practice of occupational health. The struggle between benefits and liabilities is one in which the OEHN has the opportunity to impact both the employer and employee. The OEHN is in a unique position to help employees navigate aging and working while at the same time assisting administration with the challenges of preparing for and managing an aging workforce. Specifically, the OEHN can strive to ensure the health and safety of the aging worker through such means as hazard identification, injury/illness prevention, health promotion initiatives, and education/training of both employee and employer. The OEHN can work with top executives and managers to plan now for the changing demographics of the U.S. workforce - in particular the aging worker. Lastly, OEHNs can contribute to future research initiatives investigating the aging worker and related topics. Hazard Identification
The workforce is aging and older employees make up a large portion of the U.S. workforce. As older employees remain in the workforce, it is imperative that OEHNs work with employees and employers to identify workplace hazards and look for ways by which to decrease occupational injury and illness.
Specifically, the OEHN should conduct worksite walkthrough surveys to observe obvious or overt hazards in the work environment paying particular attention to the work and work processes of the older worker. In addition to observation, the
the work process to identify potential hazards and to develop solutions.
Silverstein (2008) suggests that workplace strategies to reduce injury and illness in the workplace should “…build upon the strengths and protect against the vulnerabilities of workers as they age” with the ultimate goal of keeping the aging worker healthy and on the job. The OEHN can play an important part in the realization of this goal.
Health Promotion
Older workers remaining in the workforce have an increased likelihood of suffering from one or more chronic medical conditions (CDC, 2009b). Often these conditions can be prevented or detected early in the disease process with timely screening and detection. For this reason, it is imperative that the OEHN work to promote health and wellness in the workplace to keep the aging worker at work. “Helping people stay healthy and optimize health is the prime goal of health promotion initiatives and services” (Rogers, 2003, p.375). Health promotion initiatives for the older worker might include onsite immunization programs for flu and pneumonia vaccines – immunizations recommended specifically for aging adults. Screening programs for breast and colon cancer, hypertension, and total blood cholesterol should be included in a health promotion program tailored to meet the needs of the aging workforce. The potential benefits of age appropriate diet and exercise warrant the formulation of programs
specifically geared toward older workers. Such programs might include information on fat, cholesterol, and caloric intake as well as adequate calcium intake for the older adult. Injury prevention strategies such as use of vehicle
safety belts, smoke detectors, and fall prevention strategies are also appropriate interventions and topics for health promotion strategies aimed at the aging worker (Rogers, 2003). The OEHN can be instrumental in developing and initiating a health and wellness program that addresses the specific needs of the aging worker by tailoring interventions to the needs of this population (Shultz & Adams, 2007). Education and Training
The OEHN should play a pivotal role in developing education and training initiatives designed specifically for the aging worker. According to Rogers
(2003), “new programs will need to be developed to maximize worker health and keep the employee at work.” The OEHN can establish educational opportunities and programs specific for the aging worker on such topics as eldercare, family care support, retirement planning/benefits, financial planning, Social Security, and information on community resources for the aging adult. In addition, the OEHN should educate the aging worker about normal physiologic and cognitive changes associated with age, risk factors for disease, as well as signs and symptoms of pathological and chronic conditions.
Collaboration with Management
The business community is not properly preparing or planning ahead for future changes in the workforce (Lockwood, 2003). According to the AARP (2000), only a small number of companies develop and implement policies or programs that fully utilize older workers and realize their assets and skills. Similarly, in a 2003 Older Workers Survey, less than 30% of respondents
management strategies in response to the inevitable increasing age of the workforce (Collison, 2003). This lack of preparedness with regard to the aging workforce offers the OEHN a multitude of opportunities for collaboration with management to prepare and plan for the changes the aging worker will bring to the workplace. The OEHN can work with corporations to embrace the attributes of the aging worker. In addition, the OEHN can assist business in developing plans to address issues associated with aging such as physical and cognitive changes, injury prevention, health promotion, safety, education and training, and psychosocial support.
