Many older workers have existing chronic illness or disorder and disease risk factors that are under various levels of personal and clinical management and control, including mental illnesses or disorders. Research is needed on how potentially adverse workplace exposures—physiochemical, biological, biomechanical, and psychosocial—affect the status, control, and outcomes of these chronic conditions. For example, these exposures may have direct, toxic effects on already diseased organs, interact pharmacologically with medications used to treat existing conditions, or distract and impede older workers from timely disease management interventions. Outcomes that might be studied include longevity and mortality, changes in disease and illness or disorder severity, changes in physical functional status, social effects on the individual and families, interactions with the health care system, and overall quality of life. Chronic conditions that are high priority for consideration in such investigations include cardiovascular disease and musculoskeletal disorders.

Recommendation 6: A research program should be conducted to provide systematic and substantial understanding of the effects of potentially harmful workplace exposures on individual and population outcomes among older workers with existing chronic conditions, both during periods of employment and after retirement.

A variety of public policy interventions have been designed to enable workers to remain in the labor market while minimizing or preventing occupationally caused morbidity. These include polices that operate directly through regulation of workplace hazards (Occupational Safety and Health Act, Mine Safety and Health Act) or indirectly through intervention in more general employment practices that impact older or disabled workers (Americans with Disabilities Act, Age Discrimination in Employment Act, Family and Medical Leave Act). Little is known about the effectiveness of these laws in achieving their goals for older workers. For example, there are insufficient data regarding whether the Americans with Disabilities Act has resulted in increased job accommodation, and therefore greater work longevity, for aging workers with qualifying disabilities. There has been no systematic evaluation of the combined and independent effectiveness of the Age Discrimination in Employment Act, the Americans with Disabilities Act, or the Family and Medical Leave Act in assisting aging workers to remain in the workforce and to obtain new employment when they are dislocated. Further study is also needed to assess whether these laws create barriers for continued and safe employment or reemployment of aging workers.

Recommendation 7: Evaluation research is needed to determine the degree to which public policies intended to enable workers to remain at

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