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WORK, AGING' AND VISION Report of a Conference Working Group on Aging Workers and Visual Impairment Committee on Vision Commission on Behavioral and Social Sciences and Education National Research Council National Academy Press Washington, D.C. 1987

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NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance. This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The National Research Council was established by the National Academy of Sciences in 1916 to associate the broad community of science and technology with the Academy's purposes of furthering knowledge and of advising the federal government. The Council operates in accordance with general policies determined by the Academy under the authority of its congressional charter of 1863, which establishes the Academy as a private nonprofit, self-governing membership corporation. The Council has become the principal operating agency of both the National Academy of Sciences and the National Academy of Engineering in the conduct of their services to the government, the public, and the scientific and engineering communities. It is administered jointly by both Academies and the Institute of Medicine. The National Academy of Engineering and the Institute of Medicine were established in 1964 and 1970, respectively, under the charter of the National Academy of Sciences. This work relates to Department of the Nary contract N0014-80-C-0159 issued by the Office of Naval Research under Contract Authority NR 201- 124. However, the content does not necessarily reflect the position or the policy of the government, and no official endorsement should be inferred. The United States government has at least a royalty-free, nonexclusive, and irrevocable license throughout the world for government purposes to publish, translate, reproduce, deliver, perform, dispose of, and to authorize others to do, all or any portion of this work. Available from: Committee on Vision National Research Council 2101 Constitution Avenue N.W. Washington, D.C. 20418 Printed in the United States of America 11

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WORKING GROUP ON AGING WORKERS AND VISUAL IMPAIRMENT ROBERT SEKULER (Chair), Departments of Psychology, Ophthalmology, and Neurobiology/Physiology, Northwestern University STEVEN FERRIS, School of Medicine, New York University SAMUEL M. GENENSKY, The Center for the Fetidly Sighted, Santa Monica, Calif. ROBERT GOTTSDANKER, Department of Psychology, University of California, Santa Barbara DONALD KLINE, Department of Psychology, University of Notre Dame DAVID D. MICHAELS, Department of Ophthalmology, University of California, Los Angeles MEREDITH MORGAN, Walnut Creek, Calif. DONALD G. PITTS, College of Optometry, University of Houston - ~ 111

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COMMITTEE ON VISION ANTHONY 3. ADAMS (Chair), School of Optometry, University of California, Berkeley ROBERT SEKULER (Past Chair), Departments of Psychology, Ophthalmology, and Neurobiology/Physiology, Northwestern University IRVING BIEDERMAN, Department of Psychology, State University of New York, Buffalo RANDOLPH BLAKE, Cresap Neuroscience Laboratory, Northwestern University RONALD E. CARR, New York University Medical Center SHELDON EBENHOLTZ, State University of New York, College of Optometry ANN B. FULTON, Department of Ophthalomology, Children's Hospital, Boston CHRIS A. JOHNSON, Department of Ophthalmology, University of California, Davm JO ANN KINNEY, vision consultant, Surry, Maine AZRIEL ROSENFELD, Center for Automation Research, University of Maryland PAMELA EBERT FLATTAU, Study Director CAROL METCALF, Senior Secretary iv

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Foreword The Committee on Vision is a standing committee of the Na- tional Research Council's Commission on Behavioral and Social Sciences and Education. The committee provides analysis and advice on scientific issues and applied problems involving vision. It also attempts to stimulate the further development of visual science and to provide a forum in which basic and applied sci- entists, engineers, and clinicians can interact. Working groups of the committee study questions that may involve engineering and equipment, physiological and physical optics, neurophysiol- ogy, psychophysics, perception, environmental effects on vision, and the treatment of visual disorders. In order for the committee to perform its role effectively, it draws on experts from a wide range of scientific, engineering, and clinical disciplines. The members of this working group were chosen for their expertise in research related to the aging of the human eye and for their familiarity with the application of those research findings to employment issues. This report reflects their evaluation of present understanding of the interactive effects of work, aging, and vision. The report outlines the nature of the problem and describes some of the solutions that have emerged as employers have attempted to sustain the employment of older persons given the changes that occur in vision with age. The report considers the scientific, technological, and social contexts for enhancing the employment of older workers and provides an agenda for further research in this area. v,

