2. Introduction
Return-to-work of our increasingly older workforce is a
significant challenge
Do older workers generally require longer to recover
from injury?
What factors may influence the older worker’s recovery
from injury?
How can we create an optimal healing environment for
the older worker?
3. Do older workers require longer periods
of rehabilitation? Are outcomes similar?
Average duration of absence (weeks)
12
Time off work
10
8 Older workers are off
6
4
work longer
2
0
< 20 20-24 25-29 30-34 35-39 40-44 45-49 50-54 55-59 60-64 65+
Sustained return to work (% of workers in employment 14 -19 months
post injury)
Sustained return to work
100%
Men 55+
80%
60% are somewhat less likely to
40%
20%
RTW
0%
15-24 25-34 35-44 45-54 55-64 65+
Age male female
4. Factors influencing RTW of older workers
Tissue
Specific
Severity & Healing Skills &
Chronicity Rates Experience
of Injury
Age Related Lifestyle &
Physiological Systemic
Changes Health
Status
Older Worker
& Injury Ergonomics
Individual Recovery & Individual
Genetic Body
Attributes Mechanics
Psychosocial Physiology of
Environment Pain
Mental
Well- Being
5. Age-related changes in functional capacity
Age-related changes are
specific to each
individual
Genetic disposition
Lifestyle & health
behaviours
History of hazardous
exposures
Individual body mechanics
Age-related functional changes are a product of
individual factors & not simply chronological age
6. General characteristics of ageing (1)
Physical
↓ aerobic capacity
↓ muscular strength &
endurance
↓ threshold to fatigue
↓ resilience to physical
stress
↓ maintenance of healthy
tissues & injury healing
Physical work capacity is
reduced +++ by inactivity
7. General characteristics of ageing (2)
Sensory: Mental:
↓ vision ↓ information processing
ability
↓ hearing
↓ sensory information
↓ balance processing
↓ motor control
Body control may decline
when off-work for extended
periods
9. Tissue Healing (2)
Chronic MSDs &
Occupational Overuse
Syndromes
Tissue irritation due to
excessive load-bearing
Inflammatory & repair
processes co-exist
Chronicity dictates the
time & extent of recovery
Difficult to predict prognosis.
Early intervention is crucial.
Physiotherapy may assist in acute flare-ups
10. Tissue Healing (3)
Muscle - well vascularised & short duration
Tendon - less vascularised & moderate duration
Ligament - poorly vascularised & longer duration
Intervertebral disc – extended
duration & capacity for
repair unclear
Healing rate is related to the specific tissue type
11. Health Status – a snapshot
Workforce reflects the broader health status of the
Australian population
Systemic health of injured workers will interface with the
rehabilitation process.
Return-to-Work process should recognise the
systemic health status of the workforce
12. Health Status (2)
Body Weight:
Dietary over-consumption
& physical inactivity has
increased the weight of
Australians;
In the 50-59 yr age group,
24% men & 30% women
are obese.
High proportion of workers are substantially
overweight with ↑ risk of disease & biomechanical
impacts
13. Health Status (3)
Cardiovascular Health
CHD, stroke, heart
failure, hypertension &
peripheral vascular
disease affects 750,000
Victorians
Cardiovascular illness causes reduced work capacity,
lower fatigue threshold, increased injury risk &
increased susceptibility to de-conditioning when
injured
14. Health Status (4):
Diabetes - prevalence rate across Victoria has doubled in
the past 5 years
Diabetes causes metabolic disruption to normal tissue
maintenance & healing processes with possible
impacts (?) for repetitive work tasks & injury recovery
15. Health Status (5)
Osteoarthritis
~11% of workforce have
osteoarthritis
OA may create abnormal
stresses on adjacent
body segments
OA may reduce
weightbearing exercise &
lead to reduced fitness
OA may increase the risk of injury recurrence & impact
on risk control based on ‘correct lifting techniques’
16. Body mechanics
Body mechanics:
may vary on the same
tasks
may change with age &
deconditioning
Faulty body mechanics may perpetuate MSDs in some
individuals & restrict return-to-work
17. Psychosocial environment
Control over pace of work
Control over breaks
Supervisor support
Peer support
Role clarity
Shift work
18. Managing the environment to facilitate
Return-to-Work
What factors can we influence to create an optimal
healing environment for the older worker?
19. Promote a Healthy Lifestyle
Diet
Management of drug
& alcohol consumption
Exercise
20. Job Ergonomics & Body Mechanics
Manual handling risk
management
Suitable duties to match
functional capacity
Improve body mechanics
Improve general &
specific fitness
Fit the task to the worker and correct faulty body
mechanics
21. Create a Supportive Psychosocial
Environment at the Workplace
Supervisor support
Peer support
Control over tasks etc
Flexibility
Shift work
Minimise the stress response to maintain positive
mental well being & prevent adverse physiological
affects on healing tissues
22. Work Ability
Work ability of the older worker:
Age
Genetic pre-disposition
Physiological & psychological
changes
Health behaviours/lifestyle
Experience & skills
Match/mismatch with critical job demands
23. Health
Work Ability functional
capacities
Model
Adjustment of Promotion of Adjustment of
physical work work ability psychosocial
environment 45+ work environment
Professional
competence
Good work ability, health
and competence
Good productivity and Good quality of life
quality of work and well-being
Good retirement,
meaningful, successful and
productive “Third Age”
Ilmarinen 2001
24. Conclusion
Return-to-Work of our older workers remains a challenge
Older worker health reflects exposure to occupational
hazards & individual health behaviors
Young worker OHS is a high priority to prevent
deteriorating health with advancing age
OHS management should promote health & wellness in
a broad context