Future Research
The aging workforce also provides opportunities for continued and future research and study. Recommendations for possible future research include studies to determine age-related differences in employee outcomes, such as fatalities, disability, lost work days, and modified duty days after occupational illness or injuries. As previously discussed, the differences between younger and older workers with respect to severity, frequency, and types of work injuries are well documented. Understanding the differences in outcomes between younger and older workers can influence the practice of the OEHN.
Much of the existing research and literature categorizes the aging worker as being between the ages of 40-55. However, workforce trends indicate that participation workers over the age of 55 and even beyond retirement age will increase. To prepare for the future trend of employing older workers, additional longitudinal research about the 55 year old and beyond worker is needed. This
research will help to form policy, develop workplace strategies, create age
appropriate training methods, and address physiological and cognitive changes of aging (Popkin, 2008).
Additional opportunities for research include documenting work and working conditions that older workers find troublesome or result in
injuries/illness. As well as detailing the areas in which older workers are vulnerable, it is important to examine ways in which the older worker may be more resilient than their younger counterparts (Shultz & Adams, 2007). Conclusion
Older workers are remaining in the work force because of increasing longevity, a financial need to work, the ability to work beyond normal retirement age, the desire to remain socially active, and the need to remain physically and cognitively stimulated. “As a result of complex interactions between lifestyle choices, socioeconomic variables, and financial needs, people are working later into life; age 65 is no longer considered the cut-off age for retiring...”(Popkin et al., 2008). This aging of the U.S. workforce provides employers with an invaluable resource. The older worker not only offers experience and
knowledge, good work performance, and work attitude but also possesses positive traits such as loyalty, motivation, stability, and grounded work ethic (Lockwood, 2003; AARP, 2000). At the same time, employers must contend with issues associated with the aging worker specifically age-related illness, injuries, psychosocial considerations, and health care costs.
As the worker ages, changes in cognitive and physical capabilities must be addressed by both the worker and the employer. Normal changes with aging include visual disturbances, hearing loss, diminished mobility and muscle strength, altered sleep patterns, declines in information processing, as well as delayed reaction times. It is imperative for aging workers and their employers to be cognizant of these normal changes associated with aging and to understand how they affect the worker at home and on the job.
To accommodate the effects of aging, strategies such as injury and illness prevention, hazard identification, ergonomics, education and training, and health and wellness initiatives are employed in the workplace. The OEHN collaborates with a multidisciplinary team that includes employees, employers, and other occupational health professionals to keep older workers safe and on the job. In addition, the OEHN utilizes the roles of practitioner/clinician, leader, health promotion specialist, educator and collaborator to meet the health and safety needs of the older worker. Therefore, the OEHN is in a unique position to address the opportunities and challenges presented by the aging U.S. labor force. The OEHN can assist older workers as they navigate work and the aging process. In addition, the OEHN works with management administration to prepare for and manage an aging workforce. Ensuring the health and safety of older workers allows for the protection of the knowledge and expertise that the older worker possesses - thus allowing this valuable asset to continue to contribute in the workplace.
REFERENCES
Administration on Aging (2007). A profile of older Americans: 2007. Retrieved February 25, 2009, from
http://www.aoa.gov/PROF/Statistics/profile/2007/3.aspx
Alspaugh, L. (n.d.). A guide for nurses: teaching healthcare effectively to patients. Retrieved June 14, 2009, from http://www.healthcareersjournal.com/a- guide-for-nurses-teaching-healthcare-effectively-to-patients/
American Association of Retired People (2000). American business and older employees: a summary of findings. Retrieved March 14, 2009, from http://assets.aarp.org/rgcenter/econ/amer_bus_findings.pdf
American Association of Retired People (2002). American business and older employees: a summary of findings cited in Silverstein, M. (2008). Meeting the challenges of an aging workforce. American Journal of Industrial Medicine, 51 (269-280).
