the ageing workforce and its implications for occupational health and safety prevention programs and...
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The ageing workforce and its implications for occupational health and safety prevention programs and work-injury compensation systems: A Canadian perspective
Peter SmithSchool of Public Health and Preventive Medicine, Monash University
Acknowledgements• This work is supported through grants from WorkSafeBC
(RS2009-OG03) and the Canadian Institutes for Health Research (111273).
• Peter Smith was supported by a New Investigator Award from the Canadian Institutes of Health Research.
• Access to data sources was made available through the Statistics Canada’s Data Liberation Initiative via the University of Toronto, and through the Statistics Canada Research Data Centre and the University of Toronto.
The Institute for Work & Health
• Independent, non-profit research institute in Toronto, Canada• Majority of funding from the Ontario WSIB ($4.7 million)• Plus approx 2.5 million / year from competitive funding
agencies• Two broad research goals
• to protect the health of workers by studying the prevention of work-related injury and illness.
• to improve the health and recovery of injured workers. • Staff of 22 scientists from a variety of disciplines• Approximately 80 FTE staff in total• Governed by a Board of Directors and a Scientific Advisory
Committee
Compensation systems in Ontario and British ColumbiaLost-time claims (LTCs)After the day if accident/illness, the worker is absent from work; or has reduction in earnings (through fewer hours at old job or
lower wages doing modified work).
No-lost-time-claims (NLTCs)Worker requires health care (arising from work injury or illness), but is not absent from work other than the day of Injury. Also includes modified work for more than seven days at regular pay and hours, even without health care.
Overview Who are older workers and why should we be interested in
them?
Older age and the prevention of work injuries.
Older age and the consequences of work injuries.
Related plans for future research in Victoria
Who are older workers and why should we be interested in them?
Who are older workers?
Human Resources and Skill Development Canada = 45 years or older
Statistics Canada & European Foundation for the Improvement of Living and Working Conditions = 55 years or older
Workers’ Compensation policy around older workers in CanadaLoss of earning benefits End at age 65 for workers who were less than 63-years-old at
the time of injury Workers who are injured when over the age of 63 are paid loss
of earnings for up to two years after the date of injury. In some provinces (e.g. BC) entitlements may be extended
past age 65
Health Care Is available to workers past age 65, regardless their age at
injury
Re-employment Employer’s obligation to re-employ injured workers ends on
the date a worker turns 65 years of age
Population Pyramids: Canada (1980, 2000, 2050)
0 - 4
5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85+
12 8 4 4 8 12
Men Women
Population Pyramids: Australia (1980, 2000, 2050)
0 - 4
5 - 9
10 - 14
15 - 19
20 - 24
25 - 29
30 - 34
35 - 39
40 - 44
45 - 49
50 - 54
55 - 59
60 - 64
65 - 69
70 - 74
75 - 79
80 - 84
85+
12 8 4 4 8 12
Men Women
Canada Australia
Life Expectancy at age 65. Canada: 1991 to 2006
18 yrs
21 yrs
Percent of older persons who are currently working. Canada: 1990 to 2011
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0%
10%
20%
30%
40%
50%
60%
70%
80%
50 to 64 years65+ years55 to 59 years (A)
Source: Canadian Labour Force Survey
Percent of the employed labour force who are over 50 years of age. Canada: 1990 to 2011
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0%
5%
10%
15%
20%
25%
30%
65+ years
app. 3,6 mill
workers
app 271,000 workers
app. 1,6 mill workers
app 98,000 workers
Source: Canadian Labour Force Survey
Planned age of retirement for respondents age 45 to 49 years of age: 1991, 2002 and 2007
Before 60 60 - 64 yrs 65 or older Don't know0%
5%
10%
15%
20%
25%
30%
35%
40%
34%
20% 20%
26%
32%
20%22%
26%30%
22%
27%
21%
1991 2002 2007
Shellenberg and Ostrovsky, 2008
These trends will continue and may increase
Retirement plans for 45 to 59 year olds by level of self-rated health. Canada 2007
Excellent Very good Good Fair or Poor0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
24% 26%
33%39%
32%35%
45% 46%
78%
71%
58%
50%
Don't know when will retire
Plan to retire at 65 or older
Expect adequate income
Shellenberg and Ostrovsky, 2008
And it is not just healthy workers who want to stay in the labour force
Types of employment for workers age 50 and over. Canada: 1996 to 2011
Source: Canadian Labour Force Survey
Number of persons and FTE’s over 50 years of age working in temporary work arrangements and first 6 months of a job. Canada 1996 to 2011
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
0
50,000
100,000
150,000
200,000
250,000
300,000
350,000
400,000
Temp (Pers) Temp (FTE)LT 6 mnths (Pers) LT 6 mnths (FTE)
Source: Canadian Labour Force Survey
Summary
Older workers are an increasing proportion of the labour force– More older people– More wanting to work– A greater percentage in temporary employment
relationships
In Canada, 11% of people over the age of 65 are working (up from 6% in 2000)
These trends will likely further increase as more workers “choose” not to retire
Older age and the prevention of work injuries?
