It is the smart administrator, engineer, safety professional or health provider who understands the value of the veteran employee as well as the problems and risks facing employees when they grow older. We want the brain power and the experience and knowledge, but not the lost work-time days, workers' compensation claims or any of the negatives associated with injuries/illnesses.
Just when the old are most needed in the work force, government policies encourage early retirement and employers are afraid to maintain the older work force based on their fear of some aspects of human aging.
What is so significant about human aging and our bodies? If you have not already started to experience some of these changes, get ready. They do happen and they are natural. We will all have them to some degree:
- Loss of strength
- Loss of muscular flexibility
- Loss of joint range of motion
- Diminished postural steadiness
- Reduced grip strength
- Reduced nervous system responses
- Reduced blood flow and tactile feedback
- Reduced visual capacity
- Slowing of our mental processing
Strength and Flexibility
Let's begin at the beginning of the list. Loss of strength happens due to decreased muscle mass and the diminished force capabilities of our muscles. They take longer to respond to an action and fatigue faster as we age. As muscles age, they begin to shrink and lose mass. This is a natural process, but a sedentary lifestyle can accelerate it. The number and size of muscle fibers also decrease. It takes muscles longer to respond in our 50s than they did in our 20s. The water content of tendons the cord-like tissues that attach muscles to bones decreases as we age. This makes the tissues stiffer and less able to tolerate stress. The chemistry of cartilage, which provides cushioning between bones, changes. With less water content, the cartilage becomes more susceptible to stress. As cartilage degenerates, arthritis can develop. Ligaments, connective tissues between bones, become less elastic, reducing flexibility. Relax! All is not lost ... there are solutions!
What should an employer do to assist its employees -- at any age -- to prevent injuries to muscles and other soft tissues of the body? Find the jobs that possess the greatest physical risks to the various soft tissue groups through an organized, systematic process that is quantifiable. This will assist in prioritizing the jobs that need to be changed as well as those that could be used for return-to-work and to keep employees working longer. Some of the ways to help employees include:
- Reduce work with static muscle effort (e.g. sustained, fixed postures).
- Increase use of mechanical lifts.
- Keep work in "neutral zone."
- Eliminate twisting of the upper torso.
- Stretch upper body throughout the day.
- Continue or begin regular exercise programs.
Stretching after working also keeps the muscles flexible and reduces the risks of injuries. Joint motion becomes more restricted and flexibility decreases with age because of changes in tendons and ligament. As the cushioning cartilage begins to break down from a lifetime of recreation, daily living activities and job tasks, joints can become inflamed and arthritic. Employees' joints become more painful in cold, damp weather. Jobs that require excessive and repetitive lifting, reaching, pushing or pulling will eventually create lost work days and workers' compensation claims for employees' with arthritis or bursitis in their joints.
The solution is to find and reduce the weights, reaches, lifts, carries, pulls and pushes through the use of mechanical ergonomic manual material handling aides.
Postural steadiness can be assisted through fixtures that are designed "in-house," when possible, to assist in the holding of any product. Also, range-of-motion exercises and isometric and isotonic strength-training exercises, flexibility exercises and progressive strength-and balance-training exercises might be suggested. Aquatic therapy, fancy terminology for exercises in a swimming pool, provides a reduced weight-bearing environment. It allows workers to perform movements in the water with reduced stress on joints and provides resistance for strengthening, toning and stabilization. Exercising in water also increases strength and endurance, increases range of motion, decreases swelling of ankles, improves balance and coordination, improves circulation and assists in stabilization around joints.
This exercise also would assist the older worker in reducing the risks of trips and falls. You don't have to put in a backyard pool for this type of anti-aging regimen. There are YMCAs, health clubs and university atheletic departments that have pools in communities of all types. Sometimes, a physician's prescription can get you a reduced rate, too.
Reduced grip strength goes along with reduced muscle and soft tissue capabilities. Handgrip strength decreases, making it more difficult to accomplish routine activities such as gripping, lifting, turning a valve, opening a jar or pulling tasks. We can assist the aging worker by reducing the time spent on jobs that require a lot of grip strength or by providing mechanical assists. Choosing tools and hand-held devices that are appropriately sized for the human hand helps to compensate for reduced grip strength.
Hot and Cold
As we age, our blood supply begins to slow as our heart is unable to pump the same volume that it did when we were 20. One of the symptoms of increased aging is the diminished nervous system response and reduced tactile feedback. Humans experience decreased insulin production (might produce diabetes) and decreased thyroid function. These issues all lead to a decreased tolerance to heat or cold.
"Aging is often associated with decreased physiologic function, including a decreased ability to regulate body temperature effectively during heat stress. Older individuals respond to an imposed heat challenge with higher core temperatures and heart rates, lower sweating rates and a greater loss of body fluid compared to younger individuals," wrote W. Larry Kenney, Ph.D., in Sports Science Exchange, Volume 6 (1993).
According to the Center for Environmental Physiology, the body needs time to adjust to hot weather. A sudden increase in temperature is particularly serious because it can place a dangerous strain on the heart and blood vessels before the body can acclimate itself. Heat stress, which can lead to heat exhaustion, heart failure and stroke, may well be a life-threatening problem for the aging employee who is working in continuously hot environments. These exposures can be outdoor or indoor.