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Abe observations Id reco~d~lons arming Tom the eF forts of this working group merit consideration ~ employers and employees Ekes Ed by the chnki~s Ed scie~bts interested in Proving the employment Ed elite ~ older workers. hotbox J. Adam Cab Settee OD Vision V1

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Contents PREFACE 1 NATURE OF THE PROBLEM Vision Changes and Older Workers, 4 Vision Screening Programs in the Workplace, 17 Matching Workers and Jobs, 20 Workplace Design, 22 Responding to the Vision Needs of Older Workers, 24 2 SOLUTIONS Compensating for Declining Visual Function, 28 Better Vision Screening Procedures, 31 Providing Visual Aids, 32 Retraining Older Workers, 33 Modifying the Workplace, 35 Job Redesign, 37 3 CONTEXT FOR CHANGE The Potential of Science and Technology, 39 Employer Commitment as a Critical Element for Change, 44 Federal Prograrrm and Policies, 45 Conclusion, 47 1X 1 28 38 APPENDIX A: Conference Participants and Program 49 APPENDIX B: Annotated Bibliography . V11 54

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Preface At the request of the Veterans Adrn~nistration and the Na- tional Institute on Aging, the Committee on Vision established the Working Group on Aging Workers and Visual Impairment. The working group was asked to examine the issue of keeping older workers in the work force longer given the many changes that occur In vision with age. In order to accomplish its task, the working group organized an invitational conference to review the dimensions of the prob- lem of work, aging, and vision. Twenty-eight specialists, including members of the working group, met for two days In Washington, D.C., in February 1986 (see Appendix A for the conference partic- ipants and program.) These specialists were drawn from the fields of gerontology, economics, sociology, statistics, psychology, politi- cal science, optometry, ophthalmology, human factors engineering, and physiology. The two-day conference was organized around sessions focus- ing on individual alla interactive elements of work, aging, and vision. Members of the first pane} were asked to describe what happens to the eye with age; some relationships between visual changes with age and changes in behavior; and the impact of visual deficits on cognitive functions. The second pane! considered the availability of information on the incidence and prevalence of visual impairment with age; the role of health status in leaving the work force; and demographic changes in the U.S. work force. The third pane} explored the effects of visual changes on job skills; problems of performance assessment; and relevant components of "bona fide K

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occupational qualifications." The fourth panel addresseci issues related to keeping older Americans in the work force longer, such as screening practices; the availability of visual prosthetics; job and task redesign; work station design; and economic incentives and disincentives for keeping older workers employed. Each participant prepared a brief background paper, which was circulated in advance of the meeting. Participants were asked to provide a brief presentation of their papers at the conference. Scheduled discussion periods aDowed extensive treatment of the pane} topics and included questions and comments from the audi- ence. This report ~ based on those conference papers and discus- sions and has been organized into three parts. The first part is a discussion of the problem of maintaining older workers in the labor force given the changes that occur in vision with age. The report then shifts to a description of some of the solutions proposed by conferees. The final section explores some of the factors involved in bringing about such changes. Two appendixes provide additional information: Appendix A contains a list of conference participants and the detailed program. Appendix B contains an annotated bibliography on work, aging, ~ anc vision. In addition to the 28 participants at the conference, a num- ber of people contributed in important ways to the success of the conference and to this report. Samuel M. Genensky and Herbert Parnes prepared background papers for the conference, although they were unable to attend. David Worthen of the Veterans Ad- min~stration and Leonard Jakubczak of the National Institute on Aging provided valuable guidance as project monitors to the work- ing group throughout this effort. Wayne Shebilske, the commit- tee's study director through June 1985, planned the working group activity, and Pamela Ebert Flattau, the committee's study direc- tor after July 1985, provided important assistance in organizing the conference and preparing the workshop report. Patricia A. An- derson, who served as consultant to the committee on this project, contributed significantly to the design and scope of the February conference. Chrmt~ne L. McShane, editor of the Commission on

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Beb~loral Id Social Sciences and Educatlon, helped lmpr~e the sale and clarity ~ the report. Carol ~etc~f, the committees senior secretary, provided voluble secretary and admlulstrstlve Hesitance. ~ aD of these people, we express our grathude far their exerts. Robert SeRuler, Cbalr Earplug Group on Aglug Parkers Id V6u~ Hammed X1

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