Health and Safety Needs of Older Workers (2004) / Chapter Skim
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5 Physical and Cognitive Differences Between Older and Younger Workers
5 Physical and Cognitive Differences Between Older and Younger Workers
Pages 95-122
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From page 95... ...
are disadvantageous to the older workers because their work performance is diminished relative to that of younger workers. For example, older workers are likely to have decreased capacity to sustain heavy physical labor for extended periods.
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From page 96... ...
For example, overall health status and mortality of successive cohorts of Americans has been improving, but some persons with previously fatal diseases are now surviving to older adulthood and participating in the workforce. Thus, successive cohorts will require special consideration vis-à-vis future workplace threats to older workers.
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From page 97... ...
Thus, removing or limiting many toxic environmental exposures, particularly the intensive ones that can occur in the workplace, may lead to lower disease rates and improved maintenance of general human function, irrespective of whether the intervention affects aging or disease pathogenesis. Disease phenomena, particularly the large number of chronic conditions that increase in frequency with age, have very important implications for health status and outcomes, including among older workers, but distinguishing a disease from other aging manifestations is often arbitrary or one of degree.
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From page 98... ...
Mental conditions take a substantial toll on health status, and while major mental illnesses or disorders may have their onset in young adulthood, they often persist into old age. Mental illnesses or disorders such as various psychoses, major depression, bipolar disorder, and substance abuse often have important functional, social, and health consequences and can be related to workplace performance, absenteeism, and the risk workplace-related conditions.
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From page 99... ...
While some active conditions may limit or preclude employment, many prevalent conditions in older workers are well controlled and do not have a substantial functional impact on worker performance. Comorbidity may, however, affect the use and timing of medical care utilization or encompass treatments that may alter workplace activities, such as somnolent or other psychoactive drugs.
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From page 100... ...
However, as noted above, the causes for these changes are often unclear, and the consequences for complex activities such as individual job performance are even more uncertain because of personal adaptations and selective forces over time. Nor is it clear how many of the measurable changes are preventable or modifiable, but an increasing literature on intervention studies suggests that some mutability is possible.
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From page 101... ...
Candidate causes of these changes include genetic forces, modifiable environmental exposures, and nascent clinical illnesses or disorders; the implications for maintaining worker health and functions are very different for each of these factors.
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From page 102... ...
Weight-bearing exercise improves muscle glucose and lipid uptake, as well as strength and exercise endurance (Mittendorfer and Klein, 2001) , suggesting a possible role for exercise activity in older worker health promotion programs.
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From page 103... ...
There is relatively little research into the functional and health consequences to workers of mild to moderate hearing loss. Pulmonary Function Physiological aging of the lung is associated with dilation of the alveoli, enlargement of airspaces, decrease in exchange surface, and loss of supporting tissue for peripheral airways.
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From page 104... ...
These exposures and related medical conditions may have an effect on general human function and hence on work capacity. The net impact on the older worker will depend on the job demands and environment, as well as on individual clinical illnesses or disorders, exercise, and other hygienic habits.
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From page 105... ...
Metabolism Many changes in intermediary and xenobiotic metabolism occur with age, and these undoubtedly have great import for the older worker. For example, with increasing age, mitochondria produce less adenosine triphosphate (ATP)
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From page 106... ...
One is the possibly increased risk of clinical infections and the need for clinical prevention to maintain worker health. The other is the potential for increased infection risk among older workers exposed to special biological agents in the work environment.
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From page 107... ...
Yet, as shown in the data from the Health and Retirement Study, certain workplace situations-such as ageism, increasing physical and cognitive demands, and pressure to retire -- may have disparate effects on older workers' mental health. Mental health problems with job implications include the consequences of work-related stress, clinical depression, and a variety of other psychological problems such as burnout, alcohol and other substance abuse, unexplained physical symptoms, and chronic fatigue as well as the secondary consequences of these conditions, such as higher injury rates (Hotopf and Wessely, 1997)
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From page 108... ...
Specific items from the job stressors questionnaire, such as "poor relationship with superior" and "too much trouble at work" were particularly associated with higher mental health risk. While such studies do not prove that perceived job stressors cause mental illness or disorder, they point to direction for further research on the causes and potential interventions for such problems.
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From page 109... ...
Over 70 percent of people with major depression were thought to be actively employed, and employees treated for depression incurred annual per capita health and disability costs of $5,414, significantly higher than the cost for treating hypertension. Employees with depressive illness or disorder and any other medical condition cost 1.7 times more than those with the comparable medical conditions alone.