Older employees are more vulnerable to heat stress than younger employees because they do not adjust as well to heat. They perspire less. They are also more likely to have health problems requiring medications that work against the body's natural defenses for adjusting to heat. For example, diuretics (often prescribed for high blood pressure, a common disease of the aging) prevent the body from storing fluids and restrict the opening of blood vessels near the skin's surface. Certain tranquilizers and drugs used to treat Parkinson's disease interfere with perspiring. These and other chronic conditions (such as circulatory problems, diabetes, a previous stroke, overweight and a weak or damaged heart) often upset normal body responses.
The best advice for avoiding heat stress is to keep employees as cool as possible. Solutions are not cheap for aging employees working indoors in a hot environment. Air conditioning can provide the best protection from heat stress, especially if a worker has heart disease. In many organizations, it is not possible to cool the working environment with air conditioning. Fans, though, can help to circulate indoor air during the day. Air movement reduces heat stress by removing extra body heat. Loose fitting, lightweight, light-colored clothing is more comfortable in hot weather. Hats and umbrellas protect the head and neck when employees are working outdoors. The body needs more water in hot weather. Employees shouldn't wait until they are thirsty to have a drink. If they have a medical condition, or a problem with body-water balance, they should check with their doctor for advice on how much water to drink during exposure to excessive heat. Have them avoid hot foods and heavy meals. They add heat to any body. Always provide education to your employees on the symptoms and the solutions for heat-related occupational hazards.
Employees who must work outdoors may also face exposure to the cold. Prolonged exposure to freezing temperatures can result in health problems as serious as trench foot, frostbite and hypothermia. Workers in such industries as the postal service, construction, commercial fishing, food warehousing and agriculture need to be especially mindful of the weather, its effects on the body, proper prevention techniques and treatment of cold-related disorders. When body temperature drops even a few degrees below its normal temperature of 98.6 degrees F (37 degrees C), the blood vessels constrict, decreasing peripheral blood flow to reduce heat loss from the surface of the skin. With an older employee, the blood vessels have constricted normally with age and this increases the risks of working in a cold environment. The four environmental conditions that cause cold-related stress are:
- Low temperatures
- High/cool winds
- Cold water
Preventing long-term exposures to extreme hot and cold environments is the best way to protect the aging employee and all employees. For any cold exposure, the next step is personal protective equipment. Providing adequate layers of insulation is perhaps the most important step in fighting the elements.
Employees should wear at least three layers of clothing:
- An outer layer to break the wind and allow some ventilation (like Gore-Tex or nylon).
- A middle layer of wool or synthetic fabric (Qualofil or Pile) to absorb sweat and retain insulation in a damp environment. (Down is a useful lightweight insulator; however, it is ineffective once it becomes wet.)
- An inner layer of cotton or synthetic weave to allow ventilation.
Pay special attention to protecting feet, hands, face and head. Up to 40 percent of body heat can be lost when the head is exposed. Footgear should be insulated to protect against cold and dampness. Keep a change of clothing available in case work garments become wet. Educate all employees regarding exposures to cold.
Reduced Visual Capacity
Aging employees also experience vision-related problems. One of the tell-tale signs of being "over the hill" is the need for reading glasses. The need for help to see close objects or small print is due to a condition called presbyopia (prez-bee-OH-pee-uh). It is a normal process that happens over a lifetime. You and your employees may not notice any change until after the age of 40. People with presbyopia often hold reading materials at arm's length; the joke is the need to "grow longer arms." Some employees may get headaches or "tired eyes" while reading or doing other close work. This is a common symptom. Presbyopia is often corrected with reading glasses, but the employer needs to pay attention to the lighting levels for aging employees as well. Appropriate lighting needs to be task-specific.
Aging employees may also complain of floaters tiny spots or specks that float across the field of vision. Most people notice them in well-lit rooms or outdoors on a bright day. Floaters often are normal, but sometimes they warn of eye problems such as retinal detachment, especially if they happen with light flashes. If an employee notices a sudden change in the type or number of spots or flashes, recommend an eye doctor check.
Cataracts are cloudy areas in part or all of the eye lens. The lens is usually clear and lets light through. Cataracts keep light from easily passing through the lens, and this causes loss of eyesight. They often form slowly and cause no pain, redness or tearing in the eye. Some stay small and don't change eyesight very much. If a cataract becomes large or thick, it usually can be removed by surgery. During surgery, the doctor takes off the clouded lens and, in most cases, puts in a clear, plastic lens. Cataract surgery is very safe. It is one of the most common surgeries done in the United States.
Retinal disorders are a leading cause of blindness in the United States. The retina is a thin lining on the back of the eye. It is made up of cells that get visual images and pass them on to the brain. Retinal disorders include age-related macular degeneration, diabetic retinopathy and retinal detachment.
There are other medical conditions associated with aging employees such as dry eyes, tearing, glaucoma and macular degeneration. Have your health care professionals stay up to date on the vision problems associated with aging and remember that education is the key to employee eye health.
Next month: The mental side of aging and its impact on safety.
Cynthia L. Roth is president and CEO of Ergonomic Technologies Corp. (ETC), an ergonomics consulting and training firm based in Syosset, N.Y. She is a member of Occupational Hazards' Editorial Advisory Board. She can be reached at (516) 682-8558 or via e-mail at croth @ergoworld.com.