Age and work injury
General assumption that risk of work-related injury declines with age, but that when injuries do occur they are usually more serious
Rates of work injuries per 100 full-time equivalents by age groups. Canada 2003-05
15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs0.0
1.0
2.0
3.0
4.0
5.0
6.0
7.0
Activity Limiting Req Med Att Men Women
Source: Canadian Community Health Surveys, cycles 2.1 and 3.1
Percent distribution of lost-time claims in Ontario by age: 1991, 1996, 2001 and 2008
15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65+0%
5%
10%
15%
20%
25%
30%
35%
1991 1996 2001 2008
Relative change in number of accepted lost-time claims in Ontario: 1996 to 2008 by age group
-25%
Percent distribution of time loss claims in Victoria by age: 2000-01, 2004-05 and 2008-09
Under
20
20-2
4
25-2
9
30-3
4
35-3
9
40-4
4
45-4
9
50-5
4
55-5
9
60-6
465
+0%
2%
4%
6%
8%
10%
12%
14%
16%
2000-01 2004-05 2008-09Source: WorkSafe Victoria 2008/09 Statistical Summary (available at
ww.worksafe.vic.gov.au)
Relative change in number of accepted time loss claims in Victoria: 2000-01 to 2008-09 by age group
-12%
Source: WorkSafe Victoria 2008/09 Statistical Summary (available at ww.worksafe.vic.gov.au)
Rates of accepted claims per 1,000 full-time-equivalents by age group. British Columbia, 1997 and 2007
15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs0.0
50.0
100.0
150.0
200.0
250.0
Men 1997 Women 1997 Men 2007 Women 2007
Source: Smith et al (in progress)
Rates of claims accepted per 1,000 full-time-equivalents by age group. British Columbia, 2007
15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
180.0
Men (all) Women (all) Men (TL) Women (TL)Source: Smith et al (in progress)
Rates of wage loss claims per 1,000 full-time-equivalents by age groups. Males only, British Columbia, 2007
15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs0.0
20.0
40.0
60.0
80.0
100.0
120.0
140.0
160.0
Men Noise EquipmentSource: Smith et al (in progress)
Rates of wage loss claims per 1,000 full-time-equivalents by age groups. Males working in occupation with equipment: British Columbia, 1997-98, 2001-02, 2005-06
0
20
40
60
80
100
120
140
0
10
20
30
40
50
60
All Bone traumaOpen wounds Muscular Trauma
Source: Smith et al (in progress)
Rates of serious injuries by age per 1000 persons. WorkSafe BC compensation claims
15 to 24 yrs
25 to 34 yrs
35 to 44 yrs
45 to 54 yrs
55 to 64 yrs
65+ yrs0
2
4
6
8
10
12
Men WomenMen (fractures) Women (fractures)
Source: Fan et al, 2011
Rates of disability claims (10 or more days) per 1000 person-years, Victoria 2001 to 2004
Berecki-Gisolf et al 2012
Rates of self-reported time loss work injuries per 1,000 full-time-equivalents. Australia, 2005-06 and 2009-10 (MPHS)
15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs0.0
20.0
40.0
60.0
80.0
100.0
120.0
Men 2005-06 Women 2005-06Men 2009-10 Women 2009-10
Source: Smith et al (in progress)
Summary
Compensation boards are dealing with an increasing number of claims from workers over the age of 45 years of age.
Older age is not always associated with a reduced risk of injury – relationship differs by gender, occupational exposures and injury type
The relationship between age and work injury has changed over time. Differences in injury rates are now less pronounced.
In Australia, not all age and gender groups have had reductions in injury risk between 2005-06 and 2009-10. This has changed the relationship between age and work injury.
Aging biological, psychological, social
and societal change
Chronologicalage
Functionalage
Societal age
Organisational age
Kooij et al, J Man Psych, 2008
Thinking outside of chronological age to understand issues related to the aging workforce
Functional age: what is the relationship between chronic conditions and work injury and recovery from work injury?
Societal age: are older workers treated differently by the health care or compensation system than younger workers, even with the same type of injury?
Organisational age: are older workers treated differently in the workplace than younger workers, even with the same type of injury?
Distribution of medically diagnosed chronic conditions among labour force participants by age. Canada 2007
Asthma Athritis Back Probs
High BP Diabetes CVD 1 CC 2+ CC0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
30.0%
35.0%
Less than 50 yrs
50+ years
Source: Canadian Community Health Survey, Cycle 4.1
Prevalence of medically diagnosed chronic conditions among labour market participants. Canada: 1994 to 2007
46%
107%36%
164%58%
Source: National Population Health Surveys and Canadian Community Health Surveys
A hypothetical example of the relationship between declining worker capacity and occupational physical demands
Energy reserve
Energy Reserve
Occupation with high demands
Occupation with moderate demands
Occupation with low demands
Questions
What is the role that chronic conditions and functional declines associated with age play in the risk of work injury?
