Peter Smith School of Public Health and Preventive Medicine, Monash University

The ageing workforce and its implications

for occupational health and safety

prevention programs and work-injury

compensation systems: A Canadian

perspective

Peter Smith

School 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

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

Columbia

Lost-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

Workers’ Compensation policy around older workers in

Canada

Loss 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)

Men

Women

Population Pyramids: Australia (1980, 2000, 2050)

Men

Women

Life Expectancy at age 65. Canada: 1991 to 2006

18 yrs

Percent of older persons who are currently working.

Canada: 1990 to 2011

55 to 59 years (A) 60 to 64 years (A) 65+ yrs (A)

Percent of the employed labour force who are over 50

years of age. Canada: 1990 to 2011

0% 5% 10% 15% 20% 25% 30% 19 90 19 91 19 92 19 93 19 94 19 95 19 96 19 97 19 98 19 99 20 00 20 01 20 02 20 03 20 04 20 05 20 06 20 07 20 08 20 09 20 10 20 11 65+ years 50 to 64 years

app. 3,6 mill

workers

app 271,000

workers

app. 1,6 mill

workers

app 98,000

workers

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 know 1991 2002 2007

Shellenberg and Ostrovsky, 2008

Retirement plans for 45 to 59 year olds by level of self-rated

health. Canada 2007

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Excellent Very good Good Fair or Poor

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

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

Temp (Pers) Temp (FTE)

LT 6 mnths (Pers) LT 6 mnths (FTE)

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

0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0

15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs Activity Limiting Req Med Att Men Women

Percent distribution of lost-time claims in Ontario by

age: 1991, 1996, 2001 and 2008

Relative change in number of accepted lost-time

claims in Ontario: 1996 to 2008 by age group

Percent distribution of time loss claims in Victoria by

age: 2000-01, 2004-05 and 2008-09

Relative change in number of accepted time loss

claims in Victoria: 2000-01 to 2008-09 by age group

-12%

Rates of accepted claims per 1,000 full-time-equivalents

by age group. British Columbia, 1997 and 2007

0.0 50.0 100.0 150.0 200.0 250.0

15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs Men 1997 Women 1997 Men 2007 Women 2007

Rates of claims accepted per 1,000

full-time-equivalents by age group. British Columbia, 2007

0.0 20.0 40.0 60.0 80.0 100.0 120.0 140.0 160.0 180.0

15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs Men (all) Women (all) Men (TL) Women (TL)

Rates of wage loss claims per 1,000 full-time-equivalents

by age groups. Males only, British Columbia, 2007

0.0 20.0 40.0 60.0 80.0 100.0 120.0 140.0 160.0

15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs Men Noise Equipment

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

All Bone trauma Open wounds Muscular Trauma

Rates of serious injuries by age per 1000 persons.

WorkSafe BC compensation claims

0 2 4 6 8 10 12

15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55 to 64 yrs 65+ yrs Men Women Men (fractures) Women (fractures)

Rates of disability claims (10 or more days) per

1000 person-years, Victoria 2001 to 2004

Rates of self-reported time loss work injuries per 1,000

full-time-equivalents. Australia, 2005-06 and 2009-10 (MPHS)

0.0 20.0 40.0 60.0 80.0 100.0 120.0

15 to 24 yrs 25 to 34 yrs 35 to 44 yrs 45 to 54 yrs 55+ yrs Men 2005-06 Women 2005-06 Men 2009-10 Women 2009-10

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

Chronological

age

Functional

age

Societal

age

Organisational

age

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

Distribution of medically diagnosed chronic conditions

among labour force participants by age. Canada 2007

0.0% 5.0% 10.0% 15.0% 20.0% 25.0% 30.0% 35.0%

Asthma Athritis Back

Probs High BP Diabetes CVD 1 CC 2+ CC Less than 50 yrs

50+ years

Prevalence of medically diagnosed chronic conditions

among labour market participants. Canada: 1994 to 2007

46%

107% 36%

164% 58%

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?

Chronic conditions and risk of activity limiting injury

requiring medical attention. Canada: 2003 – 05.

0.00 0.50 1.00 1.50 2.00 2.50 3.00

Arthritis High BP CVD Diabetes Back Probs

Purple square = women Red square = men

Chronic conditions and risk of repetitive movement

injuries. Canada: 2003 – 05.

Purple square = women Red square = men

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

Percent of severe injuries* after the same event by age group.

Ontario 2004 to 2008. Lost-time claims

Occupational injury fatality rate by age. US Data, 2007

Physical capacity required to return to work (% of max) by age:

hypothetical example using occupational with moderate physical demands

55% 58% 58% 60% 63% 66% 69% 75% 81% 88% 0 10 20 30 40 50 60 70 80 90 100 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 25 30 35 40 45 50 55 60 65 70 % 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

0 20 40 60 80 100 120

1994 (mean) 2004 (mean) 1994 (med) 2004 (med) 15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65+

Mean and median health care costs (2002 $’s) over first

two years. Lost-time claims. Ontario, 1994 and 2004

$0 $200 $400 $600 $800 $1,000 $1,200 $1,400 $1,600 $1,800 $2,000

1994 (mean) 2004 (mean) 1994 (med) 2004 (med) 15 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65+

Adjusted* mean health care over two years. No-lost-time

claims: Ontario 1991, 1997, 2006

15 - 24 yrs 25 - 34 yrs 35 - 44 yrs 45 - 54 yrs 55+ yrs

Median days to first full-return to work by age:

WorkSafe Victoria claimants 2001 to 2004.

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

 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 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?

57

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

For more information or to get a copy of this

presentation

Peter Smith

Senior Research Fellow

School of Population Health and Preventive Medicine

Email: peter.smith@monash.edu

Ph: 9903.0283