American Association of Retired People (2003). Staying ahead of the curve 2003: The AARP working in retirement study. Retrieved February 27, 2009, from http://assets.aarp.org/rgcenter/econ/multiwork_2003.pdf
American Association of Retired People (2008). Staying Ahead of the Curve 2007: The AARP Work and Career Study. Retrieved February 25, 2009, from http://www.aarp.org/research/work/employment/work_career_08.html
Berger, A.M., & Hobbs, B.B. (2006). Impact of shift work on the health and safety of nurses and patients. Clinical Journal of Oncology Nursing,10(4), 465-471.
Buckner, R. Memory and executive function in aging and AD multiple factors that cause decline and reserve factors that compensate. Neuron, 44(1), 195-208. Retrieved May 16, 2009, from
http://linkinghub.elsevier.com/retrieve/pii/S0896627304005811
Canadian Centre for Occupational Health and Safety (2002). Aging workers. Retrieved January 25, 2009, from
http://www.ccohs.ca/oshanswers/psychosocial/aging_workers.html
Center for the Deaf and Hard of Hearing (2007). Hearing loss information and resources. Retrieved February 19, 2009, from
Centers for Disease Control and Prevention (2003). The power of prevention: reducing the health and economic burden of chronic disease. Retrieved February 22, 2009, from
http://www.welcoa.org/freeresources/pdf/power_of_prevention.pdf
Centers for Disease Control and Prevention (2008a). Chronic disease overview. Retrieved May 17, 2009, from
http://www.cdc.gov?NCCdphp/overview.htm
Centers for Disease Control and Prevention (2008b). Health myths: get the facts. Retrieved June 14, 2009, from http://www.cdc.gov/women/owh/myths/
Centers for Disease Control and Prevention (2009a). Chronic disease prevention and health promotion. Retrieved May 23, 2009, from
http://www.cdc.gov/nccdphp/
Centers for Disease Control and Prevention (2009b). Healthy aging – improving and extending quality of life among older Americans. Retrieved June 15, 2009, from http://www.cdc.gov/NCCdphp/publications/aag/aging.htm
Cohen, A., and Colligan, M. (1998). Assessing occupational safety and health training: A literature review. Cincinnati, OH: National Institute for Occupational Safety and Health. Retrieved February 11, 2009, from http://www.cdc.gov/niosh/98-145-b.html
Collison, J. (2003). SHRM[R]/NOWCC/CED older workers survey. Society for Human Resource Management. Retrieved March 14, 2009, from www.shrm.org
Costa, G. & Di Milia, L. (2008). Aging and shift work: a complex problem to face. Chronobiology International, 25(2), 165-181.
Czaja, S.J. & Sharit, J. (2000). Technology-based jobs, stress and older workers. Review of Public Personnel Administration, 15(2), 46-61.
David, K., Collins, S., Coty, M., & Holmgren, A. (2005). Health and productivity among U.S. workers. Commonwealth Fund. Retrieved June 13, 2009, from http://www.ncbi.nlm.nih.gov/pubmed/16138438
Demott, J.S. (2001). Welcome, America, to the Baby Bust. Time, June 24. Retrieved February 27, 2009, from
Department of Industrial Relations (2005). Guide to developing your workplace injury and illness prevention program with checklists for self- inspection. Retrieved May 27, 2009, from
http://www.dir.ca.gov/dosh/dosh_publicationsIIPP.html
Devol, R. & Bedroussian, A. (2007). Milken Institute. An unhealthy America: the economic burden of chronic disease. Retrieved May 23, 2009, from http://www.chronicdiseaseimpact.com
Employment Law Information Network (2009). Age discrimination in employment act. Retrieved February 7, 2009, from
http://www.elinfonet.com/ADEAsum.php
Farm Employers Labor Service (2009). Injury and illness prevention program. Retrieved May 27, 2009, from
http://www.fels.org/data/summery?IIPP.htm
Foley, D.J., Monjan, A.A., Masaki, K.H., Enright, P.L., Quan, S.F., and White, L.R. (1999). Associations of symptoms of sleep apnea with cardiovascular disease, cognitive impairment, and mortality among older Japanese-American men. Journal of the American Geriatrics Society, 47(5), 524-528.
