the ageing workforce dr robin ‘sid’ o’toole occupational physician
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The Ageing WorkforceDr Robin ‘Sid’ O’TooleOccupational Physician
Scope
• Australia’s Ageing workforce• Effect of Ageing
• Body and Soul• Workplace
• Prevention versus Accommodation
Ageing Ozo 2007
oPopulation ≅ 21millionoProportion ≥ 65yrs ≅ 13%oProportion 15 - 64yrs ≅
67%
o 2056 (projected)oPopulation ≅ 35.5 millionoProportion ≥ 65yrs ≅ 23%oProportion 15 - 64yrs ≅
60%
Dependency Ratio
o 2007 Dependency Ratio = 48
o 2056 Dependency Ratio = 65
o Increase in ratio is expected
to commence from 2015.
Life Expectancy
o In 1970o ♀ - 74.5 yearso ♂ - 67.8 years
o In 2010o ♀ - 84.9 yearso ♂ - 80.4 years
o In 2050o ♀- 88.0 yearso ♂- 84 years
Quick Summary
o Enter the Workforce at 18
o Leave at 65
o Die aged 84
o Contributed to Dependency for 47 years
o Been Dependent for 47 years
95
58 years
75
37 years
57 years
Decreasing Dependency
o Can't start earlier
o Exploitation and Fair Work legislation
o Best to get people to work longer
o Less time that they are dependent
o Earn more as you get older therefore
more tax revenue.
Effect of Ageing - Body
o ↓ muscle strength and balance
o ↓ aerobic capacity and endurance
o ↓ Joint mobility – flexibility and
posture
o ↑ reaction time
o ↓ Hearing/vision
o Altered Sleep Pattern
o Increased potential for chronic
disease
Effects of Ageing - Soul
• Slower mental
processes (NB Quality
may be the same)
• Ingrained perceptions
• Rigidity
Effect of Ageing - Workplace
o Physical Effects of Ageing
o↑ risk of trips, slips and falls
o↓ tolerance to shift worko Particular significance c.f. night shift
o↓ ability maintain intensity of effort
o↓ Ability to work in extremes of temperature
o↑ Time to train on new practices.
Effect of Ageing - Workplace
o Injury rates are less
o Injury more severe
o Result of Injury longer to resolve
o Injury healing time only slightly longer
o De-conditioning is a major contributor
o Premature retirement
o Injury costs more (up to ~ 2x)
Effect of Ageing - Workplace
But…..
o Older Workers are;oMore happy with their post injury
outcomeoHave better adaptationoCorporate knowledge
Job Lock
• Worker feels locked into their job and unable to securely seek further employment
Prevention vs Accommodation
Prevention
o Alter the populationo Alter Employment Strategies
oOnly employ youngoOnly employ for set period of time
(contract)oStrict Pre-employment Physical
StandardsoMaintenance of Physical Standards
Accommodation
oWorkplace ChangesoManagementoPhysical
General approach
People are lazy
Organisations / Governments are lazier
Prefer to be given something that they can
approve and take credit for than to actually
develop it
Workplace Management Changes
Accept there is a problem
Apply resources to assess extent
Create defined mission statements
Create Protocols / Procedures
Assess your progress
Adapt
Need for rigid protocols
Current level
Injured Worker
Injury Retirement
Lateral Integration
Maintain Current Job
Reduced Level
Someone else’s Job
Vacant job
Random Company X
o Everyone must be able to do
Everything
o Guise of Cross Training
o Can they safely perform all tasks?
o Fitness for duty assessment
o Ask an OP.
o Functional Capacity Examination
Job Task Analysis1.Show up
2.Drink coffee
3.Talk to mates
4.Lift heavy things
5.Clean toilets
6.Drive trucks
7.Mop floor
8.Juggle cats
9.Shave widgets
Functional Capacity Evaluation
Current level
Injured Worker
Injury Retirement
Lateral Integration
Current Job Reduced Level
Someone else’s Job
Vacant job
Pass
Fail
FCE
Need for rigid protocols
Current level
Injured Worker
Injury Retirement
Lateral Integration
Current Job Reduced Level
Someone else’s Job
Vacant job
Pass
Fail
FCEOlder Worker
Discrimination
ALL Workers
Need for rigid protocols
Current level
Injury Retirement
Lateral Integration
Current Job Reduced Level
Someone else’s Job
Vacant job
Pass
Fail
FCEOlder Worker
Periodic Health Examination
Age Periodic Health Exam Functional Exam
20 - 39 If indicated If indicated
40 Both
41 - 49 5 yearly If indicated
50 Both
52 & 54 Yes If indicated
55 + Yearly Every 2-5 years
But
o Confrontingo Needs to be sold to the workforceo Argued that it is a company’s DoC to do this.
Protocols
o Must cover off ono Failures
o Reasonable accommodation
o Workplace Rehabilitation
o Change the Job Task Analysis
Workplace Physical Changes
o MHEo Technology
o Worker advice
o Worker
What about the Insurer?
• Must decide– Injury versus – Exacerbation/Aggravation versus –Normal Ageing Process
Decision requires
• Knowledgable specialists practicing Evidence Base Assessment– Seriously!
But….
o My workforce aren’t performing a physical task
o A fitness for duty assessment isn’t necessarily a physical test.o Cognitive assessmentso Psychological assessmentso Assessment of effects of Chronic Disease
Take home messages
o We’re getting older, and having to
work longer
o Proportion of those available for
recruitment islessening
o Stuck having to employ older people
o Need to take care of those we’ve got
Take home messages
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