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From page 110... ...
In many studies, depression and depressive symptoms are not rigorously defined, and, as noted above, age-at-onset is rarely considered. Patients with major depression often have substantial psychiatric comorbidity, such as mania or alcoholism, and the effects of drug or other psychotherapeutic regimens should be considered in assessing health or economic outcomes.
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From page 111... ...
. The causes of CSF are unknown, but there are many variables that appear to predispose individuals to develop CFS, including various lifestyle behaviors, personality traits, and work stress.
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From page 112... ...
There are few studies on alcoholic women, since the prevalence of alcoholism is lower in women across all age groups. However, older women are more problematic users of prescribed psychoactive drugs than men, and a prevailing comorbidity among older women alcohol abusers is depressive disorder (Gomberg, 1995)
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From page 113... ...
In contrast to the small and generally positive effects of age on variables related to personality or adjustment, age-related effects on many measures of cognitive functioning are large and negative. Figures 5-2 and 5-3 illustrate age trends in several cognitive variables from nationally representative samples used to establish norms from recent standardized cognitive test batteries (i.e., Wechsler, 1997a,b; Woodcock, McGrew, and Mather, 2001)
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From page 114... ...
114 HEALTH AND SAFETY NEEDS OF OLDER WORKERS 1 0 50 Distribution Units SD 1 16 20-34 Information 20-34 Block Design Age Matrix Reasoning of Age Digit Symbol 2 Logical Memory 2 Word Lists Percentile 3 20 30 40 50 60 70 80 90 Chronological Age FIGURE 5-2 WAIS III and WMS III test results by age. 1 0 50 Units 1 16 Distribution SD Comprehension-Knowledge 20-29 2 2 20-29 Long-Term Retrieval Visual-Spatial Thinking Age Age Auditory Processing of Fluid Reasoning 3 Processing Speed 0.1 Short-Term Memory Percentile 4 20 30 40 50 60 70 80 90 Chronological Age FIGURE 5-3 WJ III cognitive clusters by age.
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From page 115... ...
A considerable body of research has established that there are nearly continuous declines from early adulthood in the effectiveness of fluid, mechanics, or process cognition, as reflected in the detection and extrapolation of relationships, novel problem solving, memory of unrelated information, efficiency of transforming or manipulating unfamiliar or meaningless information, and real-time processing in continuously changing situations. In contrast, the research indicates that there are increases at least until about age 50 in crystallized, pragmatics, and product cognition, as assessed by measures of acquired knowledge.
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From page 116... ...
In contrast, negative relations might be expected between age and work performance, because cognitive abilities are important for work, and, as indicated above, increased age is associated with declines in certain aspects of cognitive functioning. However, reviews of research on aging and work performance have revealed little overall age trend in measures of job performance (e.g., Avolio, Waldman, and McDaniel, 1990; McEvoy and Cascio, 1989; Salthouse and Maurer, 1996; Waldman and Avolio, 1986; Warr, 1994)
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From page 117... ...
SOURCE: Table 63, Traffic Safety Facts 1999, National Highway Traffic Safety Administration, U.S. Department of Transportation.
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From page 118... ...
It is possible that older drivers rely on their stable or increasing strategic and tactical knowledge acquired through experience to minimize dependence on operational abilities that may be declining. In fact, when crash rates are adjusted for distance driven they do start to increase with age after age 65, and it is reasonable to expect that they would increase to an even greater extent if it were also possible to take into consideration when the individual is driving and under what conditions (e.g., during the day or at night, in the middle of the day or during rush hour, etc.)
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From page 119... ...
There were no age effects on problem-solving performance, just an effect of skill. Cross-sectional studies by Salthouse and colleagues on architects and engineers showed similar rates of decline in spatial abilities for professionals whose work required spatial reasoning as for control professionals not working in environments demanding spatial reasoning (e.g., Salthouse, 1991)
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From page 120... ...
(2003) suggests that crash rates among professional pilots do not increase as the pilots age from their 40s to their late 50s and, after age adjustment, increased flight experience was associated with markedly lower crash rates.
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From page 121... ...
(2001) in which age-related declines in measures of cognitive functioning were greater for workers with a history of lead exposure than for workers without prior lead exposure.
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From page 122... ...
122 HEALTH AND SAFETY NEEDS OF OLDER WORKERS reflecting the impact of work conditions on the individual. This is unfortunate because measures of psychological adjustment and of cognitive functioning could prove to be informative outcomes relevant to issues of health and safety in the workplace.
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