Government Accounting Office (2005). Older workers: labor can help employers and employees plan better for the future. Retrieved January 15, 2009, from http://www.gao.gov/new.itmes/d0680pdf
Hart, B.G. & Moore, P.V. (1992). The aging work force – challenges for the occupational health nurse. American Association of Occupational Health Nursing Journal, 40(1), 36-40.
Hart, K. (2007) the aging workforce: implications for health care organizations. Nursing Economics, 25(2), 101-102.
Healy, M.L. (2001). Management strategies for an aging work force. American Association of Occupational Health Nursing Journal, 49(11), 523-531.
Hedge, J.W., Borman, W.C. & Lammlein, S.E. (2006). The Aging Workforce. Washington: American Psychological Association.
HRHero.com (2009). Older workers benefit protection act (OWBPA). Retrieved May 22, 2009, from http://www.hrhero.com/topics/owbpa.html
Ilmarinen, J. (2001). Aging workers. Occupational and Environmental Medicine, 58(8), 546-552.
Institute for Health Research and Policy (2009). Cost-effective health promotion for older workers. Retrieved June 13, 2009, from
http://ihrp.uic.edu/study/cost-effective-health-promotion-older-workers
International Labour Organization (n.d.). Your health and safety at work – controlling hazards. Retrieved May 26, 2009, from http://actrav.itcilo.org/actrav- english/telearn/osh/hazard/controla.htm#I.%20Introduction
Johns Hopkins University (2004). Partnership for Solutions. Chronic conditions: making the case for ongoing care. Retrieved May 22, 2009, from http://wrjf.org/files/research/Chronic%20Conditions%20 Chartbook%209- 2004.ppt
Kenny, G.P, Yardley, J.E., Martineau, L. & Jay, O. (2008). Physical work capacity in older adults: implications for the aging worker. American Journal of Industrial Medicine, 51, 610-625.
Kowalski-Trakofler, K.M., Steiner, L.J. & Schwerha, D.J. (2005). Safety considerations for the aging workforce. Safety Science, 43 (10), 779-793.
Kung, H.C., Hoyert, D.L., Xu, J.Q. & Murphy, S.L. (2008). National Vital Statistics Report – Final Draft for 2005. National Center for Health Statistics, 56(10). Retrieved May 17, 2009, from
http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf
Labor Law Attorneys (2009). The older workers benefit protection act of 1990 (OWBPA). Retrieved June 13, 2009, from
http://www.labor.lawattorneys.com/older_workers_benefit_protection_act.html Laflamme, L. & Menckel, E. (1995). Aging and occupational accidents a review of the literature of the last three decades. Safety Science, 21(2), 145-161. Retrieved June 10, 2009, from
http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VF9- 3YCM0F9-5&_user=10&_rdoc=1&_fmt=&_orig=search&_
sort=d&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10& md5=5def3955b474508f851207d22c1e6dc6
Langton, T. (2008). AT and older workers. Assistivetech.net National Public Website on Assistive Technology. Retrieved May 26, 2009, from http://atwiki.assistivetech.net/index.php/AT_and_older_workers
Leggett, D. (2007). The aging work force – helping employees navigate midlife. American Association of Occupational Health Nursing Journal, 55(4), 169-175.
Levy, B.S. & Wegman, D. H. (2000). Occupational Health: recognizing and preventing work-related disease and injury. (4th ed). Philadelphia: Lippincott Williams & Wilkins.
Lockwood, N. R. (2003). The aging workforce: the reality of the impact of older workers and eldercare in the workplace. HR Magazine, 48(12), A1-A11. Retrieved January 24, 2009, from http://findarticles.com/p/articles/mi_m3495/is_ 12-48/ai_n5989579/print?tag=artBody;col1
McMahan, S. & Phillips, K. (1999). America‟s aging workforce:
ergonomic solutions for reducing the risk of CTDs. American Journal of Health Studies (15)4, 199-202.
McMurray, A. (2007). Community health and wellness: a sociological approach. Australia: Elsevier.
