Among those occupations identified as older-worker-intensive the following appear to represent higher risk for biomechanical exposures and, in some cases, additional hazardous exposures: administrative support, production/craft/repair, transportation and material moving, farming/forestry/ fishing, private household services, protective services, and services–other. Most of these occupations are projected to experience moderate to high growth in employment.

The ILO estimates that injuries and diseases together cause over 1.2 million fatalities globally per year; workers suffer more than 250 million accidents; and more than 160 million workers fall ill due to workplace hazards and exposures (International Labour Organization, 2004). Anan (1997:59) estimated that the economic burden of such disease and injury amounted to “4 percent of the world’s gross national product; in terms of shattered families and communities, the damage is incalculable.”

The WHO is currently assessing the global burden of disease and death from approximately 20 risk factors, among which are those factors that result in the burden associated with work. Leigh and colleagues provide a summary assessment of the approach being taken (Leigh et al., 1999). The methodology includes consideration of age-specific disease and injury risks, although they have age-adjusted their data to achieve their objectives. In order to arrive at age-adjusted estimates, they have relied on data from countries where conditions are reported by age and sex (Finnish Institute of Occupational Health, 1994; Worksafe Australia, 1995). This approach suggests it may be possible to assess age-specific burdens in the United States if age-specific risk information from other developed countries is used.

Leigh et al. (1999) note that efforts to estimate rates of occupational illness in any jurisdiction are constrained by the fact that most work-related illnesses have multiple potential causes and long latency periods. Work-related events (injury or illness) with rapid onset are easier to identify, but even among these the reporting methods emphasize the most severe and significant events. Other limitations of the available evidence include the general lack of training of health care providers in recognizing occupational illness or disorder and the mix of approaches to data collection used, even within a country with information derived from death records, hospital records, workers’ compensation claims, cancer registry records, workplace records, surveys, and sentinel reports. All of these limitations apply to assessment of occupational illness or disorders and injury burden in the United States.