Trends of the “Aging Workforce” and Injury Prevention

1. Melissa Barrows Gill, Doctor of Physical Therapy Trends of the “Aging Workforce” and Injury Prevention

2. Aging trends of the workforce: • According to the U.S. Bureau of Labor Statistics: • Between 1997 and 2007, employment of workers 65 and over increased by 101%. • The number of older workers in full-time jobs doubled between 1995 and 2007. • During the period of 2006-2016, workers age 55-64 are expected to climb by 36.5% and workers between 65-74 and over 75 are predicted to soar to more than 80%. • Generally, 55 years and older is considered the “aging workforce.”

3. Why is the older employee continuing to work? • Variety of factors • Need the income • Healthcare benefits • Increase in retirement age

4. How many year is the oldest person on record?

5. Oldest person on record • Jeanne Calment from Arles, France • At age 85 y.o she took up fencing • Rode a bike until she was 110 y.o. • Was walking until 114 y.o. • Smoked for over 100 years (< than 2 cig/day) • Drank port wine and at chocolate • Not a bad life style!

6. Aging theories…. • Hayflick limit theory – cells can only divide so many times in a life span(50). Nutrition (calorie restriction) effects the ability of the cell to divide. • Free radical theory – free radicals in the body bind to healthy cells and destroy. Anti-0xidants (beta-carotene, vit c and vit e) stabilize the free radicals and they are less damaging. • DNA or genetic theory – our cells are predestined for a specific life span. The “clock” can be influenced by lifestyle, diet, toxins, pollution, radiation, and other factors.

7. How does the normal body age? • Cardiovascular • Respiratory • Muscular • Skeletal • Neurologic • Sensory

8. How does aging effect the cardiovascular system? • Some changes that may occur in the cardiovascular system are a decrease in the elasticity of the blood vessels and heart valves, restricted blood flow due to the thickening of the vessel walls and because of the fatty deposits lining the vessels, and a decrease in the ability of the heart to pump out as much blood with each beat. • The result: you may feel fatigued, become short of breath more easily and have less capacity for physical exertion. Increase probability for high blood pressure and heart disease.

9. What can you do to slow aging of your cardiovascular system? • Diet • Decrease fatty foods in diet • Increase anti-oxidant foods (fruits and veggies) • Exercise • Aerobic and strength training • Stress reduction • Deep meaningful breathing • Yoga • Meditation

10. Effects on the respiratory system • Decreased elasticity of the lungs may occur with aging. This may affect your lung's ability to utilize oxygen, as well as your ability to cough and take deep breaths. • The result: you may be more prone to fatigue and shortness of breath on exertion, and become more susceptible to infections. Effects of posture on the respiratory system…..

11. Effects on the muscular system • There tends to be a gradual loss of muscle tone, elasticity and strength. In some areas, the muscle is often replaced with fatty tissue leaving you with little rolls or soft, flabby spots. • The result: endurance or strength to perform certain tasks may also decrease.

12. Effects on the skeletal system • The skeletal system gradually changes over the years until it is porous and brittle, as the bones lose calcium and also their density. This may be more pronounced in women. • The result: more prone to fractures, poor posture, and loss in height.

13. Who cares about posture?

14. What can you do to slow down the effects on the skeletal system? • Weight bearing exercise • Increase calcium and Vit D

15. Effects on the muscular system • Muscles become less elastic • Decrease in joint range of motion • Loss in strength

16. Strain on the muscle tissue

17. What can you do to slow the effects of aging on the muscular system? • Yoga/ stretching/Tai Chi • Weight training at any age • Aerobic exercise to increase endurance of the muscle

18. Effects on the neurological system • What happens here is, the messages take a slightly longer time to pass from the nerves to the muscles, and the muscles take a slightly longer time to react to these messages. So take this into consideration while doing things that require a quick response. • The response: slower reaction time to respond to emergency situations, decrease in balance and ability to navigate over uneven terrain.

