-term Labor Force Projections to 2050. Monthly Labor Review, November 2006, page 19-39.
• VanDerhei J, Copeland C, Salisbury, D. (2006). Retirement Security in the United States – Current Sources, Future Prospects, and Likely Outcomes of Current Trends. The Employee Benefit Research Institute - Education and Research Fund (EBRI-ERF).

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