Palmer et al (2008), OEM, 65, 757 -- 764
Chronic conditions and risk of activity limiting injury requiring medical attention. Canada: 2003 – 05.
Arthritis High BP CVD Diabetes Back Probs0.00
0.50
1.00
1.50
2.00
2.50
3.00
Purple square = womenRed square = men
Source: Smith et all (in press) JOEM
Chronic conditions and risk of repetitive movement injuries. Canada: 2003 – 05.
Purple square = womenRed square = men
Source: Smith et al (in press) JOEM
Summary Limited research is currently available on how changes in
function, societal or organisational age impact on risk of work injury
Available data in Canada suggests that chronic conditions associated with older age are associated with an increased probability of both acute work injuries and repetitive movement injuries
Statistically significant risk for arthritis and back problems among both men and women.
Older age and the consequences of work injuries?
Percent distribution of types of injuries for lost-time injuries involving falls on the same level. US Data, 2003
Monthly Labour Review, October 2005
Older age is associated with more severe consequences, even after the same event
Percent of severe injuries* after the same event by age group. Ontario 2004 to 2008. Lost-time claims
*Injuries to bones/nerves/spinal cord/intracranial injuries and multiple injuries
Occupational injury fatality rate by age. US Data, 2007
US Department of Labour, 2008
Physical capacity required to return to work (% of max) by age: hypothetical example using occupational with moderate physical demands
25 30 35 40 45 50 55 60 65 700%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
10
20
30
40
50
60
70
80
90
100
55%58% 58% 60%
63%66% 69%
75%
81%
88%% of max to RTW
Physical Capacity
Occupation with moderate demands
Declining physical function can also influence the ability to return to work
Mean and median days of wage replacement over the first two years. Lost-time claims, Ontario, 1994 and 2004
1994 (mean) 2004 (mean) 1994 (med) 2004 (med)0
20
40
60
80
100
120
15 to 24 25 to 34
35 to 44 45 to 54
55 to 64 65+
Hogg-Johnson et al, in preparation
Mean and median health care costs (2002 $’s) over first two years. Lost-time claims. Ontario, 1994 and 2004
1994 (mean) 2004 (mean) 1994 (med) 2004 (med)$0
$200
$400
$600
$800
$1,000
$1,200
$1,400
$1,600
$1,800
$2,000
15 to 24 25 to 34
35 to 44 45 to 54
55 to 64 65+
Hogg-Johnson et al, in preparation
Adjusted* mean health care over two years. No-lost-time claims: Ontario 1991, 1997, 2006
1991 1997 2006$0
$100
$200
$300
$400
$500
$600
15 - 24 yrs 25 - 34 yrs 35 - 44 yrs 45 - 54 yrs 55+ yrsSmith et al, JOEM, 2011
Median days to first full-return to work by age: WorkSafe Victoria claimants 2001 to 2004.
Berecki-Gisolf et al 2012
Summary Older age is associated with more severe consequences even
after the same event
In Ontario, age differences in health care costs and time lost from work after a injury are increasing– severity of injury– health care utilisation (both number of treatments and
type of treatments)
The relationship between aspects of aging (outside of chronological age) and the consequences of work injury (wage replacement and health care costs) is not known ....
Overall Summary
What we know The Canadian labour force is aging While work after age 65 is not common, it is increasing Rates of injuries generally decline with age, although not
always. This relationship is changing. Chronic conditions, in particular arthritis and back problems,
are associated with increased risk of work injury (acute and repetitive movement) among men and women
Differences in health care expenditures across age groups may be widening
Differences in the duration of wage replacement across age groups may be widening
Overall Summary
What we need to know What specific aspects of aging impact both primary and
secondary prevention of work injuries – Are specific chronic conditions associated with more severe
injuries? greater health care utilisation, costs or time away from work? Is this morbidity or injury specific?
– Is there an interplay between measures of functional age and occupational characteristics in return to work after injury?
– Are older workers treated differently (by medical, workplace, compensation) than younger workers even after the same injury?
What happens to workers injured when 63 and older?
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Planned future work at MonCOEH
The relationship between age and work injury and the consequences of work injury in Victoria using information from the Compensation Research Database (CRD)
– Estimating the size of the insured labour force in Victoria across key labour market characteristics (e.g. age, gender, occupation)
– Time trends in the relationship between age and different injury outcomes (e.g. health care spending, days off work).
– How similar are trends in workers’ compensation claims to trends in self-reported injury?
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Planned future work at MonCOEH
Developing a framework for occupational health and safety vulnerability (underway – funded through ISCRR)
Understanding individual, workplace and system level influences on return to work in the context of the ageing Victorian labour market. The influence of types of injuries and measures of chronological and functional age (work in progress – funded through ISCRR)
For more information or to get a copy of this presentation
Peter Smith
Senior Research Fellow
School of Population Health and Preventive Medicine
Email: [email protected]
Ph: 9903.0283
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