19. Effects on the sensory system • There is a gradual decrease in the overall sensual acuity of the body. • Your sense of touch is decreased • Your ability to hear some high-pitched sounds decreases • Decrease in the ability to smell and a loss of some of the sweet and salty taste buds. • The lenses of your eyes lose some of their ability to accommodate and the size of the pupil decreases, so you may find yourself reading at arm's length and it is harder to adapt to dim light.

20. What can SLOWthe natural changes that occur with aging? • Cardiovascular exercise • Strength training • Balance and proprioceptive exercise • Work and/or task specific exercise program to address demands of work activities • Education on nutrition as it relates to healing the body and keeping the body strong. Using food to combat injury and disease

21. There are really two issues….. • How do I protect my current employees from sprain/strain or other injuries that they may be more susceptible to as they age? • How do I hire an older employee without on added risk?

22. According to the Work Comp Insider (Lynch Ryan) • When valued at 18 months, the rotator cuff sprain of an olderworker costs about a third more than for any other age group, $28,360 versus $21,910 for all other age groups. Moreover, every one of the top ten injuries to older workers costs substantially more than the same injuries among younger workers. And this situation will get worse as more and more older workers are literally forced by financial circumstances to stay on the job. • Here's something to think about. The rotator cuff sprain ranks 28th in terms of injury frequency for all workers, but 3rd for workers age 65 and above. In fact, 3 of the top 4 injuries to older workers are of the soft tissue variety to the shoulder, neck and lower back.

23. What could have been done to avoid an overuse injury? • Early intervention of the sprain/strain complaint • What is leading to or caused the injury? • What can be done to assist this employee and to avoid the same injury? • Who has the ability to assess and evaluate the work, worker, and the worksite

24. Workers’ Comp and Our Aging Workforce by Julie Croushore (national interstate insurance company) • John Smith, age 65, retires from long haul to become a local delivery driver • After a few months on the job, Smith c/o knee pain from getting in/out of his delivery truck constantly for deliveries • Doctor recommends a knee replacement surgery and files work comp with the new employer • The knee surgery and associated disability costs between $100,000 - $200,000 • Could this situation be prevented?

25. How could this incident have been avoided? • Provide a clear job description (FJA) to the physician that provides fit-for-duty exams • Contract with a local medical provider (PT/OT) to perform pre-employment physical exam • How does a pre-employment screen work?

26. Sue Olson has worked at ABC manufacturing for 30 years… • Sue loves working at ABC manufacturing company where she has been employed for 30 years. She assembles electrical circuits. • Sue has been experiencing neck pain on and off for 5 years, and recently has numbness and tingling into her right hand. Her production has decreased and she cannot play softball or lift up her grandchildren because of neck and arm pain. • By the time her supervisor approaches her on her lack of production, Sue has a full-blown neck and upper extremity injury. • She files a work comp claim.

27. What could have been done prior to opening a Work Comp claim? • Injury Prevention Assessment • Group stretch and/or strengthening program • Work station evaluation • Educational programming

28. Injury Prevention Assessment • As soon as the discomfort is felt • Prior to a doctor visit • Can provide “first aid” • Can follow up with the employee • Can assess the work station

29. Group stretching/strengthening • Customized group stretching and strengthening programs • Pre- shift or during production “down time” • Individualized home exercise programs and home modality use

30. Work station evaluation • Evaluation of the work, worker, work site • Give recommendations for proper body mechanics and use of tools and/or equipment • Suggestions for best practices at work

31. Educational programming • Proper body mechanics and best lifting at work • Healthy options in eating and exercise • Basic ergonomics and neutral positions of the body

32. Summary • The workforce is aging and companies of all sizes need to be prepared • In list the help of a local PT/OT that specializes in work related issues • Be proactive in preventing injuries. Every dollar spent on prevention will be saved in avoiding an OSHA recordable or work comp claim

33. Thank you! • Questions? • Contact info: Melissa Gill, DPT On-Site Solutions Physical Therapy 612-501-4753