Mangino, M. (2000). The aging employee. American Association of Occupational Health Nursing Journal, 48,(7), 349-357.
Morbidity Mortality Weekly Report (2009). Recommended adult immunization schedule – United States, 2009. Retrieved June 14, 2009, from http://www.cdc.gov/mmwr/PDF/wk/mm5753-Immunization.pdf
Mosner, E. & Spiezle, C. (2003). The convergence of the aging workforce and accessible technology: the implications for commerce, business and policy. Retrieved January 5, 2009, from
http://dowload.micorsoft.com/download/d/2/3/d23515f3-2d73-49f4-b3b3- 6fae6ac975ce/agingworkforce.doc
Murray, J. (2008). Older workers – the employer perspective. HR Guru. Retrieved May 26, 2009, from http://www.hrguru.com/training/articles/32-older- workers-the-employer-perspective
National Institutes of Health (2009). Ergonomics. Retrieved February 13, 2009, from http://www.nlm.nih.gov/medlineplus/ergonomics.html
National Institute for Occupational Safety and Health (n.d.). The work life initiative – protecting and promoting worker health and well-being. Retrieved May 22, 2009, from http://www.cdc.gov/niosh/worklife
National Institute for Occupational Safety and Health (2004). Worker Health Chartbook 2004. Chapter 5 – Special Populations – Older Workers. Retrieved May 22, 2009, from http://www.cdc.gov/niosh/docs/2004-146/ch5/ch5- 3.asp.htm
National Institute for Occupational Safety and Health (2009). Engineering controls. Retrieved February 17, 2009, from http://www.cdc.gov/niosh/topics/ engcontrols/
Naumanen, P. (2006). The health promotion model as assessed by ageing workers. Journal of Clinical Nursing, 15, 219-226.
Neis, M. & McEwen, M. (2001). Community health nursing: promoting the health of populations. Philadelphia: Saunders.
Ohio Bureau of Workers‟ Compensation (2005). Protecting older workers – safety tips. Retrieved January 15, 2009, from
http://www.ohiobwc.com/downloads/blankpdf/OlderWorkersSafetyTips.pdf Ohio Bureau of Workers‟ Compensation (n.d.). Employing older workers and controlling workers‟ compensation costs. Retrieved January 15, 2009, from http://www.ohiobwc.com/downloads/blankpdf/OlderWorkersPos Paper.pdf .
O‟Rourke, M. & Sullivan, L. (2003). A healthy return on employee investment. Risk Management, 50(11), 34-38.
Park, D.C. & Schwartz, N. (2000). Cognitive Aging: A Primer. Philadelphia: Taylor and Francis.
Pipow, V. (2008). Aging workers: disability management strategies. Work Steps. Retrieved May 27, 2009, from
http://kabrick.com/WorkSteps/AgingWorkers.aspx
Pitt-Catsouphes, M. & Smyer, M. (2005). Older workers: What keeps them working? The Center on Aging and Work/Workplace Flexibility. Chestnut Hill, MA: Boston College. Issue Brief 01.
Popkin, S., Morrow, L., Domenico, T. & Howarth, H. (2008). Age is more than just a number: implications for an aging workforce in the US
transportation sector. Applied Ergonomics, 39(5), 542-549. Retrieved January 25, 2009, from
http://www.sciencedirect.com.libproxy.lib.unc.edu/science?_ob=ArticleURL&_u di=B6V1
Quillen, D.A. (1999). Common causes of vision loss in elderly patients. American Family Physician 60(1), 99-108. Retrieved February 20, 2009, from http://www.aafp.org/afp/990700ap/99.html
Randolph, S. (2003). Roles of the occupational and environmental health nurse. In. B. Rogers (Ed.), Occupational and environmental health nursing. 2nd ed. (pp.81-100). Philadelphia: Saunders.
Randolph, S. (2004). Occupational and environmental health nursing. National Student Nurses‟ Association. Retrieved May 27, 2009, from
http://nsna.org/pdf/career/Randolph2.pdf